Magnetic Resonance Imaging of the Brain and Stomach in Healthy Volunteers and Gastroparesis
Magnetic Resonance Imaging of the Brain and Stomach in Healthy Volunteers and Gastroparesis
The study is to lay the groundwork for non invasive imaging of the GI tract and the brain gut
 interaction
Magnetic resonance imaging (MRI) produces non-invasive exquisite spatial resolution of
 internal organs. However, its application to the GI tract has been limited by several
 challenges. The GI tract has a complex and convoluted geometry. The GI geometry changes
 slowly over the course of meal digestion, as well as rapidly due to contraction of various
 compartments of the GI tract. As a person takes natural breaths during MRI, the respiratory
 motion further complicates the acquisition and analysis of GI images. In addition, different
 types of meal or nutrients have variable property as image contrast in upper GI MRI. It is
 difficult to standardize the MRI analysis for accurate and quantitative assessment of gastric
 emptying, motility, absorption, and secretion, to name a few. In a recently published study
 by our research collaborators at Purdue University, they have addressed many of these
 challenges in rodents and are ready to refine and translate their technical solutions to
 human upper GI MRI.

 Functional MRI of the brain has been used to study afferent response in various GI disorders,
 such as dysphagia, functional dyspepsia, and irritable bowel syndrome.1-3 Brain activity is
 altered in the emotional response areas, and activity is reduced in the areas associated with
 top-down modulation of visceral afferent signals.4 However, direct correlation between
 regional brain activation by functional-MRI and GI motility by meal-contrast MRI is lacking.

 The outcome of the proposed research is expected to lay the groundwork for non-invasive
 imaging of GI anatomy and function and the brain-gut interaction towards better
 understanding, diagnosis, prevention, and treatment of GI disorders.
HEALTHY VOLUNTEERS

 Inclusion Criteria:

 • Healthy volunteers from 18 to 65 years of age

 Exclusion Criteria:

 -  Contraindication to MR scanning: pregnancy, implanted gastric stimulator, neural
 stimulator, implanted cardiac pacemaker, auto-defibrillator, cochlear implant, ocular
 foreign body (e.g. metal shavings), pain pump, insulin pump or any pre-existing eye
 conditions.

 -  Presence of gastroparesis symptoms, such as nausea, emesis, early satiety, effortless
 regurgitation, post-prandial fullness and pain, and/or postprandial epigastric pain.

 -  Prior diagnosis of the upper GI disorders, including gastroparesis, gastric or
 duodenal ulcer, gastric outlet obstruction, acute or chronic pancreatitis, large
 hiatal or paraesophageal hernia, small intestinal bacterial overgrowth, celiac
 disease, Crohn's disease.

 -  Prior systemic disorders associated with GI neuromuscular disorder listed in Appendix
 B.

 -  Taking medications that can effect GI motility, including opiate, metoclopramide,
 dopamine agonist for Parkinson or restless leg syndrome, anticholinergics.

 -  Prior brain or abdominal surgery (except cholecystectomy or appendectomy).

 -  Prior diagnosis of central nervous system illness, neurological lesion, a psychiatric
 history, or recurrent migraines that require medication.

 -  Uncontrolled medical problems, such as hypertension, pulmonary or airway disease,
 heart failure, or coronary artery disease.

 -  Allergy to pineapple.

 -  Presence of dysphagia.

 -  Unable to give own informed consent.

 GASTROPARESIS PATIENTS

 Inclusion Criteria:

 -  Patients with gastroparesis from 18 to 65 years of age.

 -  Symptoms of gastroparesis of at least 12 weeks duration with varying degrees of
 nausea, emesis, early satiety, effortless regurgitation, post-prandial fullness and
 pain, and/or postprandial epigastric pain.

 -  Abnormal 4-hour gastric emptying scintigraphy within the last 6 months >60% retention
 at 2 hrs and/or >10% retention at 4 hrs.

 Exclusion Criteria:

 -  Contraindication to MR scanning: pregnancy, implanted gastric stimulator, neural
 stimulator, implanted cardiac pacemaker, auto-defibrillator, cochlear implant, ocular
 foreign body (e.g. metal shavings), pain pump, insulin pump or any pre-existing eye
 conditions.

 -  Prior diagnosis of the upper GI disorders other than gastroparesis, including gastric
 or duodenal ulcer, gastric outlet obstruction, acute or chronic pancreatitis, large
 hiatal or paraesophageal hernia, small intestinal bacterial overgrowth, celiac
 disease, Crohn's disease .

 -  Prior brain or abdominal surgery (except cholecystectomy or appendectomy).

 -  Prior diagnosis of central nervous system illness, neurological lesion, a psychiatric
 history, or recurrent migraines that require medication.

 -  Uncontrolled medical problems, such as hypertension, pulmonary or airway disease,
 heart failure, or coronary artery disease.

 -  Allergy to pineapple.

 -  Prior history of dysphagia.

 -  Unable to give own informed consent.