Key result
Automated classifiers using autonomic and gastric myoelectric biomarkers achieved 89% accuracy in separating healthy controls from gastroparetic patients and 90% accuracy in separating diabetics with and without gastroparesis.
Why the study?
To identify autonomic and gastric myoelectric biomarkers that differentiate patients with gastroparesis, diabetics without gastroparesis, and healthy controls, while providing insight into etiology.
Does 24-hour ambulatory ECG and EGG monitoring differentiate patients with gastroparesis, diabetics without gastroparesis, and healthy controls?
Cross-Sectional (n=13)
No
Does 24-hour ambulatory ECG and EGG monitoring differentiate patients with gastroparesis, diabetics without gastroparesis, and healthy controls?
At-home 24-hour non-invasive autonomic and gastric myoelectric monitoring can successfully differentiate between healthy controls and various gastroparesis phenotypes with high accuracy.
May support non-invasive gastroparesis phenotyping; leaves open prospective validation before clinical use.
OBJECTIVE: The goal of this study was to identify autonomic and gastric myoelectric biomarkers from throughout the day that differentiate patients with gastroparesis, diabetics without gastroparesis, and healthy controls, while providing insight into etiology. METHODS: We collected 19 24-hour recordings of electrocardiogram (ECG) and electrogastrogram (EGG) data from healthy controls and patients with diabetic or idiopathic gastroparesis. We used physiologically and statistically rigorous models to extract autonomic and gastric myoelectric information from the ECG and EGG data, respectively. From these, we constructed quantitative indices which differentiated the distinct groups and demonstrated their application in automatic classification paradigms and as quantitative summary scores. RESULTS: We identified several differentiators that separate healthy controls from gastroparetic patient groups, specifically around sleep and meals. We also demonstrated the downstream utility of these differentiators in automatic classification and quantitative scoring paradigms. Even with this small pilot dataset, automated classifiers achieved an accuracy of 79% separating autonomic phenotypes and 65% separating gastrointestinal phenotypes. We also achieved 89% accuracy separating controls from gastroparetic patients in general and 90% accuracy separating diabetics with and without gastroparesis. These differentiators also suggested varying etiologies for different phenotypes. CONCLUSION: The differentiators we identified were able to successfully distinguish between several autonomic and gastrointestinal (GI) phenotypes using data collected while at-home with non-invasive sensors. SIGNIFICANCE: Autonomic and gastric myoelectric differentiators, obtained using at-home recording of fully non-invasive signals, can be the first step towards dynamic quantitative markers to track severity, disease progression, and treatment response for combined autonomic and GI phenotypes.
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Subramanian et al. (2023) conducted a cross-sectional in Gastroparesis (n=13). Autonomic and gastric myoelectric monitoring vs. Healthy controls was evaluated on Accuracy of automated classifiers separating controls from gastroparetic patients. Automated classifiers using autonomic and gastric myoelectric biomarkers achieved 89% accuracy in separating healthy controls from gastroparetic patients and 90% accuracy in separating diabetics with and without gastroparesis.
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