# Using the GI Tract as a Window to the Autonomic Nervous System in the Thorax and in the Abdomen

> **NIH NIH OT2** · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · 2020 · $275,646

## Abstract

One of the main stumbling blocks to using autonomic nerve modulation, as a therapy, is the inability to
access peripheral branches of autonomic nerves innervating end organs in the abdominal and thoracic
cavities. By placing electrodes on peripheral autonomic nerves, it will be possible to record and modulate these
nerves and reproduce or inhibit various autonomic physiologic functions. In contrast to truncal vagal nerve
stimulation, the effects of peripheral vagal nerve stimulation will be targeted at specific organs, and can be
specific for particular physiologic effects. In addition, we hypothesize that the effects can be made more or less
intense by varying the frequency, strength and/or duration of the nerve signal within a range that will not
engender systemic side effects.
 Transmural endoscopy uses Z track tunneling through the esophagus and/or stomach to access the
nerves and organs of the thoracic and abdominal cavity in a minimally-invasive manner. Using this minimally-
invasive technique, safe and reliable access to the thoracic and abdominal cavity is easily obtained, and
patients can go home on the same day after the procedure.
 The main objectives of the current study are to 1) develop a swine model, methods, technology, tools
and devices to perform transmural endoscopy in order to identify, localize and place electrodes on the
peripheral branches of the Vagus nerve, in order to record and stimulate the nerve near to the end organ and
2) to transition this technology for use in humans during POEM procedures. Nerve targets and end organs that
can be reached through the esophagus are the lungs, heart, esophagus, small and great vessels of the thorax
and stomach. Organs that can be reached through the stomach are the stomach, liver, pancreas, kidneys,
small intestine, large and small vessels of the abdomen, spleen and colon.
 These techniques have the potential to treat many diseases that respond to stimulation of the
autonomic nervous system. We are particularly optimistic about the future prospects of treating chronic
hypertension, diabetes, GERD, gastroparesis, end stage CHF, end stage pulmonary disease such as
pulmonary hypertension, and obesity to name a few of the obvious examples where peripheral autonomic
nerve modification could have a significant impact on longevity and quality of life. We are excited to contribute
to the development of next generation of neuromodulation devices and mapping of the PNS as a part of the
SPARC program.

## Key facts

- **NIH application ID:** 10237485
- **Project number:** 3OT2OD026539-01S2
- **Recipient organization:** FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
- **Principal Investigator:** LARRY S MILLER
- **Activity code:** OT2 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $275,646
- **Award type:** 3
- **Project period:** 2018-09-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10237485

## Citation

> US National Institutes of Health, RePORTER application 10237485, Using the GI Tract as a Window to the Autonomic Nervous System in the Thorax and in the Abdomen (3OT2OD026539-01S2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10237485. Licensed CC0.

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