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

基本信息

批准号：
10001523
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
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-25 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10001523
关键词：
Abdomen Abdominal Pain Antidepressive Agents Anxiety Brain Brain imaging Brain region Caring Chronic Clinical Clinical Research Clinical Trials Cognitive Therapy 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 Placebos Quality of life Radionuclide Imaging 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 comorbidity early satiety experience improved insight mindfulness motor disorder outcome forecast persistent symptom post intervention recruit reduce symptoms success symptomatic improvement tertiary care

项目摘要

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) 被定义为在缺乏胃排空的情况下延迟胃排空。严重的结构异常，伴有慢性恶心和呕吐的症状，早期饱腹感、餐后饱胀、腹胀。经常出现疼痛或不适联系。与改善相关的一个因素是抗抑郁药物的使用和因素与症状没有减轻相关的包括使用疼痛调节剂，中度至严重腹痛，以及中度至重度抑郁。穷人的共同主题预后是可能由肠道以外的病理学引起的因素尽管胃轻瘫最初被定义为肠道疾病，但运动功能运动障碍。虽然胃轻瘫的原因可能是多方面的，但当疾病变成慢性并且症状的严重性会对身体产生很大影响生活质量（QOL），复杂的病理学可能开始在肠道和中枢进化神经系统不仅仅是导致其他感觉缺陷的运动异常。这些其他因素的神经生物学需要进一步探索，以便这些因素见解可以转化为治疗成功率的有意义的提高中度至重度胃轻瘫患者。为了实现这些目标，我们建议与新英格兰胃轻瘫合作组织创建一个额外网站以加入 NIH GR。多中心网络将有助于招募我们的提案来探索胃轻瘫的周围和中枢神经生物学，以及帮助进行认知行为疗法 (CBT) 干预旨在针对这些具有挑战性的病症。我们计划探索与胃轻瘫症状、临床并发症的关系疼痛、抑郁、焦虑和灾难化等合并症以及其他胃肠道疾病生理测试，例如胃排空扫描 (GES)、无线运动胶囊 (WMC)、胃电图 (EGG) 和流质餐饱腹感饮料测试 (SDT)。我们将在全科医生中进行安慰剂对照 CBT 试验，以检查非该治疗方案对胃轻瘫症状的药理影响以及其他临床合并症，如疼痛、抑郁、焦虑和灾难化。一个 CBT 试验患者的子集将在干预前/后接受仔细的表型分析脑部 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。这些的表征关系或缺乏关系可以帮助指导更有针对性的未来发展治疗胃轻瘫的有效方法。