Amplitude Of Gastric Contractions Research Articles

Whole Gut Motility Patterns in Patients with Chronic Nausea and Vomiting

Background/Objectives: Chronic nausea and vomiting (N/V) disorders are common in clinical practice. Our primary aim was to compare total and segmental gastrointestinal transit times as well as gastric contraction patterns in patients with chronic N/V syndrome to those of healthy volunteers (HVs). In the patient group, our secondary aim was to explore how symptoms and motility patterns were affected by a serotonin HT4 receptor agonist (Prucalopride). Methods: Patients with chronic N/V syndrome and HVs underwent baseline assessment of regional gastrointestinal (GI) motility/transit using the Motilis 3D-Transit system. Patients were then treated with Prucalopride 2 mg daily for 28 days, with the 3D-transit examination repeated within 10–20 days after treatment onset. Two self-administered questionnaires (the Gastrointestinal Symptom Rating Scale [GSRS] and Gastroparesis Cardinal Symptom Index [GCSI]) were used to assess patients’ symptoms. Results: A total of 19 patients (13 F; median age 25 years (IQR 22–39) and 55 HVs (25 F; median age 28 (24–35) were included. At baseline, no differences in regional GI transit times were found between groups. However, patients had a significantly lower gastric contraction amplitude than HVs (9 mmHg (IQR 8–11) vs. 12 (10–15: p < 0.001). In response to Prucalopride treatment, gastric emptying time was reduced from a median of 3.1 h to 1.6 h (p < 0.005). Further, the GCSI was significantly reduced from GCSI 3.0 (IQR 2.3–3.7) at baseline to GCSI 1.9 (IQR 1.3–3.2) with Prucalopride. Conclusions: Patients with chronic N/V syndrome have significantly lower gastric contraction amplitude than HVs and may symptomatically benefit from prokinetics. They do not, however, have evidence of panenteric dysmotility.

Vagus nerve stimulation in bursts can efficiently modulate gastric contractions and contraction frequency at varying gastric pressures.

There has been recent clinical interest in the use of vagus nerve stimulation (VNS) for treating gastrointestinal disorders as an alternative to drugs or gastric electrical stimulation. However, effectiveness of burst stimulation has not been demonstrated. We investigated the ability of bursting and continuous VNS to influence gastric and pyloric activity under a range of stimulation parameters and gastric pressures. The goals of this study were to determine which parameters could optimally excite or inhibit gastric activity. Data were collected from 21 Sprague-Dawley rats. Under urethane anesthesia, a rubber balloon was implanted into the stomach, connected to a pressure transducer and a saline infusion pump. A pressure catheter was inserted at the pyloric sphincter and a bipolar nerve cuff was implanted onto the left cervical vagus nerve. The balloon was filled to 15 cmH2O. Stimulation trials were conducted in a consistent order; the protocol was then repeated at 25 and 35 cmH2O. The nerve was then transected and stimulation repeated to investigate directionality of effects. Bursting stimulation at the bradycardia threshold caused significant increases in gastric contraction amplitude with entrainment to the bursting frequency. Some continuous stimulation trials could also cause increased contractions but without frequency changes. Few significant changes were observed at the pylorus, except for frequency entrainment. These effects could not be uniquely attributed to afferent or efferent activity. Our findings further elucidate the effects of different VNS parameters on the stomach and pylorus and provide a basis for future studies of bursting stimulation for gastric neuromodulation.

Liraglutide modulates morpho-functional and inflammatory gastrointestinal responses in rats.

