Body Region Specificity for Neuromodulation of the Gut-Brain Axis in Functional Dyspepsia

项目总结/摘要 候选人是一位有成就的生物工程师，受过人脑-身体成像方面的正式培训， 神经调节，并致力于在综合医学研究的转化研究事业 和神经胃肠病学。候选人的长期职业目标是发展转化研究计划 肠-脑调节的综合医学方法。候选人的短期职业目标是1） 通过指导培训向独立过渡，重点是综合医学，安慰剂研究， 和神经胃肠病学; 2）将新的研究技能融入她的技术成像背景， 用于评价非药物治疗的纵向研究; 3）生成数据和出版物 成功过渡到R 01应用程序所必需的。本申请概述了机构承诺， 研究计划，职业发展活动，以及参与的主要导师，以确保候选人完成 这些目标。在最近发表的工作中，候选人已经证明了使用动态电影的可行性- MRI用于健康受试者和胃溃疡患者胃功能多方面的非侵入性表征 功能性消化不良（FD）。在本提案中，候选人寻求应用基于MRI的工具来比较 不同穴位刺激对FD患者脑干神经回路和胃运动的影响， 以及治疗和期望操纵之间的相互作用。 本研究的具体目标是：1）评估经皮穿刺的潜在脑干神经回路 FD患者的穴位电刺激（TEAS）; 2）比较腿部（ST 36穴）与腹部的作用 （3）评价期待手法对FD患者胃运动的影响。 诱发症状和生理结果。作为本提案的组成部分，候选人的职业生涯 发展将通过参与高级课程来补充，以发展安慰剂方面的专业知识 研究、中西医结合、胃肠病学和临床试验的开展。一个正式的指导委员会， 由安慰剂研究、神经胃肠病学、神经影像学、针灸、 和中西医结合，将提供监督，指导和帮助候选人实现她 目标.研究环境，其中包括斯波尔丁康复医院，阿西诺拉A。 Martinos生物医学成像中心，综合疼痛神经成像中心（CiPNI）， 胃肠单位和MGH神经肠道健康中心，以及哈佛医学院将提供一个 丰富、协作和智力刺激的氛围，以确保候选人的成功。通过这个 奖，候选人将成为一个独立的调查员，有助于我们的理解， 脑-肠机制支持穴位特异性作用于患有肠-脑相互作用障碍的患者。

PROJECT SUMMARY/ABSTRACT The candidate is an accomplished bioengineer with formal training in human brain-body imaging and neuromodulation, and a commitment to a career in translational research in the study of integrative medicine and neurogastroenterology. The candidate’s long-term career goal is to develop a translational research program in integrative medicine approaches for gut-brain modulation. The candidate’s short-term career goals are to 1) transition towards independence through mentored training focused on integrative medicine, placebo research, and neurogastroenterology; 2) weave new research skills into her technical imaging background, with potential for longitudinal studies evaluating non-pharmacological therapies; 3) produce the data and publications necessary to transition into a successful R01 application. This application outlines the institutional commitment, research plan, career development activities, and key mentors involved to ensure the candidate accomplishes these goals. In recently published work, the candidate has demonstrated the feasibility of using dynamic cine- MRI for non-invasive characterization of multiple aspects of gastric function in healthy subjects and patients with functional dyspepsia (FD). In this proposal, the candidate seeks to apply MRI-based tools to compare the impact of stimulation at different acupoint locations on brainstem neurocircuitry and gastric motility in patients with FD, as well as the interaction between treatment and expectancy manipulation. The specific goals of this study are to 1) evaluate the underlying brainstem neurocircuitry of transcutaneous electrical acupoint stimulation (TEAS) in FD; 2) compare the effect of leg (acupoint ST36) versus abdomen (acupoint ST25) TEAS on gastric motility in FD; 3) evaluate the effect of expectancy manipulation on meal- evoked symptoms and physiological outcomes. As an integral part of this proposal, the candidate’s career development will be complemented by participation in advanced coursework to develop expertise in placebo research, integrative medicine, gastroenterology, and conduct of clinical trials. A formal mentorship committee, consisting of multidisciplinary experts in placebo research, neurogastroenterology, neuroimaging, acupuncture, and integrative medicine, will provide supervision, guidance, and assistance for the candidate to achieve her goals. The research environment, which includes the Spaulding Rehabilitation Hospital, the Athinoula A. Martinos Center for Biomedical Imaging, the Center for Integrative Pain Neuroimaging (CiPNI), the Gastrointestinal Unit and MGH Center for Neurointestinal Health, and the Harvard Medical School will provide a rich, collaborative, and intellectually stimulating atmosphere to ensure the candidate’s success. Through this award, the candidate will emerge as an independent investigator by contributing to our understanding of the brain-gut mechanisms supporting acupoint-specific effects in patients with a disorder of gut-brain interactions.