Neurogastroenterology and Motility最新文献

{"title":"Intrarectal Injections of Botulinum Toxin for the Treatment of Urge Fecal Incontinence: Long-Term Results of an FI-Toxin Cohort Study.","authors":"Charlotte Desprez, Charlène Brochard, Véronique Vitton, Isabelle Etienney, Frank Zerbib, Gérard Amarenco, Francois Mion, Michel Queralto, Guillaume Gourcerol, Laurent Siproudhis, Henri Damon, Julie Philip, Elie Lacroix, André Gillibert, Anne-Marie Leroi","doi":"10.1111/nmo.70025","DOIUrl":"10.1111/nmo.70025","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of intrarectal botulinum toxin A (BoNT/A) injections in patients with urge fecal incontinence (FI) were evidenced in a large, multicenter, randomized, placebo-controlled study (FI-TOXIN). The aims of the present study were to evaluate the long-term efficacy and safety of intrarectal BoNT/A injections in a real-world setting in patients who participated in the FI-TOXIN study.</p><p><strong>Methods: </strong>Data collected from patients who had previously participated in the FI-TOXIN study in 8 French centers from November 2015 to November 2020 were retrospectively analyzed. Given the transient effect of BoNT/A, patients who had received the first injection in the FI-TOXIN study could be re-injected if symptoms recurred. Information on re-injections, satisfaction of patients, severity of FI symptoms, adverse effects, and the switch to another treatment was retrospectively collected from medical charts between M6 (end of the double-blind phase) and M54 of the inclusion in the FI-TOXIN study.</p><p><strong>Key results: </strong>Of the 191 patients in the initial FI-TOXIN cohort, 147 (77.0%) were included at M6. Between M6 and M54, 114 of these patients received 233 injections (68 first injections, 165 re-injections). Satisfaction information was available for 70 patients, of whom 43/70 (61.4%) were satisfied with all their injections. The treatment failed in 52/147 (35.4%) of the patients, with rejections of the treatment by patients due to insufficient perceived efficacy (34 patients), adverse effects or poor tolerance (11 patients), or switch to a surgical treatment (23 patients). Nonsevere adverse events were recorded after 45/233 (19.3%) injections. The two severe adverse events (cervical cancer and psychiatric hospitalization) were unrelated to the treatment.</p><p><strong>Conclusions: </strong>Intrarectal injections of BoNT/A displayed moderate long-term efficacy without major adverse effects.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70025"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding Gastric Reflexes: The Role of Mechanosensitive Enteric Neurons in Stomach Motility.","authors":"Gemma Mazzuoli-Weber, Sophia Mayr, Kristin Elfers","doi":"10.1111/nmo.70011","DOIUrl":"10.1111/nmo.70011","url":null,"abstract":"<p><p>This review focuses on mechanosensitive enteric neurons (MEN) in the guinea pig stomach and their roles in gastric motor reflex pathways. The guinea pig model is advantageous for studying gastric physiology, as its stomach structure and function closely resemble those of humans. Gastric motility involves distinct functional regions: the fundus and proximal corpus act as reservoirs, while the distal corpus and antrum handle food mixing and propulsion. Mechanosensitivity in both gastric cholinergic and nitrergic enteric neurons plays a critical role in adapting muscle activity in response to gastric content volume. These neurons enable reflex circuits involved in the accommodation reflex, with cholinergic excitatory and nitrergic inhibitory pathways promoting relaxation. This review summarizes the anatomical, functional, and neurochemical characteristics of MEN across gastric regions, their direct and indirect interactions with smooth muscle, and the role of distinct neurotransmitters in modulating gastric motility. The need for future studies on mechanosensitive pathways and involved neuronal receptors is highlighted to enhance our understanding, finally aiding therapeutic development.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70011"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Neurogenesis Status Among Achalasia Subtypes.","authors":"Qianjun Zhuang, Niandi Tan, Xun Hou, Songfeng Chen, Xingyu Jia, Mengyu Zhang, Fangfei Chen, Zhanye Zhang, Xiangbin Xing, Yinglian Xiao","doi":"10.1111/nmo.70021","DOIUrl":"10.1111/nmo.70021","url":null,"abstract":"<p><strong>Backgrounds and aims: </strong>Achalasia is an acquired esophageal neurodegenerative disorder, characterized by selective loss of inhibitory neurons in the myenteric plexus of the lower esophageal sphincter (LES). The Enteric neural precursor cell (ENPC) is essential in maintaining neurogenesis, but its role in achalasia pathogenesis is unknown. This study aimed to explore the neurogenesis status in the LES among achalasia patients.