Obesity impairs homeostatic control of energy and is associated with chronic low-grade inflammation. Effects of glucagon-like peptide-1, the target in the gastrointestinal tract for anti-obesity drugs such as Liraglutide, were not properly associated with inflammation markers. This study investigated the effects of Liraglutide on metabolic and gastrointestinal parameters in a rat model of obesity. Twenty-six Wistar rats with obesity were randomly distributed to receive saline (n = 10), 400 μg (n = 8), or 1200 μg of Liraglutide/kg/day (n = 8), subcutaneously for 30 consecutive days, once a day. Weight gain, feeding efficiency, caloric consumption, gastric motility, adiposity, histomorphometric, murinometric, biochemical parameters and cytokines TNF-α and TGF-β1 in duodenal tissue were measured. Data were analysed by ANOVA, followed by Bonferroni post hoc or Kruskal-Wallis test, followed by Dunn's multiple comparison test. Liraglutide-treated animals had better feeding efficiency and higher caloric intake in a dose-dependent manner. Higher doses slowed gastric emptying and diminished the amplitude of gastric contractions. These effects were accompanied by decreases in intestinal muscle layer thickness and crypt depth. Liraglutide significantly reduced retroperitoneal and visceral white adipose tissue depots. High-dose treatment decreased levels of TNF-α and enhanced levels of TGF-β1 in duodenal tissue. Liraglutide treatment provided significant reductions in total cholesterol, triglyceride and hepatic transaminases. Liraglutide reduced fat accumulation, improved metabolic parameters and downregulated levels of inflammatory signalling in duodenal tissue. Liraglutide at high doses controlled obesity-related outcomes, and such effects seemed to be driven by its action on glucagon-like peptide-1 receptors in the gastrointestinal tract slowing gastric motility.

Alternate-day fasting induces metabolic and morphofunctional changes in the gastrointestinal tract of male rats.

Alternate-day fasting (ADF) is a nutritional intervention with modulatory and overall protective effects, but its role in the gastrointestinal (GI) tract is still uncertain. The aim of this study was to investigate the influence of ADF on the metabolic patterns and morphofunctional motility of the GI tract in rats. Thirty-two male Wistar rats were allocated into groups: control for 15 days (CON 15, n=8), control for 30 days (CON 30, n=8), ADF for 15 days (ADF 15, n=8), and ADF for 30 days (ADF 30, n=8). Blood glucose, body weight, and food and water consumption were measured. Frequency and amplitude of gastric contractions as well as gastric emptying time, small intestinal transit time, and cecum arrival time were measured. Intestinal histomorphometric, relative weight of organs, lipidogram, and leptin levels were also evaluated. ADF decreased water consumption and food consumption. The weight gain decreased; however, the relative kidney weight increased. ADF triggered an increase in the amplitude of gastric contractions and accelerated gastric emptying. However, small intestinal transit time was delayed in both ADF groups. Total cholesterol, triglycerides, non-HDL cholesterol, and very low-density lipoprotein cholesterol levels decreased, whereas villus height, depth of the crypts and thickness of the circular, and longitudinal muscular layers of intestine increased after ADF. In conclusion, our results showed ADF exert an effect on both metabolism and GI motility and impacts on overall digestive functions.

Gastric Emptying Time and Volume of the Small Intestine as Objective Markers in Patients With Symptoms of Diabetic Enteropathy.

Background/AimsPatients with diabetes mellitus (DM) often suffer from gastrointestinal (GI) symptoms, but these correlate poorly to established objective GI motility measures. Our aim is to perform a detailed evaluation of potential measures of gastric and small intestinal motility in patients with DM type 1 and severe GI symptoms.MethodsTwenty patients with DM and 20 healthy controls (HCs) were included. GI motility was examined with a 3-dimensional-Transit capsule, while organ volumes were determined by CT scans.ResultsPatients with DM and HCs did not differ with regard to median gastric contraction frequency (DM 3.0 contractions/minute [interquartile range {IQR}, 2.9-3.0]; HCs 2.9 [IQR, 2.8-3.1]; P = 0.725), amplitude of gastric contractions (DM 9 mm [IQR, 8-11]; HCs 11 mm (IQR, 9-12); P = 0.151) or fasting volume of the stomach wall (DM 149 cm3 [IQR, 112-187]; HCs 132 cm3 [IQR, 107-154]; P = 0.121). Median gastric emptying time was prolonged in patients (DM 3.3 hours [IQR, 2.6-4.6]; HCs 2.4 hours [IQR, 1.8-2.7]; P = 0.002). No difference was found in small intestinal transit time (DM 5 hours [IQR, 3.7-5.6]; HCs 4.8 hours [IQR, 3.9-6.0]; P = 0.883). However, patients with DM had significantly larger volume of the small intestinal wall (DM 623 cm3 [IQR, 487-766]; HCs 478 cm3 [IQR, 393-589]; P = 0.003). Among patients, 13 (68%) had small intestinal wall volume and 9 (50%) had gastric emptying time above the upper 95% percentile of HCs.ConclusionIn our study, gastric emptying time and volume of the small intestinal wall appeared to be the best objective measures in patients with DM type 1 and symptoms and gastroenteropathy.

