Characterization of Gastric Evoked Potentials

胃诱发电位的表征

• 批准号: 10451224
• 负责人: DAVID J LEVINTHAL
• 金额: $ 23.79万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451224
• 关键词: Area; Base of the Brain; Brain; Cerebral cortex; Characteristics; Chronic stress; Clinical; Clinical Research; Clinical Trials; Coupling; Cutaneous; Data; Development; Diagnosis; Diagnostic; Electric Stimulation; Electrodes; Electrophysiology (science); Evoked Potentials; Fasting; Foundations; Frequencies; Future; Gastrointestinal tract structure; Generations; Human; Lead; Left; Link; Location; Measures; Methods; Monitor; Mood Disorders; Motor; Motor Activity; Motor Cortex; Motor Evoked Potentials; Movement; Muscle; Neural Pathways; Neurons; Output; Parkinson Disease; Pathway interactions; Peripheral; Phase; Physiologic pulse; Physiology; Pilot Projects; Reproducibility; Rodent Control; Role; Sensory; Shapes; Signal Transduction; Site; Skeletal Muscle; Smooth Muscle; Spinal Cord; Standardization; Stomach; Stroke; System; Systems Development; Techniques; Therapeutic; Training; Transcranial magnetic stimulation; Visceral; Water; Work; awake; base; cell motility; clinical application; diagnostic tool; effective therapy; experimental study; gastrointestinal system; human subject; insight; motility disorder; motor control; motor disorder; multiple sclerosis patient; neural circuit; neuroregulation; nonhuman primate; noninvasive brain stimulation; novel; relating to nervous system; repetitive transcranial magnetic stimulation; research and development; response; stomach motility; stress disorder; tool

Project Summary: Motor evoked potentials (MEPs) elicited via non-invasive electrical stimulation of the human brain are the foundational basis for investigating the neural circuits that link cortical output to the spinal cord and muscles. Transcranial magnetic stimulation (TMS) methods have allowed the study of the organization and plasticity of motor control systems by monitoring MEPs in awake human subjects, with insights leading to myriad clinical applications for assessing and treating motor dysfunction. In stark contrast to MEPs from peripheral skeletal muscle, there is no comparable, objective measure of central neural influences on the smooth muscles of the gastrointestinal tract. This fundamental barrier has hindered progress in neurogastroenterology by limiting the ability to study the organization and plasticity of cortical influences on the neural control of the GI system in awake human subjects. To overcome this barrier, we have recently developed a direct electrophysiological readout of a neural circuit linking the cortex to the stomach that we call gastric evoked potentials (GEPs). GEPs are generated by coupling TMS with cutaneous electrogastrography (EGG), which provides a continual electrophysiological readout of gastric smooth muscle activity. Our pilot studies demonstrated distinct GEP signals resulting from TMS stimulation of the primary motor cortex (M1) in human subjects. Analogous to the fundamental role TMS-elicited MEPs have had in guiding the exploration of the neural control of movement, TMS-elicited GEPs will guide the exploration of the neural control of GI movement (i.e. `gut motility'). In this project, we seek to determine and standardize how best to record GEPs, to optimize the TMS parameters and conditions necessary to evoke GEPs, and to identify the location of cortical sites that most readily generate GEPs (`GEP hotspots') (Aim 1). We then will assess whether various modes of repetitive TMS (rTMS) neuromodulation (inhibitory 1Hz or stimulatory 10Hz) targeted to GEP hotspots shape gastric motor responses (Aim 2). This preliminary clinical research will develop GEPs as a non-invasive, direct measure of the neural circuit linking the cerebral cortex to the control of the stomach, with similar reliability and reproducibility to methods used to elicit MEPs. Our work will guide the development of TMS as a tool for mechanistic studies of gastric physiology in human subjects and brain- based methods to manipulate stomach function. This line of work could lead to clinical trials of TMS neuromodulation, directed to cortical sites identified as inducing maximal GEP responses, to treat gastric motility disturbances that arise in a variety of clinical contexts.

项目摘要：通过非侵入性电刺激诱发运动诱发电位 (MEP) 人脑是研究将皮质输出与脊髓连接起来的神经回路的基础 绳索和肌肉。经颅磁刺激 (TMS) 方法允许研究 通过监测清醒人类受试者的 MEP 来观察运动控制系统的组织和可塑性， 见解导致了评估和治疗运动功能障碍的无数临床应用。与之形成鲜明对比的是 来自外周骨骼肌的 MEP，没有可比的、客观的中枢神经影响测量方法 对胃肠道平滑肌的影响。这一根本性障碍阻碍了进展 神经胃肠病学通过限制研究皮质影响的组织和可塑性的能力 清醒人类受试者胃肠道系统的神经控制。为了克服这一障碍，我们最近 开发了一种连接皮层和胃的神经回路的直接电生理读数，我们称之为 胃诱发电位（GEP）。 GEP 是通过 TMS 与皮肤耦合生成的 胃电图 (EGG)，提供胃平滑肌的连续电生理读数 活动。我们的试点研究证明了 TMS 刺激初级细胞产生的不同 GEP 信号 人类受试者的运动皮层（M1）。类似于 TMS 引发的欧洲议会议员在 TMS 引发的 GEP 指导运动神经控制的探索，将指导运动神经控制的探索 胃肠道运动的神经控制（即“肠道运动”）。在这个项目中，我们寻求确定并标准化如何 最好记录 GEP，优化激发 GEP 所需的 TMS 参数和条件，并识别 最容易产生 GEP 的皮质位点（“GEP 热点”）的位置（目标 1）。然后我们将评估 是否有各种重复 TMS (rTMS) 神经调节模式（抑制性 1Hz 或刺激性 10Hz） 针对 GEP 热点塑造胃运动反应（目标 2）。这项初步临床研究将 开发 GEP 作为连接大脑皮层和对照的神经回路的非侵入性直接测量 胃的，与用于引出 MEP 的方法具有相似的可靠性和重现性。我们的工作将指导 TMS 的发展作为人类受试者胃生理学和脑部生理学机制研究的工具 基于控制胃功能的方法。这一系列工作可能会导致 TMS 的临床试验 神经调节，针对被确定为诱导最大 GEP 反应的皮质部位，以治疗胃病 在各种临床情况下出现的运动障碍。