Pancolonic spatiotemporal mapping reveals regional deficiencies in, and disorganization of colonic propagating pressure waves in severe constipation

Dinning, Phil G.; Zárate, Natalia; Hunt, Linda M.; Fuentealba, Sergio E.; Mohammed, Sahar; Szczesniak, Michal; Lubowski, David Z.; Preston, Sean; Fairclough, P. D.; Lunniss, Peter J.; Scott, S. M.; Cook, Ian J.

doi:10.1111/j.1365-2982.2010.01597.x

Cited by 91 publications

(107 citation statements)

References 36 publications

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“…In our study, we were not able to elicit any distension or electrical nerve stimulation response, as was possible in some, but not all, control (non-STC) specimens. Also, in the study by Dinning et al (6), it was found that in vivo there was a disorganization among consecutive propagating sequences and reduced responses to physiological stimuli. In support of this, we found no responses were evoked to intraluminal balloon distension or electrical stimulation of STC colons.…”

Section: Comparison Of the Characteristics Of Cmcs Recorded In Human mentioning

confidence: 99%

Characterization of motor patterns in isolated human colon: are there differences in patients with slow-transit constipation?

Spencer

Kyloh

Wattchow³

et al. 2012

American Journal of Physiology-Gastrointestinal and Liver Physi

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Section: Comparison Of the Characteristics Of Cmcs Recorded In Human mentioning

confidence: 99%

Characterization of motor patterns in isolated human colon: are there differences in patients with slow-transit constipation?

Spencer

Kyloh

Wattchow³

et al. 2012

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…As a result our understanding of normal pressure/flow relationships is still relatively simplistic [3]. Therefore while abnormal contractility is implicated in FGIDs [4][5][6], how these abnormalities relate to impaired flow remains largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Investigating the relationships between peristaltic contraction and fluid transport in the human colon using Smoothed Particle Hydrodynamics

Sinnott¹,

Cleary²,

Arkwright³

et al. 2012

Computers in Biology and Medicine

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The gastrointestinal tract comprises of several distinct organs in sequence, extending over 7 meters in the human abdomen. Controlled propulsion and mixing of content along the digestive tract is essential for a normal life. This is achieved by a rich assortment of motor patterns that ensure that movements and propulsion are appropriate for the breakdown of food, absorption of nutrients and excretion of waste. These movements (motility) are due to coordinated contractions and relaxations of circular and longitudinal smooth muscle layers. For oesophageal FGIDs the combined technical advances in recording abnormal contractility, via oesophageal manometry, and relating these abnormalities to impaired flow [2] has seen a dramatic improvement in our understanding of the problem and therefore our ability to treat the patient.However, this is not the case for FGIDs in regions below the stomach. The small and large intestines are relatively inaccessible and obtaining detailed manometric recordings and visualizing the movement of digesta is difficult. As a result our understanding of normal pressure/flow relationships is still relatively simplistic [3]. Therefore while abnormal contractility is implicated in , how these abnormalities relate to impaired flow remains largely unknown.Computational modeling of gastrointestinal systems has the potential to help understand these complex relationships. Many mathematical models of peristaltic pumping in flexible tubes have been developed over the last decades and the reader is referred to [7,8] for comprehensive reviews of 3/37 this research. The vast majority of these models do not take into account the solid wall mechanics of the flexible tube in predicting the transient wall deformation. Instead the wall shape is fully prescribed. Some exceptions to this include Carew and Pedley [9] who developed a model of peristaltic flow in the ureter with an active contracting wall coupled to the internal resistance from the intra-luminal pressures in an infinitely long tube. Such models are based on lubrication theory and are therefore limited to simple geometry systems with low inertial flows and long waves. They are well suited to studying the dynamics of the ureter. However, the development of intestinal flow models for studying the effect of single and multiple wave trains on transport requires an active wall model that can accommodate more realistic geometry and non-linear wall mechanics.More recently detailed computational models of oesophageal motility [10,11] have helped to define relationships between motility and flow. In addition CFD models have started to consider the effect of peristaltic motor patterns in the small intestine [12] and the stomach [13,14]. While these studies in the stomach and small bowel have sourced anatomically accurate wall geometries from MRI, they have not attempted a 2-way coupling of the motor activity in the wall with the fluid content.Instead motor patterns are prescribed as a sequence of fixed geometric changes to the boundary.Physiologically real...

