Effects of Cutaneous Gastric Electrical Stimulation on Gastric Emptying and Postprandial Satiety and Fullness in Lean and Obese Subjects

Goals: The aim of this study was to investigate the therapeutic potential of cutaneous gastric electrical stimulation (CGES) at a tachygastrial frequency for obesity. Background: Implantable gastric electrical stimulator has been proposed for the treatment of obesity and it has recently been reported that the gastric electrical stimulation at a tachygastrial frequency inhibits gastric motility. Study Methods: Ten lean and 10 obese healthy volunteers were studied in 3 randomized sessions: no CGES, CGES at the physiologic frequency (3 cycles/min), and CGES at tachygastrial frequency (12 cycles/min). Electrical stimulation was performed using sinusoidal waves. The protocol included the following sequence: 20-minute baseline, 30-minute CGES, 30-minute recording without CGES, 30-minute CGES, ingestion of a 500 kcal liquid meal, and 30-minute CGES. Gastric slow waves were recorded using cutaneous electrogastrography during the periods without CGES. Gastric emptying was assessed by ultrasound. Dyspeptic symptoms were recorded. Results: (1) The half-time of gastric emptying was longer with CGES at the tachygastrial frequency than CGES at the physiologic frequency in both lean subjects (75.0 +/- 16.5 min vs. 41.0 +/- 8.7 min, P < 0.01) and obese subjects (64.1 +/- 13.3 min vs. 32.7 +/- 5.0 min, P < 0.01). (2) Postprandial dyspeptic symptom score (mainly satiety and fullness) was significantly higher with CGES at the tachygastrial frequency than CGES at the physiologic frequency in both lean (3.2 +/- 1.47 vs. 1.7 +/- 0.94, P < 0.01) and obese (3.9 +/- 1.89 vs. 1.8 +/- 1.15, P < 0.01) subjects. Conclusions: CGES at a tachygastrial frequency enhances postprandial fullness and satiety, and delays gastric emptying. Its therapeutic potential for obesity needs to be studied.