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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.

项目概要/摘要肌筋膜疼痛综合征（MPS）是一个常见的公共卫生问题。了解 MPS 损伤机制和目前，由于缺乏客观的评估工具，这种情况的治疗受到限制。努力更好地理解 MPS 的起源和病理学越来越关注涉及肌筋膜结缔组织的损伤以及筋膜界面的功能。使用超声成像技术评估滑动功能的研究肌筋膜界面为了解该综合征的潜在机制提供了见解。研究人员表明筋膜结构粘弹性特性的改变可能有助于 MPS 病因。这患者可能会感觉到筋膜僵硬增加以及运动受限的疼痛。然而，主要对肌筋膜生物力学以及这些结构如何变化的理解仍然存在知识差距导致肌筋膜疼痛。开发能够定量提供生物标志物的技术表征肌筋膜组织的粘弹性特性和界面处的粘附状态将解决这些差距并有助于评估治疗方式。目前，一种非侵入性的量化工具筋膜的机械性能非常有限。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特性并（2）建立新的定量生物标志物评估受损的肌筋膜组织和治疗效果。在目标 1（R61 阶段）中，我们将构建一个基于 MRE 的集成多个驱动系统的框架，在下背部、上背部和下背部产生所需的剪切运动腿，分别；用于测量相应全体积动态 4D 肌肉的先进脉冲序列位移场；以及评估肌筋膜由此产生的机械参数的后处理方法体内这些区域的界面。这将为表征肌筋膜界面移动性奠定基础，刚度、粘度和负载敏感性。在目标 2（R61 阶段）中，我们将评估重复性和使用重测策略对健康志愿者进行 MRE 评估的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/性别匹配的正常人和患有 MPS 谱系疾病的患者。我们的转型里程碑寻找具有统计显着性（p < 0.05）组间差异的成像生物标志物。目标 3 （R33 阶段），我们将评估 R61 阶段开发的定量生物标志物监测的能力对基于物理力的推拿治疗（推拿）的治疗反应并预测结果纵向研究。总而言之，这些目标将为研究提供创新方法和独特的数据集肌筋膜生物力学，区分健康与异常肌筋膜组织的新型成像生物标志物界面和新的成像生物标志物，帮助临床医生开发治疗肌筋膜疼痛的有效方法，以及帮助解决导致过度使用阿片类镇痛药的最重要条件之一。