Transcutaneous neuromodulation improves symptoms in functional dyspepsia

Patients with functional dyspepsia (FD) may benefit from transcutaneous neuromodulation (TN) treatment, which can significantly improve symptoms and quality of life, according to a study.

Specifically, “TN treatment increases the percentage of normal gastric slow waves (GSW), reduces the proportion of gastric electrical rhythm disorder, and improves the gastric accommodation and gastric emptying rate,” the authors said.

Fifty-seven patients with FD were randomized into three groups: TN Neiguan (PC6), TN Zusanli (ST36), and sham. Participants received the corresponding treatment for 4 weeks. All patients then received TN PC6 combined with ST36 for an additional 4 weeks.

Symptom severity was assessed using the dyspepsia symptom questionnaire, short form health survey (SF-36), and Hospital Anxiety and Depression Scale. On the other hand, the pathological mechanism of FD was evaluated using gastric accommodation, gastric emptying rate, and related parameters of electrogastrogram.

The authors then examined the possible gastrointestinal hormonal mechanism involved by detecting serum ghrelin, neuropeptide Y, and vasoactive intestinal peptide. They also explored the possible duodenal inflammation mechanism involved by detecting duodenal mucosa.

Treatment with TN resulted in a reduction in the dyspepsia symptom score (p<0.05) and improvement in the quality of life. Increases in gastric accommodation (p<0.01), gastric emptying rate (p<0.01), and percentages of preprandial (p<0.05) and postprandial (p<0.05) GSW were observed after TN.

The proportions of preprandial (p<0.05) and postprandial (p<0.05) gastric electrical rhythm disorder decreased. Notably, the double acupoint combination therapy improved the therapeutic effect of the single acupoint.

Furthermore, significant increases in the levels of ghrelin (p<0.001) and neuropeptide Y (p<0.001) were observed, while that of vasoactive intestinal peptide (p<0.001) significantly decreased. The total number of mast cells (p<0.001) in the duodenal bulb also decreased following double acupoints combination therapy.

“The therapeutic effect of TN may be caused by regulating gastrointestinal hormone secretion and alleviating local inflammatory responses in duodenum,” the authors said. “In addition, the improvement of TN on GSW was closely related to the decrease of bradygastria.”