Keywords
gastroparesis, niche, therapy, nerve, stimulation, bibliometric
Gastroparesis is a condition characterized by the accumulation of bile salts. It is prevalent globally, with a global prevalence of 0.9% and 1.3% in individuals with diabetes. New techniques for diagnosing gastroparesis, such as bile salt titration and nitric oxide sulfate, can improve patient care. However, simptomatic control is needed to increase gastric salts, reduce inflammation, and control potential diseases. Gastroparesis can cause complications like weight loss, malnutrition, and gastrointestinal changes that cannot be predicted. Neurological techniques like gyroscope stimulation and endoscopy (G-POEM) can help diagnose refractive gastroparesis. Interdisciplinary collaboration is crucial in addressing gastroparesis issues, and bibliometric research is essential for finding effective new treatments.
In this work, a literature review methodology is employed to gather data from the Scopus database using the keywords neuroaid. Data were analyzed using Biblioshiny and VOSviewer software to produce visualizations and bibliometric maps. We conducted quantitative and qualitative analysis.
The research trend found are documents by year, most relevant sources, factorial map of the most cited documents, factorial map of The documents with the highest contributes, documents by author, documents by country or territory, documents by subject area, documents by affiliation, network visualization, overlay visualization of scopus database using vosviewer, density visualization, thematic map, thematic evolution, cluster analysis, topic dendogram, and country collaboration map.
The study on gastroparesis identifies key themes such as diet modification, glucose control, and medication therapy. It also discusses the role of Cajal in smooth muscle concentration, common causes of gastroparesis, and transcutaneous stimulation. The study also explores motorcycle themes, such as the vagus nerve, and emerging themes like devices and electronics. Basic themes include gastrointestinal disorders, neuromodulation, patients, diabetes, and gastric electrical stimulation. Management involves multidisciplinary approaches, lifestyle changes, medication therapy, and bedtime interventions.
gastroparesis, niche, therapy, nerve, stimulation, bibliometric
A disorder called gastroparesis is characterized by a delayed stomach emptying.1–3 The global prevalence of gastroparesis-like symptoms (GPLS) was 0.9% overall and 1.3% among individuals with diabetes.1,2 In the US, the prevalence of gastroparesis is estimated to be approximately 267.7 per 100,000 adults.1,2
Gastroparesis is usually diagnosed based on clinical symptoms and delayed gastric emptying demonstrated by imaging tests.1–3 New techniques for assessing gastric emptying, such as the gastric emptying breath test and wireless motility capsules, allow clinicians to better characterize their patients.2
The goals of symptomatic control, notwithstanding the limitations of existing treatments, are to improve stomach emptying, reduce nausea and vomiting, and manage related abdominal discomfort.4 Other possible treatments target bacterial overgrowth, enhance stomach accommodation or pyloric dysfunction, and lessen acid production.4
Gastroparesis can cause complications such as severe dehydration, malnutrition, and unpredictable blood sugar changes.5
Gastric electrical stimulation (GERD) and oral endoscopic pyloric myotomy (G-POEM) are some of the neurological techniques that can help treat refractory gastroparesis.6
Finding the right therapy for gastroparesis is essential because it can improve the patient's quality of life and reduce complications associated with this condition.2,4
Collaboration between interdisciplinary scientists is very important in overcoming the problem of gastroparesis. An interdisciplinary approach allows professionals to approach patient care from multiple perspectives.1
Bibliometric research is essential in the search for effective new therapies. By analyzing scientific publications in this field, researchers can identify research trends and discover areas that require further research.1,2
Bibliometric research is a research method that uses scientific publication data to describe and analyze the development of a field of science. This research aims to identify and map trends, patterns, and relationships between scientific documents related to certain topics. In this research, the topic chosen was gastroparesis, therapy, and “nerve stimulation”. This research uses data from the website www.scopus.com, which is one of the largest and most trusted databases for scientific publications. This research was conducted on early June 2024.
To carry out bibliometric research, the steps to follow are as follows:
1. Determine search keywords. In this research, the keywords used are gastroparesis, therapy, and “nerve stimulation”. These keywords are entered into the search column on the www.scopus.com site by selecting the topic field (title, abstract, keywords).
