Digestive Diseases and Sciences

, Volume 48, Issue 4, pp 698–705

Therapeutic Potential of Gastric Electrical Stimulation for Obesity and Its Possible Mechanisms: A Preliminary Canine Study

  • Hui Ouyang
  • Jieyun Yin
  • J.D.Z. Chen
Article

Abstract

Our aim was to investigate the effects of gastric electrical stimulation on food intake, weight, gastric myoelectrical, and parasympathetic activity. Dogs were implanted with serosal electrodes and a subcutaneous stimulator. The stimulator was turned on and off alternately every month for 4 months. Food intake, weight, gastric myoelectrical activity, and electrocardiograms were recorded. Daily food intake and weight were significantly decreased during the months with stimulation. Stimulation did not show any acute effect on gastric myoelectrical activity; however, it chronically and significantly impaired gastric myoelectrical activity in the fed state, but not in the fasting state. The parasympathetic activity in the fasting state assessed from the spectral analysis of heart rate variability was markedly decreased with stimulation both acutely and chronically. In conclusion, chronic gastric electrical stimulation results in a reduction in food intake, weight loss, a reduction in parasympathetic activity, and chronic inhibition of gastric myoelectrical activity. These data suggest that gastric electrical stimulation is a potential therapy for the treatment of obesity and its inhibitory effect on food intake and weight may involve both muscles and the vagal afferent pathway.

