Diagnostic Ultrasound for Focal Neuropathies

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PROJECT SUMMARY: The candidate, Michael S. Cartwright, MD is a junior neurologist with experience using neuromuscular ultrasound in clinical and research settings. In June 2008 he completed a Clinical Research Training Grant from the MDA, during which he received training in epidemiology, research design, and biostatistical methods. This will provide him with a solid foundation for clinical research, but to develop as a translational researcher he requires training in the basic science of medical imaging and experience with longitudinal patient-oriented studies. During the award period, Dr. Cartwright will be mentored by two individuals with complementary experience in medical imaging. Dr. Francis Walker is an international expert in neuromuscular ultrasound, and Dr. Peter Santago is a biomedical engineer with expertise in the basic science of medical imaging. In addition, Dr. Cartwright will take medical imaging graduate level courses at the Virginia Tech-Wake Forest School of Biomedical Engineering. The research plan is designed to highlight the importance of neuromuscular ultrasound in the diagnostic evaluation of individuals with focal neuropathies and to provide Dr. Cartwright with experience organizing and conducting a clinical trial. The first component of the study will demonstrate the validity and reliability of neuromuscular ultrasound. The second component is a double-masked randomized clinical trial to assess the efficacy of diagnostic ultrasound on the functional outcomes of 150 individuals with focal neuropathies. The hypothesis driving the second component of the study is that individuals diagnosed with a focal neuropathy by a combination of electrodiagnostic studies and ultrasound will have a more refined and accurate diagnosis, will be referred for appropriate treatment more often, and will, therefore, have better functional outcomes compared to those evaluated with traditional electrodiagnostic studies alone. RELEVANCE (See instructions): Focal neuropathies affect more than 300,000 individuals each year in the United States and medical costs exceed $500 million annually. During this career development award, Dr. Cartwright will acquire the knowledge and skills necessary to bring sophisticated neuromuscular imaging technologies from the developmental stage into the realm of patient care, and the research plan will test if diagnostic ultrasound can lead to improved functional outcomes in individuals with focal neuropathies.