2. Filter search results. In this study, were not filtered.
3. Get data from search results. In this study, search result data is retrieved in three different formats:
In this study we found are documents by year has been an increase in the number of documents; until 2023, there were 5 documents, most relevant sources is journal of neurogastroenterology and mobility, factorial map of the most cited documents following is a summary of a study entitled Bioelectric neuromodulation for gastrointestinal disorders: effectiveness and mechanisms by Payne SC, published in the journal Nature Reviews Gastroenterology & Hepatology, Factorial map of the documents with the highest contributes entitled Clinical trial: interferential electric stimulation in functional dyspepsia patients: a prospective randomized study by Koklu S, published in the journal Alimentary Pharmacology & Therapeutics.
Documents by author with 5 documents are Yin, J., documents by country or territory is United States is the country with the largest number of document producers 46 documents, documents by subject area, network visualization, overlay visualization of scopus database using vosviewer, density visualization, thematic map based on the title shows that the niche theme is the keyword mitochondria signaling pathway, effects neuroprotective effect, dan oxidative stres toxicity, thematic evolution, cluster analysis, qualitative analysis, and word cloud.
We used the following terms to do a search on the Scopus website, taking into consideration that this website contains research that is considered to be valid: TITLE – ABS – KEY (gastroparesis) AND TITLE – ABS – KEY (therapy) AND TITLE – ABS – KEY (“nerve stimulation”) are the titles of the products that are under consideration. fifty-nine documents were received by us. We then save the document from Scopus in the form of a file with the extension.csv file following this step.
Both the Biblioshiny and Vosviewer software packages were utilised in the analysis process.
Documents by year
Based on Figure 1, it appears that there has been an increase in the number of documents, until in 2023 there were 5 documents. The oldest document in 2002 was entitled Gastric electrical stimulation in intractable symptomatic gastroparesis., written by Abell, T. L et al.,7 Next is the article entitled Physiology and pathophysiology of the interstitial cells of cajal: From bench to bedside VI. Pathogenesis and therapeutic approaches to human gastric dysrhythmias written by Owyang, C., and Hasler, W.L.8 Meanwhile, the latest document in 2024 is entitled F Non-invasive neuromodulation: an emerging intervention for visceral pain in gastrointestinal disorders written by Alam, M.J. and Chen, J.D.Z.9 Next is the article entitled Transcutaneous electrical stimulation for gastrointestinal motility disorders written by Song, G. et al,10 next article is Gastric peroral endoscopic myotomy for management of refractory gastroparesis in patients with gastric neurostimulator devices: a multicenter retrospective case control study written by Ichkhanian, Y. et al.11 next article is Electroceuticals for Neurogastroenterology and Motility Disorders written by Jiang, Y. and Soffer, E.12 And next article is Noninvasive electrical neuromodulation for gastrointestinal motility disorders written by Yin, J. and Chen, J.D.Z.13
Most relevant sources
Based on Figure 2, the following are the journals that publish the most important documents: The first is neurogastroenterology and mobility. This journal has been indexed in Scopus. The Journal of Neurogastroenterology and Motility is published by Wiley-Blackwell Publishing Ltd. The SJR (Scientific Journal Rankings) for Neurogastroenterology and Motility in 2023 is 0.944. The H-index for neurogastroenterology and mobility is 126. This journal accepts articles that focus on the fields of gastroenterology and neurology, especially those related to gastrointestinal motility. Some topics that frequently appear in publications in this journal include, but are not limited to, the pathophysiology and treatment of gastroparesis, esophageal smooth muscle phenotype in achalasia, retrograde cricopharyngeus dysfunction, and the effects of trimebutine and rifaximin on glucose breath testing in patients with functional bloating.