</p><p><strong>Methods: </strong>LES specimens from 59 patients with achalasia who underwent peroral endoscopic myotomy (POEM) and from 19 controls with esophageal cancer were examined. Double-labeled immunofluorescence staining was performed to evaluate Nestin-expressing ENPC and axonal innervation in the LES. Immunofluorescence values were compared between groups and correlated with clinical variables, including demographics, disease duration, Eckardt score, manometric parameters, and treatment outcome.</p><p><strong>Key results: </strong>A significant reduction of Nestin-positive cells, PGP9.5- and nNOS-labeled axon innervation was observed in achalasia. The number of Nestin-positive cells significantly correlated with axon innervation, confirming their roles in neurogenesis. The number of Nestin-positive cells, immature total axons (Nestin+PGP9.5+) and immature nitrergic axons (Nestin+nNOS+) were different among achalasia subtypes. Type 2 achalasia exhibited a more severe loss of both ENPC and axon innervation, while type 1 achalasia was characterized by retained ENPC and immature nitrergic axons, but with severe depletion of mature axons (Nestin-nNOS+).</p><p><strong>Conclusions: </strong>Neurogenesis is generally impaired in achalasia; however, the status of neurogenesis varies across different manometric subtypes, suggesting that the pathophysiology of each subtype may be distinct.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70021"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Transit Time Assessed Using a CT-Based Radiopaque Marker Method in Patients With Acute Pancreatitis During Methylnaltrexone Treatment.","authors":"Cecilie Siggaard Knoph, Andreas Svenstrup Hesthaven, Mathias Ellgaard Cook, Srdan Novovic, Mark Berner Hansen, Michael Bau Mortensen, Liv Bjerre Juul Nielsen, Irene Maria Høgsberg, Celina Salomon, Ole Thorlacius-Ussing, Esben Bolvig Mark, Jens Brøndum Frøkjær, Søren Schou Olesen, Asbjørn Mohr Drewes","doi":"10.1111/nmo.70027","DOIUrl":"10.1111/nmo.70027","url":null,"abstract":"<p><strong>Introduction: </strong>Dysmotility is common in acute pancreatitis (AP) and may be evaluated using radiopaque markers and imaging. We present a simple CT-based approach, which was employed in hospitalized patients with AP.</p><p><strong>Methods: </strong>This was a secondary analysis of a randomized, controlled trial conducted at four Danish centers. Patients admitted with AP and systemic inflammatory response syndrome were randomized to receive 5 days of intravenous methylnaltrexone or placebo (lactated ringer) added to standard management. Self-reported stool frequency was documented daily. Patients ingested a capsule containing 10 radiopaque markers on Day 3. A subsequent CT scan on Day 5 was used to identify the location of retained markers for the calculation of gastrointestinal transit, and colonic dimensions (diameters and cross-sectional areas) were measured.</p><p><strong>Results: </strong>In total, 47 patients were included. Patients receiving methylnaltrexone less often had laxative treatment (57% vs. 88%, p = 0.01) compared with placebo. Transit times were similar between the methylnaltrexone and the placebo groups (difference, -4 h (95% CI, -16 to 8), p = 0.53). Marker retention scores, colon diameters, and colon cross-sectional areas did not differ between treatment groups (all p > 0.05). Transit times (ρ = -0.53; p < 0.001), marker retention scores (ρ = -0.42; p = 0.004), diameter (ρ = -0.43; p = 0.003), and cross-sectional areas (ρ = -0.36; p = 0.01) of the descending colon were negatively correlated with self-reported stool frequency.</p><p><strong>Conclusion: </strong>Our CT-based method was feasible in hospitalized patients with AP. Methylnaltrexone did not change gastrointestinal transit compared with placebo. However, laxative therapy was more frequent with the placebo.