Medical College Wisconsin (MCW) - Milwaukee submitted by Kathleen Adams
Cyclic Vomiting Syndrome Association (CVSA) science/clinical reporting and brainstorming meeting - MCW.
Our agenda included the topics listed here as they relate to research and clinical issues about CVS. We asked attendees for a brief overview of their work and to share their expertise to the discussion. These annual science meetings with our Primary Medical Advisors (PMA) are informal sessions of progress reporting, occasional presentations and creative brainstorming. This results in plans for moving forward with research and clinical implementation. See attendee list for credential and affiliation.
fMRI technology Erica Samuel, M.D., Reza Shaker, M.D.
After a brief welcome and basic introduction to fMRI technology by Dr. Shaker, Dr. Erica Samuel presented her work that was featured in a poster session at the Digestive Disease Week (May 2012). She emphasized that this work is a mere crack in opening the door to study CVS using fMRI technology. This initial work is focused on the cortical regions of the brain, which are important in pain and emotion processing. 21 CVS patients were studied in their well state. There were statistically significant findings between the CVS patients and normal controls in regard to the connections developed between different regions in the brain.
Samuel E, Venkatesan T, Shaker R, et al: Classification of CVS patients in inter-episodic phase from healthy controls using cortical resting state functional connectivity. Digestive Disease Week 2012 (abstract)
Differences in pediatric and adult onset CVS Dr. Nilay Kumar presented his findings from his paper. He acknowledged that CVS is a well-recognized functional gastrointestinal disorder in children but its presentation is poorly understood in adults. Genetic differences in pediatric-onset (presentation before age 18) and adult-onset CVS have been reported recently but their clinical features and possible differences in response to therapy have not been well studied. He did a retrospective study of 101 patients seen at the Medical College of Wisconsin CVS clinic. He reported that, despite reported genetic differences, the clinical features and response to standard therapy in pediatric- and adult-onset CVS were mostly similar.
Kumar N, Qumseya B, Reddy N, Sengupta J, Ananthakrishnan A, Schroeder A, Hogan W, Venkatesan T: Cyclic Vomiting Syndrome (CVS): is there a difference based on onset; pediatric vs. adult? BMC Gastroenterology, 12:52, 2012
Clinical trials—including mitochondrial cofactors (CoQ10 and carnitine) & amitriptyline: B Li, MD, Rick Boles, MD and Pippa Simpson, PhD A good amount of time was devoted to discussion of the design of a grant proposal for a clinical trial to include mitochondrial cofactors (co-enzyme Q10 and l-carnitine) and amitriptyline. Designing the study in order to determine efficacy, tolerance, absorbability, placebo use, compliance to name a few variables proves to be very challenging. Subject recruitment and Internal Review Board issues were also discussed at length. CVSA would be a source of announcement and subject recruitment. There was much apparent value in this roundtable, cross specialty forum.