Title | Document | Reference No. |
---|---|---|
Cutaneous | 11 documents | 7,9,10,12,13,15,19,25–30 |
Non cutaneus | 48 documents | 1–6,8,11,14,16–18,20–24,31–71 |
In second place is the journal Neuromodulation. This journal has been indexed in Scopus. The Journal of Neuromodulation is published by Elsevier on behalf of the International Neuromodulation Society. The SJR (Scientific Journal Rankings) for neuromodulation in 2023 is 0.827. The H-index for neuromodulation is 77. This journal accepts papers focused on the field of neuromodulation, including clinical, translational, and basic research. Some topics that frequently appear in this journal's publications include, but are not limited to, pain, headaches, movement disorders, spasticity, paralysis, psychiatric disorders, epilepsy, sensory deprivation, gastric dysfunction, obesity, and incontinence.
In third place is the American Journal of Physiology—Gastrointestinal. This journal has been indexed in Scopus since 1980. The American Journal of Physiology—Gastrointestinal is published by the American Physiological Society. The SJR (Scientific Journal Rankings) for the American Journal of Physiology-Gastrointestinal in 2023 is 1,383. The H-index for the American Journal of Physiology-Gastrointestinal is 191. Original research on any area of the gastrointestinal tract, hepatobiliary system, or pancreas, whether normal or pathological, is welcome to be published in this publication. Manuscripts pertaining to these organs' growth and development, digestion, secretion, absorption, metabolism, and motility are all welcome, as are research reports on immune and inflammatory processes, as well as those involving neural, endocrine, and circulatory control mechanisms.
Factorial map of the most cited documents
Based on Figure 3, the following is a summary of a study entitled Bioelectric neuromodulation for gastrointestinal disorders: effectiveness and mechanisms by Payne SC, published in the journal Nature Reviews Gastroenterology & Hepatology.14
This study examines the use of electrical stimulation of nerves or brain centers as a therapeutic tool being tested in a variety of human diseases, including Parkinson's disease, arthritis, depressive disorders, schizophrenia, pain, and bladder dysfunction.14
Neuromodulation, bioelectrical neuromodulation, or electroceuticals are terms used to describe this therapy. The clinical community is very interested in the potential application of bioelectric neuromodulation to treat gastrointestinal-related illnesses, and several gastrointestinal tract sites have been studied for a variety of conditions.14
In many cases, The variability of outcomes and the lack of clarity around mechanisms of action pose significant therapeutic problems (such as the ideal stimulus settings) that have already been discussed in other reviews. Sacral nerve stimulation for fecal incontinence is still the sole widely utilized neuromodulation protocol for gastrointestinal problems, despite the fast advancements in bioelectrical neuromodulation technology during the past ten years.14
Success rates for treating various ailments like IBD, obesity, nausea, and gastroparesis have varied. By gaining more insight into the targeted brain circuits and their physiological and pathological roles, improving stimulation protocols, and identifying the patients who would benefit most from these therapies, the therapeutic effectiveness of these bioelectric neuromodulation therapies may be increased.14
Factorial map of the documents with the highest contributes
In Figure 4, the following is a summary of the study entitled Clinical trial: interferential electric stimulation in functional dyspepsia patients: a prospective randomized study by Koklu S, published in the journal Alimentary Pharmacology & Therapeutics.15
This study aimed to analyze if transcutaneous electrical stimulation is a treatment that works for patients with functional dyspepsia. Functional dyspepsia patients were randomly assigned to vacuum interference flow (IFC) and placebo groups. Both treatments consisted of 12 sessions given over 4 weeks.15
The outcomes demonstrated that while heartburn and vomiting did not significantly change in the placebo group, all symptoms in the therapy group—aside from early satiety—improved during and after treatment sessions. During treatment sessions, it was demonstrated that IFC therapy was more effective than placebo in terms of pyrosis, bloating, early satiety, and post-meal satiety.15
