The Autonomic Nervous System and Gastrointestinal Tract Disorders
NEUROMODULATION THE AUTONOMIC NERVOUS SYSTEM AND GASTROINTESTINALTRACT DISORDERS
TERRY L. POWLEY, PH.D.
PURDUE UNIVERSITY • MULTIPLE REFRACTORY GI DISORDERS EXIST.
• VISCERAL ATLASES OF THE GI TRACT ARE AVAILABLE.
• REMEDIATION WITH ELECTROMODULATION MAY BE PRACTICAL.
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TERRY l. POWLEY, PH.D. PURDUE NEU ROMODUlATION : THE AUTO N OMIC NERVOUS SYSTEM A N D G A STP.OINTESTINAL TRACT DISORDERS UNI V E R SI TY ROUX-EN-Y BYPASS
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TERRYl. POWLEY, PH.D. PURDUE NEUROMOOUlATION: THE AUTONOMIC NERVOUS SYSTEM ANO 0.-STP.OINTESTINAL TRACT DISORDERS UHIVlflSITY • DESPERATE PATIENTS
• ABSENCE OF SATISFACTORY PHARMACOLOGICAL TREATMENTS
• POPULAR MEDIA HYPE
• ABSENCE OF A SOLID MECHANISTIC UNDERSTANDING
• UNCRITICAL ACCEPTANCE OF PROPONENT'S CLAIMS
• MYOPIA REGARDING SIDE EFFECTS
TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY ENTERIC NERVOUS SYSTEM: ''LIRLE BRAIN'' IN GUT
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TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY Prech~ and Powley
TERRY L. POWLEY, PH.D. PURDUE NEUROMODULATION : THE A UTO NOMIC NERVOUS SYSTEM A ND GASH OINTESTINAL TRACT DISORDERS UNIVERSITY I J "'
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TERRYl. POWLEY, PH.D. PURDUE NEUROMOOUlATION: THE AUTONOMIC NERVOUS SYSTEM ANO 0.-STP.OINTESTINAL TRACT DISORDERS U HIV l flSITY ROUX-EN-Y BYPASS VAGAL NETWORK
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TERRY l. POWLEY, PH.D. PURDUE NEU ROMODUlATION : THE AUTO N OMIC NERVOUS SYSTEM A N D GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY ROUX-EN-Y BYPASS VAGAL NETWORK
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TERRY l. POWLEY, PH.D. PURDUE NEU ROMODUlATION : THE AUTO N OMIC NERVOUS SYSTEM A N D GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY VAGAL MOTOR INNERVATION OF MYENTERIC PLEXUS
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TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY VAGAL SENSORY IGLE INNERVATES CHOLINERGIC NEURONS & IGNORES NITRERGIC NEURONS IN MYENTERIC GANGLION
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TERRY L. POWLEY, PH.0. PURDUE NEUROMODULATION : THE A UTO NOMIC NERVOUS SYSTEM A ND GASHOINTESTINAL TRACT DISORDERS UNIVERSITY A
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I I • MULTIPLE REFRACTORY GI DISORDERS EXIST.
• VISCERAL ATLASES OF THE GI TRACT ARE AVAILABLE.
• REMEDIATION WITH ELECTROMODULATION MAY BE PRACTICAL.
TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY GI NEUROMODULATION PRIORITIES
• HIGH-PRIORITY OPPORTUNITIES:
o OBESITY o GASTROPARESIS
• TECHNOLOGICAL NEEDS:
o NEXT-GENERATION STIMULATORS • Fiber-caliber tuned • Closed Loop • Self-programming, real time
o DATA ON VAGAL INTEGRATIVE ARCHITECTURE
TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY MACROPHAGES INTERACT WITH:
MYENTERIC GANGLIA (AND EXTRINSIC NERVE AXONS)
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MACROPHAGES INTERACT WITH:
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Walter, 2014 • DESPERATE PATIENTS
• ABSENCE OF SATISFACTORY PHARMACOLOGICAL TREATMENTS GASTRIC BYPASS • POPULAR MEDIA HYPE
• ABSENCE OF A SOLID MECHANISTIC UNDERSTANDING
• UNCRITICAL ACCEPTANCE OF PROPONENT'S CLAIMS
• MYOPIA REGARDING SIDE EFFECTS
TERRY L POWLEY, PH .D. PURDUE NEVROMODUIATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTtolNTESTlNAt TRACT DISORDERS UNIVEASITY ENTERIC NERVOUS SYSTEM: ''LITILE BRAIN'' IN GI TRACT
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ORAL ANAL
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TERRY L. POWLEY, PH.D. PURDUE NEUROMODULATION : THE A UTO NOMIC NERVOUS SYSTEM A ND GASH OINTESTINAL TRACT DISORDERS UNIVERSITY VAGAL MOTOR · MYENTERIC PLEXUS
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TERRY l. POWLEY, PH.D. PURDUE NEUROMODUlATION: THE AUTONOMIC NERVOUS SYSTEM AND GASTP.OINTESTINAL TRACT DISORDERS UNIVERSITY GASTROPARESIS: GASTRIC STIMULATION
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TERRY l. POWLEY, PH.D. PURDUE NEU ROMO DUlATION : THE AUTO N OMIC NERVO US SYSTEM A N D G A STP.OINTESTINAL TRACT DISORDERS UNI V ERSI TY VAGAL MOTOR INNERVATION OF ESOPHAGUS:
CO-INNERVATION OF MUSCLE FIBERS AND GANGLIA
Powley et al., 2013