Dynamic Ultrasound to Enhance Understanding of Carpal Tunnel Syndrome

动态超声增强对腕管综合症的了解

• 批准号: 8627869
• 负责人: Peter C. Amadio
• 金额: $ 34.98万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8627869
• 关键词: Activities of Daily Living; Adherence; Adult; Affect; Aftercare; Algorithms; Anterior; Biological Markers; Carpal Tunnel Syndrome; Clinical; Clinical Research; Clinical assessments; Connective Tissue; Diagnosis; Dorsal; Equipment; Etiology; Evaluation; Fibrosis; Functional disorder; Future; Hand; Individual; Injection of therapeutic agent; Intervention; Investigation; Ligaments; Magnetic Resonance Imaging; Measures; Methods; Monitor; Motion; Movement; Nerve; Operative Surgical Procedures; Outcome; Patient Monitoring; Patients; Pattern; Peripheral Nervous System Diseases; Prevalence; Procedures; Shapes; Steroids; Synovectomy; Tendon structure; Testing; Time; Translating; Treatment outcome; Ultrasonography; Variant; Wrist; cost; disability; effective therapy; improved; innovation; insight; kinematics; lifetime risk; median nerve; novel; public health relevance; reconstruction; tool; treatment response

Carpal tunnel syndrome (CTS), is the most common peripheral neuropathy, but currently there are no biomarkers to help guide treatment or to predict patient specific outcomes. We hypothesize that ultrasound detectable variations in nerve, tendon and subsynovial connective tissue (SSCT) mobility in patients with CTS may be useful clinically as functional biomarkers that correlate with, and thereby serve as predictors for, treatment response. To test this hypothesis, we propose a clinical study in which patients presenting for treatment of CTS will be monitored by ultrasound and by clinical assessment before and after surgical and non-surgical treatment. We will correlate the clinical outcomes with the initial ultrasound motion patterns that we have found to be most variable in CTS patients. We will also test the hypothesis that successful treatment results in a change towards normal in the affected ultrasound variables. There are 4 Specific Aims. Aim 1 is to assess the ability of the functional biomarkers we have identified (the ratio of SSCT to tendon motion, dorsal nerve motion, and changes in nerve shape with motion) to predict outcome after steroid injection in patients with CTS. Aim 2 is to assess the ability of the functional biomarkers we have identified to predict outcome after surgery in patients with CTS. Aim 3 is to test our secondary hypothesis that treatment response after both injection and surgery correlates with a change towards normal in the affected ultrasound variables. Aim 4 is to, using the results from Aims 1-3, identify additional biomarkers that may correlate with treatment outcome, and to identify any composite clinical and biomarker measures that may improve the ability to predict outcome after treatment for CTS. If these aims are achieved, functional biomarkers will, for the first time, be available to tailor treatment for specific patients with CTS. This new US tool can be rapidly translated into clinical use, since the equipment is commonly available and the new algorithms could be rapidly disseminated.

腕管综合症（CTS）是最常见的周围神经病，但目前 没有生物标志物可以帮助指导治疗或预测患者的具体结果。 我们假设超声波可检测到神经、肌腱和 滑膜下结缔组织 (SSCT) 活动度对 CTS 患者可能有用 临床上作为与相关的功能性生物标志物，从而充当 治疗反应的预测因子。为了检验这一假设，我们提出了一项临床研究 研究中，接受 CTS 治疗的患者将接受超声波监测 并通过手术和非手术治疗前后的临床评估。我们将 将临床结果与我们拥有的初始超声运动模式相关联 发现 CTS 患者的变化最大。我们还将检验以下假设： 成功的治疗会使受影响的人恢复正常 超声变量。 有 4 个具体目标。目标 1 是评估职能部门的能力 我们已经确定的生物标志物（SSCT 与肌腱运动、背神经运动的比率， 以及神经形状随运动的变化）来预测类固醇注射后的结果 患有 CTS 的患者。目标 2 是评估我们拥有的功能生物标志物的能力 确定用于预测 CTS 患者手术后的结果。目标 3 是测试我们的 次要假设是注射和手术后的治疗反应相关 受影响的超声变量向正常变化。目标 4 是利用 目标 1-3 的结果，确定可能与治疗相关的其他生物标志物 结果，并确定可能的任何复合临床和生物标志物测量 提高预测 CTS 治疗后结果的能力。 如果这些目标得以实现，功能性生物标志物将首次被 可针对特定的 CTS 患者制定治疗方案。这个美国新工具可以 由于设备普遍可用并且 新算法可以迅速传播。