Neurogastroenterology and Motility最新文献

Differential Neurogenesis Status Among Achalasia Subtypes.

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-11 DOI: 10.1111/nmo.70021

Qianjun Zhuang, Niandi Tan, Xun Hou, Songfeng Chen, Xingyu Jia, Mengyu Zhang, Fangfei Chen, Zhanye Zhang, Xiangbin Xing, Yinglian Xiao

{"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":"https://doi.org/10.1111/nmo.70021","url":null,"abstract":"Backgrounds and aims: 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.Methods: 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.Key results: 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+).Conclusions: 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.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70021"},"PeriodicalIF":3.5,"publicationDate":"2025-03-11","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}

引用次数: 0

Prevalence and Factors Associated With Symptom Profiles of Disorders of Gut-Brain Interaction in Obesity Before and After Treatment. 肥胖症治疗前后肠脑互动紊乱症状特征的发生率和相关因素。

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-10 DOI: 10.1111/nmo.70017

Esther Colomier, Janita Halminen, Malin Björck, Gudrún Höskuldsdóttir, Karin Mossberg, My Engström, Björn Eliasson, Ville Wallenius, Lars Fändriks, Jan Tack, Hans Törnblom, Magnus Simrén

{"title":"Prevalence and Factors Associated With Symptom Profiles of Disorders of Gut-Brain Interaction in Obesity Before and After Treatment.","authors":"Esther Colomier, Janita Halminen, Malin Björck, Gudrún Höskuldsdóttir, Karin Mossberg, My Engström, Björn Eliasson, Ville Wallenius, Lars Fändriks, Jan Tack, Hans Törnblom, Magnus Simrén","doi":"10.1111/nmo.70017","DOIUrl":"https://doi.org/10.1111/nmo.70017","url":null,"abstract":"Background & aims: Disorders of gut-brain interaction (DGBI) in obesity could impair health outcomes. Therefore, we aimed to study the prevalence and burden of symptoms compatible with a DGBI in obesity and assess the effect of obesity treatment on comorbid DGBI.Methods: We used baseline and two-year follow-up data from a prospective non-randomized cohort study including patients with obesity referred for obesity treatment. Patients completed the Rome III questionnaire before and after receiving Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), or medical treatment. Validated questionnaires and blood parameters were used to assess the burden of DGBI in obesity.Results: In total, 939 patients (73% female, 44 ± 13 years, 42 ± 5 kg/m2, 36% medical treatment, 38% RYGB, 20% SG) completed the Rome III questionnaire at baseline and 651 patients (32 ± 6 kg/m2) at follow-up. The proportion of patients with a DGBI symptom profile was reduced from 61% (24% esophageal, 27% gastroduodenal, 38% bowel, and 8% anorectal disorders) to 53% (15% esophageal, 25% gastroduodenal, 34% bowel, 8% anorectal disorders) at follow-up. There was a substantial shift between the baseline and follow-up DGBI symptom profiles across all GI regions. Patients with a DGBI symptom profile at baseline presented with more severe psychological distress, a poorer quality of life, and were more likely to be female.Conclusions: DGBI symptom profiles are common and can impair health outcomes in obesity. Obesity treatment lowers the prevalence of DGBI symptoms in general, but an important shift between baseline and follow-up DGBI symptom profiles across all GI regions can be observed.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70017"},"PeriodicalIF":3.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586408","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}

引用次数: 0

The Vibrating Capsule: Safety and Tolerability in Patients With Chronic Idiopathic Constipation. 振动胶囊：慢性特发性便秘患者的安全性和耐受性

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-10 DOI: 10.1111/nmo.15004

Bryan F Curtin, Eamonn M M Quigley, William D Chey, Anthony J Lembo, Darren M Brenner, Brennan M R Spiegel, Satish S C Rao

