Novel Electrical Impedance Methodology to Understand Functional Dysphagia

了解功能性吞咽困难的新型电阻抗方法

• 批准号: 10004028
• 负责人: RAVINDER K. MITTAL
• 金额: $ 49.09万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10004028
• 关键词: Air; Algorithms; Area; Barium swallow; Bathing; Biomechanics; Bolus Infusion; Caliber; Characteristics; Clinical; Clinical Research; Colon; Computer software; Contracts; Deglutition; Deglutition Disorders; Diagnosis; Dimensions; Elements; Esophagus; Esophagus motility; Etiology; Fluoroscopy; Gastroesophageal reflux disease; Gastrointestinal tract structure; Goals; Human; Image; Intestines; Intrinsic factor; Laboratories; Large Intestine; Laws; Limb structure; Liquid substance; Manometry; Measurement; Measures; Mechanics; Methodology; Methods; Monitor; Motor; Motor Activity; Movement; Muscle; Nutcracker Esophagus; Oral; Organ; Patients; Peristalsis; Phase; Plant Roots; Play; Preparation; Property; Radiation exposure; Reflex action; Relaxation; Research; Resolution; Roentgen Rays; Role; Side; Small Intestines; Structure; Sturnus vulgaris; Surrogate Markers; Symptoms; Techniques; Testing; Transducers; Travel; Tube; Tubular formation; Validation; Water; Width; clinical examination; clinical practice; electric impedance; gastrointestinal; in vivo; innovation; motility disorder; novel; pressure; programs; solid state; tool; treatment strategy

Title: Novel Electrical Impedance Methodology to Understand “Functional Dysphagia” ABSTRACT Motor activity associated with peristalsis is responsible for the orderly propulsion of swallowed contents in the aboral direction throughout the gastrointestinal (GI) tract. For the bolus to move efficiently through the tubular structure of GI tract, it requires contraction of the segment of the GI tube behind the bolus (ascending contraction) and relaxation in front of the bolus (descending relaxation), which in essence are the two essential elements of a peristaltic reflex (law of intestine). Contraction in the GI tract can be recorded relatively easily using intraluminal pressure or high resolution manometry (HRM). On the other hand, even in year 2015 it is not clear how to record the relaxation limb of the peristaltic reflex during routine clinical esophageal manometry. Normal esophageal dimensions during peristaltic transport are not known. Multiple intraluminal impedance (MII) technique; has been in use for almost 25 years to monitor movements of liquid and air, in both oral and aboral direction in the esophagus. Recent studies from our laboratory show that MII can measure luminal cross section area (CSA) or esophageal distension during peristaltic transport accurately. We propose that esophageal distension is a surrogate marker of descending relaxation of peristalsis and distension can be measured accurately by MII technique. There are 5 major goals of the proposed research. First; to record dynamic changes in the luminal CSA of the esophagus during peristalsis from MII measurements: the method will then be incorporated into a software program that will allow measurement of high resolution distension and high resolution contraction as part of peristalsis using a novel algorithm. We foresee that such a program would become the standard or routine for clinical esophageal motility testing. Second; we propose to test the hypothesis that similar to contraction, the inhibition phase of peristaltic reflex also travels the esophagus in a peristaltic fashion. Third; we will study the relationship between esophageal distension and contraction amplitude, velocity and other parameters of esophageal peristalsis. Fourth; most importantly, we will test the hypothesis that the lack of distension/defective esophageal inhibition is the cause of “functional dysphagia”. Fifth; finally, we will determine the root cause of poor esophageal distension in patients with functional dysphagia. This proposal is innovative in its application (recording inhibition during routine clinical studies has never been carried out in routine esophageal motility studies). We focus on using MII to quantify luminal distension during bolus transport, and the central role that electrical bio-impedance can play in esophageal motility testing. The proposed project will potentially revolutionize esophageal motility testing, by adding another powerful tool alongside manometry in diagnosing motility disorders related to the abnormalities of the distension/inhibition phase of the peristaltic reflex.

标题：了解“功能性吞咽困难”的新型电阻抗方法 摘要 与吞咽相关的运动活动负责吞咽内容物在胃中的有序推进。 在整个胃肠道（GI）中的反口方向。为了使药团有效地移动通过管 胃肠道的结构，它需要收缩胃肠道后面的部分（上行收缩） 和在推注前的松弛（下行松弛），这在本质上是两个基本要素， 蠕动反射（肠道定律）。胃肠道的收缩可以相对容易地使用管腔内 压力或高分辨率测压（HRM）。另一方面，即使在2015年，也不清楚如何记录 常规临床食管测压中蠕动反射的松弛支。正常食管 蠕动输送期间的尺寸是未知的。多重腔内阻抗（MII）技术;已被 已使用近25年，用于监测液体和空气在口腔和反口方向的移动 食道我们实验室最近的研究表明，MII可以测量管腔横截面积（CSA）或 蠕动输送过程中食管扩张准确。我们认为食管扩张是一种 MII可准确测量膨胀和扩张下行松弛替代标记物 法 本研究的主要目标有5个。首先，记录管腔CSA的动态变化 MII测量中的食管测量：然后将该方法纳入软件中 该程序将允许测量高分辨率扩张和高分辨率收缩， 使用一种新的算法来进行预测。我们预见，这样的计划将成为标准或例行的 临床食管动力测试。第二，我们建议测试的假设，类似于收缩， 蠕动反射的抑制期也以蠕动方式穿过食道。第三，我们将研究 食管扩张与收缩幅度、速度等参数的关系 食管糜烂第四，最重要的是，我们将测试缺乏扩张/缺陷的假设， 食管抑制是“功能性吞咽困难”的原因。第五，最后，我们将确定的根源， 功能性吞咽困难患者的食管扩张不良。这一建议在应用上具有创新性 （在常规临床研究期间记录抑制从未在常规食管运动中进行 研究）。我们专注于使用MII来量化团注运输过程中的管腔扩张， 电生物阻抗可以在食管运动测试中起作用。该项目将有可能 革命性的食管动力测试，通过增加另一个强大的工具，除了测压在诊断 与蠕动反射的扩张/抑制相异常相关的运动障碍。