Dynamic Ultrasound to Enhance Understanding of Carpal Tunnel Syndrome

动态超声增强对腕管综合症的了解

• 批准号: 9329387
• 负责人: Peter C. Amadio
• 金额: $ 34.98万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9329387
• 关键词: Activities of Daily Living; Adherence; Adult; Affect; Aftercare; Algorithms; Anterior; Biological Markers; Carpal Tunnel Syndrome; Clinical; Clinical Research; Clinical assessments; Connective Tissue; Diagnosis; Dorsal; Equipment; Etiology; Evaluation; Fibrosis; Functional disorder; Future; Hand; Individual; Injection of therapeutic agent; Intervention; Investigation; Ligaments; Magnetic Resonance Imaging; Measures; Methods; Monitor; Motion; Movement; Nerve; Operative Surgical Procedures; Outcome; Pathologic; Patient Monitoring; Patient-Focused Outcomes; Patients; Pattern; Peripheral Nervous System Diseases; Prevalence; Procedures; Radial; Shapes; Steroids; Synovectomy; Tendon structure; Testing; Time; Translating; Treatment outcome; Ultrasonography; Variant; Wrist; clinical biomarkers; cost; disability; effective therapy; improved; individualized medicine; innovation; insight; kinematics; lifetime risk; median nerve; novel; outcome prediction; predictive of treatment response; public health relevance; reconstruction; tool; treatment response

DESCRIPTION (provided by applicant): Carpal tunnel syndrome (CTS), is the most common peripheral neuropathy, but currently there are no biomarkers to help guide treatment or to predict patient specific outcomes. We hypothesize that ultrasound detectable variations in nerve, tendon and subsynovial connective tissue (SSCT) mobility in patients with CTS may be useful clinically as functional biomarkers that correlate with, and thereby serve as predictors for treatment response. To test this hypothesis, we propose a clinical study in which patients presenting for treatment of CTS will be monitored by ultrasound and by clinical assessment before and after surgical and non-surgical treatment. We will correlate the clinical outcomes with the initial ultrasound motion patterns that we have found to be most variable in CTS patients. We will also test the hypothesis that successful treatment results in a change towards normal in the affected ultrasound variables. There are 4 Specific Aims. Aim 1 is to assess the ability of the functional biomarkers we have identified (the ratio of SSCT to tendon motion, dorsal nerve motion, and changes in nerve shape with motion) to predict outcome after steroid injection in patients with CTS. Aim 2 is to assess the ability of the functional biomarkers we have identified to predict outcome after surgery in patients with CTS. Aim 3 is to test our secondary hypothesis that treatment response after both injection and surgery correlates with a change towards normal in the affected ultrasound variables. Aim 4 is to, using the results from Aims 1-3, identify additional biomarkers that may correlate with treatment outcome, and to identify any composite clinical and biomarker measures that may improve the ability to predict outcome after treatment for CTS. If these aims are achieved, functional biomarkers will, for the first time, be available t tailor treatment for specific patients with CTS. This new US tool can be rapidly translated into clinical use, since the equipment is commonly available and the new algorithms could be rapidly disseminated.

描述（由申请人提供）：腕管综合征（CTS）是最常见的周围神经病，但目前尚无生物标志物来帮助指导治疗或预测患者的特定结果。我们假设CTS患者的神经，肌腱和肌腱结缔组织（SSCT）迁移率在神经，肌腱和肌腱结缔组织（SSCT）中的超声检测变化可能在临床上作为功能性生物标志物与与治疗反应相关的功能性生物标志物有用。为了检验这一假设，我们提出了一项临床研究，在该研究中，将通过超声检查和手术和非手术治疗前后通过临床评估来监测进行CTS治疗的患者。我们将将临床结局与最初发现的CTS患者中最大变化的最初超声运动模式相关联。我们还将检验以下假设：在受影响的超声变量中，成功的治疗导致正常变化。有4个具体目标。目标1是评估 我们已经鉴定出的功能生物标志物（SSCT与肌腱运动的比率，背神经运动和通过运动的神经形状变化），以预测CTS患者类固醇注射后的预后。目标2是评估我们已经确定的功能性生物标志物的能力，以预测CT患者手术后的结果。目的3是测试我们的次要假设，即注射和手术后的治疗反应与受影响的超声变量的正常变化相关。 AIM 4是使用AIMS 1-3的结果确定 可能与治疗结果相关的其他生物标志物，并确定任何综合临床和生物标志物测量方法，这些测量可能会提高CTS治疗后预测结果的能力。如果实现这些目标，功能性生物标志物将首次为特定CTS患者提供T量裁缝治疗。由于设备通常可用，并且新算法可以迅速传播，因此该新的美国工具可以迅速转化为临床用途。