Neurogastroenterology and Motility最新文献

{"title":"Deciphering Gut Microbiome Dynamics in Irritable Bowel Syndrome Using Deep Learning.","authors":"Faisal, S R Mani Sekhar, D S Anurag, Vijaya Kumar, Dhruv Shetty, Divakar Sharma","doi":"10.1111/nmo.70153","DOIUrl":"https://doi.org/10.1111/nmo.70153","url":null,"abstract":"<p><strong>Purpose: </strong>This work delves into the critical role of the human gut microbiome in health and disease, emphasizing its influence on a range of physiological processes and its connection to conditions such as irritable bowel syndrome (IBS). The microbiome is made up of a very large and complicated group of microorganisms that have big effects on metabolic and immune functions. This makes it an interesting area for researching new ways to diagnose and treat diseases. Analyzing this data introduces substantial challenges due to its high dimensionality, intricate microbial interactions, and significant inter-individual variability.</p><p><strong>Methods: </strong>The above factors demand the application of sophisticated machine learning techniques that can efficiently manage and interpret such complex, high-dimensional data. The XGBoost, RandomForest, Logistic Regression, LightGBM, and a deep neural network (DNN) are specifically tailored for this work. Each model's implementation is meticulously designed to extract meaningful patterns from the microbiome data with the required preprocessing by focusing on achieving high accuracy, sensitivity, and specificity in disease classification. The models are implemented using Python's libraries and are evaluated through rigorous cross-validation on a comprehensive dataset of microbiome profiles to ensure robustness and reliability.</p><p><strong>Results: </strong>A comparison study is done to find out what each model does well and what it does not do so well. The DNN's dense layered neurocomputing pattern recognition skills make it very good at dealing with the complexity of microbiome data, resulting in an accuracy of 92.79%.</p><p><strong>Conclusion: </strong>This study not only adds to our knowledge of how the microbiome affects health, but it also pushes the limits of diagnostic methods. By using cutting-edge deep machine learning innovations in biomedical research, we may be able to improve health outcomes around the world.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70153"},"PeriodicalIF":2.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001042","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":"First Real-World Evidence of an AI-Enhanced Digital Collaborative Care Model to Improve IBS Symptoms.","authors":"Stephen E Lupe, Joseph M Olson, Kendra Kamp, Margaret Heitkemper, Mythili P Pathipati, Madison L Simons, Jordan Brown, Samuel N Jactel, Miguel Regueiro, Anthony Lembo, Tiffany H Taft","doi":"10.1111/nmo.70144","DOIUrl":"https://doi.org/10.1111/nmo.70144","url":null,"abstract":"<p><strong>Background and aims: </strong>Health systems struggle to deliver guideline-recommended multidisciplinary care to patients with irritable bowel syndrome (IBS). Digital collaborative care models (DCCMs) that integrate technology with experienced providers offer a promising solution for improving IBS management. We aimed to evaluate whether a novel DCCM improved clinical outcomes in IBS.</p><p><strong>Methods: </strong>A prospective, longitudinal uncontrolled single-arm study design was used to assess the Ayble Health program. Participants were recruited online via social media, clinic, or employer. Data were prospectively collected from 202 participants (78% female; 78% white) with active IBS symptoms at baseline (≥ 75 on the IBS symptom severity scale (IBS-SSS)) and completed at least one follow-up symptom survey. All participants engaged in at least one care pathway: (1) a multidisciplinary care team, (2) a nutrition program with a personalized elimination diet, and (3) a brain-gut behavioral therapy (BGBT) program. Each pathway was supported by AI algorithms trained on a large, multimodal GI dataset to identify and communicate key trends in patient-reported outcomes, further personalizing care plans.</p><p><strong>Results: </strong>Of the 202 participants, 197 (98%) participated in the nutrition pathway, 152 (75%) the BGBT pathway, and 156 (77%) the care team pathway. The majority of participants (62%) enrolled in all three pathways. Participants experienced a 140-point decrease in IBS-SSS, on average, with 86% experiencing a ≥ 50-point reduction.</p><p><strong>Conclusion: </strong>The novel DCCM successfully delivered evidence-based care to participants with active IBS symptoms, with clinically significant, sustained symptom relief. Randomized clinical trials are recommended to assess cost and treatment efficacy compared to standard of care approaches.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70144"},"PeriodicalIF":2.