gastric electrical stimulation gastric myoelectrical activity heart rate variability obesity 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Klein S: Obesity. Clin Perspect Gastroenterol 3:232-236, 2000Google Scholar
  2. 2.
    Martin LF, Hunter SM, Lauve RM, O'Leary JP: Severe obesity: expensive to society, frustrating to treat, but important to confront. South Med J 88:895-902, 1995Google Scholar
  3. 3.
    Colditz GA: Economic costs of obesity. Am J Clin Nutr 55(suppl 2):503S-507S, 1992Google Scholar
  4. 4.
    Wolf AM, Colditz GA: Current estimates of the economic cost of obesity in the United States. Obes Res 6:97-106, 1998Google Scholar
  5. 5.
    Enzi G: Socioeconomic consequences of obesity: the effect of obesity on the individual. PharmacoEconom. 5(suppl 1):54-57, 1994Google Scholar
  6. 6.
    AACE/ACE: Position statement on the prevention, diagnosis, and treatment of obesity. Endocrine Pract 4:297-330, 1998Google Scholar
  7. 7.
    Bray GA, Greenway FL: Current and potential drugs for treatment of obesity. Endocr Rev 20(6):805-875, 1999Google Scholar
  8. 8.
    Hvizdos KM, Markham A: Orlistat: a review of its use in the management of obesity. Drugs 58(4):743-760, 1999Google Scholar
  9. 9.
    Sagar PM: Surgical treatment of morbid obesity Br J Surg 82:732-739, 1995Google Scholar
  10. 10.
    Consensus Development Conference Panel: Gastrointestinal surgery for severe obesity. Ann Intern Med 15:956-961, 1991Google Scholar
  11. 11.
    Cigina V, Saggioro A, Rigo V, Pinato GP, Ischia S: Long-term effects of gastric pacing to reduce feed intake in swine. Obes Surg 6:250-253, 1996Google Scholar
  12. 12.
    Cigaina V, Rigo V, Greenstain RJ: Gastric myo-electrical pacing as therapy for morbid obesity: preliminary results. Obes Surg 9:333-334, 1999Google Scholar
  13. 13.
    Chen J, McCallum RW (eds). Electrogastrography: Principles and Applications. New York, Raven Press: 1995Google Scholar
  14. 14.
    Chen J, Pan J, McCallum RW: Clinical significance of gastric myoelectrical dysrhythmias. Dig Dis 13:275-290, 1995Google Scholar
  15. 15.
    You CH, Chey WY: Study of electromechanical activity of the stomach in human and in dogs with particular attention to tachygastria. Gastroenterology 86:1460-1468, 1985Google Scholar
  16. 16.
    Telander RL, Morgan KG, Kreulen DL, Schemalz PF, Kelly KA, Szurszewki JH: Human gastric atony with tachygastria and gastric retention. Gastroenterology 75:495-501, 1978Google Scholar
  17. 17.
    Bortolotti M, Sarti P, Barara L, Brunelli F: Gastric myoelectric activity in patients with chronic idiopathic gastroparesis. J Gastrointest Motil 2:104-108, 1990Google Scholar
  18. 18.
    Geldof H, van der Schee EJ, Van Blankenstein M, Grashius JL: Electrogastrographic study of gastric myoelectrical activity in patients with unexplained nausea and vomiting. Gut 26:799-808, 1986Google Scholar
  19. 19.
    Chen J, McCallum RW: Gastric slow wave abnormalities in patients with gastroparesis. Am J Gastroenterol 87:477-482, 1992Google Scholar
  20. 20.
    Chen J, Stewart WR, McCallum RW: Adaptive spectral analysis of episodic rhythmic variations in gastric myoelectric potentials. IEEE Trans Biomed Eng 40:128-135, 1993Google Scholar
  21. 21.
    Ouyang H, Yin J, Wang Z, Pasricha PJ, Chen JDZ: Electroacupuncture accelerates gastric emptying in association with changes in vagal activity. Am J Physiol 282:G390-G396, 2002Google Scholar
  22. 22.
    Wang ZS, Chen JDZ: Robust ECG R-R wave detection using evlutionary-programming-based fuzzy inference system (EPFIS) and its application to assessing brain-gut interaction. IEEE Proc Sci, Meas Technol 147:351-356, 2000Google Scholar
  23. 23.
    Wright RA, Krinsky S, Fleeman C, Trujillo J, Teague E: Gastric emptying and obesity. Gastroenterology 84:747-751, 1983Google Scholar
  24. 24.
    Phillips RJ, Powley TL: Gastric volume rather than nutrient content inhibits food intake. Am J Physiol 271:R766-R779, 1996Google Scholar
  25. 25.
    Duggan JP, Booth DA: Obesity, overating, and rapid gastric emptying in rats with ventromedial hypothalamic lesions. Science 231:609-611, 1986Google Scholar
  26. 26.
    Moran TH, McHugh PR: Cholecystokinin suppresses food intake by inhibiting gastric emptying. Am J Physiol 242:R491-R497, 1982Google Scholar
  27. 27.
    Sheldon RJ, Qi JA, Porreca F, Fisher LA: Gastrointestinal motor effects of corticotropic-releasing factor in mice. Regul Pept 28:137-151, 1990Google Scholar
  28. 28.
    Asakawa A, Inui A, Ueno N, Makino S, Fujino MA, Kasuga M: Urocortin reduces food intake and gastric emptying in lean and ob/ob obese mice. Gastroenterology 116:1287-1292, 1999Google Scholar
  29. 29.
    Chen JDZ, Lin XM, Zhang M, Torres-Pinedo RB, Orr WC: Gastric myoelectrical activity in healthy children and children with functional dyspepsia. Dig Dis Sci. 43:2384-2391, 1998Google Scholar
  30. 30.
    Lin ZY, McCallum RW, Schirmer BD, Chen JDZ: Effects of pacing parameters in the entrainment of gastric slow waves in patients with gastroparesis. Am J Physiol (Gastrointest Liver Physiol) 37:G186-G191, 1998Google Scholar
  31. 31.
    Qian LW, Lin XM, Chen JDZ: Normalization of atropine-induced postprandial dysrhythmias with gastric pacing. Am J Physiol (Gastrointest Liver Physiol) 39:G387-G392, 1999Google Scholar
  32. 32.
    Lin XM, Peters LJ, Hayes J, Chen JDZ: Entrainment of segmental small intestinal slow waves with electrical stimulation in dogs. Dig Dis Sci 45:652-656, 2000Google Scholar
  33. 33.
    Chen J, McCallum RW. The reponse of electrical activity in normal human stomach to water and solid meals. Med Biol Eng Comput 29:351-357, 1991Google Scholar
  34. 34.
    Chen J, Richards RD, McCallum RW: Identification of gastric contractions from the cutaneous electrogastrogram. Am J Gastroenterol 89:79-85, 1994Google Scholar
  35. 35.
    Sun WM, Smout A, Malbert C, Edelbroek L, Jones K, Dent J, Horowitz M: Relationship between surface electrogastrography and antropyloric pressure. Am J Physiol 31:G424-G430, 1995Google Scholar
  36. 36.
    Chen JDZ, Lin ZY, Edmunds MC IV, McCallum RW: Effects of octreotide and erythromycin on gastric motility and myoelectrical activity in patients with gastroparesis. Dig Dis Sci 43:80-89, 1998Google Scholar
  37. 37.
    Kim CH, Zinsmeister AR, Malagelada JR: Effect of gastric dysrhythmias on postcibal motor activity of the stomach. Dig Dis Sci 33:193-199, 1988Google Scholar
  38. 38.
    Chen JDZ, Lin ZY, McCallum RW: Abnormal gastric myoelectrical activity and delayed gastric emptying in patients with symptoms suggestive of gastroparesis. Dig Dis Sci 41(8):1538-1545, 1996Google Scholar
  39. 39.
    Berntson GG, Bigger JT, Eckberg D, Grossman P, Kaufmann PG, Malik M, Nagaraja HN, Porges SW, Saul JP, Stone PH, van der Molen MW: Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology 34:623-648, 1997Google Scholar
  40. 40.
    Markad VK, Fallen EL: Power spectral analysis of heart rate variability: A noninvasive signature of cardiac autonomic funciton. Critical Reviews in Biomed Eng 21:245-311, 1993Google Scholar
  41. 41.
    Vila J, Palacios F, Presedo J, Fernandez-Delgado M. Felix P. Barro S: Time—frequency analysis of heart-rate variability. IEEE Eng Med Biol 16:119-126, 1997Google Scholar
  42. 42.
    Cox HS, Kaye DM, Thompson JM, Turner AG, Jennings GL, Itsiopoulos C, Esler MD: Regional sympathetic nervous activation after a large meal in humans. Clin Sci 89:145-154, 1995Google Scholar
  43. 43.
    Lu CL, Zou XP, Orr WC, JDZ Chen: Postprandial changes of sympathovagal balance measured by heart rate variability. Dig Dis Sci 44:857-861, 1999Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Hui Ouyang
    • 1
  • Jieyun Yin
    • 1
  • J.D.Z. Chen
    • 1
  1. 1.Division of GastroenterologyUniversity of Texas Medical BranchTexasUSA

Personalised recommendations