Basal electrical rhythm

The Basal or Basic electrical rhythm (BER) or electrical control activity (ECA) determines the frequency of the contractions in the gastrointestinal (GI) tract.

Physiology
Smooth muscle within the GI tract causes the involuntary peristaltic motion that moves consumed food down the esophagus and towards the rectum. The smooth muscle throughout most of the GI tract is divided into two layers: an outer longitudinal layer and an inner circular layer. Both layers of muscle are located within the muscularis externa. The stomach has a third layer: an innermost oblique layer.

The physical contractions of the smooth muscle cells can be caused by action potentials in efferent motor neurons of the enteric nervous system, or by receptor mediated calcium influx. The inner circular layer is innervated by both excitatory and inhibitory motor neurons, while the outer longitudinal layer is innervated by mainly excitatory neurons. These action potentials cause the smooth muscle cells to contract or relax, depending on the particular stimulation the cells receive. Longitudinal muscle fibers depend on calcium influx into the cell for excitation-contraction coupling, while circular muscle fibers rely on intracellular calcium release. Contraction of the smooth muscle can occur when the BER reaches its plateau (an absolute value less than -45mV) while a simultaneous stimulatory action potential occurs. A contraction will not occur unless an action potential occurs. Generally, BER waves stimulate action potentials and action potentials stimulate contractions.

The Interstitial cells of Cajal are specialized pacemaker cells located in the wall of the stomach, small intestine, and large intestine. These cells are connected to the smooth muscle via gap junctions and the myenteric plexus. The cell membranes of the pacemaker cells undergo a rhythmic depolarization and repolarization from -65mV to -45mV. This rhythm of depolarization-repolarization of the cell membrane creates a slow wave known as a BER, and it is transmitted to the smooth muscle cells. The frequency of these depolarizations in a region of the GI tract determines the possible frequency of contractions. In order for a contraction to occur, a hormone or neurocrine signal must induce the smooth muscle cell to have an action potential. The basal electrical rhythm allows the smooth muscle cell to depolarize and contract rhythmically when exposed to hormonal signals. This action potential is transmitted to other smooth muscle cells via gap junctions, creating a peristaltic wave.

Frequency
The number of action potentials during the plateau of a particular BER slow wave can vary. Multiple action potentials during the same slow wave peak create a stronger muscle contraction.

The frequency of the BER, and thus the contractions, changes throughout the GI tract. The frequency in the stomach is 3 per minute, while the duodenum is 11 to 12 per minute and the ileum is 9 per minute. The colon can have a BER frequency between 2 and 13 per minute. The electrical activity is oscillatory, so that the BER has peaks and valleys when graphed over time.