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001055","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":"Characterization of a Duodenal Propagating Wave Identified on High-Resolution Antroduodenal Manometry During the Digestive Phase.","authors":"Ricardo A Arbizu, Jose M Garza, Ikhianosen Ukhuedoba, Ariana Prezzie-Blue, Jessica Srouji, Leonel Rodriguez","doi":"10.1111/nmo.70152","DOIUrl":"https://doi.org/10.1111/nmo.70152","url":null,"abstract":"<p><strong>Background: </strong>The duodenal digestive phase shows irregular non-propagating pressure contractions on antroduodenal manometry (ADM). This study aims to characterize a specific duodenal wave during this phase using high-resolution ADM (HR-ADM).</p><p><strong>Methods: </strong>Twenty HR-ADM traces were analyzed. Duodenal waves were identified during meal ingestion and postprandially and assessed for: peaks/min, mean amplitude, area under the curve (AUC), frequency, propagation length, and velocity. Wave parameters and characteristics are described and compared according to patient symptomatology.</p><p><strong>Key results: </strong>Median patient age was 16 years (range 4-19), with 70% female. A total of 292 duodenal waves were identified: 142 during the meal and 150 postprandially. Wave parameter and characteristics by phase were: meal (4.4 ± 1.3 peaks/min, mean amplitude 30.9 ± 5.9 mmHg, AUC 295 ± 98.2 mmHg*s, frequency 0.23 ± 0.1 waves/min, 15.7 ± 4.4 cm propagation length, 1.6 ± 1.2 cm/s velocity) and postprandial (3.8 ± 1.3 peaks/min, mean amplitude 32 ± 6.4 mmHg, AUC 245.9 ± 76.2 mmHg*s, frequency 0.12 ± 0.07 waves/min, 17.4 ± 4.5 cm propagation length, 1.5 ± 0.2 cm/s velocity). All waves had antegrade propagation and were interspersed with semental non-propagating contractions. The wave AUC (p = 0.008) and frequency (p < 0.001) were significantly higher during the meal, while propagating length was longer postprandially (p = 0.009) on paired sample analysis. The wave frequency (p < 0.001) and AUC (p = 0.043) were significantly higher during the meal on independent sample analysis. No significant difference was found on the rest of the parameters or according to symptom type.</p><p><strong>Conclusion and inferences: </strong>This study describes an antegrade propagating duodenal wave during the digestive phase, which may facilitate nutrient movement to the distal small bowel.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70152"},"PeriodicalIF":2.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962404","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":"The Association of Avoidant/Restrictive Food Intake Disorder (ARFID) and Neurogastroenterology Disorders (Including Disorders of Gut-Brain Interaction [DGBI]): A Scoping Review.","authors":"Hiba Mikhael-Moussa, Valérie Bertrand, Emeline Lejeune, Claire Dupont, Alexandra Aupetit, Najate Achamrah, Chloé Melchior","doi":"10.1111/nmo.70039","DOIUrl":"10.1111/nmo.70039","url":null,"abstract":"<p><strong>Background: </strong>Patients with neurogastroenterology disorders like disorders of gut-brain interaction (DGBI) and gastrointestinal (GI) motility disorders often adopt restrictive diets to manage symptoms. Without professional guidance, these patients may risk developing avoidant/restrictive food intake disorder (ARFID), potentially affecting their physical and mental health.</p><p><strong>Purpose: </strong>This scoping review aimed to explore the prevalence of ARFID in patients with neurogastroenterology disorders and vice versa, the direction of their association, potential risk factors, and available treatments.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, we searched PubMed, Web of Science, and Cochrane. Abstracts were screened for eligibility by two independent reviewers.</p><p><strong>Key results: </strong>Eighteen studies met our inclusion criteria. The prevalence of ARFID symptoms in neurogastroenterology patients ranged from 10% to 80%, while the prevalence of neurogastroenterology disorders and related GI symptoms in ARFID patients ranged from 7% to 60%. Findings on the direction of the association between eating difficulties and GI symptom occurrence were conflicting. Patients with ARFID-neurogastroenterology disorder overlap were more likely to be female, have a lower BMI, higher anxiety and depression levels, and poorer quality of life. Two small studies evaluating treatment for this overlap suggested promising effects of cognitive behavioral therapy (CBT).</p><p><strong>Conclusions and inferences: </strong>This review highlights heterogeneity in study designs and questions the suitability of ARFID assessment tools in this context. It also underscores gaps in understanding the underlying pathophysiology and treatment approaches. Future research should prioritize validating ARFID screening tools specific to this population and standardizing study methodologies. Improved understanding of this overlap will help healthcare professionals improve management strategies and patient outcomes.