Comparison of the Local Tissue Milieu in Normal muscle and Active and Latent Myo

正常肌肉与活跃和潜在肌肉局部组织环境的比较

• 批准号: 7733655
• 负责人: Jay Shah
• 金额: $ 4.41万
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7733655
• 关键词: Address; Affect; Area; Biochemical; Biological Assay; Blood Vessels; Blood flow; Catecholamines; Class; Clinical; Condition; Data; Diagnosis; Electrolytes; Enzymes; Etiology; Exhibits; Functional disorder; Goals; High Prevalence; Human; Image; Inflammation; Inflammatory; Invasive; Localized; Measures; Mediator of activation protein; Microdialysis; Microscopic; Muscle; Myalgia; Myofascial Pain Syndromes; Myofascial Trigger Point; Natural History; Needles; Neuropeptides; Nodule; Pain; Pain Disorder; Pain management; Palpable; Patients; Physical Examination; Physiology; Property; Recording of previous events; Sampling; Site; Skeletal Muscle; Spottings; Structure; Symptoms; System; Techniques; Testing; Time; Tissues; Treatment outcome; Ultrasonography; base; chronic pain; cytokine; design; improved; medical specialties; novel; soft tissue; tool; trigger point; vibration

Our findings confirm that subjects with active myofascial trigger points (MTrPs) have a significantly different biochemical profile (i.e., elevated levels of pro-inflammatory mediators, neuropeptides, cytokines, and catecholamines) within the local milieu of the MTrP compared to those without MTrPs or those with a latent (non-symptomatic) MTrP. These classes of substances are known to be associated with chronic pain states. Furthermore, we found significant differences in analyte levels at needle insertion between the trapezius and unaffected gastrocnemius in the Active group, suggesting that the vicinity of the active MTrP exhibits a unique biochemical milieu of substances associated with pain and inflammation. Additionally, gastrocnemius analyte levels were higher in the Active group than either the Latent or Normal groups. This further suggests that analyte abnormalities may not be limited to local areas of active MTrPs in the upper trapezius but may also be present at sites remote from the active MTrP. The MTrP is a palpable, discreet, localized tender spot in a taut band of skeletal muscle. In spite of the high prevalence, there are currently no imaging criteria for the diagnosis of MTrPs or for assessing clinical outcome of treatments. Accordingly, the diagnosis of myofascial pain is based exclusively on history and physical examination. Our preliminary findings using diagnostic ultrasound imaging and vibration sonoelastography suggest that MTrPs can be differentiated from surrounding muscle based on differences in echogenicity measures of tissue stiffness and local muscle blood flow properties. It is unclear how the symptoms and physical findings of MTrPs and uninvolved muscle behave over time; they could improve, worsen or remain stable. It is suspected that the symptoms and physical findings of MTrPs will change over time, and we intend to correlate any clinical changes with local biochemical analyte levels, viscoelastic properties of the MTrP and unaffected tissue and local muscle blood flow properties.

我们的研究结果证实，具有活动性肌筋膜触发点（MTrP）的受试者具有显著不同的生化特征（即，促炎介质、神经肽、细胞因子和儿茶酚胺水平升高）。 已知这些种类的物质与慢性疼痛状态有关。 此外，我们发现活性组中的腓肠肌和未受影响的腓肠肌之间在针插入时的分析物水平存在显著差异，这表明活性MTrP附近表现出与疼痛和炎症相关的物质的独特生物化学环境。此外，活性组的腓肠肌分析物水平高于潜伏组或正常组。这进一步表明，分析物异常可能不限于上肌中的活性MTRP的局部区域，但也可能存在于远离活性MTRP的部位。 肌筋膜后凸是一个可触及的、不明显的、位于骨骼肌绷紧带的局部压痛点。尽管发病率很高，但目前还没有诊断MTRP或评估治疗临床结果的成像标准。因此，肌筋膜疼痛的诊断完全基于病史和体格检查。 我们使用诊断超声成像和振动声弹性成像的初步研究结果表明，MTrPs可以区分从周围的肌肉组织硬度和局部肌肉血流特性的回声测量的基础上的差异。 目前尚不清楚肌筋膜激惹和未受累肌肉的症状和体征如何随着时间的推移而表现;它们可能会改善，恶化或保持稳定。 怀疑MTrP的症状和身体检查结果将随时间变化，我们打算将任何临床变化与局部生化分析物水平、MTrP的粘弹性和未受影响的组织和局部肌肉血流特性相关联。