Preprint Body Surface Gastric Mapping Delineates Specific Patient Phenotypes In Adolescents With Functional Dyspepsia And Gastroparesis, 2024, Humphrey et al.

Body Surface Gastric Mapping Delineates Specific Patient Phenotypes In Adolescents With Functional Dyspepsia And Gastroparesis
Gayl Humphrey; Celia Keane; Gabriel Schamberg; Alain Benitez; Stefan Calder; Binghong Xu; Christian Sadaka; Christopher N Andrews; Gregory O'Grady; Armen Gharibans; Hayat Mousa

IMPORTANCE
Persistent upper gastroduodenal symptoms, such as nausea, vomiting, bloating, and abdominal pain, are widespread among pediatric patients. Multiple overlapping symptoms complicate the diagnostic process, necessitating the development of novel gastric function tests with actionable biomarkers. Body Surface Gastric Mapping (BSGM) has emerged as a promising diagnostic tool for gastroduodenal disorders, and this is the first detailed evaluation in adolescents.

OBJECTIVES
This study aimed to assess the utility of BSGM in delineating specific patient phenotypes among adolescents with functional dyspepsia (FD) and gastroparesis in order to guide clinical decision-making.

DESIGN
A prospective cross-sectional study recruited adolescents aged 12 to 21 between 2022 and 2024.

SETTING
Controls were recruited from New Zealand (controls) and

PATIENTS
from the Children9s Hospital of Philadelphia, Pennsylvania, USA. Participants Prospectively recruited participants included controls without gastroduodenal symptoms or motility-related medication usage and patients diagnosed with either gastroparesis (delayed gastric emptying test (GET)) or FD according to ROME IV criteria and a normal GET. Procedures BSGM was performed using a standardized protocol, including simultaneous symptom reporting and the completion of validated symptom, psychometric and physical health questionnaires. Main Outcome The primary outcome was to evaluate if BSGM could delineate specific patient phenotypes and provide clinically meaningful distinctions between gastroparesis and FD diagnoses, utilizing BSGM spectral outcome data.

RESULTS
Fifty-six subjects were recruited (31 controls, 25 patients); median age 16; 96% of patients were female. Control data showed that adult reference intervals provided an acceptable interpretation framework. Patients with FD (n=10) and gastroparesis (n=15) had common symptoms, mental health, quality of life and functional disability (all p>0.05). Three distinct BSGM phenotypes were identified: BSGM Normal (n=10), BSGM Delay (n=8), and Low Stability/Low Amplitude (n=7), having spectral differences in BMI-Adjusted Amplitude 34.6 vs 39.1 vs 19.9 (p=.01) and Gastric Alimetry Rhythm Index: 0.45 vs 0.45 vs 0.19 (p=.003). BSGM phenotypes demonstrated differences in symptoms (nausea p=0.04), physical health (p=.04) and psychometrics (anxiety p=.03).

CONCLUSIONS AND RELEVANCE
Adolescent patients with FD and gastroparesis have overlapping clinical profiles, making individualized treatment challenging. Conversely, employing BSGM to categorize patients into distinct phenotypes revealed clinically relevant differences, offering potential avenues for individualized therapeutic pathways.


Link | PDF (Preprint: MedRxiv) [Open Access]

 

A few of their references —

Normative Values for Body Surface Gastric Mapping Evaluations of Gastric Motility Using Gastric Alimetry: Spectral Analysis (2022, American Journal of Gastroenterology)

Gastric dysfunction in patients with chronic nausea and vomiting syndromes defined by a noninvasive gastric mapping device (2022, Science Translational Medicine)

Consensus Recommendations for Gastric Emptying Scintigraphy: A Joint Report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine (2008, Journal of Nuclear Medicine Technology)