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70039"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753698","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":"Artificial Intelligence Model for Time Series Classification: Prediction of Delayed Balloon Expulsion Test Using High-Resolution Anorectal Manometry Data and Time-Series Integrated Pressurized Volume.","authors":"Myeongsook Seo, Kiwon Yoon, Kee Wook Jung, Seung-Jae Myung, Satish S C Rao, Segyeong Joo","doi":"10.1111/nmo.70044","DOIUrl":"10.1111/nmo.70044","url":null,"abstract":"<p><strong>Background: </strong>We previously demonstrated the novel concept of using the integrated pressurized volume (IPV) with high-resolution anorectal manometry (HRAM) and found that it was predictive of delayed balloon expulsion (BE) test results. However, previous IPV methods did not account for chronological changes in anorectal force. To fully utilize the temporal dynamics of HRAM data and enhance BE test prediction, we introduced time-series IPVs (TS-IPVs) and developed an artificial intelligence (AI)-based diagnostic model.</p><p><strong>Methods: </strong>A total of 300 patients with constipation (130 male and 170 female patients) were enrolled and underwent HRAM and BE tests from September 2020 to May 2021. The TS-IPVs were calculated within a particular time interval during the push maneuver. Convolutional neural networks (CNNs) and a long short-term memory (LSTM) network were applied to predict BE test results.</p><p><strong>Key results: </strong>Delayed BE was observed in 69 (53.1%) male and 49 (28.8%) female patients. According to the receiver operating characteristic curve analysis, the TS-IPV ratio between the upper 1 cm and lower 3 cm of the anal canal (TS-IPV₁₃ ratio) was the best parameter for predicting BE test results in all patients. Using the TS-IPV₁₃ ratio, the proposed model achieved area under the curve (AUC) values of 0.988 and 0.996 for female and male patients, respectively.</p><p><strong>Conclusions and inferences: </strong>Our AI model accurately classified delayed BE test results using raw HRAM data and TS-IPVs of male and female patients with an AUC of 0.99. Furthermore, the model used time-variant HRAM pressure data and TS-IPVs throughout the push maneuver without any data loss; therefore, TS-IPV could be used as a more reliable marker than conventional parameters for classifying delayed BE test results.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70044"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780640","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":"Studying the Role of Myenteric Amyloidosis in Gastrointestinal Dysmotility and Enteric Neural Dysfunction Using APP/PS1 Mice-Is It an Adequate Animal Model?","authors":"Roxanne Fernandes, Marlene Masino, Emma Flood, Theresa A Lansdell, Nikitha Srikrishna, Ryan Mui, Anne M Dorrance, James J Galligan, Hui Xu","doi":"10.1111/nmo.70056","DOIUrl":"10.1111/nmo.70056","url":null,"abstract":"<p><strong>Background: </strong>The Gastrointestinal (GI) microbiome and gut-brain axis are associated with the progression and pathology of Alzheimer's disease (AD). Amyloid deposition is thought to be a driver of AD, causing synaptic dysfunction and neuronal death in the brain. Chronic constipation is a common gastrointestinal (GI) dysmotility in AD patients, which impacts patient outcomes and quality of life. It is unknown if enteric amyloidosis disrupts myenteric neuron function and causes GI dysmotility.</p><p><strong>Methods: </strong>Untreated male and female APP/PS1 (a transgenic murine model of brain amyloidosis) and sex-matched control mice were followed until 12 months of age. A separate cohort of mice was treated with a vehicle or the beta-secretase (BACE1) inhibitor, lanabecestat, starting at 5 months of age until 7 months. GI motility was assessed in all mice by measuring whole GI transit in vivo. Propulsive colonic motility and GI smooth muscle contractions were measured ex vivo. At 7 or 12 months old, amyloidosis in the brain and myenteric plexus was determined by immunohistochemistry or ELISA; the myenteric neural density, including the cholinergic and nitrergic neurons, was evaluated by immune staining and RT-PCR; expression of pro-inflammatory factors in the GI wall was assessed by RT-PCR.</p><p><strong>Key results: </strong>By 7 months of age, male and female APP/PS1 mice developed abundant amyloid plaques in the brain. Aged untreated male APP/PS1 mice also demonstrated Aβ deposition in the colonic myenteric ganglia, which was associated with increased fecal output and faster whole GI transit starting at 4-7 months old, but vehicle- and lanabecestat-treated male APP/PS1 mice had similar GI motility to their non-genetic controls until 7 months old. None of the female APP/PS1 mice showed GI dysmotility or myenteric amyloidosis. Two months of lanabecestat treatment effectively reduced amyloid plaque burden in the brains of female APP/PS1 mice but not in male APP/PS1 mice. Treatment with lanabecestat did not affect myenteric Aβ intensity or GI motility in all APP/PS1 mice. All APP/PS1 mice did not show myenteric neuronal degeneration or inflammation until 12 months old.