Artifact Rejection Methodology Enables Continuous, Noninvasive Measurement of Gastric Myoelectric Activity in Ambulatory Subjects

The increasing prevalence of functional and motility gastrointestinal (GI) disorders is at odds with bottlenecks in their diagnosis, treatment, and follow-up. Lack of noninvasive approaches means that only specialized centers can perform objective assessment procedures. Abnormal GI muscular activity...

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Published inScientific reports Vol. 8; no. 1; pp. 5019 - 12
Main Authors Gharibans, Armen A., Smarr, Benjamin L., Kunkel, David C., Kriegsfeld, Lance J., Mousa, Hayat M., Coleman, Todd P.
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 22.03.2018
Nature Publishing Group
Subjects
639/166/985
692/4020/1503/1502/2747
692/4020/1503/1828/1977
692/4020/2741/533
Abdomen
Adolescent
Automation
Child
Circadian rhythms
Correlation coefficient
Data processing
Electrocardiography
Electrodes
Electromyography - methods
Female
Gastric emptying
Gastrointestinal Diseases - diagnosis
Gastrointestinal Diseases - physiopathology
Gastrointestinal Motility - physiology
Humanities and Social Sciences
Humans
Male
Manometry - methods
Meals
Mobile Applications
Monitoring, Ambulatory - instrumentation
Monitoring, Ambulatory - methods
Motility
multidisciplinary
Oscillations
Patients
Science
Science (multidisciplinary)
Signal processing
Signal Processing, Computer-Assisted
Smartphone
Smooth muscle
Stomach - physiology
Wearable Electronic Devices
Online AccessGet full text
ISSN2045-2322
2045-2322
DOI10.1038/s41598-018-23302-9

