Neural Gastric Electrical Stimulation: Future Prospects in Managing Gastric Emptying Disorders

Neural gastric electrical stimulation (NGES) is a multi-channel high-energy gastrointestinal stimulation technique that directly activates cholinergic motor neurons to evoke contractions that improve gastric emptying. NGES stimulation superimposes on spontaneous electromechanical activity to generate coordinated propagating contractions. In contrast, the most commonly applied form of gastric electrical stimulation (Enterra), employs paired pulses that stimulate vagal afferent pathways to reduce symptoms of nausea and vomiting, but does not enhance emptying. This review examines the evolution and implementation of NGES, focusing on its potential role as a treatment option to enhance gastric propulsion in gastroparesis and delayed gastric conduit emptying. While initial acute animal studies have shown promising results, continued development of the technology and refinement of stimulation protocols through chronic experiments remains essential for successful clinical translation.