Multi-Channel Electrogastrography And Autonomic Nervous System Function In Different Subtypes Of Patients With Functional Dyspepsia

Previous studies have shown that patients with functional dyspepsia (FD) had significantly lower percentage of slow wave coupling (%SWC) in fasting state. The aim of this study was to utilize MEGG and ANS test to investigate the difference of MEGG parameters and ANS parameters between different subtypes of FD patients and healthy subjects (HS). Methods:  Sixty-two patients with the diagnosis of FD were enrolled in this study (16 M, 46 F, mean age: 43 years) and divided into dysmotility-like FD group (15 M, 35 F, mean age: 42 years) and ulcer-like FD group (1 M, 11 F, mean age: 46 years) based on Rome II criteria. 50 HS were recruited as control (25 M, 25 F, mean age: 44 years). MEGG were recorded simultaneously with the electrocardiogram (ECG) recording for 30 min in the fasting state and 60 min after a standard 450 Kcal test meal. MEGG parameters included dominant frequency (DF), normal percentage of 2–4 cpm gastric slow waves (%N) and %SWC. ANS parameters included sympathovagal balance LF/HF Ratio, mainly sympathetic activity LF and vagal activity HF. Results:  (1) Compared with HS, %SWC was significantly lower in ulcer-like FD group in fasting state (P < 0.05) but not in fed state. No significant difference of %SWC was shown between dysmotility-like FD group and HS either in fasting state or in fed state. There was no significant difference between the two FD groups and HS in DF and %N neither in fasting state nor in fed state. (2) Compared with HS, LF/HF ratio and LF were significantly lower and HF was significantly higher in fasting state in dysmotility-like FD group (P < 0.05), this difference was abolished by test meal in the 1st 30 min fed state and the lower LF and higher HF were present in the 2nd 30 min fed state again in dysmotility-like FD group. There was no significant difference between ulcer-like FD group and HS in any of those ANS parameters either in fasting state or in fed state. Conclusions:  Gastric slow wave coupling was abnormal in patients with ulcer-like FD. Patients with dysmotility-like FD had abnormal ANS function in fasting state and test meal could only correct the abnormal ANS for short time, which suggest that different subtypes of FD may have different patterns in ANS test.