Niranchan Paskaranandavadivel

Comparison of filtering methods for extracellular gastric slow wave recordings.

Background Extracellular recordings are used to define gastric slow wave propagation. Signal filtering is a key step in the analysis and interpretation of extracellular slow wave data; however, there is controversy and uncertainty regarding the appropriate filtering settings. This study investigated the effect of various standard filters on the morphology and measurement of extracellular gastric slow waves.

The bioelectrical basis and validity of gastrointestinal extracellular slow wave recordings

•  Extracellular recording techniques are commonly used to measure bioelectrical activity. However, the validity of gastrointestinal extracellular recordings has recently been challenged. •  In this joint experimental and modelling study, slow waves were recorded during contractile inhibition, biphasic and monophasic slow wave potentials were recorded simultaneously, and the biophysical basis of extracellular potentials was modelled with comparison to experimental data. •  The results showed that in vivo extracellular techniques reliably recorded slow waves in the absence of contractions, and potentials recorded using conventional serosal electrodes (biphasic) were concordant in phase and morphology with those recorded using suction electrodes (monophasic). •  Modelling further demonstrated that the morphology of experimental recordings is consistent with the biophysics underlying slow wave depolarisation. •  In total, these results demonstrate that gastrointestinal extracellular recordings are valid when performed and analysed correctly, reliably representing bioelectrical slow wave events. Motion suppression is not routinely required for in vivo extracellular studies.

Circumferential and functional re‐entry of in vivo slow‐wave activity in the porcine small intestine

Slow‐waves modulate the pattern of small intestine contractions. However, the large‐scale spatial organization of intestinal slow‐wave pacesetting remains uncertain because most previous studies have had limited resolution. This study applied high‐resolution (HR) mapping to evaluate intestinal pacesetting mechanisms and propagation patterns in vivo.

Improved signal processing techniques for the analysis of high resolution serosal slow wave activity in the stomach

High resolution electrical mapping of slow waves on the stomach serosa has improved our understanding of gastric electrical activity in normal and diseased states. In order to assess the signals acquired from high resolution mapping, a robust framework is required. Our framework is semi-automated and allows for rapid processing, analysis and interpretation of slow waves via qualitative and quantitative measures including isochronal activation time mapping, and velocity and amplitude mapping. Noise removal techniques were validated for raw recorded signals, where three filters were evaluated for baseline drift removal and three filters for removal of high frequency interference. For baseline drift removal, the Gaussian moving median filter was most effective, while for eliminating high frequency interference the Savitzky Golay filter was the most effective. Methods for assessing slow wave velocity and amplitude were investigated. To estimate slow wave velocity, a finite difference approach with interpolation and smoothing was used. To evaluate the slow wave amplitude and width, a peak and trough method based on Savitzky Golay derivative filters was used. Together, these methods constitute a significantly improved framework for analyzing gastric high resolution mapping data.

An Improved Method for the Estimation and Visualization of Velocity Fields from Gastric High-Resolution Electrical Mapping

High-resolution (HR) electrical mapping is an important clinical research tool for understanding normal and abnormal gastric electrophysiology. Analyzing velocities of gastric electrical activity in a reliable and accurate manner can provide additional valuable information for quantitatively and qualitatively comparing features across and within subjects, particularly during gastric dysrhythmias. In this study, we compared three methods of estimating velocities from HR recordings to determine which method was the most reliable for use with gastric HR electrical mapping. The three methods were 1) simple finite difference (FD) 2) smoothed finite difference (FDSM), and 3) a polynomial-based method. With synthetic data, the accuracy of the simple FD method resulted in velocity errors almost twice that of the FDSM and the polynomial-based method, in the presence of activation time error up to 0.5 s. With three synthetic cases under various noise types and levels, the FDSM resulted in average speed error of 3.2% and an average angle error of 2.0° and the polynomial-based method had an average speed error of 3.3% and an average angle error of 1.7 °. With experimental gastric slow wave recordings performed in pigs, the three methods estimated similar velocities (6.3-7.3 mm/s), but the FDSM method had a lower standard deviation in its velocity estimate than the simple FD and the polynomial-based method, leading it to be the method of choice for velocity estimation in gastric slow wave propagation. An improved method for visualizing velocity fields is also presented.

Multi-channel wireless mapping of gastrointestinal serosal slow wave propagation.

High‐resolution (HR) extracellular mapping allows accurate profiling of normal and dysrhythmic slow wave patterns. A current limitation is that cables traverse the abdominal wall or a natural orifice, risking discomfort, dislodgement or infection. Wireless approaches offer advantages, but a multi‐channel system is required, capable of recording slow waves and mapping propagation with high fidelity.

Experimental and Automated Analysis Techniques for High-resolution Electrical Mapping of Small Intestine Slow Wave Activity.

