Effects of transcranial direct current stimulation on esophageal motility in patients with gastroesophageal reflux disease |
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| Affiliation: | 1. Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy;2. Department of Emergency Surgery – Digestive Motility Section, University of Palermo, Italy;3. Santa Maria del Prato Hospital, Feltre, Italy;1. Centre for Digestive Diseases, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK;2. Gastrointestinal Physiology Unit, Barts Health NHS Trust, Royal London Hospital, London, UK;1. Department of Surgery, Hamad Medical Corporation, Doha, Qatar;2. Trauma Surgery Section, Hamad General Hospital, Doha, Qatar;3. Clinical Research, Hamad General Hospital, Doha, Qatar;4. Weill Cornell Medical College, Doha, Qatar;5. Department of Surgery, Arizona University, Tucson, AZ, United States;1. Section of Digestive Disease and Nutrition, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;2. Division of Gastroenterology, Department of Medicine, Oklahoma Foundation for Digestive Research, Oklahoma University School of Medicine, 525 Northwest 9th Street, Suite 325, Oklahoma City, OK 73102, USA |
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| Abstract: | ObjectiveTo evaluate the effects of transcranial direct current stimulation (tDCS) on esophageal peristalsis in patients with gastroesophageal reflux disease (GERD).MethodsPatients with GERD preliminary diagnosis were included in a randomized double-blind sham-controlled study. Esophageal manometry was performed before and during transcranial direct current stimulation (tDCS) of the right precentral cortex. Half of patients were randomly assigned to anodal, half to sham stimulation. Distal waves amplitude and pathological waves percentage were measured, after swallowing water boli, for ten subsequent times. Last, a 24 h pH-bilimetry was done to diagnose non-erosive reflux disease (NERD) or functional heartburn (FH). The values obtained before and during anodal or sham tDCS were compared.ResultsSixty-eight patients were enrolled in the study. Distal waves mean amplitude increased significantly only during anodal tDCS in NERD (p = 0.00002) and FH subgroups (p = 0.008) while percentage of pathological waves strongly decreased only in NERDs (p = 0.002).ConclusionsTranscranial stimulation can influence cortical control of esophageal motility and improve pathological motor pattern in NERD and FH but not in erosive reflux disease (ERD) patients.SignificancePathophysiological processes in GERD are not only due to peripheral damage but to central neural control involvement as well. In ERD patients dysfunctions of the cortico-esophageal circuit seem to be more severe and may affect central nervous system physiology. |
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| Keywords: | tDCS Distal amplitude Pathological waves NERD ERD Sensitization |
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