Multimodal imaging biomarkers for investigating fascia, muscle and vasculature in myofascial pain.
用于研究肌筋膜疼痛中的筋膜、肌肉和脉管系统的多模态成像生物标志物。
基本信息
- 批准号:10569868
- 负责人:
- 金额:$ 148.37万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-21 至 2024-08-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAnisotropyBiological MarkersBiological ProcessBlood VesselsBlood flowClassificationClinicalClinical TrialsCollaborationsCommunitiesComplexConnective TissueDataData ScientistDevelopmentDiagnosisDoppler UltrasoundDouble-Blind MethodElectromyographyExtracellular FluidFasciaFunctional disorderHyaluronidaseImpairmentInflammatoryInjectionsIntercellular FluidInterventionLeadLiquid substanceLongitudinal observational studyLymphaticMeasuresMethodsModalityMonitorMotorMultimodal ImagingMuscleMyofascial Pain SyndromesNeedlesNerveNeurogenic InflammationObservational StudyPainPain managementPain-FreePathogenesisPathologic ProcessesPathway interactionsPatient Self-ReportPatientsPerfusionPhasePhenotypePhysical ExaminationPhysicians&apos OfficesPhysiologicalPhysiological ProcessesPlacebo ControlPlayPrediction of Response to TherapyRadiology SpecialtyRandomizedRandomized Clinical TrialsRecording of previous eventsReproducibilityRoleScanningSensitivity and SpecificitySpectrum AnalysisSurfaceTimeTissuesUltrasonographyVascular remodelingbaseclinical heterogeneityclinical imagingclinical phenotypeclinical practiceclinical predictorsdata acquisitiondensitydesigndiagnostic toolelastographyevidence basefluid flowimaging biomarkerimaging scientistimprovedinnovationinsightinterstitiallymphatic drainagemultimodalityneurobiological mechanismnovelresponsesoft tissuesuccessultrasound
项目摘要
Summary/Abstract
Myofascial pain syndrome (MPS) is highly prevalent in the community. It is primarily diagnosed using patient self
reports and physical examination, which lack reliability, sensitivity and specificity and does not provide insights
into the abnormal biological and physiological processes in soft tissues. While a number of treatment methods
are available to patients, there are currently no criteria to determine which treatments might be best for each
patient’s unique myofascial pain phenotype. To improve evidence-based management of myofascial pain, there
is a critical need to develop quantitative measures that advance our understanding of the physiological processes
in the underlying the soft tissues across the clinical continuum of MPS. The objective of this project is to develop
a quantitative biomarker informed by the current understanding of underlying tissue-level mechanisms at the
level of the “myofascial unit” (muscle, nerve, fascia, vasculature, lymphatics) that are likely to be involved in
MPS. This project has two phases: a R61 phase for developing and validating the biomarker and an R33 phase
for utilizing the biomarker for treatment monitoring in a randomized clinical trial of two different mechanism-based
interventions.
The R61 phase has two specific aims:
Specific Aim 1: Develop and refine quantitative measures of muscle, fascia, interstitium and blood flow and
determine reproducibility. The measures will be based on quantifying three physiological mechanisms: (1) Aim
1a: impaired myofascial gliding quantified through measures of shear anisotropy using ultrasound shear wave
elastography; (2) Aim 1b: abnormal accumulation of interstitial fluid and impaired perfusion quantified through
ultrasound elastography, Doppler ultrasound and bioimpedance spectroscopy; (3) Aim 1c: increased motor unit
excitability associated with segmental sensitization quantified through high-density surface electromyography.
Specific Aim 2: Develop and clinically validate a composite classifier of myofascial state. We will measure the
tissue-level biomarkers in a longitudinal observational study of patients with myofascial pain and pain-free
controls. The classifier will be designed to predict clinical phenotypes that include within subject variability over
time, as well as variability between subjects with myofascial pain and controls.
The transition criteria from the R61 to R33 phase will be achieving >90% classification accuracy using a classifier
based on tissue-level biomarkers to differentiate between normal, latent, and active phases.
Our objective in the R33 phase is to determine the sensitivity and specificity of the composite classifier to predict
treatment response. To evaluate whether the composite measure is sensitive to mechanism-based changes, we
will evaluate two interventions that target two different mechanistic pathways: dry needling targeting segmental
sensitization, and hyaluronidase injections targeting impaired fascial gliding. We will conduct a randomized,
placebo-controlled double-blind clinical trial of the two interventions using a factorial design.
摘要/文摘
项目成果
期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Evidence for an association of serum microanalytes and myofascial pain syndrome.
- DOI:10.1186/s12891-023-06744-9
- 发表时间:2023-08-01
- 期刊:
- 影响因子:2.3
- 作者:
- 通讯作者:
A model for personalized diagnostics for non-specific low back pain: the role of the myofascial unit.
- DOI:10.3389/fpain.2023.1237802
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
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Siddhartha Sikdar其他文献
Siddhartha Sikdar的其他文献
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{{ truncateString('Siddhartha Sikdar', 18)}}的其他基金
Pathogenesis and Pathophysiological Mechanisms of Myofascial Trigger Points
肌筋膜触发点的发病机制和病理生理机制
- 批准号:
8041042 - 财政年份:2010
- 资助金额:
$ 148.37万 - 项目类别:
Pathogenesis and Pathophysiological Mechanisms of Myofascial Trigger Points
肌筋膜触发点的发病机制和病理生理机制
- 批准号:
8241622 - 财政年份:2010
- 资助金额:
$ 148.37万 - 项目类别:
Pathogenesis and Pathophysiological Mechanisms of Myofascial Trigger Points
肌筋膜激痛点的发病机制和病理生理机制
- 批准号:
8450835 - 财政年份:2010
- 资助金额:
$ 148.37万 - 项目类别:
Pathogenesis and Pathophysiological Mechanisms of Myofascial Trigger Points
肌筋膜触发点的发病机制和病理生理机制
- 批准号:
7889442 - 财政年份:2010
- 资助金额:
$ 148.37万 - 项目类别:
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