Inverse Methods for Spatiotemporal Characterization of Gastric Electrical Activity and its Association with Upper GI Symptoms from Cutaneous Multi-electrode Recordings

项目摘要 胃肠道(GI)问题是导致旷工或旷课的第二大原因，导致 在美国，病人去看初级保健医生的原因中，每年花费1420亿美元。一个 大多数这样的病例被转诊给胃肠道专家，在那里内窥镜检查、成像和血液测试允许 阻塞和感染的诊断。然而，超过一半的胃肠道疾病与异常有关 胃肠道的神经肌肉功能，发生在大多数帕金森病和糖尿病患者中 实例。此类胃肠道疾病的诊断通常需要基于症状的主观问卷调查或 在专门中心进行客观但有侵入性的手术。基于症状的诊断是有问题的，因为 许多不同治疗方案的胃肠功能障碍都有重叠的症状。侵入性 在专门中心执行的方法可以区分肌病和神经病功能 并可改变15%至20%有上消化道症状的患者的诊断/治疗。 然而，它们有成本和侵入性的缺点：胃闪烁成像及其放射性成像； 测压，即在透视或内窥镜下将导管插入口腔或鼻子 指导。与神经肌肉GI评估相关的长等待时间和间歇性监测 疾病，再加上患者强烈倾向于非侵入性检测，而不是目前的方法， 指出了与通过专业中心扩大GI评估相关的重大挑战。 总之，不存在一种客观的、非侵入性的方法来监控功能性胃肠道疾病及其 与暂时性症状的关联是一个重大缺陷，它在经济、社会和医疗保健方面都具有广泛的影响 后果。我们已经开发并演示了一种使用非侵入性多电极的程序 传感器阵列以及一套统计信号处理方法，客观地提供波 与症状相关的胃肠道神经肌肉功能的传播描述。此外，使用此 多电极阵列我们开发了新的贝叶斯推理方法来定位胃慢波 在胃部表面挥动。在这个项目中，我们将改进我们的源定位方法，以减少 需要人工干预，然后将我们的方法应用于一组现有的受试者 已经收集到的数据。该项目是朝着验证可量化的非侵入性 胃健康的措施，可以帮助现代化的功能胃肠病学。它促进了一种廉价、 非侵入性技术与新的信号处理方法相结合，可能导致 临床方法，允许了解疾病病因，评估疾病进展，以及 预测治疗反应。

Project Summary Gastrointestinal (GI) problems are the second leading cause for missing work or school, giving rise to 10 percent of reasons a patient visits their primary care physician and costing $142 billion annually in the US. A majority of such cases are referred to GI specialists, where endoscopy, imaging, and blood tests allow for easy diagnosis of blockages and infections. However, more than half of GI disorders involve abnormal neuromuscular functioning of the GI tract, occurring in a majority of Parkinson’s and diabetes patients for instance. Diagnosis of such GI disorders typically entails subjective symptom-based questionnaires or objective but invasive procedures in specialized centers. Symptom-based diagnosis is problematic because many GI functional disorders with different treatment regimens have overlapping symptoms. Invasive approaches performed in specialized centers can differentiate between myopathic and neuropathic functional disorders and can change the diagnosis/treatment of 15% to 20% of patients with upper GI symptoms. However, they have drawbacks of cost and invasiveness: gastric scintigraphy with its radioactive imaging; manometry, which involves a catheter inserted through the mouth or nose with fluoroscopic or endoscopic guidance. Long wait times and intermittent monitoring associated with assessment of neuromuscular GI disorders, coupled with a strong preference by patients for non-invasive testing instead of current approaches, pinpoints the non-trivial challenges associated with scaling up GI assessment with specialized centers. Altogether, the non-existence of an objective, non-invasive, way to monitor functional GI disorders and their association with transient symptoms is a significant drawback that has vast economic, social, and healthcare consequences. We have developed and demonstrated a procedure that uses a non-invasive multi-electrode sensor array along with a suite of statistical signal processing methods that objectively provide wave propagation descriptions of GI neuromuscular functions that correlate with symptoms. Additionally, using this multi-electrode array we have developed novel Bayesian inference methods to source localize the gastric slow wave on the stomach surface. In this project, we will advance our source localization method to reduce the requirement of human intervention and then apply our method to an existing set of subjects for whom we have already collected data. This project is an important step towards validation of a quantifiable non-invasive measure for gastric health that can help modernize functional gastroenterology. It promotes an inexpensive, non-invasive technology coupled with novel signal processing methods that may lead to transformational clinical approaches that allow for understanding disease etiology, assessing disease progression, and predicting treatment response.