</p><p><strong>Conclusions: </strong>APP/PS1 mice do not recapitulate myenteric amyloidosis persistently and lack the phenotype of constipation observed in human AD patients; these mice should not be considered an adequate murine model for studying the role of myenteric amyloidosis in GI dysmotility. An adequate animal model with myenteric amyloidosis is required for further study.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70056"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012147","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":"Study on the Effect and Mechanism of Weichang'an Pill and Its Extract on Slow Transit Constipation.","authors":"Na Wang, Xingyue Lu, Panwei Gao, Peng Zhang, Yi Wang, Lin Miao, Han Zhang, Lijuan Chai","doi":"10.1111/nmo.70052","DOIUrl":"10.1111/nmo.70052","url":null,"abstract":"<p><strong>Background: </strong>Weichang'an pill (WCA) possesses potential advantages in promoting gastrointestinal motility and treating constipation. Ethanol extract (EE) and aqueous extract (AE) of WCA were used to investigate its efficacy in treating slow transit constipation (STC) and the material basis for exerting this effect.</p><p><strong>Methods: </strong>The STC model was established in vivo by gavage of loperamide (Lop) in Sprague-Dawley rats, followed by gavage of WCA, EE, and AE. In vitro, norepinephrine (NE) was used to stimulate isolated ileal smooth muscle of rats to imitate the state of insufficient gastrointestinal motility during STC, and a model of excessive relaxation of isolated ileal smooth muscle was established. This model was used to observe and record the changes in contraction tension, amplitude, and frequency of ileal smooth muscle after treatment with WCA, EE, AE, and the active ingredients of WCA.</p><p><strong>Key results: </strong>In vivo, WCA, EE, and AE treatment increased fecal parameters, improved gastrointestinal transit time, and alleviated pathological damage to the colon in STC rats. Its mechanism might be closely related to c-kit/SCF, RhoA/ROCK/MYPT1/MLC signaling pathways. In vitro, WCA, EE, AE, and the active ingredients of WCA, including costunolide (Cos), dehydrocostus lactone (Deh), agarotetrol (Aga), muscone (Mus), gallic acid (GA), oleic acid (Oleic), linoleic acid (Lin), umbelliferone (Umb), synephrine (Syn), ferulic acid (FA), chlorogenic acid (ChA), betaine (Bet), and riboflavin (Rib), significantly inhibited the NE-induced excessive relaxation of ileal smooth muscles.</p><p><strong>Conclusions: </strong>WCA, EE, and AE significantly improved constipation in STC rats. Moreover, the active ingredients in WCA, including Cos, Deh, Aga, Mus, GA, Oleic, Lin, Umb, Syn, FA, ChA, Bet, and Rib, might be the material basis for promoting intestinal motility.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70052"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005553","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":"The Burden of Fecal Incontinence: Evaluating the Societal Impact in Terms of Economic Burden and Health-Related Quality of Life.","authors":"Sadé L Assmann, Merel L Kimman, Stéphanie O Breukink, Daniel Keszthelyi","doi":"10.1111/nmo.70036","DOIUrl":"10.1111/nmo.70036","url":null,"abstract":"<p><strong>Introduction: </strong>Fecal incontinence (FI) is a chronic condition characterized by the involuntary loss of stool, significantly impacting health-related quality of life (HRQoL) and imposing a substantial economic burden on society.</p><p><strong>Methods: </strong>This bottom-up, retrospective, cross-sectional burden of disease study offers a comprehensive cost analysis of FI in a Dutch population sample. Utilizing the iMTA Medical Consumption Questionnaire (MCQ) and the iMTA Productivity Cost Questionnaire (PCQ), we analyzed costs over a 3-month period from a societal perspective, which encompasses healthcare costs, out-of-pocket expenses, and productivity losses. Non-parametric bootstrapping was applied to identify differences in costs between several subgroups of patients. Additionally, we assessed HRQoL using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire. Differences in HRQoL between subgroups were determined using the nonparametric Mann-Whitney U test.</p><p><strong>Results: </strong>Cost and HRQoL data were collected from 80 FI patients aged 39-89 (82.5% female). The mean societal costs were €2424 per patient per quarter, of which €1572 can be contributed to healthcare costs. Notably, unemployed patients incurred significantly higher costs compared to employed and retired patients. No significant difference in costs was seen between subgroups based on gender, age, educational level, or frequency of FI episodes. The mean HRQoL score was 0.72 (SD 0.78). Younger and unemployed patients reported lower HRQoL scores.