Hypothesis Disorders of gut–brain interaction through the lens of polyvagal theory 2024 Porges

Abstract

This paper introduces a metric capable of tracking a hypothetical brainstem “switching” mechanism involved in regulating the afferent influence of blood pressure on the vagal efferent control of heart rate. In theory, this metric could be applied to evaluate the “efficiency” of brainstem pathways involved in common mechanisms of autonomic function involving the vagal influences on the gut as well as the heart.

Thus, by exploring the dynamic “efficiency” of the brainstem feedback circuit linking heart rate to posture, a clinically relevant index of vagal flexibility might be extracted that would provide a generalizable window into the vagal regulation of both the heart and gut. Recent research supports this contention and has documented that this metric, VE, appears to covary with disorders of the gut.

Clinical application of this metric might identify individual vulnerabilities that frequently reflect symptoms assumed to have features of a dysregulated autonomic nervous system (i.e., dysautonomia). If this is confirmed by additional research, then this objective measure of neural regulation of autonomic function might provide insight into the pathogenesis of disorders of gut–brain interaction.


Key points

• Modern healthcare often focuses on symptoms without addressing underlying neural mechanisms, which can lead to fragmented care and missed root causes.
• Prioritizing symptom relief without addressing underlying neural issues can lead to misdiagnoses, inappropriate treatments, and prolonged mediciine use.
• Monitoring a novel metric of dynamic autonomic regulation, vagal efficiency, is proposed to offer valuable insights into the autonomic nervous system’s role in promoting optimal gut function and general health.

Open access, https://onlinelibrary.wiley.com/doi/10.1111/nmo.14926

 

Looks interesting from a quick look, but I'm rather puzzled by the reference at the end to 'United States Association for Body Psychotherapy'. Also supported by the Chaja Foundation.

???

 

Rona Moss-Morris had a German friend who offered body psychotherapy on the NHS I think. It looked like the usual make-believe. The posted article looks pretty simplistic.

 

I have a simple rule, any mention of any of the tropey "mind interaction" gets the whole thing thrown in the bin without even looking beyond the title.

OK I have many rules but this one never fails. It's as reliable as any mention of quantum in the context of health care or medicine.

There are basically about a dozen of those terms where that never fail either. They're pretty much all reliable flags for woowoo. Biopsychosocial is definitely one of them. I don't think I've ever seen anything worth reading that features it without being dismissive of it. Some signs are just that reliable.