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: 10394942
• 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/10394942
• 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）问题是失踪或学校失踪的第二大原因，使得10 患者访问其初级保健实体主义者的原因百分比为美国，每年在美国造成1420亿美元。一个 大多数此类病例都被称为GI专家，内窥镜检查，成像和血液检查可以轻松 诊断阻塞和感染。但是，超过一半的GI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氏症患者和糖尿病患者中 实例。此类胃疾病的诊断通常需要基于主观症状的问卷或 专业中心的客观但侵入性程序。基于症状的诊断是有问题的，因为 许多具有不同治疗方案的GI功能障碍都有重叠的症状。侵入性 在专业中心执行的方法可以区分肌性和神经性功能 疾病，可以改变15％至20％具有GI符号的患者的诊断/治疗。 但是，它们具有成本和侵入性的缺点：带有放射性成像的胃闪烁显像。 测量法，涉及通过透视或内窥镜插入口腔或鼻子的导管 指导。等待时间长，与神经肌肉GI评估相关的间歇性监测 疾病，以及患者对非侵入性测试而不是当前方法的强烈偏爱， 查明与专业中心扩大胃肠道评估相关的非平凡挑战。 总的来说，监测功能性GI疾病及其的客观，无创的方法的不存在 与短暂症状的关联是一个具有巨大经济，社会和医疗保健的重要缺点 结果。我们已经开发并演示了使用非侵入性多电极的过程 传感器阵列以及一套统计信号处理方法，这些方法客观地提供波浪 与症状相关的GI神经肌肉功能的传播描述。另外，使用此 多电极阵列我们开发了新颖的贝叶斯推理方法来来源地定位胃慢 在stalch表面上挥手。在这个项目中，我们将推进我们的来源本地化方法，以减少 人类干预的要求，然后将我们的方法应用于我们拥有的现有主题集 已经收集了数据。该项目是验证可量化的非侵入性的重要一步 测量胃健康，可以帮助现代化功能性胃肠病学。它促进了便宜的 非侵入性技术以及新的信号处理方法，可能导致转化 可以理解疾病学，评估疾病进展的临床方法，并 预测治疗反应。