Paternal obesity and its transgenerational effects on gastrointestinal function in male rat offspring.

The interplay between obesity and gastrointestinal (GI) motility is contradictory, and the transgenerational influence on this parameter is unknown. We aimed to evaluate the GI function in a model of paternal obesity and two subsequent generations of their male offspring. Newborn male rats were treated with monosodium glutamate (MSG) and composed the F1 generation, while control rats (CONT) received saline. At 90 days, male F1 were mated with non-obese females to obtain male offspring (F2), which later mated with non-obese females for obtaining male offspring of F3 generation. Lee Index analysis was adopted to set up the obesity groups. Alternating current biosusceptometry (ACB) technique was employed to calculate GI transit parameters: mean gastric emptying time (MGET), mean cecum arrival time (MCAT), mean small intestinal transit time (MSITT), and gastric frequency and amplitude of contractions. Glucose, insulin, and leptin levels and duodenal morphometry were measured. F1 obese rats showed a decrease in the frequency and amplitude of gastric contractions, while obese rats from the F2 generation showed accelerated MGET and delayed MCAT and MSITT. Glucose and leptin levels were increased in F1 and F2 generations. Insulin levels decreased in F1, F2, and F3 generations. Duodenal morphometry was altered in all three generations. Obesity may have paternal transgenerational transmission, and it provoked disturbances in the gastrointestinal function of three generations.

Gastrointestinal Side Effects of Triple Immunosuppressive Therapy Evaluated by AC Biosusceptometry and Electrogastrography in Rats.

Triple immunosuppressive therapy is associated with several gastrointestinal disorders. The aim of this study was to investigate the effects induced by the triple immunosuppressive therapy on the gastrointestinal tract of rats. Male Wistar rats were randomly assigned into three experimental groups: Control: filtered water; TAC + MPS + PRED: treated with Tacrolimus plus Mycophenolate Sodium plus Prednisone; and CSA + AZA + PRED: treated with Cyclosporine plus Azathioprine plus Prednisone. The treatment was done for 14 days by gavage. Gastric emptying and contractility were evaluated by the Alternating Current Biosusceptometry (ACB) and Electrogastrography (EGG). Histological, biochemical and hematological analyses were also performed. Gastric emptying time was slower in the CSA + AZA + PRED group in comparison with control (p<0.01) and TAC + MPS + PRED groups (p<0.001). Animals treated with TAC + MPS + PRED showed accelerated gastric emptying (p<0.05) compared to control. The amplitude of gastric contractions in both immunosuppressed groups was higher than observed in the control. The frequency of gastric contractions for the CSA + AZA + PRED group was also increased (p<0.01). Results obtained by EGG were similar to those recorded with the ACB. The thickness of the circular layer from stomach muscle decreased in both immunosuppressed groups, while the longitudinal layer was reduced only in the CSA + AZA + PRED group. Triple immunosuppressive therapy alters gastric motility, compromises the muscular layers and the association between CSA, AZA, and PRED provokes the major alterations in the structure and gastric function. Specific gastrointestinal side effects resulting from different immunosuppressive therapies still need to be elucidated in order to provide more effective and personalized therapy for patients.

