• Zhaoxiu Liu, Dewen Lu, Jie Guo, Yanmei Liu, Zhaohong Shi, Feng Xu, Lin Lin, and Chen Jiande D Z JDZ Ningbo Pace Translational Medical Research Center, Ningbo, China. Division of Gastro.
• Division of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
• Neuromodulation. 2019 Jul 1; 22 (5): 586-592.

BackgroundGastroesophageal reflux disease (GERD) is a common esophageal disorder. Transcutaneous electrical acustimulation (TEA), as a needleless method of electroacupuncture (EA) has been reported to improve hypotensive lower esophageal sphincters pressure (LESP) in GERD. Synchronized TEA (STEA) with inspiration has been revealed to be more effective than TEA in enhancing vagal tone.AimTo explore the effect of STEA on LESP in GERD and possible mechanisms involving autonomic functions.MethodsSixty patients were randomly allocated into a STEA group (45 patients) and sham-TEA group (15 patients). The ECG was recorded for the assessment of the autonomic function, followed with an esophageal high-resolution manometry (HRM) test. When the test was completed, the STEA or sham-TEA treatment was performed for 30 minutes. Then the HRM test was repeated.ResultsSTEA increased LESP from 21.9 to 31.9 mmHg in GERD patients (p < 0.001). A negative correlation between the percentage of STEA-induced increase in LESP and basal LESP was observed (R = -0.471, p = 0.001). STEA reduced the number of ineffective esophageal contractions (p < 0.05). STEA rather than sham-TEA increased vagal activity (0.27 ± 0.14 vs. 0.36 ± 0.18, p < 0.001) and decreased sympathetic activity (0.73 ± 0.14 vs. 0.64 ± 0.18, p < 0.001).ConclusionsAcute STEA augments LESP in GERD and the percentage of the increase in LESP was negatively correlated with basal LESP. The effect of STEA on LESP might be mediated via autonomic function.Conflict Of InterestThe authors reported no conflict of interest.© 2019 International Neuromodulation Society.

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