Vacuum IFC was demonstrated to be more effective than a placebo one month following the treatment session in terms of early satiety and stomach ulcers. To sum up, vacuum IFC is a successful, non-invasive treatment for functional dyspepsia. Patients with drug-resistant functional dyspepsia may benefit from a novel kind of treatment called transcutaneous electrical stimulation.15
Documents by author
Based on Figure 5. the most authors with 5 documents are Yin, J., with the titles of several articles, namely: A novel approach in spinal cord stimulation for enhancing gastric motility: A preliminary study on canines, Emerging Gastric Stimulation for Dysmotility Disorder and Obesity, Electrical therapies for gastrointestinal motility disorders, Ameliorating effect of transcutaneous electroacupuncture on impaired gastric accommodation induced by cold meal in healthy subjects, and Gastric neuromodulation with Enterra system for nausea and vomiting in patients with gastroparesis.16–20
The next most author with 4 documents is Chen, J.D.Z., with the titles of several articles, namely: A novel approach in spinal cord stimulation for enhancing gastric motility: A preliminary study on canines, Electrical therapies for gastrointestinal motility disorders, Gastric neuromodulation with Enterra system for nausea and vomiting in patients with gastroparesis, and Effects and mechanisms of electrical stimulation of the stomach, duodenum, ileum, and colon on gastric tone in dogs.16,18,20,21
The next most author with 4 documents is McCallum, R.W., with the titles of several articles, namely Surgical approaches to treatment of gastroparesis: Gastric electrical stimulation, pyloroplasty, total gastrectomy and enteral feeding tubes, Gastric neuromodulation with Enterra system for nausea and vomiting in patients with gastroparesis, Treatment of Refractory Gastroparesis: Gastric and Jejunal Tubes, Botox, Gastric Electrical Stimulation, and Surgery, and Gastrointestinal Electrical Stimulation for Treatment of Gastrointestinal Disorders: Gastroparesis, Obesity, Fecal Incontinence, and Constipation.20,22–24
Documents by country or territory
Based on Figure 6, the United States is the country with the largest number of document producers 46 documents. Followed by Canada with 4 documents, China with 4 documents, and Germany with 3 documents.
Documents by subject area (Table 1, Figure 7)
Documents by affiliation
Based on Figure 8, in first place, the producer of the most documents is affiliated with the John Hopkins University with 5 documents, next in second place is affiliated with John Hopkins University School of Medicine with 4 documents and next is the Texas Tech University Health Sciences Center with 4 documents.
Network visualization
Based on Figure 9, it can be seen that the areas studied are still not related to other areas that are divided into edges. That field is: stomach motility, electrode, electrodes implanted, diabetic stomach paresis, heart arrhythmia, diet therapy, animal experiment, irritable colon, and gabapentin.
Overlay visualization of scopus, database using Vosviewer
Based on Figure 10. In the overlay visualization, it appears that the keywords that are being researched a lot approaching 2018 are the parts colored yellow, namely: diabetic stomach paresis, abdominal pain, physiology, procedures, electrotherapy, innervation, neuromodulation, sacral nerve stimulation, gastrointestinal disease, and gastrointestinal diseases.
Density visualization
Based on Figure 11. In the visual circulation density, it appears that the part that is already saturated with research is yellow, while the part that is not yet saturated is slightly yellow and dominantly green, namely keywords: clinical article, stomach motility, young adult, electrodes implanted, electrode, animal experiment, diabetic stomach paresis, major clinical study, abdominal pain, diabetes mellitus, physiology, animals, disease severity, therapy effect case report, antiemetic agent, pyloroplastu, prokinetic agent, pyloromyotomy, gastrecromy, tegaserod, domperidone, clinical feature, cisapride, heart arrhtymia, diet therapy, gabapentin, prevalence, electrostimulation therapy, dyspepsia, irritable colon, gastrointestinal motility diso, gastrointestinal disease, gastrointestinal diseases. Sacral nerve stimulation, gastrointestinal tract, neuromodulation, electroacunpuncture, intestine innervation, innervation, animal, animals, and gastrointestinal motility.
Thematic map
Based on Figure 12, Based on the thematic map, it can be explained as follows: Upper Left Quadrant (Niche and Emerging/Declining Themes): This quadrant contains keywords such as “pain,” “transcutaneous,” “prospective clinical study,” and “cable approaches.” This indicates a focus on innovative clinical studies related to pain management via transcutaneous methods.