SPARC: Simultaneous Assessment of Gastric Emptying and Motility with Contrast Enhanced Magnetic Resonance Imaging in Humans

PurposeMagnetic resonance imaging (MRI) of the gastrointestinal (GI) tract is an emerging technique for non‐invasive assessment of gastric emptying and motility in animals and humans. However, addition of MRI contrast agents to the test meal is often required to produce high luminal contrast to facilitate image analysis. Here, we reported a recipe of a test meal that is all natural (e.g. gadolinium‐free) and safe for humans. The ingredients of the test meal all contain relatively high concentration of manganese, which allow the lumen of the GI tract to be visible inside MRI. To capture gastric emptying and motility simultaneously, we have developed a dynamic 3D imaging protocol with high spatial and temporal resolution and an image segmentation and analysis algorithm.MethodSix healthy volunteers (3 woman; age 24–31) participated in this study. All subjects were asked to fast for 12 hours. Subjects were scanned using a 3T Siemens Prisma MRI scanner using an 18‐channel body coil and a 32‐channel spine coil. Prior to meal consumption, pre‐prandial gastric volume was quantified using a 3D true fast imaging (TRUFI) with steady‐state free precession sequence under free breathing. Then the subjects were instructed to ingest 350 ml of a semi‐solid test meal (263kcal) that contains blended natural foods (i.e. pineapple, banana, blueberry, firm tofu) with a relatively high concentration of manganese. Post‐meal MRI scans were performed using a 3D Spoiled Gradient Echo Variant (VIBE) sequence under gentle breaths over a 90‐minute time course. Post‐prandial gastric volumes, as well as antral contraction frequency and amplitude of the peristaltic wave, were quantified from the dynamic 3D MRI images using a custom‐built image processing pipeline.ResultsPre‐prandial gastric volume was measured prior to test meal consumption (30.98±12.29 mL). After the subjects consumed the test meal, the presence of manganese in the meal enhanced the contrast of the gastric lumen (Fig. 1). The imaging protocol collected fast real‐time MRI scans of the stomach processing and emptying of a meal and the algorithms quantified gastric motility and emptying rate. The stomach volume decreased at a rate of 1.58±0.50 mL/min, mainly attributed to volume decrease in the fundus and the corpus (1.31±0.53 mL/min) than in the antrum (0.28±0.15 mL/min). The frequency of gastric contractions was 2.79±0.17 cycles/min, which was in line with the frequency of gastric slow wave in humans. The displacement of the luminal wall (i.e. contraction amplitude) was greater at the antrum (7.42±1.39 mm) than at the fundus and the corpus (4.52±0.25 mm), as illustrated in Fig. 2.ConclusionHere, we developed a contrast‐enhanced gastric MRI protocol to non‐invasively monitor gastric emptying and motility in humans. Such experimental protocol was further empowered by advanced image analysis to enable comprehensive assessment of gastric functions and physiology. In summary, the proposed method may become a reliable standard to guide diagnosis and treatment of gastric disorders in humans.Support or Funding InformationNIH SPARC OT2OD023847Example gastric MRI images of the stomach distended with the test meal. The contrast of the gastric lumen was significantly enhanced due to the presence of manganese in the meal.Figure 1Mapping amplitude of gastric contractions on the luminal wall. The displacement of the luminal wall was greatest at the antrum, followed by the corpus, and smallest at the fundus.Figure 2

Is normal gastric emptying a predictor of normal gastric function?

Impaired gastric emptying is common in many disorders. Assuming that gastric disorders primarily affect gastric peristalsis, which secondarily results in impaired emptying, the aim of our study was to evaluate whether quantitative analysis of gastric peristalsis might be a more sensitive parameter than gastric emptying to demonstrate functional gastric impairment. Gastric emptying was determined scintigraphically in 141 adult (age: 18-78 years) patients (long-term Type 1 diabetes mellitus, 82 cases; systemic sclerosis, 31 cases; atrophic gastritis, 28 cases) and 20 healthy age-matched controls after ingestion of a semiliquid test meal. In addition, gastric peristalsis was evaluated by Fourier analysis of condensed images. Compared to the control persons emptying was delayed in 75/141 patients, regular in 63/141 patients, and accelerated in 3/141 patients. As expected, 81% of patients with delayed emptying presented with diminished gastric contraction amplitudes. However, independent of the aetiology of the underlying disorder, 40/63 patients with regular emptying also exhibited reduced peristalsis. Normal gastric emptying does not predict normal gastric function. This assumption is supported by the presence of reduced amplitudes in subgroups of patients with various disorders and normal emptying. Our results suggest that the amplitude of gastric contractions may represent a more sensitive parameter for the detection of gastric dysfunction than does gastric emptying.