{"title":"The Vibrating Capsule: Safety and Tolerability in Patients With Chronic Idiopathic Constipation.","authors":"Bryan F Curtin, Eamonn M M Quigley, William D Chey, Anthony J Lembo, Darren M Brenner, Brennan M R Spiegel, Satish S C Rao","doi":"10.1111/nmo.15004","DOIUrl":"https://doi.org/10.1111/nmo.15004","url":null,"abstract":"Background: Chronic idiopathic constipation (CIC) remains a significant problem globally with increasing estimates for disease burden. In a Phase 3 placebo-controlled trial, a novel treatment using the Vibrating Capsule was recently shown to be effective in treating patients with CIC. However, its safety and tolerability has not been described in detail.Methods: We analyzed safety data from six trials encompassing the development of the Vibrating Capsule, including, dose-ranging and pivotal studies. The incidence of adverse events, treatment discontinuation, tolerability and satisfaction were assessed.Key results: A total of 800 patients who took either an active Vibrating Capsule or a sham/placebo (non-vibrating) but similar capsule from 6 studies were included in this post hoc analysis. The most common adverse gastrointestinal events were bloating (2.9%), abdominal pain (2.9%), nausea (2.3%) and diarrhea (1.9%). A sensation of vibration was reported by 11.7% of patients. The adverse events rates were low, and investigators categorized most of them as unrelated to treatment. There were no serious adverse events such as retention of therapeutic capsules and no patient stopped therapy or withdrew due to adverse effects. The majority of patients (83%) found the system convenient, with an overall treatment satisfaction rate of 71%.Conclusions and inferences: The Vibrating Capsule, a first in class treatment for CIC was found to be safe and well tolerated by patients in clinical trials. No patient discontinued treatment due to adverse events.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e15004"},"PeriodicalIF":3.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586381","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}

引用次数: 0

Trends in Prevalence of Rome IV Disorders of Gut-Brain Interaction During the COVID-19 Pandemic: Results From a Nationally Representative Sample of Over 160,000 People in the US.

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-10 DOI: 10.1111/nmo.70020

Christopher V Almario, So Yung Choi, William D Chey, Brennan M R Spiegel

{"title":"Trends in Prevalence of Rome IV Disorders of Gut-Brain Interaction During the COVID-19 Pandemic: Results From a Nationally Representative Sample of Over 160,000 People in the US.","authors":"Christopher V Almario, So Yung Choi, William D Chey, Brennan M R Spiegel","doi":"10.1111/nmo.70020","DOIUrl":"https://doi.org/10.1111/nmo.70020","url":null,"abstract":"Background: We hypothesized that disorders of gut-brain interaction (DGBI) increased during the pandemic due to the enteropathic nature of SARS-CoV-2, together with the potential for COVID-19 pandemic-related stress to negatively impact the gut-brain axis. To test our hypothesis, we conducted a series of pre-specified cross-sectional surveys initiated at the beginning of the pandemic to trend the prevalence of Rome IV DGBI over time among a nationally representative sample of more than 160,000 people in the US.Methods: From May 2020 to May 2022, we performed a series of cross-sectional online surveys among a representative sample of adults ≥ 18 years old in the US. We administered Rome IV gastroduodenal and bowel DGBI questionnaires (e.g., chronic idiopathic constipation [CIC], functional bloating, functional dyspepsia, irritable bowel syndrome [IBS]) along with sociodemographic and comorbidity questions. Multivariable logistic regression was used to adjust for time and potential confounders.Results: Overall, 160,154 people completed the surveys. During the COVID-19 pandemic, the prevalence of IBS (6.1% [May 2020] to 11.0% [May 2022]; +0.188%/month; adjusted p < 0.001) and CIC (6.0% [May 2020] to 6.4% [May 2022]; +0.056%/month; adjusted p < 0.001) increased over time. Among those with IBS, the largest prevalence increase was seen in mixed IBS (+0.085%/month), followed by IBS with constipation (+0.041%/month) and IBS with diarrhea (+0.037%/month). No changes in prevalence were seen for the other examined gastroduodenal and bowel DGBI.Conclusions: During the COVID-19 pandemic, we observed significant increases over time in the prevalence of IBS and CIC. Further research exploring pathophysiologic mechanisms underlying these findings and whether these trends persist beyond the pandemic is warranted.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70020"},"PeriodicalIF":3.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586382","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}

引用次数: 0

Gastrointestinal Dysfunction and Low-Grade Inflammation Associate With Enteric Neuronal Amyloid-β in a Model for Amyloid Pathology.

