Simultaneous gastric and brain electrical interfacing for development of endoscopic gastric stimulation treatments for gastroparesis

项目摘要 这项工作的目的是开发一种新的胃电刺激（GES）治疗方法， 治疗胃轻瘫。胃轻瘫是一种由胃排空延迟引起的疾病， 频繁呕吐、腹胀、早饱和感染。胃轻瘫在糖尿病患者中很常见， 某些药物如阿片类药物的常见副作用。GES被认为是通过调节胃起作用的- 脑轴GES已被测试和批准作为胃轻瘫的治疗，尽管有 临床疗效报告不一致。GES的作用机制尚不清楚，因此， GES的参数没有标准化。该提案将开发一种新的胃内刺激器， 可以通过内窥镜输送，而不是目前的侵入性放置GES器械。此外，委员会认为， 这些设备将与植入猪模型的脑电极结合使用， 胃刺激对涉及胃运动和进食的各种脑区的影响。还从未有一位 研究同时进行了直接神经记录与GES。这是描述 胃-脑轴和至关重要的设计更有效和微创GES治疗的患者 胃轻瘫和其它胃病。 具体目标如下：1）设计和制备内镜下胃内给药的 电极和2）在大型动物模型中GES对脑和胃运动的影响的表征。这 该提案将基础工程和工具开发与有针对性的临床需求结合在一起，利用 机械工程、微加工、化学、生物学、神经科学和 胃肠病学

Project Summary The purpose of this work is to develop a new class of gastric electrical stimulation (GES) therapies for the treatment of gastroparesis. Gastroparesis is a disorder arising from delayed gastric emptying leading to nausea, frequent vomiting, bloating, early satiety, and infection. Gastroparesis is common among diabetics and is a frequent side-effect of certain medications such as opiates. GES is believed to act by modulation of the stomach- brain axis. GES has been tested and approved as a treatment of gastroparesis, although there have been inconsistent reports of clinical efficacy. The mechanism of action of GES is not well understood and, as a result, parameters of GES are not standardized. This proposal will develop a new class of intragastric stimulators that can be delivered endoscopically, as opposed to current GES devices that are placed invasively. Furthermore, these devices will be used in conjunction with implanted brain electrodes in porcine models to directly examine the effect of gastric stimulation on various brain regions implicated in gastric motility and feeding. No previous study has conducted direct neural recording simultaneously with GES. This is a crucial step in characterizing the stomach-brain axis and vital to design more effective and less invasive GES therapies for patients with gastroparesis and other gastric disorders. The specific goals are summarized as follows: 1) Design and fabrication of endoscopically-delivered intragastric electrodes and 2) Characterization of GES effects on brain and gastric motility in large animal models. This proposal joins together fundamental engineering and tool development with a targeted clinical need, utilizing a wide-variety of disciplines in mechanical engineering, microfabrication, chemistry, biology, neuroscience, and gastroenterology.