Gastrointestinal disorders after immunosuppression: an experimental model to evaluate the influence of monotherapy on motility parameters.

What is the central question of this study? The aim was to propose an animal model for investigating the effects of immunosuppressive monotherapy on gastrointestinal motility using a non-invasive biomagnetic technique. What is main finding and its importance? In our experimental study, immunosuppressive drugs currently in use accelerated gastric emptying whilst increasing the frequency and amplitude of gastric contractions after treatment, except for Mycophenolate and azathioprine. Alternating current biosusceptometry is a useful tool to evaluate side-effects of drugs on the gastrointestinal tract, which will help in understanding the symptoms and improving clinical management of patients. The aim was to propose an animal model for investigating the effects of immunosuppressive monotherapy on gastrointestinal motility using a non-invasive biomagnetic technique. Male Wistar rats were randomly distributed into the following treatment groups: ciclosporin, tacrolimus, prednisone, sirolimus, mycophenolate mofetil, everolimus, azathioprine and control. Each animal was treated for 14days by gavage with dosages ranging from 1 to 20mgkg-1 day-1 considering the area-to-volume ratio and hepatic metabolism. Gastrointestinal transit and gastric contractility measurements were evaluated by alternating current biosusceptometry before and after treatment. Gastric emptying was faster in animals treated with tacrolimus, prednisone, sirolimus and everolimus compared with control animals (126.7±12.7min). There was a significant increase in the frequency of contractions after ciclosporin, tacrolimus, azathioprine and sirolimus treatment compared with control animals (4.6±0.3cyclesmin-1 ). Increases in the amplitude of contraction were observed after treatment with tacrolimus, sirolimus and everolimus compared with control rats (34.9±6.0dB). The results showed that our animal model was suitable for demonstrating that mostimmunosuppressive drugs currently in useimpaired at least one gastrointestinal motility parameter. As a non-invasive technique, alternating current biosusceptometry is a potentially useful tool for evaluation of side-effects of drugs in gastrointestinal tract, helping us to understand the symptoms to improve clinical management of patients.

Gastrointestinal motility during sleep assessed by tracking of telemetric capsules combined with polysomnography - a pilot study.

Studies of gastrointestinal function during sleep are hampered by lack of applicable techniques. Recent development of a novel ambulatory telemetric capsule system, which can be used in conjunction with polysomnography, offers a solution to this problem. The 3D-Transit system consists of ingestible electromagnetic capsules traceable through a portable extracorporeal receiver while traversing the gut. During sleep monitored by polysomnography, gastrointestinal motility was concurrently investigated using 3D-Transit in nine healthy subjects. Overall, the amplitude of gastric contractions decreased with depth of sleep (light sleep, N2 versus deep sleep, N3; P<0.05). Progression through the small intestine did not change with depth of sleep (Kruskal–Wallis probability =0.1), and there was no association between nocturnal awakenings or arousals and the occurrence of colonic or small intestinal propagating movements. Basal colonic activity was suppressed during both deep sleep (P<0.05) and light sleep (P<0.05) when compared with nocturnal wake periods. In conclusion, the novel ambulatory 3D-Transit system combined with polysomnography allows minimally invasive and completely ambulatory investigation of associations between sleep patterns and gastrointestinal motility.

Experimental model of mild diabetes: long-term evaluation of glycemic profile and gastric contractility in rats

Materials and methods Male Wistar rats were divided into mild diabetes (n=14) and control (n=8) groups. For mild diabetes induction, newborn rats received streptozotocin (STZ-100 mg/kg, subcutaneously) in a citrate buffer and control animals received only citrate buffer on the first day of life. The oral glucose tolerance test (OGTT) was performed three months later and blood glucose was measured monthly by glucometer Facil True Read (Home Diagnostics). The gastric contractility was evaluated by Alternate Current Biosusceptometry (ACB), a previously validated and noninvasive biomagnetic technique. After 12 h fasting, the animals were fed with 2g of magnetically marked chow and anesthetized with sodium pentobarbital (40 mg/kg, intraperitoneally). All rats were placed in a supine position with ACB sensor positioned on the gastric region during 30 min. Frequency and amplitude of gastric contractions, also abnormal rhythmic index, were obtained from signals. Comparisons were performed by ANOVA (Tukey), being significant at p<0.05. OGTT confirmed diabetes in the STZ-induced group, demonstrating the success of the model.