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-06 DOI: 10.1111/nmo.15016

Kinga Réka Tasnády, Reindert Jehoul, Manuel Gutiérrez de Ravé, Marion J Gijbels, Bert Brône, Ilse Dewachter, Veerle Melotte, Werend Boesmans

{"title":"Gastrointestinal Dysfunction and Low-Grade Inflammation Associate With Enteric Neuronal Amyloid-β in a Model for Amyloid Pathology.","authors":"Kinga Réka Tasnády, Reindert Jehoul, Manuel Gutiérrez de Ravé, Marion J Gijbels, Bert Brône, Ilse Dewachter, Veerle Melotte, Werend Boesmans","doi":"10.1111/nmo.15016","DOIUrl":"https://doi.org/10.1111/nmo.15016","url":null,"abstract":"Background: Patients suffering from Alzheimer's disease, a progressive neurodegenerative disorder involving cognitive decline and memory impairment, often present with gastrointestinal comorbidities. Accumulating data also indicate that alterations in the gut can modulate Alzheimer's disease pathology, highlighting the need to better understand the link between gastrointestinal abnormalities and neurodegeneration in the brain.Methods: To disentangle the pathophysiology of gastrointestinal dysfunction in Alzheimer's disease, we conducted a detailed pathological characterization of the gastrointestinal tract of 5xFAD mice by performing histological analyses, gene expression studies, immunofluorescence labeling and gut function assays.Results: We found that 5xFAD mice have elevated levels of intestinal amyloid precursor protein and accumulate amyloid-β in enteric neurons. Histopathology revealed that this is associated with mild intestinal inflammation and fibrosis and accompanied by increased expression of proinflammatory cytokines. While overall enteric nervous system composition and organization appeared unaffected, 5xFAD mice have faster gastrointestinal transit.Conclusion: Our findings indicate that amyloid-β accumulation in enteric neurons is associated with low-grade intestinal inflammation and altered motility and suggest that peripheral pathology may cause gastrointestinal dysfunction in Alzheimer's disease patients.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e15016"},"PeriodicalIF":3.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573465","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}

引用次数: 0

Therapeutic Value of Lactobacillus gasseri 345A in Chronic Constipation.

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-03 DOI: 10.1111/nmo.70012

Stefan Roos, Atti-La Dahlgren, Yu-Kang Mao, Anton Pallin, Andrew M Stanisz, Paul Forsythe, Wolfgang Kunze, Per M Hellström

{"title":"Therapeutic Value of Lactobacillus gasseri 345A in Chronic Constipation.","authors":"Stefan Roos, Atti-La Dahlgren, Yu-Kang Mao, Anton Pallin, Andrew M Stanisz, Paul Forsythe, Wolfgang Kunze, Per M Hellström","doi":"10.1111/nmo.70012","DOIUrl":"https://doi.org/10.1111/nmo.70012","url":null,"abstract":"Background: Chronic constipation is a prevalent, burdensome gastrointestinal disorder whose etiology and pathophysiology remain poorly understood. Differences in the composition of the intestinal microbiota have been shown between constipated patients and healthy people. Data indicate that these microbial differences contribute to the disorder.Methods: Preclinical studies in mice examined the effects of Lactobacillus gasseri on intestinal motility ex vivo, the reversal of motility inhibition by μ-opioid receptor agonists ex vivo and in vivo in mice, and the effects on capsaicin-stimulated transient receptor potential vanilloid 1 (TRPV1) in Jurkat cells. Thereafter, a clinical study of 40 women with functional constipation was conducted to investigate the effects of Lactobacillus gasseri with a randomized parallel design. After 14 days of baseline recording, treatment with Lactobacillus gasseri or placebo was given over 28 days, with 14 days of follow-up. Outcomes with complete spontaneous bowel movements (CSBM), spontaneous bowel movements, emptying frequency, abdominal pain, time spent for defecation, Bristol stool form scale, use of rescue laxatives, and impact on sex life were investigated.Key results: In preclinical studies, Lactobacillus gasseri increased intestinal motility in an ex vivo model, reversed the motility inhibition caused by μ-opioid receptor agonist ex vivo and in vivo in mice, and counteracted capsaicin-stimulated activity of TRPV1 in Jurkat cells. In the clinical trial, Lactobacillus gasseri showed a significant reduction in abdominal pain, along with a correlation and tendency for an increased number of CSBM. Few adverse events were encountered.Conclusions and inferences: Treatment with Lactobacillus gasseri can alleviate pain sensations in functional constipation, possibly with an improved bowel-emptying function.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70012"},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542581","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}

