Central Nervous System Mechanisms of Nausea in Gastroparesis: An fMRI-Based Case–Control Study

Phillip Snodgrass, Hugo Sandoval, Vince D. Calhoun, Luis Ramos-Duran, Gengqing Song, Yan Sun, Ben Alvarado, Mohammad Bashashati, Irene Sarosiek, Richard W. McCallum

Research output: Contribution to journalArticlepeer-review


Background/Aims: Nausea is a major complaint of gastroparesis (GP), and the pathophysiology of this condition is poorly understood. Therefore, this study utilized fMRI to investigate the possible central nervous system (CNS) mechanisms of nausea in 10 GP patients versus 8 healthy controls (HCs). Methods: Nausea severity was assessed on a 0–10 scale and presented as mean ± SD. Nausea was increased from baseline utilizing up to 30 min of visual stimulation (VS). Functional network connectivity was measured with fMRI at baseline and after 30 min of VS. fMRI data were preprocessed using statistical parametric mapping software. Thirty-four independent components were identified as meaningful resting-state networks (RSNs) by group independent component analysis. The Functional Network Connectivity (FNC) among 5 RSNs considered important in CNS nausea mechanisms was calculated as the Pearson’s pairwise correlation. Results: Baseline nausea score in GP patients was 2.7 ± 2.0 and increased to 7.0 ± 1.5 after stimulation (P < 0.01). In HCs nausea scores did not increase from baseline after stimulus (0.3 ± 0.5). When comparing GP patients to HCs after VS, a significant reduction (P < 0.001) in bilateral insula network connectivity compared to the right insula network was detected. No significant differences in connectivity were noted among the other RSNs. Additionally, the average gray matter volume was non-significantly reduced in the insula in GP patients compared to HC. Conclusions: The insula connectivity network is impaired in nauseated GP patients. This phenomenon could explain the susceptibility of GP patients to nausea or may have resulted from a state of chronic nausea.

Original languageEnglish (US)
Pages (from-to)551-556
Number of pages6
JournalDigestive diseases and sciences
Issue number2
StatePublished - Feb 1 2020


  • Central nervous system
  • Functional network connectivity
  • Gastroparesis
  • Nausea
  • fMRI

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology


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