Novel Non-Invasive Measurement of Carpal Tunnel Pressure

 描述(申请人提供)：腕管综合征(CTS)是最常见的神经病；它影响数百万人，特别是在工薪阶层人口中，并造成巨大的经济负担。腕管压力增加被认为是CTS的主要原因。腕管压力升高直接损伤滑膜下结缔组织，导致缺血再灌注损伤，导致结缔组织纤维化，这是CTS最常见的病理表现。腕管压力是临床公认的重要生物标志物，也是评估CTS分期、严重程度和治疗效果的敏感指标。然而，目前测量腕管压力的技术是侵入性的和痛苦的，因此它不是常规的临床使用。相反，肌电图被用来检测正中神经的变化，这种变化通常发生在CTS的晚期，即正中神经功能受损的时候。因此，发展一种无创测量腕管压力的方法是评估CTS的关键。目前应用的总体目标是开发新的技术来非侵入性地测量腕管压力，利用在高压下横波沿肌腱的传播速度改变的事实，并可以通过超声弹性成像来检测。我们从一个简化模型中获得的初步数据表明，手腕上的肌腱很有可能充当感知腕管压力的换能器。在完成我们提出的目标后，我们将开发出一种新颖、独特和非侵入性的工具，可以用于确定腕管压力在CTS起源、进展因素、早期诊断、治疗选择和结果方面的作用。

 DESCRIPTION (provided by applicant): Carpal tunnel syndrome (CTS) is the most common neuropathy; it affects millions, especially in the working- class population, and causes a huge economic burden. Increased carpal tunnel pressure is considered a major cause of CTS. Elevated carpal tunnel pressure directly damages subsynovial connective tissue and induces ischemia reperfusion injury, which leads to connective tissue fibrosis, the most common pathologic finding in CTS. Carpal tunnel pressure is clinically well recognized as a key biomarker and sensitive indicator for assessing stage or severity of CTS and the effectiveness of treatment. However, the current technique for measuring carpal tunnel pressure is invasive and painful; it therefore is not routinely used clinically. Instead, electromyography is used to detect median nerve changes that generally occur during late-stage CTS, when median nerve function is impaired. Therefore, development of a noninvasive method to measure carpal tunnel pressure is critical for evaluating CTS. The overall goal of the current application is to develop novel technology to noninvasively measure carpal tunnel pressure by exploiting the fact that under high pressure, shear wave propagation velocity along a tendon is altered and can be detected by ultrasound elastography. Our preliminary data from a simplified model has demonstrated a high likelihood that a tendon in the wrist can serve as a transducer that senses carpal tunnel pressure. After completion of our proposed aims, we will have developed a novel, unique and noninvasive tool that can be used to define the role of carpal tunnel pressure with regard to CTS origin, progressive factors, early diagnosis, treatment options, and outcome.