New England Gastropareis Consortium: Neurobiology of Gastroparesis

新英格兰胃轻瘫联盟：胃轻瘫的神经生物学

• 批准号: 9357604
• 负责人: Braden Kuo
• 金额: $ 42.75万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-25 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9357604
• 关键词: Abdomen; Abdominal Pain; Anxiety; Brain; Brain imaging; Brain region; Caring; Chronic; Clinical; Clinical Research; Clinical Trials; Cognitive Therapy; Comorbidity; Complex; Defect; Development; Diabetes Mellitus; Disease; Dyspepsia; Education; Enrollment; Enteral; Enteric Nervous System; Epidemiology; Frequencies; Functional disorder; Future; Gastric Emptying; Gastroparesis; Goals; Health; Liquid substance; Magnetic Resonance Imaging; Measurement; Measures; Medical; Mental Depression; Motion Sickness; Motor; Natural History; Nausea; Nausea and Vomiting; Neuraxis; Neurobiology; Neuropathy; New England; Pain; Pathology; Patients; Peripheral; Phenotype; Physiological; Physiology; Placebo Control; Quality of life; Radionuclide Imaging; Recruitment Activity; Registries; Research; Satiation; Sensory; Severities; Site; Structural defect; Symptoms; Syndrome; Test Result; Testing; Therapeutic Intervention; Therapy trial; Time; Translating; United States National Institutes of Health; Visceral; Wireless Technology; capsule; cell motility; chronic pain; early satiety; experience; improved; insight; mindfulness; motor disorder; outcome forecast; persistent symptom; post intervention; reduce symptoms; success; symptomatic improvement; tertiary care

ABSTRACT Gastroparesis (GP) is defined as delayed gastric emptying in the absence of a gross structural abnormality with the symptoms chronic nausea and vomiting, early satiety, postprandial fullness, and abdominal distention. Pain or discomfort is frequently associated. A factor associated with improvement was anti-depressant use and factors associated with no symptom reduction included use of pain modulators, moderate to severe abdominal pain, and moderate to severe depression. The common theme of poor prognosis are factors which may arise from pathology that exist beyond just enteric motor function despite the fact that gastroparesis is indeed initially defined as an enteric motor disorder. Although the causes of gastroparesis can be multi-factorial, when the disease becomes chronic and the severity of the symptoms result in a high impact on Quality of Life (QOL), complex pathologies may begin to evolve in the enteric and central nervous system beyond just motor abnormalities contributing to other sensory defects. The neurobiology of these other factors needs to be explored further so that these insights can be translated into meaningful increases in treatment success in the moderate to severe gastroparetic patients. To accomplish these goals, we propose to create an additional site with the New England Gastroparesis Collaborative to join the NIH GR. The multi-center network will help recruit to our proposal to explore the peripheral and central neurobiology of gastroparesis and as well as help to conduct a Cognitive Behavioral Therapy (CBT) intervention to target these challenging pathologies. We plan to explore the relationships with gastroparesis symptoms, clinical co- comorbidities such as pain, depression, anxiety and catastrophization, and other GI physiological testing such as gastric emptying scitigraphy (GES), Wireless Motility Capsule (WMC), Electrogastrography (EGG) and Liquid Meal Satiety Drink Tests (SDT). We will perform a placebo controlled CBT trial in GP to examine the non- pharmacological impact of this treatment option on gastroparesis symptoms and the other clinical co-comorbidities such as pain, depression, anxiety and catastrophization. A subset of the CBT trial patients will undergo careful phenotyping pre/post intervention with brain MRI, AFT, and other GI physiological testing: GES, WMC, EGG and SDT to determine the impact of CBT on these physiologies. Characterization of these relationships or lack thereof can help guide future development of more targeted effective approaches in gastroparesis.

抽象的 胃轻瘫（GP）定义为在没有A的情况下延迟胃排空 症状严重的结构异常，慢性恶心和呕吐，早期 饱腹感，餐后饱满和腹部扩张。疼痛或不适经常 联系。与改善相关的因素是抗抑郁药和因素 与没有症状的无症状相关的包括使用疼痛调节剂，中等 严重的腹痛，中度至重度抑郁。穷人的共同主题 预后是可能由肠子范围内存在的病理引起的因素 运动功能尽管胃轻瘫确实最初被定义为肠 运动障碍。尽管胃轻瘫的原因可能是多因素的，但是 疾病变为慢性，症状的严重程度导致对 生活质量（QOL），复杂的病理可能开始在肠和中心发展 神经系统不仅仅是运动异常，导致其他感觉缺陷。 这些其他因素的神经生物学需要进一步探讨，以便这些 洞察力可以转化为在治疗成功中有意义的增加 中度至严重的毛线护理患者。为了实现这些目标，我们建议 与新的英格兰胃胃合作创建一个额外的网站，以加入 NIH GR。多中心网络将有助于招募我们的建议来探索 胃肉食的周围和中央神经生物学，并有助于进行 认知行为疗法（CBT）干预以针对这些具有挑战性的病理。 我们计划探索与胃轻瘫症状的关系，临床共同 疼痛，抑郁，焦虑和灾难性等合并症以及其他GI 生理测试，例如胃清空Scitigraphy（GES），无线运动 胶囊（WMC），电扫描（EGG）和液体餐食饮料测试（SDT）。 我们将在GP中进行安慰剂控制的CBT试验，以检查非 - 该治疗选择对胃轻瘫症状的药理影响和 其他临床合并症，例如疼痛，抑郁，焦虑和灾难性。一个 CBT试验患者的子集将在干预前/干预前进行仔细的表型 脑MRI，AFT和其他GI生理测试：GES，WMC，Egg和SDT 确定CBT对这些生理的影响。这些表征 关系或缺乏关系可以帮助指导未来的更多针对性的发展 有效的胃轻瘫方法。