Neurogastroenterology

Delaram Safarpour, MD, MSCE, FAAN

Ronald F. Pfeiffer, MD

In the late 1960s, a wildly successful Virginia Slims advertisement slogan informed women viewers and readers that “You've Come a Long Way, Baby.” Now, over 50 years later, much the same might be said regarding the topic of Neurogastroenterology, the subject of this issue of Seminars in Neurology. It is not because the concept of the gut interacting with and influencing the brain is new. In fact, back in 1817, in his seminal description of what we now know as Parkinson's disease, James Parkinson commented “Although unable to trace the connection by which a disordered state of the stomach and bowels may induce a morbid action in a part of the medulla spinalis, yet taught by the instruction of Mr. Abernethy, little hesitation need be employed before we determine on the probability of such occurrence.” However, it has only been in the past three decades that awareness of the extensive, intricate, and intimate bidirectional interaction between the brain and the gut has truly blossomed, like a gorgeous desert flower super bloom, upon the scientific and clinical canvas.

In 1996, Seminars in Neurology was in the vanguard of this explosion when it provided an early look, with an issue devoted to the then novel topic of Neurogastroenterology. In that issue, 12 reviews provided a broad overview of the subject, covering both basic and clinical topics with contributions by a distinguished group of investigators and clinicians. Over the ensuing 27 years, interest in and investigation of the connection between the brain and the gut has exploded and much has been learned, making the time ripe for an updated look at the subject—Neurogastroenterology Redux, if you will—but now through a more detailed and comprehensive, though still somewhat blurred and foggy, lens.

In this issue, the number of topics addressed has expanded to 14, opening with a trio of absolutely superb overviews of the enteric nervous system, the gut–brain axis, and the gut microbiome. The second section then addresses gastrointestinal dysfunction in neurological disorders, in which five groups of experts adroitly discuss, in a “top-to-bottom” order, the various manifestations of gastrointestinal dysfunction that may become evident at different anatomical levels of the gastrointestinal tract in neurological disorders. The final section of the monograph, composed of erudite contributions from six groups of authors, addresses specific neurological disorders in which gastrointestinal dysfunction may play a role not only with regard to clinical manifestations, but potentially also with regard to the etiology of the disease process itself.

The groups of authors who have so graciously provided their scientific, clinical, and literary expertise to the completion of this monograph are an absolutely stellar congregation of basic scientists and clinicians, including neurologists and gastroenterologists, all of whom are both notable and noteworthy, and we cannot thank them enough.

Although the field of Neurogastroenterology certainly can no longer be considered a “Baby,” there is absolutely no doubt that it now has indeed “Come a Long Way” with regard to both our recognition of its importance and our understanding of its complexity, as this monograph hopefully illustrates and articulates.

Publikationsverlauf

Artikel online veröffentlicht:
13. September 2023