引用次数: 0

Decoding Gastric Reflexes: The Role of Mechanosensitive Enteric Neurons in Stomach Motility.

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-03 DOI: 10.1111/nmo.70011

Gemma Mazzuoli-Weber, Sophia Mayr, Kristin Elfers

{"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":"https://doi.org/10.1111/nmo.70011","url":null,"abstract":"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.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70011"},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterization of Anal Slow Waves and Ultraslow Waves in Patients With Constipation and Healthy Subjects.

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-03 DOI: 10.1111/nmo.70006

Lulu Zhang, Yoav Mazor, Gillian Prott, Michael Jones, Allison Malcolm

{"title":"Characterization of Anal Slow Waves and Ultraslow Waves in Patients With Constipation and Healthy Subjects.","authors":"Lulu Zhang, Yoav Mazor, Gillian Prott, Michael Jones, Allison Malcolm","doi":"10.1111/nmo.70006","DOIUrl":"https://doi.org/10.1111/nmo.70006","url":null,"abstract":"Background: Anal slow waves (SW) and ultraslow waves (USW) have been documented previously, yet their significance remains uncertain. Our aims were to characterize the prevalence and features of SW and USW in healthy subjects and patients with constipation and to correlate them with clinical features and anorectal physiological testing.Methods: Forty-three healthy female subjects and 83 female tertiary referral patients with constipation were included. High-resolution water-perfused manometry was performed. Retrospective blinded descriptive and quantitative analyses of manometric tracings were completed with a focus on SW and USW.Key results: SW were present in 58% of healthy subjects and 62% of constipated patients (p = 0.72) yet USW were seen almost exclusively in constipated patients (27% vs. 2% health; p < 0.0001). Frequencies and mean amplitudes of SW and USW were similar in both groups. Anal resting and squeeze pressures were higher in patients with SW compared to those without (p < 0.001, p = 0.004, respectively). Patients with USW had higher anal resting pressure and shorter duration of sustained squeeze compared to those without (p < 0.001 for both). There was a trend for less obstetric injury in constipated patients with USW compared to those without (23% vs. 48%; p = 0.05).Conclusions and interferences: While SW were common in both constipated and healthy subjects, USW were almost exclusively observed in constipated patients. Some correlations were observed with other anorectal physiology parameters such as high resting anal pressure with both SW and USW. Formal definitions for SW and USW are proposed. Further research into the clinical significance of these waves is warranted.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70006"},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542636","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}

引用次数: 0

The Impact of Pediatric Disorders of Gut-Brain Interaction on the Family: The Mediating Role of Child Somatic Symptoms.

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-03 DOI: 10.1111/nmo.70014

Katlyn Garr, Cathleen Odar Stough, Meghan Flannery, Desale Yacob, Neetu Bali Puri, Ashley Kroon Van Diest

