A Comparison of Electrical Impedance Myography and EMG in Radiculopathy

描述（由申请人提供）：在这个职业生涯中期以患者为导向的研究申请中，候选人Seward Rutkove博士建议追求他的长期职业目标，即改善用于评估神经肌肉疾病患者的评估技术，并指导有前途的神经肌肉疾病研究新研究人员。在过去的8年里，他的主要研究工作一直在电阻抗肌描记术（EIM）的新技术的发展。EIM是一种无创、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开发这项技术，所有这些目标都得到了资助：1）开发改进的EIM电子/工程; 2）开发对EIM理论的更好理解; 3）该技术的临床应用，技术转让和传播。支持这项工作的环境是丰富的，包括哈佛医学院/贝丝以色列女执事医疗中心的神经病学系，Rutkove博士所在地。Rutkove博士还与马萨诸塞州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理论开发。此外，这种环境特别有利于指导新的临床研究者，Rutkove博士已经拥有丰富的导师经验。本研究计划的重点是对EIM与EMG进行盲法前瞻性评估，用于评价两种极为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I类证据，支持该技术在诊断这些神经肌肉疾病中的价值。该计划的具体目的包括：1）对EIM和EMG在诊断颈腰骶神经根病中的前瞻性盲法评价; 2）对EIM和EMG在评价神经根病严重程度中的前瞻性盲法评价; 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，包括期望年轻的研究人员在与Rutkove博士的培训期间拥有个人项目。如果这项研究证明EIM是初步评估神经根病的有效测试，那么对针EMG进行疼痛、侵入性测试的要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的疾病的个人的评估和护理。无论EIM的具体成功与否，一组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.