Diabetic gastroparesis alters the biomagnetic signature of the gastric slow wave

Background Gastroparesis is characterized by delayed gastric emptying without mechanical obstruction, but remains difficult to diagnose and distinguish from other gastrointestinal (GI) disorders. Gastroparesis affects the gastric slow wave, but non-invasive assessment has been limited to the electrogastrogram (EGG), which reliably characterizes temporal dynamics but does not provide spatial information. Methods We measured gastric slow wave parameters from the EGG and magnetogastrogram (MGG) in patients with gastroparesis and in healthy controls. In addition to dominant frequency (DF) and percentage power distribution (PPD), we measured the propagation velocity from MGG spatiotemporal patterns and the percentage of slow wave coupling (% SWC) from EGG. Key Results No significant difference in DF was found between patients and controls. Gastroparesis patients had lower percentages of normogastric frequencies (60 +/- 6% vs 78 +/- 4%, p < 0.05), and higher brady (9 +/- 2% vs 2 +/- 1%, p < 0.05) and tachygastric (31 +/- 2% vs 19 +/- 1%, p < 0.05) frequency content postprandial, indicative of uncoupling. Propagation patterns were substantially different in patients and longitudinal propagation velocity was retrograde at 4.3 +/- 2.9 mm/s vs anterograde at 7.4 +/- 1.0 mm/s for controls (p < 0.01). No difference was found in % SWC from EGG. Conclusions & Inferences Gastric slow wave parameters obtained from MGG recordings distinguish gastroparesis patients from controls. Assessment of slow wave propagation may prove critical to characterization of underlying disease processes. Future studies should determine pathologic indicators from MGG associated with other functional gastric disorders, and whether multichannel EGG with appropriate signal processing also reveals pathology.