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70027"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Specific Effects of Environmental Toxin-Derived Alpha Synuclein on Enteric Neuronal-Epithelial Interactions.","authors":"Hayley N Templeton, Alexis T Ehrlich, Luke A Schwerdtfeger, Julietta A Sheng, Ronald B Tjalkens, Stuart A Tobet","doi":"10.1111/nmo.70046","DOIUrl":"10.1111/nmo.70046","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's Disease (PD) is a neurodegenerative disorder with prodromal gastrointestinal (GI) issues often emerging decades before motor symptoms. Pathologically, PD can be driven by the accumulation of misfolded alpha synuclein (aSyn) protein in the brain and periphery, including the GI tract. Disease epidemiology differs by sex, with men twice as likely to develop PD. Women, however, experience faster disease progression, higher mortality, and more severe GI symptoms. Gut calcitonin gene-related peptide (CGRP) is a key regulator of intestinal contractions and visceral pain. The current study tests the hypothesis that sex differences in GI symptomatology in PD are the result of aSyn aggregation altering enteric CGRP signaling pathways.</p><p><strong>Methods: </strong>To facilitate peripheral aSyn aggregation, the pesticide rotenone was administered intraperitoneally once daily for 2 weeks to male and female mice. Mice were sacrificed 2 weeks after the last rotenone injection, and immunohistochemistry was performed on sections of proximal colon.</p><p><strong>Key results: </strong>Levels of aSyn were heightened in PGP9.5 immunoreactive myenteric plexus neurons, a subset of which were immunoreactive to CGRP and showed a similar increase in aSyn immunoreactivity in rotenone-treated mice. Female mice exhibited 153% more myenteric aSyn, 26% more apical CGRP immunoreactivity in the mucosa, and 66.7% more aSyn in apical CGRP⁺ fibers after rotenone when compared to males. Goblet cell numbers were diminished, but the individual cells were larger in the apical regions of crypts in the colons of rotenone-treated mice with no difference between males and females.</p><p><strong>Conclusions: </strong>This study used a mouse model of PD to uncover sex-specific alterations in enteric neuronal and epithelial populations, underscoring the importance of considering sex as a biological variable while investigating prodromal GI symptoms.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70046"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Cervical Vagus Nerve Stimulation Modulates Gastric Slow Waves in the Distal Rat Stomach.","authors":"Omkar N Athavale, Recep Avci, Alys R Clark, Leo K Cheng, Peng Du","doi":"10.1111/nmo.70030","DOIUrl":"10.1111/nmo.70030","url":null,"abstract":"<p><strong>Background: </strong>Gastric motility is coordinated by bioelectrical events, named slow waves, which propagate across the stomach. Gastric dysrhythmias are associated with disorders of gut-brain interaction. Electrical cervical vagus nerve stimulation (cVNS) affects gastric contractions, but associated changes in gastric slow waves have not been quantified.</p><p><strong>Methods: </strong>Three cVNS protocols (low: 0.30 ms, 0.25 mA, 1 Hz; medium: 0.50 ms, 0.50 mA, 5 Hz; high: 1.00 ms, 1.00 mA, 10 Hz) were administered to six rats. Gastric slow waves were concurrently recorded from the serosa of the antrum and distal corpus using flexible electrode arrays. Slow wave amplitude and frequency (mean ± standard deviation) were analyzed with a mixed linear effects model.</p><p><strong>Key results: </strong>cVNS had no effect on mean slow wave amplitude (p ≥ 0.2208). Slow wave frequency decreased during the high stimulation protocol compared to sham (3.93 ± 0.90 cpm to 3.49 ± 0.54 cpm, p = 0.0374, antrum; 3.94 ± 1.04 cpm to 3.15 ± 0.53 cpm, p < 0.0001, distal corpus) but returned to sham levels after a recovery period (p = 0.9190, antrum; p = 0.9995, distal corpus). Ectopic activation of gastric slow waves occurred during cVNS, resulting in a transient effect on gastric slow wave frequency and propagation but not amplitude.</p><p><strong>Conclusions & inferences: </strong>Slow wave activity was modified by acute medium and high cVNS stimulation protocols with changes in propagation patterns and mean frequency. Therefore, modified slow wave activity could affect gastric motility function during acute cVNS.