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

皮肤多电极记录胃电活动时空特征及其与上消化道症状关联的逆向方法

• 批准号: 10196836
• 负责人: Todd P Coleman
• 金额: $ 7.9万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10196836
• 关键词: 3-Dimensional; Absenteeism at work; Address; Bayesian Analysis; Blood Tests; Catheters; Chronic; Clinical; Coupled; Cutaneous; Data; Development; Diabetes Mellitus; Diagnosis; Diagnostic Procedure; Disease; Disease Progression; Dyspepsia; Economics; Electrodes; Endoscopy; Etiology; Food; Functional Gastrointestinal Disorders; Functional disorder; Fundus; Gastric Emptying; Gastroenterology; Gastrointestinal Diseases; Gastrointestinal tract structure; Gastroparesis; Greater curvature of stomach; Health; Healthcare; Heart; Human; Image; Infection; Interstitial Cell of Cajal; Intervention; Knowledge; Lead; Manometry; Manuals; Measures; Methods; Modeling; Modernization; Monitor; Mucous Membrane; Muscle Contraction; Nausea and Vomiting; Neuropathy; Nose; Operative Surgical Procedures; Oral cavity; Pacemakers; Parkinson Disease; Patient Preferences; Patients; Pattern; Periodicity; Peristalsis; Phenotype; Physicians; Physics; Physiological; Prediction of Response to Therapy; Primary Care Physician; Procedures; Process; Pylorus; Questionnaires; Radioactive; Radionuclide Imaging; Resolution; Schools; Severities; Signal Transduction; Smooth Muscle Myocytes; Specialist; Specialized Center; Speed; Stomach; Surface; Symptoms; Technology; Testing; Time; Treatment Protocols; Validation; Visit; Wait Time; X-Ray Computed Tomography; base; cost; gastrointestinal; gastrointestinal disorder diagnosis; gastrointestinal symptom; gastrointestinal system; human subject; large datasets; multi-electrode arrays; neuromuscular; neuromuscular activity; neuromuscular function; nodal myocyte; novel; scale up; sensor; signal processing; social; source localization; spatiotemporal; symptom treatment; symptomatic improvement; three-dimensional modeling; treatment response

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.

项目摘要 胃肠道（GI）问题是第二个主要原因错过工作或学校，导致10 在美国，这是病人去看初级保健医生的原因之一，每年花费1420亿美元。一 大多数此类病例都被转诊给GI专家，在那里内窥镜检查，成像和血液检查可以方便地检查 阻塞和感染的诊断。然而，超过一半的胃肠道疾病涉及异常 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， instance.这类GI疾病的诊断通常需要基于主观的问卷调查或 在专业中心进行客观但有创的手术。基于症状的诊断是有问题的， 采用不同治疗方案的许多GI功能性疾病具有重叠的症状。侵入性 在专业中心进行的方法可以区分肌病和神经病功能 它可以改变15%至20%的上消化道症状患者的诊断/治疗。 然而，它们有成本和侵入性的缺点：胃肠道造影及其放射性成像; 测压，包括通过口或鼻插入导管，并进行荧光镜或内窥镜检查 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，再加上患者对非侵入性检测而不是当前方法的强烈偏好， 指出了与专业中心扩大GI评估相关的重要挑战。 总之，不存在一种客观的、非侵入性的方法来监测功能性GI疾病及其 与短暂症状的关联是一个显著的缺点， 后果我们已经开发并证明了一种使用非侵入性多电极的程序 传感器阵列沿着一套统计信号处理方法， 与症状相关的GI神经肌肉功能的传播描述。此外，使用此 多电极阵列，我们已经开发了新的贝叶斯推理方法来源定位胃慢 在胃表面上波动。在这个项目中，我们将提出我们的源定位方法，以减少 然后将我们的方法应用于现有的一组受试者， 已经收集的数据。该项目是一个重要的一步，验证了一个可量化的非侵入性 测量胃健康，可以帮助现代化功能性胃肠病学。它促进了一种廉价的， 非侵入性技术与新的信号处理方法相结合， 允许理解疾病病因、评估疾病进展以及 预测治疗反应。