Device Resets Gut-Brain Loop, Boosts Gut Disorder Care

Medications that are prescribed for disorders of gut-brain interaction do not attempt to cure the condition and often only minimally improve symptoms. Research scientists at Indiana University are combining neuroscience and intelligent systems to improve treatment for these conditions.

Disorders of gut-brain interaction, which affect communication between the gastrointestinal tract and the brain via the nervous system, include irritable bowel syndrome, cyclic vomiting syndrome and functional dyspepsia. Symptoms often manifest differently based on the individual, making a one-size-fits-all treatment ineffective.

Gregory Lewis. Photo courtesy of Anna Powell DentonGregory Lewis, an assistant professor of intelligent systems engineering at the IU Luddy School of Informatics, Computing and Engineering, and IU Bloomington graduate student Sujata Punait hope to change the treatment landscape of these disorders with their ANSTracker, a software device that tracks the different branches of patients' autonomic nervous system in real time through the use of multiple physiological signals.

Lewis and Punait were recently awarded a subaward of $600,000 from a $2.4 million grant awarded to Katja Karrento, an associate professor at the Medical College of Wisconsin, and Jacek Kolacz, a research assistant professor at the Ohio State University College of Medicine, who are their partners on this project.

The subaward will be used to train clinicians on how to use the ANSTracker, collect and analyze data from patients in the clinical trial and their matched control group, and determine what updates are needed to integrate the device into patient care. Lewis and Punait's work was also sponsored by NeurAxis, a medical technology manufacturer that creates targeted therapies for pediatric patients with gut-brain interaction disorders.

Sujata Punait. Photo courtesy of Sujata PunaitThe autonomic nervous system links our body to the brain. When there is a change in our environment, external or internal, it relays sensory information about the change to the brain, which then relays commands back to the body. In gut-brain disorders, the body sends erroneous signals to the brain that then sends inappropriate signals back to the body in response. This creates a disruptive feedback loop that ultimately maintains the gut-brain disorder.

Autonomic interventions, such as those provided by NeurAxis technologies, reset this feedback loop at the interface between autonomic signals and the brain, leading to acute and chronic changes in regulation of bodily processes including the beating of the heart, digestion of food and respiration. With the ANSTracker, medical providers can measure the activation levels of the parasympathetic and sympathetic branches of the autonomic nervous system by recording heart rate and blood pressure responses during tasks such as deep breathing or handgrip maneuvers to improve effectiveness of the personalized treatment. The ANSTracker enables individualized treatment with interventions such as IBStim from NeurAxis.

Sensors are placed on the body, which lets the clinical team observe the impact of autonomic interventions on bodily functions in the seconds and minutes following the intervention. The device is carefully calibrated to the range of autonomic signals for each patient; if it is not working as intended, the clinicians can adjust the devices' placement or the intensity of the stimulation.

"This non-invasive tool significantly improves quality of life as it tackles the issues the patient is experiencing individually and is not a one-size-fits-all treatment," Lewis said. "The device provides a mechanistic understanding of the role the autonomic nervous system plays in diseases and helps provide targeted therapies for different diseases and populations."

"We plan to scale the platform to treat other conditions by adding more sensors to help diagnose patients in real time," Punait said. "This device could be a game changer for clinicians as it changes their way of thinking in making diagnoses and helps improve patient outcomes."

Lewis and Punait have filed a patent to protect their research through the IU Innovation and Commercialization Office, which aims to transfer IU innovations from lab to market for public benefit and global impact.