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2014 Research Award Recipient

Principle Investigator: Kok Ann Gwee

Adjunct Associate Professor of Medicine
Yong Loo Lin School of Medicine
National University of Singapore

Kok-Ann Gwee is Adjunct Associate Professor of Medicine at the National University of Singapore and practices at Gleneagles Hospital, Singapore. He obtained his medical degree in 1985 from the National University of Singapore, his certification in gastroenterology in 1995, and his PhD in 1998 from the University of Sheffield. His thesis on post-infectious irritable bowel syndrome is one of the early works in this field.

Professor Gwee is the immediate past president of the Asian Neurogastroenterology & Motility Association, chairs the Rome-Asian Working Team on FGIDs, is on the Rome IV chapter committee for Design of Treatment Trials, and led the Asian Consensus on IBS, and the Asian Guidelines on Management of Chronic Constipation. His areas of research include the role of melatonin and sleep disturbance in FGIDs, epidemiology of FGID in Asia, pelvic organ dysfunction in FBD, and non-celiac gluten sensitivity.

Title: The Chinese and Caucasian Brain Study: A Neuroanthropological Evaluation of the ROME III criteria.

Background: This is a cross-cultural, multi-national study using structural and functional brain imaging to characterize “brain signatures” of patients in two socio-cultural milieu (Chinese v American) who present with bloating and fullness as most bothersome symptoms, and who meet Rome III criteria for postprandial distress syndrome (PDS) and irritable bowel syndrome (IBS). The study aims to test the validity of the Rome criteria and fidelity of linguistic translatability of symptom questionnaire as it relates to cultural adaptation of English words to Chinese terms. The study is also a neuro-anthropological exploration of the socio-cultural factors that influence the language that we employ in describing symptoms that are perceived to arise from the gastrointestinal tract.

Aims: In this proposal, we aim to test the general hypothesis that while FGID symptoms are generated by neurobiological mechanisms largely shared by Asian and Western patients, the verbal and non-verbal expression of these central representations of abdominal discomfort and the cultural responses to these symptoms show significant culture and language dependent differences.

Methods: Structural (grey and white matter) and functional (resting state) brain images will be collected from 30 FGID male subjects (15 PDS-fullness; 15 IBS-Bloating) and 15 healthy male control subjects (HCs) in Mandarin speaking Chinese subjects in South China, using standardized acquisition parameters validated at UCLA. PDS and IBS will be diagnosed using the respective Rome III criteria. Brain parameters will be compared to brain scans obtained in an equal number of age and sex matched PDS, IBS & HCs sample of English speaking Caucasian subjects at UCLA. Expressions used by Mandarin speaking Chinese to describe their GI symptom experience will be identified, using validated neuroanthropological interview techniques. Correlations between subjective symptom severity ratings and brain signatures will be evaluated using both English (in Caucasian subjects) and Mandarin (in Chinese subjects).

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