Top Right Quadrant (Motor and Emerging/Declining Themes)*: This quadrant is empty, indicating that there may be little innovation currently or waning interest in this area. Bottom Left Quadrant (Niche and Basic Themes)*: This quadrant includes keywords such as “arterra electronic devices,” indicating a focus on electronic devices in the context of medical applications that are considered niche but basic.
Lower Right Quadrant (Motor and Basic Themes): This quadrant represents basic motor themes with keywords such as “vagal nerve emerging,” “gastric electrical stimulation,” and larger keyword clusters including “diabetic gastroparesis” and “gastrointestinal neuromodulation." This represents an established medical practice that focuses on electrical stimulation for conditions such as diabetic gastroparesis.
Each keyword or keyword cluster provides insight into a specific area of medical research or practice, indicating what is currently niche or basic and what is considered emerging or declining within this thematic area.
Thematic evolution
Based on Figure 13, There was an evolution of changes in themes in research in 2002–2016 with the keywords motility, gastrointestinal, diabetic, gastroparesis, and prospective. The theme then changed in 2017–2023 to gastrointestinal, stimulation, gastroparesis, and management.
Topic dendogram
Based on Figure 14. There are 2 large clusters based on keywords. There are 2 clusters of blue and red.
Country collaboration map
Based on Figure 15. Intense cooperation in this field is only carried out by China and the United States.
The most important thing in bibliometric studies on the topic of gastroparesis therapy with nerve stimulation is to look for niche themes and map things that researchers have started to leave behind.
The following is a more detailed and sequential explanation of the keywords in the thematic map:
Niche Themes
The approach to treating gastroparesis involves a variety of strategies, including diet modification, blood glucose control, and pharmacologic therapy with prokinetics and antiemetics.41,66,70
Cajal refers to the Interstitial Cells of Cajal (ICC), which act as pacemaker cells in the digestive tract and play an important role in coordinating smooth muscle contractions. Disruption or loss of ICC has been associated with several GI motility disorders, including gastroparesis.66
Pain is a common symptom of gastroparesis. The pain usually occurs in the upper abdominal area and can vary from dull to sharp.37
Transcutaneous refers to therapy that involves nerve stimulation through the skin without the need for surgery. In the context of gastroparesis, transcutaneous therapies such as transcutaneous vagus nerve stimulation have been investigated and show potential for reducing symptoms.66,70
In the context of gastroparesis, accommodation refers to the stomach's ability to relax and adjust to the volume of incoming food. Impairments in gastric accommodation may contribute to the symptoms of gastroparesis.41,66
Much research has been and is being conducted to better understand this condition and develop more effective therapies.43,57
In the context of medical research, a prospective study is a type of research that follows subjects over time to observe specific outcomes. Prospective studies are often used in gastroparesis research to better understand how this condition develops and responds to therapy.37,66
The vagus nerve is a cranial nerve that plays an important role in various body functions, including the control of muscle movements in digestion. In the context of gastroparesis, damage to the vagus nerve can cause delayed gastric emptying.37,41 Some therapies in development include relamorelin, prucalopride, and aprepitant.41,66,70
The word devices may refer to the tools or devices used in gastric electrical stimulation therapy. However, more specific information may require further research.41,66,70
The word electronic may refer to the electronic aspects of gastric electrical stimulation therapy, such as how the device generates and sends electrical signals to the stomach muscles.41,66,70
Enterra refers to Enterra Therapy, a medical treatment designed to help control chronic nausea and vomiting associated with gastroparesis. This therapy works through what is known as gastric electrical stimulation (GES). Gastric electrical stimulation involves stimulating the smooth muscles in the lower abdomen with mild electrical pulses.70
The word gastrointestinal refers to the digestive system, which includes the stomach and intestines. Gastroparesis is a gastrointestinal disorder that affects the normal function of the stomach.66
The word disorders” refers to disorders or medical conditions that affect the normal function of the stomach and digestive tract. Gastroparesis is a gastrointestinal disorder that affects the normal function of the stomach.
