Format

Send to

Choose Destination
Dig Dis Sci. 2019 Sep 7. doi: 10.1007/s10620-019-05766-5. [Epub ahead of print]

Central Nervous System Mechanisms of Nausea in Gastroparesis: An fMRI-Based Case-Control Study.

Author information

1
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Dr., El Paso, TX, 79905, USA.
2
Department of Radiology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Dr., El Paso, TX, 79905, USA.
3
Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, 55 Park Pl, 18th Floor, Atlanta, GA, 30303, USA.
4
The Department of Electrical and Computer Engineering, MSC01 1100, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
5
Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave., El Paso, TX, 79905, USA.
6
Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave., El Paso, TX, 79905, USA. Irene.sarosiek@ttuhsc.edu.

Abstract

BACKGROUND/AIMS:

Nausea is a major complaint of gastroparesis (GP), and the pathophysiology of this condition is poorly understood. Therefore, this study utilized fMRI to investigate the possible central nervous system (CNS) mechanisms of nausea in 10 GP patients versus 8 healthy controls (HCs).

METHODS:

Nausea severity was assessed on a 0-10 scale and presented as mean ± SD. Nausea was increased from baseline utilizing up to 30 min of visual stimulation (VS). Functional network connectivity was measured with fMRI at baseline and after 30 min of VS. fMRI data were preprocessed using statistical parametric mapping software. Thirty-four independent components were identified as meaningful resting-state networks (RSNs) by group independent component analysis. The Functional Network Connectivity (FNC) among 5 RSNs considered important in CNS nausea mechanisms was calculated as the Pearson's pairwise correlation.

RESULTS:

Baseline nausea score in GP patients was 2.7 ± 2.0 and increased to 7.0 ± 1.5 after stimulation (P < 0.01). In HCs nausea scores did not increase from baseline after stimulus (0.3 ± 0.5). When comparing GP patients to HCs after VS, a significant reduction (P < 0.001) in bilateral insula network connectivity compared to the right insula network was detected. No significant differences in connectivity were noted among the other RSNs. Additionally, the average gray matter volume was non-significantly reduced in the insula in GP patients compared to HC.

CONCLUSIONS:

The insula connectivity network is impaired in nauseated GP patients. This phenomenon could explain the susceptibility of GP patients to nausea or may have resulted from a state of chronic nausea.

KEYWORDS:

Central nervous system; Functional network connectivity; Gastroparesis; Nausea; fMRI

PMID:
31494751
DOI:
10.1007/s10620-019-05766-5

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center