A Comparison of Electrical Impedance Myography and EMG in Radiculopathy

描述(由申请人提供)：在这项职业生涯中期面向患者的研究申请中，候选人Seward Rutkove博士建议追求他的长期职业目标，即改进用于评估神经肌肉疾病患者的评估技术，并指导在神经肌肉疾病研究中有前途的新研究者。在过去的8年里，他的主要研究工作是开发阻抗肌电成像(EIM)这一新技术。EIM是一种非侵入性、无痛的方法，通过表面应用和测量高频、低强度电流来评估肌肉。他的研究小组一直在通过三个独立的短期目标来追求这项技术的发展，所有这些目标都得到了赠款的支持：1)改进的EIM电子学/工程学的开发；2)对EIM理论的更好理解；以及3)这项技术的临床应用、技术转让和推广。支持这项工作的环境很丰富，包括拉特科夫博士所在的哈佛医学院/贝丝以色列女执事医学中心的神经病学系。拉特科夫博士还与麻省理工学院的工程师和东北大学的物理学家建立了合作关系，他们分别在设备改进和EIM理论开发方面提供帮助。此外，这种环境特别有利于指导新的临床研究人员，因为拉特科夫博士已经拥有丰富的指导经验。该研究计划侧重于EIM与EMG的盲目、前瞻性评估，以用于评估两种非常常见的神经肌肉疾病：颈椎和腰椎神经根病。该项目的最终目标是获得支持该技术在这些神经肌肉疾病诊断中的价值的I级证据。该计划的具体目标包括：1)EIM和EMG在诊断颈椎和腰椎神经根病中的前瞻性、盲性评估；2)EIM和EMG在评估神经根病严重程度方面的前瞻性、盲性评估；3.EIM和EMG在评估神经根病的急性/慢性方面的前瞻性、盲性比较。还提供了丰富的、结构化的指导计划，包括期望年轻研究人员在与Rutkove博士一起培训期间负责个别项目。如果这项研究证明EIM是一种对神经根病的初步评估有效的测试，那么对针刺肌电的痛苦、侵入性测试的要求将大大减少或可能被取消。这将导致改善对患有这一非常常见疾病的个人的评估和护理。无论EIM的具体成功与否，一群年轻的研究人员都将接受彻底的培训，以从事以患者为导向的神经肌肉疾病研究。

DESCRIPTION (provided by applicant): In this mid-career patient-oriented research application, the candidate, Dr. Seward Rutkove, proposes to pursue his long-term career goal of improving the assessment techniques used in the evaluation of patients with neuromuscular disorders and mentoring promising new investigators in neuromuscular disease research. Over the past 8 years, his major research effort has been in the development of the new technique of electrical impedance myography (EIM). EIM is a non-invasive, painless, approach to assessing muscle through the surface application and measurement of high-frequency, low-intensity electrical current. His research group has been pursuing the development of this technique through 3 separate short-term goals all of which have been grant supported: 1) the development of improved EIM electronics/engineering; 2) the development of an improved understanding of EIM theory; and 3) the clinical application, technology transfer, and dissemination of this technique. The environment supporting this work is rich and includes the Department of Neurology at Harvard Medical School/Beth Israel Deaconess Medical Center, where Dr. Rutkove is based. Dr. Rutkove has also established collaborations with engineers at Massachusetts Institute of Technology and physicists at Northeastern University, who have been assisting in device refinement and EIM theory development, respectively. In addition, this environment is especially conducive to the mentoring of new clinical investigators, with Dr. Rutkove already having substantial experience as a mentor. The research plan focuses on the blinded, prospective assessment of EIM versus EMG for use in the evaluation of two extremely common neuromuscular disorders: cervical and lumbosacral radiculopathy. The ultimate goal of this project is that of achieving Class I evidence supporting the value of the technique in the diagnosis of these neuromuscular conditions. The specific aims of the plan include: 1) A prospective, blinded evaluation of EIM and EMG in the diagnosis of cervical and lumbosacral radiculopathy; 2) a prospective, blinded evaluation of EIM and EMG in the evaluation of radiculopathy severity; 3. a prospective, blinded comparison of EIM and EMG in assessing the acuteness/chronicity of radiculopathy. A rich, structured, mentoring plan is also provided, including the expectation that young investigator's take ownership of individual projects during their training with Dr. Rutkove. Should this research prove EIM to be an effective test for the initial assessment of radiculopathy, the requirement for the painful, invasive test of needle EMG will be substantially reduced or possibly eliminated. This would lead to improved assessment and care for individuals suffering from this very common malady. Regardless of the specific success of EIM, a group of young investigators will be thoroughly trained to pursue patient-oriented neuromuscular disease research.