Background/Aims Small intestine motility is governed by an electrical slow wave activity, and abnormal slow wave events have been associated with intestinal dysmotility. High-resolution (HR) techniques are necessary to analyze slow wave propagation, but progress has been limited by few available electrode options and laborious manual analysis. This study presents novel methods for in vivo HR mapping of small intestine slow wave activity. Methods Recordings were obtained from along the porcine small intestine using flexible printed circuit board arrays (256 electrodes; 4 mm spacing). Filtering options were compared, and analysis was automated through adaptations of the falling-edge variable-threshold (FEVT) algorithm and graphical visualization tools. Results A Savitzky-Golay filter was chosen with polynomial-order 9 and window size 1.7 seconds, which maintained 94% of slow wave amplitude, 57% of gradient and achieved a noise correction ratio of 0.083. Optimized FEVT parameters achieved 87% sensitivity and 90% positive-predictive value. Automated activation mapping and animation successfully revealed slow wave propagation patterns, and frequency, velocity, and amplitude were calculated and compared at 5 locations along the intestine (16.4 ± 0.3 cpm, 13.4 ± 1.7 mm/sec, and 43 ± 6 µV, respectively, in the proximal jejunum). Conclusions The methods developed and validated here will greatly assist small intestine HR mapping, and will enable experimental and translational work to evaluate small intestine motility in health and disease.

A theoretical study of the initiation, maintenance and termination of gastric slow wave re-entry

UNLABELLED Gastric slow wave dysrhythmias are associated with motility disorders. Periods of tachygastria associated with slow wave re-entry were recently recognized as one important dysrhythmia mechanism, but factors promoting and sustaining gastric re-entry are currently unknown. This study reports two experimental forms of gastric re-entry and presents a series of multi-scale models that define criteria for slow wave re-entry initiation, maintenance and termination. High-resolution electrical mapping was conducted in porcine and canine models and two spatiotemporal patterns of re-entrant activities were captured: single-loop rotor and double-loop figure-of-eight. Two separate multi-scale mathematical models were developed to reproduce the velocity and entrainment frequency of these experimental recordings. A single-pulse stimulus was used to invoke a rotor re-entry in the porcine model and a figure-of-eight re-entry in the canine model. In both cases, the simulated re-entrant activities were found to be perpetuated by tachygastria that was accompanied by a reduction in the propagation velocity in the re-entrant pathways. The simulated re-entrant activities were terminated by a single-pulse stimulus targeted at the tip of re-entrant wave, after which normal antegrade propagation was restored by the underlying intrinsic frequency gradient. MAIN FINDINGS (i) the stability of re-entry is regulated by stimulus timing, intrinsic frequency gradient and conductivity; (ii) tachygastria due to re-entry increases the frequency gradient while showing decreased propagation velocity; (iii) re-entry may be effectively terminated by a targeted stimulus at the core, allowing the intrinsic slow wave conduction system to re-establish itself.

Quantification of velocity anisotropy during gastric electrical arrhythmia

In this study, an automated algorithm was developed to identify the arrhythmic gastric slow wave activity that was recorded using high-resolution mapping technique. The raw signals were processed with a Savitzky-Golay filter, and the slow wave activation times were identified using a threshold-varying method and grouped using a region-growing method. Slow wave amplitudes and velocities were calculated for all cycles. Arrhythmic events were identified when the orientation of a slow wave at an electrode exceeded the 95% confidence interval of the averaged orientation of several normal cycles. A second selection criterion was further developed to identify the arrhythmic events by an anisotropy ratio. In both pig and human studies, arrhythmias were associated with the emergence of circumferential velocity components and higher amplitudes.

The virtual intestine: in silico modeling of small intestinal electrophysiology and motility and the applications.

The intestine comprises a long hollow muscular tube organized in anatomically and functionally discrete compartments, which digest and absorb nutrients and water from ingested food. The intestine also plays key roles in the elimination of waste and protection from infection. Critical to all of these functions is the intricate, highly coordinated motion of the intestinal tract, known as motility, which is coregulated by hormonal, neural, electrophysiological and other factors. The Virtual Intestine encapsulates a series of mathematical models of intestinal function in health and disease, with a current focus on motility, and particularly electrophysiology. The Virtual Intestine is being cohesively established across multiple physiological scales, from sub/cellular functions to whole organ levels, facilitating quantitative evaluations that present an integrative in silico framework. The models are also now finding broad physiological applications, including in evaluating hypotheses of slow wave pacemaker mechanisms, smooth muscle electrophysiology, structure–function relationships, and electromechanical coupling. Clinical applications are also beginning to follow, including in the pathophysiology of motility disorders, diagnosing intestinal ischemia, and visualizing colonic dysfunction. These advances illustrate the emerging potential of the Virtual Intestine to effectively address multiscale research challenges in interdisciplinary gastrointestinal sciences. WIREs Syst Biol Med 2016, 8:69–85. doi: 10.1002/wsbm.1324