Gastric motor disturbances in patients with idiopathic rapid gastric emptying

The mechanisms of 'idiopathic' rapid gastric emptying, which are associated with functional dyspepsia and functional diarrhea, are not understood. Our hypotheses were that increased gastric motility and reduced postprandial gastric accommodation contribute to rapid gastric emptying. Fasting and postprandial (300kcal nutrient meal) gastric volumes were measured by magnetic resonance imaging (MRI) in 20 healthy people and 17 with functional dyspepsia; seven had normal and 10 had rapid gastric emptying. In 17 healthy people and patients, contractility was analyzed by spectral analysis of a time-series of gastric cross-sectional areas. Logistic regression models analyzed whether contractile parameters, fasting volume, and postprandial volume change could discriminate between health and patients with normal or rapid gastric emptying. While upper gastrointestinal symptoms were comparable, patients with rapid emptying had a higher (P=0.002) body mass index than normal gastric emptying. MRI visualized propagating contractions at ∼3cpm in healthy people and patients. Compared with controls (0.32±0.04, Mean±SEM), the amplitude of gastric contractions in the entire stomach was higher (OR 4.1, 95% CI 1.2-14.0) in patients with rapid (0.48±0.06), but not normal gastric emptying (0.20±0.06). Similar differences were observed in the distal stomach. However, the propagation velocity, fasting gastric volume, and the postprandial volume change were not significantly different between patients and controls. MRI provides a non-invasive and refined assessment of gastric volumes and contractility in humans. Increased gastric contractility may contribute to rapid gastric emptying in functional dyspepsia.

Effect of motilin on gastric distension sensitive neurons in arcuate nucleus and gastric motility in rat

Intestinal motilin is known to stimulate gastrointestinal (GI) motility and the arcuate nucleus (Arc) of hypothalamus is shown to be involved in the regulation of GI motility. Single unit discharges in the Arc were recorded extracellularly by implantation of a force transducer into the stomach in rats, to evaluate the effect of motilin on gastric motility. Projection of nerve fiber and expression of motilin were observed by retrograde tracer deposits of Fluoro-Gold (FG) and fluo-immunohistochemistry staining. 65.5% of neurons in Arc responded to gastric distension (GD), 55.6% of which showed excitation (GD-E), and 44.4% showed inhibition (GD-I). After GD, the firing rate of GD-E neurons significantly increased (P<0.01), but decreased for GD-I neurons (P<0.01). Most of both GD-E and GD-I neurons were activated by motilin (P<0.05). The frequency and amplitude of gastric contractions significantly increased by administration of motilin in Arc with a dose dependent manner (P<0.05-0.01). However, pretreatment with GM109 could abolish the responses of neurons and excitatory effect of gastric motility induced by motilin. Motilin immunoreactive neurons were increased in Arc via gastric distention (P<0.05). Motilin/FG-labeled neurons were detected in hypothalamus paraventricular nucleus (PVN). Our findings suggest that motilin neurons in Arc may accept peripheral somatosensory afferent inputs from gastric mechanoreceptors of the stomach, and also may acts as a stimulatory factor in Arc to regulate gastric motility via some inferior nucleus relay pathway. The results provide insight into the role of Arc in the control of digestion mediated via motilin.

