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.

项目总结