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“…The isolated, vascularly perfused loop preparation for video recording and spatiotemporal mapping has also been applied to smaller species such as rat 33 . A recent study by Kuizenga et al is the first use of STmaps of video recorded motility patterns in ex vivo segments of human intestine 42 ; although, STmapping approaches have been applied to the analysis of manometric (pressure) recordings in humans in vivo 3,44 . The recorded motility patterns in human tissue are similar to those already recorded in animal models using similar techniques and validate the extension of this approach to human tissues.…”

Section: Discussionmentioning

confidence: 99%

“…These have ranged from the initial in vivo observations and descriptions of William Beaumont and of Walter Cannon to the more recent methods of measurement and interpretation of multisite recording of muscle tension, intraluminal pressure, and/or membrane potential (i.e., junctional potentials) [2][3][4][5][6] . These latter approaches provide a snapshot of overall motility patterns, but are limited by the number of sites of recording and the validity of interpolation of the data to areas in between the recording sites.…”

Section: Introductionmentioning

confidence: 99%

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Spatiotemporal Mapping of Motility in <em>Ex Vivo</em> Preparations of the Intestines

Kendig

Hurst

Grider

2016

JoVE

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Multiple approaches have been used to record and evaluate gastrointestinal motility including: recording changes in muscle tension, intraluminal pressure, and membrane potential. All of these approaches depend on measurement of activity at one or multiple locations along the gut simultaneously which are then interpreted to provide a sense of overall motility patterns. Recently, the development of video recording and spatiotemporal mapping (STmap) techniques have made it possible to observe and analyze complex patterns in ex vivo whole segments of colon and intestine. Once recorded and digitized, video records can be converted to STmaps in which the luminal diameter is converted to grayscale or color [called diameter maps (Dmaps)]. STmaps can provide data on motility direction (i.e., stationary, peristaltic, antiperistaltic), velocity, duration, frequency and strength of contractile motility patterns. Advantages of this approach include: analysis of interaction or simultaneous development of different motility patterns in different regions of the same segment, visualization of motility pattern changes over time, and analysis of how activity in one region influences activity in another region. Video recordings can be replayed with different timescales and analysis parameters so that separate STmaps and motility patterns can be analyzed in more detail. This protocol specifically details the effects of intraluminal fluid distension and intraluminal stimuli that affect motility generation. The use of luminal receptor agonists and antagonists provides mechanistic information on how specific patterns are initiated and how one pattern can be converted into another pattern. The technique is limited by the ability to only measure motility that causes changes in luminal diameter, without providing data on intraluminal pressure changes or muscle tension, and by the generation of artifacts based upon experimental setup; although, analysis methods can account for these issues. When compared to previous techniques the video recording and STmap approach provides a more comprehensive understanding of gastrointestinal motility. Video LinkThe video component of this article can be found at

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Pancolonic spatiotemporal mapping reveals regional deficiencies in, and disorganization of colonic propagating pressure waves in severe constipation

Cited by 91 publications

References 36 publications

Characterization of motor patterns in isolated human colon: are there differences in patients with slow-transit constipation?

Characterization of motor patterns in isolated human colon: are there differences in patients with slow-transit constipation?

Investigating the relationships between peristaltic contraction and fluid transport in the human colon using Smoothed Particle Hydrodynamics

Spatiotemporal Mapping of Motility in <em>Ex Vivo</em> Preparations of the Intestines

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