Comparison between manual and automated techniques for assessment of data from dynamic antral scintigraphy

This work aimed at determining whether data from dynamic antral scintigraphy (DAS) yielded by a simple, manual technique are as accurate as those generated by a conventional automated technique (fast Fourier transform) for assessing gastric contractility. Seventy-one stretches (4 min) of "activity versus time" curves obtained by DAS from 10 healthy volunteers and 11 functional dyspepsia patients, after ingesting a liquid meal (320 ml, 437 kcal) labeled with technetium-99m (99mTc)-phytate, were independently analyzed by manual and automated techniques. Data obtained by both techniques for the frequency of antral contractions were similar. Contraction amplitude determined by the manual technique was significantly higher than that estimated by the automated method, in both patients and controls. The contraction frequency 30 min post-meal was significantly lower in patients than in controls, which was correctly shown by both techniques. A manual technique using ordinary resources of the gamma camera workstation, despite yielding higher figures for the amplitude of gastric contractions, is as accurate as the conventional automated technique of DAS analysis. These findings may favor a more intensive use of DAS coupled to gastric emptying studies, which would provide a more comprehensive assessment of gastric motor function in disease.

Motilin activates neurons in the rat amygdala and increases gastric motility

Motilin and motilin receptors have been found in most regions of the brain, including the amygdala, one of the most important parts of the limbic system. Our previous study found that administration of motilin in the hippocampus stimulates gastric motility. We now explore the effect of motilin in the amygdala on gastric motility. In conscious rats, gastric motility was recorded after microinjection of motilin, motilin receptor antagonist (GM-109) or a mixture of the two into the basomedial amygdala nucleus (BMA). In anesthetized rats the changes of spontaneous discharges of gastric distention sensitive neurons (GDSN) in the BMA were recorded after intracerebroventricular (i.c.v.) microinjection of motilin or GM-109. In conscious rats the amplitude of gastric contractions increased dose-dependently after microinjection of motilin in the BMA, and decreased after microinjection of GM-109. The excitatory or inhibitory effects induced by motilin or GM-109 alone, were weakened by microinjection of a mixture solution of both. The spontaneous discharge frequency of gastric distention excitatory neuron (GDEN) was mainly inhibited by i.c.v. microinjection of motilin but excited by GM-109. In contrast, the spontaneous discharge frequency of gastric distention inhibitory neuron (GDIN) was mainly excited by motilin, but inhibited by GM-109. Our findings suggest that motilin may regulate gastric motility by modulating neural pathways in the BMA.

Is normal gastric emptying a predictor of normal gastric function?

Summary Aim: Impaired gastric emptying is common in many disorders. Assuming that gastric disorders primarily affect gastric peristalsis, which secondarily results in impaired emptying, the aim of our study was to evaluate whether quantitative analysis of gastric peristalsis might be a more sensitive parameter than gastric emptying to demonstrate functional gastric impairment. Patients, methods: Gastric emptying was determined scintigraphically in 141 adult (age: 18–78 years) patients (long-term Type 1 diabetes mellitus, 82 cases; systemic sclerosis, 31 cases; atrophic gastritis, 28 cases) and 20 healthy age-matched controls after ingestion of a semiliquid test meal. In addition, gastric peristalsis was evaluated by Fourier analysis of condensed images. Results: Compared to the control persons emptying was delayed in 75/141 patients, regular in 63/141 patients, and accelerated in 3/141 patients. As expected, 81% of patients with delayed emptying presented with diminished gastric contraction amplitudes. However, independent of the aetiology of the underlying disorder, 40/63 patients with regular emptying also exhibited reduced peristalsis. Conclusion: Normal gastric emptying does not predict normal gastric function. This assumption is supported by the presence of reduced amplitudes in subgroups of patients with various disorders and normal emptying. Our results suggest that the amplitude of gastric contractions may represent a more sensitive parameter for the detection of gastric dysfunction than does gastric emptying.