{"title":"The Impact of Pediatric Disorders of Gut-Brain Interaction on the Family: The Mediating Role of Child Somatic Symptoms.","authors":"Katlyn Garr, Cathleen Odar Stough, Meghan Flannery, Desale Yacob, Neetu Bali Puri, Ashley Kroon Van Diest","doi":"10.1111/nmo.70014","DOIUrl":"https://doi.org/10.1111/nmo.70014","url":null,"abstract":"Background: It is important to identify modifiable factors to reduce the negative impact of pediatric disorders of gut-brain interaction (DGBIs) on the family. The current study examined whether child somatic symptoms and caregiver mental health negatively influenced caregiver and family functioning.Methods: Participants were 84 children (8-17 years old) with DGBI symptoms and their caregivers presenting to a specialty DGBI clinic. Participants completed measures assessing demographics, child somatic symptoms, caregiver anxiety and depressive symptoms, and the impact of the child's illness on the family. Regression analyses examined if child somatic symptoms and caregiver and mental health were associated with family outcomes (i.e., Caregiver Health-Related Quality of Life [HRQoL], Family Functioning, Total Family Impact). Mediation analyses examined if child somatic symptoms mediated the association between caregiver mental health and Total Family Impact.Key results: Child somatic symptoms (self- and caregiver-report) were negatively related to Caregiver HRQoL, Family Functioning, and Total Family Impact (ps < 0.01). Caregiver anxiety was related to poorer Caregiver HRQoL (p < 0.001) and Total Family Impact (p = 0.01), while caregiver depression was negatively related to Family Functioning (p = 0.01). Self-report of child somatic symptoms partially mediated the association between caregiver anxiety and depressive symptoms and the Total Family Impact.Conclusions and inferences: Findings indicate that child somatic symptoms are one pathway by which caregiver mental health may amplify the impact of pediatric DGBIs on the family. This highlights the importance of screening for child somatic symptoms and caregiver mental health in pediatric DGBI treatment.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70014"},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542639","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}

引用次数: 0

Validation of the Dynamic Imaging Grade of Swallowing Toxicity for Amyotrophic Lateral Sclerosis.

IF 3.5 3区医学

Neurogastroenterology and Motility Pub Date : 2025-03-03 DOI: 10.1111/nmo.70008

Veena Kallambettu, Justine Dallal York, Terrie Vasilopolous, Katherine Hutcheson, Emily Plowman

{"title":"Validation of the Dynamic Imaging Grade of Swallowing Toxicity for Amyotrophic Lateral Sclerosis.","authors":"Veena Kallambettu, Justine Dallal York, Terrie Vasilopolous, Katherine Hutcheson, Emily Plowman","doi":"10.1111/nmo.70008","DOIUrl":"https://doi.org/10.1111/nmo.70008","url":null,"abstract":"Introduction: Although dysphagia is prevalent in persons with amyotrophic lateral sclerosis (pALS) and is associated with morbidity and mortality, no validated outcomes currently exist for the gold standard videofluoroscopy (VF) exam. We therefore sought to psychometrically validate the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale in pALS.Methods: One hundred pALS attended a research evaluation and underwent a standardized VF and validated clinical outcomes of oral intake (FOIS), perceived swallowing impairment (EAT-10), and ALS disease progression (ALSFRS-Revised). Duplicate, independent, and blinded VF ratings were completed using the DIGEST and MBSImP scales. Weighted kappa, ANOVAs (Tukey's HSD, Welch's correction), and Chi-square analyses were performed to determine intra- and inter-rater reliability, criterion validity, and construct validity of the DIGEST scale for use in pALS.Results: The mean age was 64.4(SD = 10.4), 50% were male, and the average ALS duration was 28.2 months (SD = 22.2). Excellent intra-rater (kappa = 0.92-1.0) and inter-rater (kappa = 0.94) reliability were noted for DIGEST ratings. DIGEST grades significantly discriminated pharyngeal pathophysiology (MBSImP, F(3,96) = 24.7, p < 0.0001), perceived dysphagia (EAT-10, F(3,40) = 20.8, p < 0.0001), oral intake (FOIS, X2:25.4, df = 3, p < 0.0001), ALS bulbar disease progression (ALSFRS-bulbar, F(3,93) = 20.8, p < 0.0001) with main effects noted for all analyses. Post hoc pairwise comparisons noted differences across all DIGEST grades with the exception of DIGEST 2 versus 3 (moderate vs. severe dysphagia), p > 0.05.Conclusions: These data confirm that the DIGEST scale is a reliable and valid VF outcome for use in pALS to distinguish normal versus impaired swallowing and mild versus moderate or severe dysphagia for use in clinical practice and as a clinical trial endpoint marker.","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70008"},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542582","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}

引用次数: 0