</p><p><strong>Conclusion: </strong>This study demonstrates that FI negatively impacts HRQoL and has a considerable impact on societal costs, extending beyond direct healthcare expenses. Policymakers, healthcare providers, and employers should take these findings into account when designing management strategies and allocating resources for FI treatment and support.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70036"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772917","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":"Esophageal Intelligence: Implementing Artificial Intelligence Into the Diagnostics of Esophageal Motility and Impedance pH Monitoring.","authors":"Amir Farah, Wisam Abboud, Edoardo V Savarino, Amir Mari","doi":"10.1111/nmo.70038","DOIUrl":"10.1111/nmo.70038","url":null,"abstract":"<p><p>Esophageal motility disorders (EMDs) encompass a range of functional abnormalities, including achalasia, ineffective esophageal motility (IEM), esophagogastric junction outflow obstruction (EGJOO), and distal esophageal spasm (DES). Diagnostic modalities like high-resolution esophageal manometry (HREM), Functional Lumen Imaging Probe (FLIP), and impedance analysis are invaluable but often limited by interpretive variability and the need for expert analysis. Artificial intelligence (AI) has emerged as a transformative tool in addressing these challenges. This manuscript explores the integration of AI in EMD diagnostics, showcasing its ability to enhance diagnostic accuracy, optimize workflows, and standardize interpretation across centers. Advanced algorithms, including convolutional neural networks (CNNs) and machine learning (ML) models, achieve high accuracy in automating classifications, subtyping disorders like achalasia, and improving diagnostic consistency. Furthermore, AI's predictive capabilities extend to treatment outcome modeling, enabling personalized care strategies and longitudinal tracking. AI also offers significant potential in medical education by reducing learning curves and standardizing esophageal motility interpretation training. These advancements collectively emphasize the role of AI in revolutionizing EMD diagnosis, treatment, and training, promising improved patient outcomes and broader clinical utility.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70038"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720817","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":"Intervening Mechanisms of Amitriptyline Combined With Domperidone on Functional Dyspepsia Rats.","authors":"Xinyao Pei, Yue Ma, Jingyan Gu, Xueyun He, Yanyu Lu, Yudong Wang, Xujiang Hao, Yongbiao Tao, Hongfang Li","doi":"10.1111/nmo.70070","DOIUrl":"10.1111/nmo.70070","url":null,"abstract":"<p><strong>Objectives: </strong>The long-term recurrent symptoms of functional dyspepsia (FD) and the prolonged course of the disease lead to varying degrees of psychological disorders in patients. The study focuses on investigating the effects of the psychological drug amitriptyline on FD rats, aiming to provide a basis for the mechanism of action in treating FD from a clinical psychological perspective.</p><p><strong>Methods: </strong>A rat model of FD was used to assess gastric emptying, intestinal propulsion, visceral sensitivity, and behavioral states after treatment with amitriptyline, domperidone, or both drugs. The concentrations of 5-hydroxytryptamine (5-HT) and the expression of related signaling molecules were measured using ELISA, RT-qPCR, and Western blot. Gastrointestinal motility was also evaluated through muscle perfusion experiments, and the composition of gut microbiota was analyzed using 16S rRNA sequencing.</p><p><strong>Results: </strong>Amitriptyline, either alone or combined with domperidone, improved FD rat behavioral scores, food intake, and mental status in FD rats. It increased 5-HT concentrations in plasma and gastrointestinal tissue, decreased visceral sensitivity, and altered the expressions of 5-HT2B receptor, phospholipase C-β₂, IP₃ receptor, and calcium-activated chloride channel anoctamin 1 (ANO1) in the gastrointestinal tissues. Although amitriptyline had no significant effect on in vivo gastric or intestinal transit rates, it significantly inhibited the contractile activity of isolated gastrointestinal muscle strips and exhibited anticholinergic effects. Additionally, amitriptyline either alone or combined with domperidone increased the relative abundance of Actinomycetota and specifically the Eggerthellales order in the gut microbiota.</p><p><strong>Conclusions: </strong>The combination of amitriptyline and domperidone relieves anxiety and depression, improves gastrointestinal motility by targeting the 5-HT2BR, PLCβ₂, and IP₃R signaling pathways, and modulates the gut microbiota. This integrated approach alleviates FD symptoms through multiple mechanisms and pathways, presenting a promising therapeutic strategy.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70070"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021103","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}