{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T21:20:52Z","timestamp":1780694452011,"version":"3.54.1"},"reference-count":57,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T00:00:00Z","timestamp":1584576000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Aims<\/jats:title><jats:p>In a recent study of sacral nerve stimulation (SNS) for colonic inflammation, a possible spinal\u2010vagal pathway was implicated. The aim of this study was to provide evidence for such a pathway by investigating the effects of SNS on dysmotility of the stomach and duodenum that are not directly innervated by the sacral efferents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010seven rats were chronically implanted with wire electrodes for SNS and gastrointestinal slow waves. SNS was performed in several acute sessions to investigate its effects on gastric\/duodenal slow waves and emptying\/transit impaired by glucagon and rectal distention (RD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>(a) SNS increased the percentage of normal gastric slow waves impaired by glucagon (from 53.9% to 77.0%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001) and RD (from 64% to 78%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.037). This improvement was abolished by atropine. (b) Similar effects were observed with SNS on duodenal slow waves, which was also blocked by atropine. (c) SNS normalized delayed gastric emptying induced by glucagon (control: 61.3%, glucagon: 44.3%, glucagon\u00a0+\u00a0SNS: 65.8%) and RD (control: 61.3%, RD: 46.7%, RD\u00a0+\u00a0SNS: 64.3%). It also normalized small intestinal transit delayed by RD (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001, RD\u00a0+\u00a0SNS vs RD; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.9, RD\u00a0+\u00a0SNS vs control). (4) Both glucagon and RD induced an increase in the sympathovagal ratio (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.007, glucagon vs baseline; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001, RD vs baseline) and SNS decreased the ratio (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.006, glucagon\u00a0+\u00a0SNS vs glucagon; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, RD\u00a0+\u00a0SNS vs RD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neuromodulation of the sacral nerve improves gastric and small intestinal pacemaking activity and transit impaired by glucagon and RD by normalizing the sympathovagal balance via a retrograde neural pathway from the sacral nerve to vagal efferents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13837","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T09:05:18Z","timestamp":1584608718000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Ameliorating effects of sacral neuromodulation on gastric and small intestinal dysmotility mediated via a sacral afferent\u2010vagal efferent pathway"],"prefix":"10.1111","volume":"32","author":[{"given":"Ximeng","family":"Wang","sequence":"first","affiliation":[{"name":"Biomedical Engineering Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj J.","family":"Pasricha","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0191-5697","authenticated-orcid":false,"given":"Jiande D. 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