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70030"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Hemoglobin A1c and Fecal Incontinence in a Nationwide Cohort Study.","authors":"Sanskriti Varma, Sonia Bhatia, Aditya Ashok, Braden Kuo, Kyle Staller","doi":"10.1111/nmo.70026","DOIUrl":"10.1111/nmo.70026","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal manifestations of diabetes include a variety of symptoms, including fecal incontinence (FI). We investigated the relationship between hemoglobin A1c and FI among US adults in a large, population-based survey.</p><p><strong>Methods: </strong>We identified adults (≥ 20 years) who completed the bowel health questionnaire and had A1c data in the National Health and Nutrition Examination Survey from 2005 to 2010 (N = 13,787). FI was defined as any involuntary loss of mucus, liquid, or solid stool during the last 30 days. Adjusted odds ratios (aORs) for FI were estimated in a multivariable logistic model according to A1c. Subgroup analyses examined relevant characteristics.</p><p><strong>Results: </strong>We identified 1283 (9.3%) adults with FI. A1c was associated with a 26% increase in the odds of FI (crude OR 1.26, 95% CI 1.20-1.33), which persisted after stepwise adjustment for age, demographic factors, and comorbidities (aOR 1.09, 95% CI 1.01-1.17). In subgroup analyses, A1c was associated with FI in diabetes (aOR 1.13, 95% CI 1.01-1.26), women (aOR 1.15, 95% CI 1.02-1.3), those < 65 years of age (aOR 1.17, 95% CI 1.09-1.25), overweight/obesity (aOR 1.1, 95% CI 1.02-1.20), non-white (aOR 1.1, 95% CI 1.01-1.20), and those with solid stool FI (aOR 1.17, 95% CI 1.04-1.32).</p><p><strong>Conclusion: </strong>Increasing A1c was associated with an increased odds of FI. Our study provides insights into subgroups of patients who may benefit from interventions aimed at glucose control to reduce this risk of FI.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70026"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Heavy Feeling in the Stomach: Neural Correlates of Anxiety in Crohn's Disease.","authors":"Silvia Tempia Valenta, Sara Ventura, Francesca Benuzzi, Fernando Rizzello, Paolo Gionchetti, Diana De Ronchi, Anna Rita Atti, Alessandro Agostini, Nicola Filippini","doi":"10.1111/nmo.70029","DOIUrl":"10.1111/nmo.70029","url":null,"abstract":"<p><strong>Introduction: </strong>Crohn's disease (CD) is a chronic inflammatory condition associated with psychological stress and anxiety. Functional magnetic resonance imaging (fMRI) studies have shown differences in brain function between patients with CD and healthy controls (HC). This study aimed to compare the neural correlates of anxiety inindividuals with CD relative to HC, using resting-state fMRI data.</p><p><strong>Methods: </strong>Participants filled in the State-Trait Anxiety Inventory (STAI), a validated tool for measuring anxiety, and underwent an MRI acquisition, including both structural and functional sequences, to identify brain regions associated with anxiety scores.</p><p><strong>Results: </strong>Seventeen patients with CD and eighteen HC matched for age, education, and sex participated in the study. No significant group differences emerged in the STAI scores. However, resting-state fMRI analysis revealed distinct patterns of functional connectivity associated with anxiety scores for the two study groups. Among CD group, greater STAI scores correlated with increased functional connectivity, whereas, in HC, they correlated with decreased functional connectivity. Significant clusters were found in brain regions belonging to specific resting-state networks (RSNs): (a) Posterior Cingulate Cortex (PCC, within the Default Mode Network), (b) left Middle Frontal Gyrus (within the Left Fronto-Parietal Network), and (c) PCC and right Superior Temporal Gyrus (within the Dorsal Attention Network).</p><p><strong>Conclusion: </strong>The differential association between functional connectivity and STAI scores observed for CD and HC participants was located in areas within self-referential (Default Mode Network) and cognitive (Left Fronto-Parietal Network and Dorsal Attention Network) RSNs. Our findings suggest that maladaptive/dysfunctional processing of negative emotions and visceral sensitivity may occur in patients with CD.