Neuromodulation is a technique used to regulate neural activity by stimulating or inhibiting nerve signals. In the context of gastroparesis, neuromodulation may be used to help control symptoms.41,66,70
Gastroparesis is a condition characterized by delayed gastric emptying and symptoms such as nausea, vomiting, early satiety, bloating, and upper abdominal pain.43,50,57
Patients, This refers to individuals diagnosed with gastroparesis and undergoing treatment. Management of patients with gastroparesis involves a multidisciplinary approach that includes lifestyle changes, pharmacologic therapy, and, in some cases, surgical intervention.50
Gastroparesis often occurs in individuals with diabetes, and this condition is known as diabetic gastroparesis. Diabetes can cause damage to the vagus nerve, which controls muscle movement in digestion, causing gastroparesis.37
Gastric electrical stimulation is a procedure in which a small device that produces mild electrical pulses is implanted in the patient's body. This device helps promote the movement of food through the stomach more easily and controls symptoms associated with gastroparesis such as nausea and vomiting.66
The bibliometric topic study on gastroparesis focuses on identifying niche themes and discussing factors currently being studied. Key themes include interventions like diet modification, glucose control, and medication therapy with prokinetics and antiemetics. Cajal, or interstitial cajal, is crucial in coordinating smooth muscle concentration. Neighbors are common causes of gastroparesis, and transcutaneous stimulation, such as transcutaneous vagus stimulation, has been studied to develop more effective treatments. Prospective studies take time to analyze specific results. Motorcycle themes involve the vagus nerve, which controls muscle flow in medicine, and damage to it can cause gastroparesis. Emerging or declining themes include devices, electronics, and Enterra stimuli used in gastroparesis treatment. Basic themes include gastrointestinal disorders, neuromodulation, patients, diabetes, and gastric electrical stimulation. Gastroparesis, a condition affecting normal bowel function, is often associated with diabetes. Management involves multidisciplinary approaches, lifestyle changes, medication therapy, and bedtime interventions.
VOSviewer software is an open-access tool that can be used as a cost-effective method for any scientometric analysis72
Figshare: Transcutaneous stimulation as a niche theme in gastroparesis therapy
DOI: https://doi.org/10.6084/m9.figshare.25991923.v1. 73
Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).
Views | Downloads | |
---|---|---|
F1000Research | - | - |
PubMed Central
Data from PMC are received and updated monthly.
|
- | - |
Are the rationale for, and objectives of, the Systematic Review clearly stated?
Partly
Are sufficient details of the methods and analysis provided to allow replication by others?
Yes
Is the statistical analysis and its interpretation appropriate?
I cannot comment. A qualified statistician is required.
Are the conclusions drawn adequately supported by the results presented in the review?
Partly
If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.)
Not applicable
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Gastroenterology
Are the rationale for, and objectives of, the Systematic Review clearly stated?
No
Are sufficient details of the methods and analysis provided to allow replication by others?
Yes
Is the statistical analysis and its interpretation appropriate?
I cannot comment. A qualified statistician is required.
Are the conclusions drawn adequately supported by the results presented in the review?
No
If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.)
Not applicable
References
1. Ducrotte P, Coffin B, Bonaz B, Fontaine S, et al.: Gastric Electrical Stimulation Reduces Refractory Vomiting in a Randomized Crossover Trial.Gastroenterology. 2020; 158 (3): 506-514.e2 PubMed Abstract | Publisher Full TextCompeting Interests: No competing interests were disclosed.
Reviewer Expertise: Gastric motility,
Alongside their report, reviewers assign a status to the article:
Invited Reviewers | ||
---|---|---|
1 | 2 | |
Version 2 (revision) 22 Oct 24 |
||
Version 1 18 Jun 24 |
read | read |
Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
Sign up for content alerts and receive a weekly or monthly email with all newly published articles
Already registered? Sign in
The email address should be the one you originally registered with F1000.
You registered with F1000 via Google, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Google account password, please click here.
You registered with F1000 via Facebook, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Facebook account password, please click here.
If your email address is registered with us, we will email you instructions to reset your password.
If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance.
Comments on this article Comments (0)