{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:45:51Z","timestamp":1790959551538,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gastroparesis is a heterogeneous disorder with several contributing pathophysiologies. In this study, we used simultaneous body surface gastric mapping (BSGM) and gastric emptying breath testing (GEBT) to subgroup patients with gastroparesis based on dynamic spectral meal response profiles and emptying rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with chronic gastroduodenal symptoms and negative gastroscopy underwent simultaneous BSGM and GEBT with 30\u2009min fasting and 4\u2009h postprandial recording. In addition to standard metrics, the BSGM \u2018meal response ratio\u2019 (MRR) compared amplitude in the first 2\u2009h postprandially to the subsequent 2\u2009h (lagged meal response \u2264\u20091).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and forty\u2010three patients underwent simultaneous BSGM and GEBT (79% female, median age 31\u2009years, median BMI 23\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), of whom 36 of 143 (25.2%) had delayed gastric emptying. Those with a lagged meal response had longer T\n                      <jats:sub>1\/2<\/jats:sub>\n                      (median 95.0 [IQR 59\u2013373] vs. median 78.0 [IQR 31\u2013288],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) and higher rates of delayed emptying (42.9% vs. 16.7%\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). BSGM phenotypes identified in patients with delayed emptying were lagged meal response (25%), low gastric amplitude\/rhythm stability (30.6%), elevated gastric frequencies (11.1%), and normal BSGM spectral analysis (33.3%). T\n                      <jats:sub>1\/2<\/jats:sub>\n                      weakly correlated with worse total symptom burden score (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined BSGM and gastric emptying testing defines subgroups of gastroparesis based on several BSGM abnormalities, including a novel group with delayed postprandial onset of gastric motor activity in association with delayed emptying.<\/jats:p>\n                  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