Characterization of Gastric Evoked Potentials

胃诱发电位的表征

• 批准号: 10610435
• 负责人: DAVID J LEVINTHAL
• 金额: $ 19.88万
• 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/10610435
• 关键词: Area; Brain; Cerebral cortex; Characteristics; Chronic Disease; 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; 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; Techniques; Therapeutic; Training; Transcranial magnetic stimulation; Visceral; Water; Work; awake; brain based; 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; neural circuit; neuroregulation; nonhuman primate; noninvasive brain stimulation; novel; 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：运动诱发电位(MEP)通过非侵入性电刺激 人脑是研究连接皮质输出和脊髓的神经回路的基础 绳索和肌肉。经颅磁刺激(TMS)方法使研究 通过监测清醒受试者的MEP，研究运动控制系统的组织和可塑性 洞察导致评估和治疗运动功能障碍的无数临床应用。与…形成鲜明对比 来自外周骨骼肌的MEP，没有可比的、客观的中枢神经影响的衡量标准 胃肠道的平滑肌肉。这一根本障碍阻碍了在 神经胃肠病学通过限制研究大脑皮质的组织和可塑性对 清醒人体胃肠系统的神经控制。为了克服这一障碍，我们最近 开发了一种连接大脑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是通过将TMS与皮肤耦合而产生的 胃电(EGG)，提供胃平滑肌的连续电生理读数 活动。我们的初步研究显示，TMS刺激初级脑区产生了明显的GEP信号 受试者运动皮质(M1)。类似于TMS引发的欧洲议会议员在 引导神经控制运动的探索，TMS诱导的GEP将指导探索 胃肠道运动的神经控制(即‘肠道运动’)。在这个项目中，我们寻求确定和标准化如何 最好记录GEP，优化TMS参数和唤醒GEP所需的条件，并确定 最容易产生GEP的皮质部位的位置(“GEP热点”)(目标1)。然后我们将评估 不同模式的重复TMS(RTMS)神经调节(抑制性1赫兹或刺激性10赫兹) 针对GEP热点塑造胃运动反应(目标2)。这项初步的临床研究将 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 与用于诱导MEP的方法具有类似的可靠性和重复性。我们的工作将指导 TMS作为胃生理机制研究的工具在人体和脑中的发展。 基于操控胃功能的方法。这项工作可能会导致TMS的临床试验 神经调节，被确定为诱导最大GEP反应的皮质部位，用于治疗胃病 在各种临床情况下出现的运动障碍。