Parametric Study of Neural Gastric Electrical Stimulation in Acute Canine Models

Manipulation of gastric motility by gastric electrical stimulation (GES) has been suggested as a minimally invasive alternative treatment of gastric motility disorders and obesity. However, only neural GES (NGES) has been successful in invoking gastric contractions. Nevertheless, the relationship between these contractions and the controlling NGES parameters has not been quantified. We aimed at determining the relationship between the electrical energy delivered to the tissue as a function of NGES parameters, and the strength and duration of the resulting invoked gastric contractions. Five healthy mongrel dogs underwent subserosal prepyloric implantation of two NGES electrode pairs. Gastric motility was captured by a force transducer implanted in the vicinity of the distal pair of stimulating electrodes. Custom-designed implantable stimulator delivered NGES with 8-16 V (peak-to-peak) amplitudes, and 60-100% duty cycles. Normalized motility index (MI) was utilized to quantify the contractions recorded from the force transducer. The MI increased with increasing voltage amplitudes. However, it remained remarkably constant across all duty cycles when voltage was held constant. Calculated motility generation efficiency indices (MGEI) indicated that highest energy efficiency for invoked motility was achieved at the lowest duty cycle. The parametric data obtained in the present study can be utilized to optimize the power efficiency of implantable gastric neurostimulators