Gastroparesis
Conditions
Keywords
Gastroparesis, functional MRI, Gastric MRI, Brain MRI
Brief summary
The study is to lay the groundwork for non invasive imaging of the GI tract and the brain gut interaction
Detailed description
Magnetic resonance imaging (MRI) produces non-invasive exquisite spatial resolution of internal organs. However, its application to the GI tract has been limited by several challenges. The GI tract has a complex and convoluted geometry. The GI geometry changes slowly over the course of meal digestion, as well as rapidly due to contraction of various compartments of the GI tract. As a person takes natural breaths during MRI, the respiratory motion further complicates the acquisition and analysis of GI images. In addition, different types of meal or nutrients have variable property as image contrast in upper GI MRI. It is difficult to standardize the MRI analysis for accurate and quantitative assessment of gastric emptying, motility, absorption, and secretion, to name a few. In a recently published study by our research collaborators at Purdue University, they have addressed many of these challenges in rodents and are ready to refine and translate their technical solutions to human upper GI MRI. Functional MRI of the brain has been used to study afferent response in various GI disorders, such as dysphagia, functional dyspepsia, and irritable bowel syndrome.1-3 Brain activity is altered in the emotional response areas, and activity is reduced in the areas associated with top-down modulation of visceral afferent signals.4 However, direct correlation between regional brain activation by functional-MRI and GI motility by meal-contrast MRI is lacking. The outcome of the proposed research is expected to lay the groundwork for non-invasive imaging of GI anatomy and function and the brain-gut interaction towards better understanding, diagnosis, prevention, and treatment of GI disorders.
Interventions
OTHERMRI scan
MRI scan
Sponsors
Indiana University
Purdue University
National Institutes of Health (NIH)
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
HEALTHY VOLUNTEERS Inclusion Criteria: • Healthy volunteers from 18 to 65 years of age
Exclusion criteria
* Contraindication to MR scanning: pregnancy, implanted gastric stimulator, neural stimulator, implanted cardiac pacemaker, auto-defibrillator, cochlear implant, ocular foreign body (e.g. metal shavings), pain pump, insulin pump or any pre-existing eye conditions. * Presence of gastroparesis symptoms, such as nausea, emesis, early satiety, effortless regurgitation, post-prandial fullness and pain, and/or postprandial epigastric pain. * Prior diagnosis of the upper GI disorders, including gastroparesis, gastric or duodenal ulcer, gastric outlet obstruction, acute or chronic pancreatitis, large hiatal or paraesophageal hernia, small intestinal bacterial overgrowth, celiac disease, Crohn's disease. * Prior systemic disorders associated with GI neuromuscular disorder listed in Appendix B. * Taking medications that can effect GI motility, including opiate, metoclopramide, dopamine agonist for Parkinson or restless leg syndrome, anticholinergics. * Prior brain or abdominal surgery (except cholecystectomy or appendectomy). * Prior diagnosis of central nervous system illness, neurological lesion, a psychiatric history, or recurrent migraines that require medication. * Uncontrolled medical problems, such as hypertension, pulmonary or airway disease, heart failure, or coronary artery disease. * Allergy to pineapple. * Presence of dysphagia. * Unable to give own informed consent. GASTROPARESIS PATIENTS Inclusion Criteria: * Patients with gastroparesis from 18 to 65 years of age. * Symptoms of gastroparesis of at least 12 weeks duration with varying degrees of nausea, emesis, early satiety, effortless regurgitation, post-prandial fullness and pain, and/or postprandial epigastric pain. * Abnormal 4-hour gastric emptying scintigraphy within the last 6 months \>60% retention at 2 hrs and/or \>10% retention at 4 hrs.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gastric peristalsis | Baseline | Compare 3D gastric peristalsis progression before \& after test meals in healthy volunteers and patients with gastroparesis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Contraction frequency | Baseline | Compare colored 3-D heat map of stomach contraction frequency before \& after test meals in healthy volunteers and patients with gastroparesis |
| Pylorus transit | Baseline | Compare pylorus mean opening diameter before \& after test meals in healthy volunteers and patients with gastroparesis |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORJohn M Wo, MD
Indiana University
Outcome results
None listed