{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:35:54Z","timestamp":1791477354839,"version":"4.3.4"},"reference-count":61,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2019,6,26]],"date-time":"2019-06-26T00:00:00Z","timestamp":1561507200000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cyclic vomiting syndrome (<jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content>) is characterized by severe episodic emesis in adults and children. Cannabinoid hyperemesis syndrome is an increasingly recognized <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content>\u2010like illness that has been associated with chronic cannabis use. There are significant gaps in our understanding of the pathophysiology, clinical features, comorbidities, and effective management options of <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content>. Recommendations for treating <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content> are based on limited clinical data, as no placebo\u2010controlled, randomized trials have yet been conducted. Diseases associated with <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content>, including migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric comorbidities, provide clues about pathophysiologic mechanisms and suggest potential therapies. We review our current understanding of <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content> and propose future research directions with the aim of developing effective therapy. Establishing a multicenter, standardized registry of <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content> patients could drive research on multiple fronts including developing <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content>\u2010specific outcome measures to broaden our understanding of clinical profiles, to serve as treatment end points in clinical trials, and to provide a platform for patient recruitment for randomized clinical trials. Such a robust database would also facilitate conduct of research that aims to determine the underlying pathophysiological mechanisms and genetic basis for <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content>, as well as identifying potential biomarkers for the disorder. Soliciting government and industry support is crucial to establishing the necessary infrastructure and achieving these goals. Patient advocacy groups such as the Cyclic Vomiting Syndrome Association (<jats:styled-content style=\"fixed-case\">CVSA<\/jats:styled-content>), which partner with clinicians and researchers to disseminate new information, to promote ongoing interactions between patients, their families, clinicians, investigators, to support ongoing <jats:styled-content style=\"fixed-case\">CVS<\/jats:styled-content> research and education, must be an integral part of this endeavor.<\/jats:p>","DOI":"10.1111\/nmo.13607","type":"journal-article","created":{"date-parts":[[2019,6,26]],"date-time":"2019-06-26T14:06:43Z","timestamp":1561558003000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions"],"prefix":"10.1111","volume":"31","author":[{"given":"William L.","family":"Hasler","sequence":"first","affiliation":[{"name":"Division of Gastroenterology University of Michigan Health System Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Levinthal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally E.","family":"Tarbell","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Northwestern Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen A.","family":"Adams","sequence":"additional","affiliation":[{"name":"Cyclic Vomiting Syndrome Association Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B U. 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