A Comparison of Electrical Impedance Myography and EMG in Radiculopathy

描述（由申请人提供）：在这个职业中期以患者为导向的研究申请中，候选人Seward Rutkove博士提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，并指导神经肌肉疾病研究中有前途的新研究者。在过去的八年中，他的主要研究工作是电阻抗肌图（EIM）新技术的发展。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3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资助：1)改进EIM电子/工程的发展；2)提高对EIM理论的理解；3)该技术的临床应用、技术转移和推广。支持这项工作的环境是丰富的，包括哈佛医学院神经内科/贝斯以色列女执事医疗中心，Rutkove博士所在的地方。Rutkove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，他们分别协助设备改进和EIM理论发展。此外，这种环境特别有利于指导新的临床研究人员，Rutkove博士已经拥有丰富的导师经验。该研究计划侧重于EIM与肌电图的盲法、前瞻性评估，用于评估两种极其常见的神经肌肉疾病：颈椎和腰骶神经根病。该项目的最终目标是获得一级证据，支持该技术在这些神经肌肉疾病诊断中的价值。该计划的具体目的包括：1)EIM和EMG在诊断颈椎和腰骶神经根病中的前瞻性、盲法评估；2)前瞻性、盲法评价EIM和EMG对神经根病严重程度的评价；3. EIM和EMG在评估神经根病的急性/慢性方面的前瞻性、盲法比较。还提供了一个丰富的、结构化的指导计划，包括期望年轻研究者在Rutkove博士的培训期间拥有个人项目的所有权。如果本研究证明EIM是一种有效的神经根病初步评估测试，那么对针式肌电图的痛苦、侵入性测试的需求将大大减少或可能消除。这将导致改善对患有这种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将接受彻底的培训，以追求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.