Whole-body clinical research
The study of gastrointestinal physiology in intact man is an existing strength and provides an integrative dimension to the molecular physiology and health services approaches of the group. Main areas include:
- The physiology of the brain-gut axis
(studies of the interrelationships between the central nervous systems and GI function)
- Local regulation of GI function
(neuroendocrine, gut microflora-mucosal interactions)
- The physiological basis of the gastrointestinal response to food
- The relationship between genotype and phenotype expression
Disease areas of particular interest include those associated with the functional GI disorders, such as irritable bowel syndrome, functional dyspepsia, and non-cardiac chest pain. An additional strength of our research programme is the close collaborative links we have with other research groups, including for example Clinical Neuroscience and Respiratory Medicine, and with both the pharmaceutical and food industry.
Central regulation of the brain-gut axis
The programme of work exploring the central regulation of the brain-gut axis has focused on studies with human brain imaging aimed at understanding the role of cortical organisation of swallowing and anorectal function in health and disease. For example, one common clinical consequence of this brain disorganisation is difficulty with swallowing (dysphagia) after stroke, which seems associated with damage in the hemisphere dominant for swallowing. Many dysphagic stroke patients gradually recover swallowing over time which, unlike limb recovery, is clearly associated with compensatory brain reorganisation in the non-dominant hemisphere. The brain-gut axis thus provides an important opportunity for studying brain function and recovery with the potential for greater insight into the clinical relevance of neuroplasticity using a human experimental model of midline motor control (gut).
The current interests are focusing on better defining the structural, functional, physiological correlates of human cortical plasticity and neural recovery using complimentary neuroimaging modalities in the study of upper and lower GI function, both in health and after brain injury.
- The relationship between brain anatomy/structure and sensorimotor function
- The relationship between plasticity and functional changes in cortical organisation
- The physiological/neurochemical basis for cortical plasticity
- The behavioural relevance of cortical plasticity in accelerating recovery after brain injury
This work is highly translational and patient-oriented, taking observations from whole human physiology and applying them to brain injured patients. This work is collaborating with groups in Manchester (Brain Imaging), as well as investigators in London (Institute of Neurology, UCL) and Aston University.
To address these objectives, the group is carrying out a series of neurophysiologic and complimentary experiments in both healthy subjects and patients with stroke. This uses techniques that are already well utilised in our laboratory including repetitive transcranial magnetic stimulation (rTMS) and functional magnetic resonance imaging (fMRI), combined with newer more powerful approaches to explore brain function, including diffusion weighted imaging (DWI) tractography and magnetic resonance spectroscopy (MRS).