New England Gastropareis Consortium: Neurobiology of Gastroparesis

摘要 胃轻瘫的症状包括慢性恶心和呕吐，早饱，餐后饱胀， 腹胀和经常疼痛。虽然最初被认为是一种肠道运动障碍， 功能障碍（即，胃排空延迟），越来越多的研究表明（1） 症状严重程度和排空严重程度，以及（2）针对运动的治疗在很大程度上无效 功能障碍虽然胃轻瘫的原因可以是多因素的，当疾病变成慢性时， 并且症状的严重程度对生活质量（QOL）产生高度影响，复杂的病理可能 开始在肠道和中枢神经系统中进化，而不仅仅是运动异常， 感官缺陷需要进一步分析胃轻瘫的生物心理社会结构， 可以通过新的干预措施来解决。为了实现这些目标，我们建议继续实施新的 英格兰胃轻瘫协作组织是NIH胃轻瘫联盟的一部分。多中心网络 将有助于招募我们在登记研究中进一步描述胃轻瘫患者特征的建议， 继续进行胃轻瘫的多中心研究。此外，我们的网站（马萨诸塞州一般 医院; MGH）建议解决：（1）新的生物心理社会因素在维持中的作用 胃轻瘫症状，和（2）认知行为疗法（CBT）的初步疗效， 胃轻瘫

ABSTRACT Symptoms of gastroparesis include chronic nausea and vomiting, early satiation, postprandial fullness, abdominal distention and frequently pain. While initially conceptualized as a disorder of enteric motor dysfunction (i.e., delayed gastric emptying), growing research suggests both (1) a disconnect between symptom severity and emptying severity, and (2) largely ineffectiveness of treatments that target motor dysfunction. 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. Further profiling of biopsychosocial constructs in gastroparesis is needed, as such constructs could be targeted by novel interventions. To accomplish these goals, we propose to continue with the New England Gastroparesis Collaborative as part of the NIH Gastroparesis Consortium. The multi-center network will help recruit to our proposal of further gastroparesis patient characterization in the Registries and continuation of various multi-center studies for gastroparesis. In addition, our site (Massachusetts General Hospital; MGH) proposes addressing: (1) the contribution of novel biopsychosocial factors in the maintenance of gastroparesis symptoms, and (2) the preliminary efficacy of a cognitive behavioral therapy (CBT) for gastroparesis.