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70029"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra- and Interobserver Variability of Acute Food-Induced Reactions During Confocal Laser Endomicroscopy: An International Multicenter Validation Study.","authors":"Lukas Michaja Balsiger, Tom van Gils, Yaser Hatem, Amanda Blomsten, Karlien Raymenants, Cedric Van de Bruaene, Leila Juvyns, Johann P Hreinsson, Tim Vanuytsel, Hans Törnblom, Christian Sina, Magnus Simren, Jan Tack","doi":"10.1111/nmo.70031","DOIUrl":"10.1111/nmo.70031","url":null,"abstract":"<p><strong>Background and study aims: </strong>Probe-based confocal laser endomicroscopy (pCLE) enables real-time microscopic visualization of the duodenal mucosa and has shown acute food-triggered disruption of the duodenal epithelial barrier of patients with irritable bowel syndrome (IBS). The interpretation of the recordings is subjective, with unknown agreement rates. The aim of this study was to investigate the intra- and interobserver variability of this technique.</p><p><strong>Patients and methods: </strong>An international multicenter study was performed, including pCLE recordings from three centers. Recordings were randomized and re-evaluated by five blinded experienced assessors. Low-quality recordings were excluded. The mucosa was considered altered if both fluorescein leakage and luminal particles were observed. Agreement was quantified using Fleiss' and Cohen's kappa (κ). Reference videos (i.e., videos with 100% agreement) were used to assess the optimal characteristics of videos needed to make a judgment based on the optimal receiver operating characteristic curve cutoff.</p><p><strong>Results: </strong>Of the 119 individual recordings, 87 could be used for analyses (total of 86,408 frames). Intraindividual agreement rate was 80%-100%, whereas the interindividual agreement rate was 85% (κ = 0.68). The agreement rate with the endoscopist ranged 54%-95% (κ = 0.15-0.89). The optimal cutoff to distinguish altered from unaltered was by observing alterations in ≥ 2 out of 6 mucosal spots (100% sensitivity and specificity).</p><p><strong>Conclusion: </strong>Our study showed a substantial to perfect intraobserver agreement and a substantial interobserver agreement for the judgment of acute food-triggered disruption of the duodenal epithelial barrier by pCLE, confirming that this real-time readout is reliable and reproducible.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70031"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling Swallowing Safety and Physiology in People With Huntington's Disease.","authors":"Claudia Raines, Makenna Clark, Cara Donohue","doi":"10.1111/nmo.70035","DOIUrl":"10.1111/nmo.70035","url":null,"abstract":"<p><strong>Introduction: </strong>Dysphagia is prevalent in individuals with Huntington's disease (HD), yet the underlying mechanisms of dysphagia remain unknown. We profiled swallowing safety and physiology in individuals with HD using the validated Penetration-Aspiration Scale (PAS) and the Modified Barium Swallow Impairment Profile (MBSImP).</p><p><strong>Methods: </strong>This retrospective study included 40 adults with HD who underwent videofluoroscopic swallow studies (VFSS) between 2018 and 2024 at Vanderbilt University Medical Center. Trained raters extracted demographics, disease characteristics (duration, United Huntington Disease Rating Scale [UHDRS] Motor Component Total scores, cytosine, adenine, guanine [CAG] repeats), and worst PAS scores from Epic. Two MBSImP-certified clinicians performed duplicate, independent, blinded ratings to obtain overall impairment and severity ratings. Inter- and intra-rater reliability, descriptive statistics, and Spearman's Rho correlations were performed.</p><p><strong>Key results: </strong>Swallowing safety profiles observed were 65% safe, 7.5% penetration, and 27.5% aspiration. 81% of aspirators did so silently. Relationships between PAS scores and disease duration (r_s = 0.336, p = 0.036) and PAS scores and UHDRS motor scores (r_s = 0.382, p = 0.020) were noted. 85% of MBSImP oral phase scores and 97.5% of pharyngeal phase scores had none-to-mild severity, while 15% and 2.5%, respectively, showed moderate severity. No significant correlations were observed between MBSImP scores, demographics, or disease characteristics.</p><p><strong>Conclusion & inferences: </strong>Individuals with HD exhibited greater impairments in swallowing efficiency than in safety, with the oral phase more affected than the pharyngeal. Relationships between swallowing safety and disease severity characteristics in HD suggest these metrics may serve as indicators of swallowing safety impairments, and that further assessment is warranted.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70035"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}