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Abstract The increasing prevalence of functional and motility gastrointestinal (GI) disorders is at odds with bottlenecks in their diagnosis, treatment, and follow-up. Lack of noninvasive approaches means that only specialized centers can perform objective assessment procedures. Abnormal GI muscular activity, which is coordinated by electrical slow-waves, may play a key role in symptoms. As such, the electrogastrogram (EGG), a noninvasive means to continuously monitor gastric electrical activity, can be used to inform diagnoses over broader populations. However, it is seldom used due to technical issues: inconsistent results from single-channel measurements and signal artifacts that make interpretation difficult and limit prolonged monitoring. Here, we overcome these limitations with a wearable multi-channel system and artifact removal signal processing methods. Our approach yields an increase of 0.56 in the mean correlation coefficient between EGG and the clinical “gold standard”, gastric manometry, across 11 subjects (p < 0.001). We also demonstrate this system’s usage for ambulatory monitoring, which reveals myoelectric dynamics in response to meals akin to gastric emptying patterns and circadian-related oscillations. Our approach is noninvasive, easy to administer, and has promise to widen the scope of populations with GI disorders for which clinicians can screen patients, diagnose disorders, and refine treatments objectively.
AbstractList The increasing prevalence of functional and motility gastrointestinal (GI) disorders is at odds with bottlenecks in their diagnosis, treatment, and follow-up. Lack of noninvasive approaches means that only specialized centers can perform objective assessment procedures. Abnormal GI muscular activity, which is coordinated by electrical slow-waves, may play a key role in symptoms. As such, the electrogastrogram (EGG), a noninvasive means to continuously monitor gastric electrical activity, can be used to inform diagnoses over broader populations. However, it is seldom used due to technical issues: inconsistent results from single-channel measurements and signal artifacts that make interpretation difficult and limit prolonged monitoring. Here, we overcome these limitations with a wearable multi-channel system and artifact removal signal processing methods. Our approach yields an increase of 0.56 in the mean correlation coefficient between EGG and the clinical “gold standard”, gastric manometry, across 11 subjects (p < 0.001). We also demonstrate this system’s usage for ambulatory monitoring, which reveals myoelectric dynamics in response to meals akin to gastric emptying patterns and circadian-related oscillations. Our approach is noninvasive, easy to administer, and has promise to widen the scope of populations with GI disorders for which clinicians can screen patients, diagnose disorders, and refine treatments objectively.
The increasing prevalence of functional and motility gastrointestinal (GI) disorders is at odds with bottlenecks in their diagnosis, treatment, and follow-up. Lack of noninvasive approaches means that only specialized centers can perform objective assessment procedures. Abnormal GI muscular activity, which is coordinated by electrical slow-waves, may play a key role in symptoms. As such, the electrogastrogram (EGG), a noninvasive means to continuously monitor gastric electrical activity, can be used to inform diagnoses over broader populations. However, it is seldom used due to technical issues: inconsistent results from single-channel measurements and signal artifacts that make interpretation difficult and limit prolonged monitoring. Here, we overcome these limitations with a wearable multi-channel system and artifact removal signal processing methods. Our approach yields an increase of 0.56 in the mean correlation coefficient between EGG and the clinical "gold standard", gastric manometry, across 11 subjects (p < 0.001). We also demonstrate this system's usage for ambulatory monitoring, which reveals myoelectric dynamics in response to meals akin to gastric emptying patterns and circadian-related oscillations. Our approach is noninvasive, easy to administer, and has promise to widen the scope of populations with GI disorders for which clinicians can screen patients, diagnose disorders, and refine treatments objectively.The increasing prevalence of functional and motility gastrointestinal (GI) disorders is at odds with bottlenecks in their diagnosis, treatment, and follow-up. Lack of noninvasive approaches means that only specialized centers can perform objective assessment procedures. Abnormal GI muscular activity, which is coordinated by electrical slow-waves, may play a key role in symptoms. As such, the electrogastrogram (EGG), a noninvasive means to continuously monitor gastric electrical activity, can be used to inform diagnoses over broader populations. However, it is seldom used due to technical issues: inconsistent results from single-channel measurements and signal artifacts that make interpretation difficult and limit prolonged monitoring. Here, we overcome these limitations with a wearable multi-channel system and artifact removal signal processing methods. Our approach yields an increase of 0.56 in the mean correlation coefficient between EGG and the clinical "gold standard", gastric manometry, across 11 subjects (p < 0.001). We also demonstrate this system's usage for ambulatory monitoring, which reveals myoelectric dynamics in response to meals akin to gastric emptying patterns and circadian-related oscillations. Our approach is noninvasive, easy to administer, and has promise to widen the scope of populations with GI disorders for which clinicians can screen patients, diagnose disorders, and refine treatments objectively.
ArticleNumber 5019
Author Kunkel, David C.
Gharibans, Armen A.
Coleman, Todd P.
Smarr, Benjamin L.
Kriegsfeld, Lance J.
Mousa, Hayat M.
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  givenname: Benjamin L.
  surname: Smarr
  fullname: Smarr, Benjamin L.
  organization: Department of Psychology, University of California at Berkeley
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  givenname: David C.
  surname: Kunkel
  fullname: Kunkel, David C.
  organization: GI Motility & Physiology Program, University of California at San Diego
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  givenname: Lance J.
  surname: Kriegsfeld
  fullname: Kriegsfeld, Lance J.
  organization: Department of Psychology, University of California at Berkeley
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  givenname: Hayat M.
  surname: Mousa
  fullname: Mousa, Hayat M.
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  givenname: Todd P.
  surname: Coleman
  fullname: Coleman, Todd P.
  email: tpcoleman@ucsd.edu
  organization: Department of Bioengineering, University of California at San Diego
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Snippet The increasing prevalence of functional and motility gastrointestinal (GI) disorders is at odds with bottlenecks in their diagnosis, treatment, and follow-up....
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SubjectTerms 639/166/985
692/4020/1503/1502/2747
692/4020/1503/1828/1977
692/4020/2741/533
Abdomen
Adolescent
Automation
Child
Circadian rhythms
Correlation coefficient
Data processing
Electrocardiography
Electrodes
Electromyography - methods
Female
Gastric emptying
Gastrointestinal Diseases - diagnosis
Gastrointestinal Diseases - physiopathology
Gastrointestinal Motility - physiology
Humanities and Social Sciences
Humans
Male
Manometry - methods
Meals
Mobile Applications
Monitoring, Ambulatory - instrumentation
Monitoring, Ambulatory - methods
Motility
multidisciplinary
Oscillations
Patients
Science
Science (multidisciplinary)
Signal processing
Signal Processing, Computer-Assisted
Smartphone
Smooth muscle
Stomach - physiology
Wearable Electronic Devices
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Title Artifact Rejection Methodology Enables Continuous, Noninvasive Measurement of Gastric Myoelectric Activity in Ambulatory Subjects
URI https://link.springer.com/article/10.1038/s41598-018-23302-9
https://www.ncbi.nlm.nih.gov/pubmed/29568042
https://www.proquest.com/docview/2017038274
https://www.proquest.com/docview/2018018239
https://pubmed.ncbi.nlm.nih.gov/PMC5864836
Volume 8
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