O58 Neuromuscular dysfunction in patients with nausea and vomiting syndrome defined by body surface gastric mapping
Bibliographic record
Abstract
Introduction Gastroparesis and chronic nausea and vomiting syndromes are debilitating disorders of unclear etiology. Neuromuscular abnormalities, including interstitial cell of Cajal deficits, have consistently been shown to be a feature of these diseases, such that they may lie on the same disease spectrum. Gastric emptying studies fail to distinguish these abnormalities and their utility is controversial. Body surface gastric mapping (BSGM, high-resolution electrogastrography) is a new non-invasive diagnostic modality that provides direct biomarkers of gastric neuromuscular activity. Methods 42 patients with NVS were matched by age, sex, and BMI to 42 healthy controls. Gastric mapping was performed using Gastric Alimetry (Alimetry, New Zealand), employing a conformable high-resolution 64 electrode array coupled to a wearable reader and a validated symptom logging App. A 30-minute baseline recording was followed by a standardized 482 kcal meal, and then 4 hours of post-prandial recording with continuous symptom logging. Results Patients with NVS showed neuromuscular function abnormalities compared to controls, including attenuated amplitudes (median 23.6 vs 37.1 µV postprandially; p<0.001) and impaired meal responses (fed to fasting power ratio of 1.2 vs 1.6; p=0.013). Novel spatial biomarkers revealed unstable myoelectrical activity in patients, with reduced spatial frequency stability (13.6 vs 50.6; p<0.001), and reduced average spatial covariance (0.49 vs 0.52; p=0.002). Dominant frequency variance was also greater in patients (s.d. 0.7 vs 0.4; p<0.001). However, a significant patient subgroup (45.2%) showed normal (n=15) or hyperactive (n=1) gastric activity, with all biomarkers comparable to controls (p>0.1). This suggests more than one phenotype within the NVS cohort. Neuromuscular function biomarkers correlated with symptoms (excessive fullness, early satiety, bloating, heartburn, nausea, pain, and GCSI score all r>0.4; p<0.05). Conclusions Body surface gastric mapping is a new test of gastric function. NVS patients were found to frequently demonstrate gastric neuromuscular abnormalities, characterized by weaker gastric activity, impaired meal responses, and spatially unstable myoelectrical activity, which correlated with symptoms. However, 45% of NVS patients in this cohort had normal gastric activity, indicating other disease phenotypes. These data indicate that disease phenotypes in NVS may be clinically separated using Gastric Alimetry.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".