Novel Electrical Impedance Methodology to Understand Functional Dysphagia

标题：理解“功能性吞咽困难”的新电阻抗方法 摘要 与蠕动有关的运动负责吞咽的内容物的有序推进。 整个胃肠道(GI)的流产方向。为了使推进剂有效地通过肾小管 胃肠道的结构，它需要胃肠管在团剂后面的部分收缩(上行收缩) 以及团注前的放松(下降松弛)，这在本质上是 蠕动反射(肠道法则)。使用腔内技术可以相对容易地记录胃肠道收缩 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 常规临床食道测压中蠕动反射的松弛肢体。正常食道 蠕动传输过程中的尺寸是未知的。多重腔内阻抗(MII)技术；已 使用了近25年来监测液体和空气在口腔和流产方向上的运动 食管。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 在蠕动运输过程中准确的食道扩张。我们认为食道扩张是一种 MII可准确测量蠕动和扩张下行松弛的替代标志物 技术。 这项拟议的研究有五个主要目标。第一，记录管腔CSA的动态变化 来自MII测量的蠕动期间的食道：该方法将被合并到软件中 该程序将允许测量高分辨率膨胀和高分辨率收缩，作为 使用一种新的算法进行蠕动。我们预计，这样的程序将成为 临床食道运动试验。第二，我们建议检验类似于收缩的假设 蠕动反射的抑制阶段也以蠕动的方式传播到食道。第三，我们会研究 食道扩张与收缩幅度、收缩速度等参数的关系 食道蠕动。第四，最重要的是，我们将检验这样一个假设，即缺乏膨胀/缺陷 食道抑制是“功能性吞咽困难”的原因。第五，最后，我们将确定根本原因 功能性吞咽困难患者的食道扩张不良。这项建议在应用上具有创新性。 (常规临床研究期间的记录抑制从未在常规的食道运动中进行过 研究)。我们的重点是使用MII来量化丸剂运输过程中的管腔扩张，以及 生物电阻抗在食道动力检测中可以发挥作用。拟议中的项目可能会 革命性的食道动力测试，增加了另一个强大的工具，除了测压诊断 与蠕动反射的扩张/抑制相异常有关的运动障碍。

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.