Noninvasive Quantification of Nausea Severity in Pediatric Functional Nausea

Background and Aims: Functional nausea is an idiopathic gastrointestinal disorder that is common in children, carries a substantial health-care cost, and lacks objective diagnostic testing, relying primarily on symptomatology with an otherwise normal diagnostic workup. We hypothesize that high-resol...

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Main Authors: Nicole D. Muszynski, Suseela Somarajan, Jordan D. Busing, Alexandra C. Russell, Sari A. Acra, Leonard A. Bradshaw
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Gastro Hep Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772572325000159
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author Nicole D. Muszynski
Suseela Somarajan
Jordan D. Busing
Alexandra C. Russell
Sari A. Acra
Leonard A. Bradshaw
author_facet Nicole D. Muszynski
Suseela Somarajan
Jordan D. Busing
Alexandra C. Russell
Sari A. Acra
Leonard A. Bradshaw
author_sort Nicole D. Muszynski
collection DOAJ
description Background and Aims: Functional nausea is an idiopathic gastrointestinal disorder that is common in children, carries a substantial health-care cost, and lacks objective diagnostic testing, relying primarily on symptomatology with an otherwise normal diagnostic workup. We hypothesize that high-resolution electrogastrogram (HR-EGG) spatiotemporal gastric slow wave parameters, reflective of known mechanisms of gastric uncoupling, are sensitive to nausea severity and can distinguish children with severe functional nausea when asymptomatic, from healthy pediatric controls. Methods: We compared nonrandomized fasted HR-EGG recordings from control subjects (N = 10; 11–17 years; 3 M/7F) with recordings from functional nausea patients (N = 10; 12–18 years; 1M/9F) with inactive nausea at time of testing but had experienced nausea in the preceding 2 weeks. We used a second-order blind identification algorithm to minimize signal artifacts, identify gastric sources, and calculate spatiotemporal gastric slow wave frequency and propagation dynamics. Results: Frequency dynamics showed significant differences between controls and patients in dominant frequency (2.7 ± 0.5 cycles per minute vs 2.2 ± 0.5 cycles per minute; P < .01), percentage of signal distribution in the normogastric range (59 ± 11.8% vs 46.5 ± 11%; P < .001), and bradygastric power percentage (20 ± 10.5% vs 28.1 ± 9.5%; P < .01). Propagation dynamics observed in patients were more complex and disordered, with significant differences in mean propagation direction (control: 223° ± 23°; patient: 20° ± 79°; P < .05), and propagation speed (P < .01). Conclusion: We demonstrate that spatiotemporal analysis of HR-EGG propagation profiles differentiates pediatric functional nausea patients from controls. Given the high incidence of anxiety in children with functional nausea, future investigations should explore the influence of state and trait anxiety on HR-EGG parameters via the gut–brain axis.
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spelling doaj-art-a9b1c4b5e55e425cbdb4ea3caf5bdbfd2025-08-20T03:48:50ZengElsevierGastro Hep Advances2772-57232025-01-014510062810.1016/j.gastha.2025.100628Noninvasive Quantification of Nausea Severity in Pediatric Functional NauseaNicole D. Muszynski0Suseela Somarajan1Jordan D. Busing2Alexandra C. Russell3Sari A. Acra4Leonard A. Bradshaw5Department of General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee; Vanderbilt Institute for Integrative Biosystems Research and Education, Vanderbilt University, Nashville, Tennessee; Correspondence: Address correspondence to: Nicole D. Muszynski, PhD, General Surgery Division, Vanderbilt University Medical Center North, 1161 21st Avenue, Nashville, Tennessee 37232.Department of General Surgery, Vanderbilt University Medical Center, Nashville, TennesseeDivision of Pediatric Gastroenterology, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TennesseeDivision of Pediatric Gastroenterology, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TennesseeDivision of Pediatric Gastroenterology, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TennesseeDepartment of General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Physics, Lipscomb University, Nashville, TennesseeBackground and Aims: Functional nausea is an idiopathic gastrointestinal disorder that is common in children, carries a substantial health-care cost, and lacks objective diagnostic testing, relying primarily on symptomatology with an otherwise normal diagnostic workup. We hypothesize that high-resolution electrogastrogram (HR-EGG) spatiotemporal gastric slow wave parameters, reflective of known mechanisms of gastric uncoupling, are sensitive to nausea severity and can distinguish children with severe functional nausea when asymptomatic, from healthy pediatric controls. Methods: We compared nonrandomized fasted HR-EGG recordings from control subjects (N = 10; 11–17 years; 3 M/7F) with recordings from functional nausea patients (N = 10; 12–18 years; 1M/9F) with inactive nausea at time of testing but had experienced nausea in the preceding 2 weeks. We used a second-order blind identification algorithm to minimize signal artifacts, identify gastric sources, and calculate spatiotemporal gastric slow wave frequency and propagation dynamics. Results: Frequency dynamics showed significant differences between controls and patients in dominant frequency (2.7 ± 0.5 cycles per minute vs 2.2 ± 0.5 cycles per minute; P < .01), percentage of signal distribution in the normogastric range (59 ± 11.8% vs 46.5 ± 11%; P < .001), and bradygastric power percentage (20 ± 10.5% vs 28.1 ± 9.5%; P < .01). Propagation dynamics observed in patients were more complex and disordered, with significant differences in mean propagation direction (control: 223° ± 23°; patient: 20° ± 79°; P < .05), and propagation speed (P < .01). Conclusion: We demonstrate that spatiotemporal analysis of HR-EGG propagation profiles differentiates pediatric functional nausea patients from controls. Given the high incidence of anxiety in children with functional nausea, future investigations should explore the influence of state and trait anxiety on HR-EGG parameters via the gut–brain axis.http://www.sciencedirect.com/science/article/pii/S2772572325000159High-Resolution ElectrogastrogramPediatricFunctional NauseaGastric Slow WaveGastrointestinal Motility
spellingShingle Nicole D. Muszynski
Suseela Somarajan
Jordan D. Busing
Alexandra C. Russell
Sari A. Acra
Leonard A. Bradshaw
Noninvasive Quantification of Nausea Severity in Pediatric Functional Nausea
Gastro Hep Advances
High-Resolution Electrogastrogram
Pediatric
Functional Nausea
Gastric Slow Wave
Gastrointestinal Motility
title Noninvasive Quantification of Nausea Severity in Pediatric Functional Nausea
title_full Noninvasive Quantification of Nausea Severity in Pediatric Functional Nausea
title_fullStr Noninvasive Quantification of Nausea Severity in Pediatric Functional Nausea
title_full_unstemmed Noninvasive Quantification of Nausea Severity in Pediatric Functional Nausea
title_short Noninvasive Quantification of Nausea Severity in Pediatric Functional Nausea
title_sort noninvasive quantification of nausea severity in pediatric functional nausea
topic High-Resolution Electrogastrogram
Pediatric
Functional Nausea
Gastric Slow Wave
Gastrointestinal Motility
url http://www.sciencedirect.com/science/article/pii/S2772572325000159
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