Effect of VNS on Gastric Motor Functions

VNS 对胃运动功能的影响

基本信息

批准号：
10709641
负责人：
MICHAEL L. CAMILLERI
金额：
$ 7.58万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-23 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10709641
关键词：
Acceleration Address Adult Adverse effects Anatomy Autonomic nervous system disorders Cardiovascular Diseases Cervical Chronic Clinic Clinical Clinical Research Data Disease Dyspepsia Electric Stimulation Emergency department visit Epilepsy FDA approved Face Fasting Fatty acid glycerol esters Female Foundations Frequencies Future Gastric Emptying Gastrointestinal Diseases Gastroparesis Generations Goals Heart Heart failure High Prevalence Hospitalization Image Immune System Diseases Implant Incidence Inflammation Ingestion Left Measurement Measures Mediating Mental Depression Metabolic Diseases Methods Metoclopramide Minnesota Motor Movement Movement Disorders Muscle Neurons Nitrogen Obesity Operative Surgical Procedures Organ Patients Peripheral Persons Pharmaceutical Preparations Physiologic pulse Population Prevalence Protocols documentation Radiolabeled Reporting Research Review Literature Risk Sensory Solid Stomach Symptoms Tardive Dyskinesia Testing Time Universities Vagus nerve structure Width Work cholinergic cohort comorbidity effective therapy egg gastrointestinal symptom hospitalization rates improved innovation insight intravenous injection meetings mortality motor disorder nerve supply novel open label post stroke primary endpoint response single photon emission computed tomography sleep pattern stroke recovery systematic review type I and type II diabetes vagus nerve stimulation

项目摘要

ANCILLARY PROJECT 2 Abstract: Effect of VNS on Gastric Motor Functions The prevalence of gastroparesis (i.e., inability for the stomach to empty itself normally) ranges from 13.8 to 267.7 per 100,000 adults; in addition, 2.5% are hospitalized each year, with 0.3% mortality. There is no consistently effective treatment for this condition: the only FDA-approved medication, metoclopramide, can only be used for <12 weeks because of risk of the debilitating movement disorder tardive dyskinesia. To gather key data as a foundation for new gastroparesis treatment, we propose to evaluate the effect of left vagus nerve stimulation (VNS) on gastric emptying and accommodation functions in patients undergoing treatment for depression or epilepsy. Whereas the effects of VNS on other functions such as sleep patterns or heart period responses reflecting cardiovagal innervation have been reported, the effects of such treatment on gastric functions are unknown. It is clear, however, that the vagus nerve provides the extrinsic input to cholinergic intrinsic neurons that stimulate gastric muscle contractility and to the nitrogen-intrinsic neurons that mediate gastric accommodation. Our hypothesis is that cervical VNS increases gastric accommodation and accelerates gastric emptying. Our specific aim is to compare simultaneous assessment of gastric emptying and gastric accommodation in response to the same caloric meal before and three months after activation of left cervical VNS. The functions of the stomach will be measured using validated methods conducted simultaneously using SPECT camera imaging and a radiolabeled meal, with a first measurement of gastric volume during fasting after intravenous injection of pertechnetate and a second measurement of postprandial gastric volume accommodation and gastric emptying following the ingestion of a 320 kilocalorie, 30% fat egg meal. These innovative studies will document the effect of VNS as the foundation for a potential novel treatment for correcting disorders of gastric motor function.

辅助项目 2 摘要：VNS 对胃运动功能的影响胃轻瘫（即胃无法正常排空）的患病率范围为每 100,000 名成年人 13.8 至 267.7 人；此外，每年有 2.5% 的人住院，死亡率为 0.3%。对于这种情况没有一致有效的治疗方法：FDA 批准的唯一药物甲氧氯普胺只能用于 <12 周，因为存在使人衰弱的运动障碍和迟发性运动障碍的风险。为了收集关键数据作为新的胃轻瘫治疗的基础，我们建议评估左迷走神经刺激（VNS）对接受抑郁症或癫痫治疗的患者胃排空和调节功能的影响。尽管 VNS 对其他功能（如反映心血管神经支配的睡眠模式或心率反应）的影响已有报道，但这种治疗对胃功能的影响尚不清楚。然而，很明显，迷走神经向刺激胃肌肉收缩性的胆碱能内在神经元和介导胃调节的氮内在神经元提供外在输入。我们的假设是颈部 VNS 增加胃的调节并加速胃排空。我们的具体目的是比较左颈 VNS 激活前和激活后三个月对相同热量膳食的胃排空和胃调节的同步评估。将使用 SPECT 相机成像和放射性标记膳食同时进行的经过验证的方法来测量胃功能，首先测量静脉注射高锝酸盐后禁食期间的胃容量，然后第二次测量餐后胃容量调节和胃排空。摄入 320 卡路里、30% 脂肪的鸡蛋餐。这些创新研究将记录 VNS 的效果，作为纠正胃运动功能障碍的潜在新疗法的基础。