Excitatory effects of motilin in the hippocampus on gastric motility in rats

Intestinal motilin is known to stimulate gastrointestinal motility. Recently, it was shown that the motilin gene and the motilin receptor are expressed in various regions of the brain. We studied whether motilin can activate pathways in the rat hippocampus to stimulate gastric motility. Gastric motility was monitored in conscious rats, whereas extracellular electrical activity recordings of the hippocampus were performed on anaesthetized rats to measure the influence of microinjection of motilin and CCK-8 into the hippocampus and into the cerebral ventricles. We found that neurons in the CA3 region of the hippocampus are sensitive to gastric distension, and that injection of motilin into the hippocampus increased the amplitude of gastric contractions by 35.3±6.8%, while CCK-8 injection inhibited motility by −27.3±6.8%. The hippocampal motilin-induced stimulation of gastric motility (30.6±5.5%) was completely abolished by subdiaphragmal vagotomy (−2.8±4.4%) but unaffected by the intravenously applied receptor blockers atropine, phentolamine and propranolol. In vivo extracellular recordings of gastric distension-responsive CA3 neurons revealed that intracerebroventricular administration of motilin increased firing while CCK-8 inhibited firing. These opposite effects of motilin and CCK-8 fit with the nature of the actions of these gut–brain peptides on gastric motility. Our findings suggest that the stimulation of gastric motility by motilin administered in the hippocampus reflects the existence of a functional interaction between the hippocampus and a vago–vagus reflex running via a noncholinergic and nonadrenergic efferent pathway.

L-glutamate microinjection into DMV can both increase and decrease gastric volume in mice

into the skin and underlying muscles on the hind limb (ST-36) was manually twisted left and right once every second fbr 30 seconds Results: Two types of fasting gastric motor patterns were observed in conscious rats, Of 25 rats studied, 15 rats (type A; 60 %) showed no cyclic groupings of strong contractions, whik 10 rats (type B; 40 %) showed cyclic groupinga of strong contractions similar to the phase llI contractions observed in the humans and dogs in 11 (73 %) of 15 type A rats, acupuncture on the hind limb induced phase IlI-like contractions that lasted for more than 3 hrs. The amplitude of gastric contractions was significantly increased by acupuncture to 213.8 + A20.1% of controls (M +/-SE, n = 6, p<0.01). The motility index of phase llI-like contractions induced by' acupuncture in type A rats was signdlcantly higher than that of type B rats (81.2 +/3.3 vs 42.1 +A1.5 g min, n = 6, p<0.01). In contrast, acupuncture on the back had no effects on gastric contractions. Acupunctul~ failed to induce a W phase Ill-like contractions in type A rats, once treated with atropine (50 micro g/kg, s.c.), hexamethoninm (20 mg/kg, s.c.) and snbdiaphragmatic bilateral vagotomy Pretreatment wqth naloxone (5 mg/kg, i.p.) significantly' shortened the duration of pha~ lIIdike contractions induced by' acupuncture from 3.68 +/-0.10 to 1.06 +/0.11 hr (n=3 , P<0.01) In 6 of 10 type B rats, acupuncture on the hind limb significamly suppressed the atnplitude of phase Ill-like contractions to 67.4 +/-10.2 % of controls (n = 4, p<005) . Among 10 of type B rats studied, none of them showed increased phase Ill contractions in response to acupunctm'e. Conclusions: Acupuncture on the hind limb induces dual eftects, either stimulato Dor inhibitoD', on gastric motility in conscious rats. The stimulator}' effects are mediated via vagal cholinergic and opioid pathway. Opioid pathway may contribute to the long-lasting stimulatory effects ot acupuncture on gastric motility.

Effect of tetramethylpyrazine on reserpine-induced gastric lesion in rats.

The present study was undertaken to determine the effect of tetramethylpyrazine administered intraperitoneally on gastric lesions, gastric acid secretion, gastric barrier mucus secretion, and gastric contraction in reserpine-treated rats. The results of this study demonstrated that tetramethylpyrazine at doses of 0.5, 1, 10, and 20 mg/kg significantly inhibited the formation of gastric lesions induced by reserpine, with suppressive rates of 57.5%, 64.0%, 94.1%, and 96.0%, respectively. Tetramethylpyrazine (1 and 20 mg/kg) significantly prompted the secretion of gastric barrier mucus but had no effect on the secretion of gastric acid. Our findings also showed that tetramethylpyrazine (1 and 20 mg/kg) significantly suppressed the frequency of gastric contractions, but had no effect on the amplitude of gastric contraction. These results indicate that the protection of tetramethylpyrazine results, in part, from promoting gastric barrier mucus secretion and suppressing the frequency of gastric contraction, but not from suppressing the secretion of gastric acid and the amplitude of gastric contraction.