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. 2025 Jun;37(6):e70018.
doi: 10.1111/nmo.70018. Epub 2025 Mar 19.

Body Surface Gastric Mapping Delineates Specific Patient Phenotypes in Adolescents With Functional Dyspepsia and Gastroparesis

Gayl Humphrey  1 , Celia Keane  1 , Gabriel Schamberg  1   2 , Alain Benitez  3   4 , Stefan Calder  1   2 , Xu Binghong  3 , Christian Sadaka  3 , Christopher N Andrews  5 , Greg O'Grady  1   2 , Armen Gharibans  1   2   4 , Hayat Mousa  3   4
Affiliations

Body Surface Gastric Mapping Delineates Specific Patient Phenotypes in Adolescents With Functional Dyspepsia and Gastroparesis

Gayl Humphrey et al. Neurogastroenterol Motil. 2025 Jun.

Abstract

Background: Diagnosing pediatric patients with chronic gastroduodenal symptoms is clinically challenging, with the role of gastric emptying testing being controversial. Body Surface Gastric Mapping (BSGM) is a new diagnostic test that can identify specific patient phenotypes in adults with gastric dysfunction. This study evaluates whether BSGM can delineate specific phenotypes in adolescents and provide clinically meaningful distinctions between gastroparesis and functional dyspepsia diagnoses.

Methods: A prospective cross-sectional study recruited adolescents aged 12 to 21 between 2022 and 2024. Controls were recruited from New Zealand and patients from the Children's Hospital of Philadelphia, USA. BSGM followed a standardized protocol, including simultaneous symptom reporting and completion of validated symptom, psychometric, and physical health questionnaires.

Key results: Fifty-six subjects were recruited (31 controls, 25 patients); median age 16; 96% of patients were female. Control data showed that adult reference intervals provided an acceptable interpretation framework. Patients with FD (n = 10) and gastroparesis (n = 15) had common symptoms, mental health, quality of life, and functional disability (all p > 0.05). Three distinct BSGM phenotypes were identified: BSGM Normal (n = 10), BSGM Delay (n = 8), and Low Stability/Low Amplitude (n = 7), having spectral differences in BMI-Adjusted Amplitude 34.6 versus 39.1 versus 19.9 (p = 0.01) and Gastric Alimetry Rhythm Index: 0.45 versus 0.45 versus 0.19 (p = 0.003). BSGM phenotypes demonstrated differences in symptoms (nausea p = 0.04), physical health (p = 0.04), and psychometrics (anxiety p = 0.03).

Conclusion and inferences: Adolescents with FD and gastroparesis have overlapping clinical profiles, making treatment challenging. Conversely, employing BSGM to categorize patients into distinct phenotypes reveals clinically relevant differences, offering avenues for individualized therapeutic pathways.

Keywords: disorders of gut–brain interaction (DGBI); gastric alimetry; gastroduodenal symptoms.

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Conflict of interest statement

G.O.G. and A.G. hold grants and intellectual property in gastrointestinal electrophysiology. G.S., S.C., G.O.G., A.G., and C.N.A. are Alimetry's shareholders and employees. G.O.G. is a Director at The Insides Company. The remaining authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
(A) The BSGM protocol encompassing a 30‐min fasting baseline, a 10‐min meal challenge, and a 4‐h postprandial recording with concurrent symptom logging at 15‐min intervals and completion of validated questionnaires. (B) Screenshots of the symptom‐logging app. (C) Image of an array and reader on the abdomen of an adolescent.
FIGURE 2
FIGURE 2
Averaged BSGM spectral and symptom burden plots with median (IQR shaded) for BMI‐adjusted amplitude and symptom burden for Contols (A), Functional Dyspepsia (B) and Gastroparesis (C).
FIGURE 3
FIGURE 3
Average spectral and symptom data for each BSGM phenotype: BSGM Normal (A), Delayed (B), and Low Stability/Low Amplitude (C). The Sankey Plot (D) shows there was no relationship between clinical diagnoses (FD and gastroparesis) and the BSGM phenotypes (3D).
See this image and copyright information in PMC

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