MRI-based quantitative characterization of impaired myofascial interface properties in myofascial pain syndrome

基于 MRI 的肌筋膜疼痛综合征受损肌筋膜界面特性的定量表征

基本信息

批准号：
10569208
负责人：
Brent A Bauer
金额：
$ 196.62万
依托单位：
MAYO CLINIC ROCHESTER
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：
2022-09-19 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10569208
关键词：
3-Dimensional Address Adhesions Anatomy Assessment tool Automobile Driving Back Biological Markers Biomechanics Clinical Clinical Research Connective Tissue Data Set Etiology Evaluation Exhibits Fascia Foundations Frequencies Goals Image Imaging Techniques Imaging technology Impairment Injury Intramuscular Knowledge Leg Location Longitudinal Studies Magnetic Resonance Elastography Magnetic Resonance Imaging Matched Group Measures Mechanics Methods Modality Monitor Motion Muscle Myofascial Pain Syndromes Opioid Analgesics Pain Pathology Patient-Focused Outcomes Patients Phase Phase Transition Physiologic pulse Pilot Projects Property Public Health Reproducibility Research Personnel Scanning Slide Structure Syndrome System Techniques Testing Therapeutic Time Tissues Treatment Efficacy Ultrasonography Validation Variant Viscosity base computerized data processing efficacy evaluation efficacy outcomes elastography functional status healthy volunteer imaging biomarker imaging modality imaging system in vivo innovation insight mechanical properties novel novel marker opioid overuse outcome prediction pain score quantitative imaging recruit response sex technology development tissue mapping tool transmission process treatment response vibration viscoelasticity

项目摘要

PROJECT SUMMARY/ ABSTRACT Myofascial pain syndrome (MPS) is a common public health problem. Knowledge of MPS injury mechanisms and treatment of this condition is currently limited by a lack of objective assessment tools. Efforts to better understand the origin and pathology of MPS have increasingly focused on impairments involving myofascial connective tissue and the function of fascial interfaces. Studies using ultrasound imaging technology to evaluate the function at sliding myofascial interfaces have provided insights into the underlying mechanisms of the syndrome. Researchers suggest that alterations in the viscoelastic properties of fascial structures may contribute to the MPS etiology. This may be perceived by patients as an increase in fascial stiffness and pain with restricted motion. However, major knowledge gaps remain in the understanding of myofascial biomechanics and how changes in these structures contribute to myofascial pain. Development of technology capable of providing biomarkers that quantitatively characterize the viscoelastic properties of myofascial tissue and the state of adhesion at interfaces would address these gaps and contribute to the assessment of therapeutic modalities. Currently, a noninvasive tool for quantifying fascia mechanical properties is very limited. Our goals are to (1) develop an MRE-based imaging technique for quantifying the mechanical properties of myofascial tissue and (2) establish new quantitative biomarkers for assessing impaired myofascial tissue and treatment efficacy. In Aim 1 (R61 phase), we will build an MRE-based framework to integrate multiple driving systems inducing desired shear motion in the lower back, upper and lower legs, respectively; an advanced pulse sequence to measure the corresponding full-volume dynamic 4D muscle displacement fields; and a post-processing approach to assess resultant mechanical parameters of the myofascial interface in those regions in vivo. This will create a foundation to characterize the myofascial interface mobility, stiffness, viscosity, and loading sensitivity. In Aim 2 (R61 phase), we will evaluate the repeatability and reproducibility of the MRE-assessed fascia mechanical properties in healthy volunteers using a test-retest strategy. A pilot clinical study will also be performed to evaluate and compare MRE-assessed fascia mechanical properties in age-/sex-matched normal and patients with conditions in the MPS spectrum. The transition milestone we are looking for is imaging biomarker(s) that demonstrate a statistically significant (p < 0.05) group difference. In Aim 3 (R33 phase), we will assess the abilities of the quantitative biomarker(s) developed in the R61 phase to monitor treatment responses to a physical force-based manipulation treatment (Tuina) and predict outcomes in a longitudinal study. Taken together, these aims will provide innovative methods and unique datasets for studying myofascial biomechanics, novel imaging biomarkers to distinguish healthy versus abnormal myofascial tissue and interfaces, and new imaging biomarkers to aid clinicians in developing effective approaches to myofascial pain, and helping to address one of the most important conditions that has led to overuse of opioid analgesics.

项目摘要/摘要肌筋膜疼痛综合征（MPS）是一个常见的公共卫生问题。 MPS伤害机制的知识和目前，这种情况的治疗受到客观评估工具的限制。努力更好地理解国会议员的起源和病理越来越集中于涉及肌筋膜结缔组织的损伤以及筋膜界面的功能。使用超声成像技术的研究来评估滑动功能肌筋膜界面为综合征的基本机制提供了见解。研究人员表明筋膜结构的粘弹性特性的改变可能有助于MPS病因。这患者可能会认为筋膜僵硬和疼痛受到限制运动的增加。但是，主要知识差距在理解肌筋膜生物力学以及这些结构中的变化如何导致肌筋膜疼痛。开发能够提供定量的生物标志物的技术表征肌筋膜组织的粘弹性和接口处的粘附状态这些差距并有助于评估治疗方式。当前，是一种量化的无创工具筋膜机械性能非常有限。我们的目标是（1）开发一种基于MRE的成像技术量化肌筋膜组织的机械性能，（2）为评估肌筋膜组织受损和治疗功效。在AIM 1（R61阶段）中，我们将建立一个基于MRE的集成多个驾驶系统的框架，在下背部，上和下部引起所需的剪切运动腿分别；高级脉冲序列，用于测量相应的全册动态4D肌肉位移字段；以及一种评估肌筋膜的最终机械参数的后处理方法体内这些区域的接口。这将为表征肌筋膜界面移动性创造一个基础，刚度，粘度和加载灵敏度。在AIM 2（R61阶段）中，我们将评估可重复性和使用测试策略的健康志愿者中MRE筋膜机械性能的可重复性。还将进行一项试点临床研究，以评估和比较MRE评估的筋膜机械性能年龄/性别匹配的正常患者和患有MPS频谱状况的患者。我们是过渡里程碑寻找成像生物标志物（S），表现出具有统计学意义（p <0.05）的群体差异。在目标3中（R33阶段），我们将评估在R61阶段开发的定量生物标志物的能力以监测对基于物理力的操纵治疗（TUINA）的治疗反应，并预测纵向研究。综上所述，这些目标将为研究提供创新的方法和独特的数据集肌筋膜生物力学，新型成像生物标志物，以区分健康与异常肌筋膜组织和界面和新成像生物标志物，以帮助临床医生开发有效的肌筋膜疼痛方法，并帮助解决导致阿片类镇痛药过度使用的最重要条件之一。