Noninvasive markers of functional nausea in children

儿童功能性恶心的无创标记物

• 批准号: 9753025
• 负责人: LEONARD A BRADSHAW
• 金额: $ 31.31万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-10 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9753025
• 关键词: Abdomen; Adolescent; Adult; Affect; Algorithms; American; Anatomy; Biophysics; Cardiac; Characteristics; Child; Childhood; Chronic; Clinical; Complex; Computer Simulation; Coupling; Custom; Data; Detection; Diagnosis; Diagnostic; Digestion; Disease; Dyspepsia; Electromagnetics; Electromyography; Electrophysiology (science); Endoscopic Biopsy; Evaluation; Frequencies; Functional Gastrointestinal Disorders; Functional disorder; Gastric Emptying; Gastroenterologist; Gastrointestinal Diseases; Gastroparesis; Giant Cells; Histologic; Hyperglycemia; Image; Intervention; Lead; Maps; Measures; Mediating; Methods; Modeling; Monitor; Mucous Membrane; Nausea; Nausea and Vomiting; Pathologic Processes; Patients; Pattern; Peristalsis; Pharmacology; Phenotype; Physiological; Population; Property; Quality of life; Resolution; Severities; Severity of illness; Signal Transduction; Source; Stomach; Structural defect; Structure; Symptoms; Testing; Therapeutic; Time; Ultrasonography; Vision; Vomiting; X-Ray Computed Tomography; abdominal fat; base; blind; clinical decision-making; clinical phenotype; cost; experience; functional disability; functional status; gastrointestinal; gastrointestinal system; insight; magnetic field; mathematical model; neuromuscular; pediatric patients; portability; psychologic; psychosocial; research clinical testing; response; spatiotemporal; tool; treatment response

Project Summary The gastric electrical slow wave mediates neuromuscular interactions in the gastrointestinal syncytium that determine the functional status of peristalsis and digestion. Millions of patients present to gastroenterologists each year with functional GI disorders which are associated with gastric slow wave dysrhythmia. However, noninvasive methods for assessing this activity quantitatively remain elusive. Structural imaging provided by CT and ultrasound can be useful when functional disorders are associated with anatomical changes, but frequently, gastric disorders occur with no concomitant structural abnormality. Functional nausea (FN) is a GI disorder that affects millions of Americans, particularly adolescents, but diagnoses remain largely exclusionary relying on symptomology with an otherwise normal diagnostic workup. FN is important to study in adolescents because it is ubiquitous, chronic, tracks into adulthood and adversely affects the quality of life in patients, yet understanding the pathophysiology might allow interventions at a time of therapeutic plasticity. The ability to study FN is limited by the lack of an objective clinical test to characterize or measure nausea or to predict its response to treatment or exacerbating factors. Electrogastrography (EGG) is as a possible approach, but signal quality and limitations of volume conduction in the abdomen have previously limited its utility to the characterization of temporal dynamics. Our preliminary data show that blind source separation applied to the multichannel electrogastrogram (EGG) can characterize propagation of the gastric slow wave, and that the magnetogastrogram (MGG), which measures spatiotemporal properties of magnetic fields from the gastric slow wave, also allows characterization of the propagation of the gastric slow wave in addition to evaluation of its frequency and power distribution. Furthermore, these spatiotemporal characteristics change during hyperglycemia and functional disorders like gastroparesis. We propose to study how functional nausea in adolescents may be characterized noninvasively by the use of multichannel EGG and MGG recordings. Our main aims in this proposal are to develop a mathematical model of FN, correlate functional differences in slow waves with nausea in patients with FN using modeling and experimental approaches, and to characterize biophysical, clinical and psychosocial phenotypes of FN using EGG/MGG. We will investigate differences between standard four-channel EGG and multichannel EGG/MGG, assess changes in slow wave rhythm and propagation pattern from EGG and MGG with disease in FN patients, examine differences between EGG and MGG signatures of severe nausea in FN patients, and will determine how MGG/EGG slow wave rhythm and pattern abnormalities relate to psychological functioning and pharmacological intervention. The analysis of slow wave activity represents the first physiologically-quantifiable noninvasive assessment method for pathological processes associated with functional nausea in adolescents.

项目摘要 胃电慢波介导胃肠道合成中的神经肌肉相互作用 确定蠕动和消化的功能状态。数以百万计的患者出现在胃肠病医生 每年都有与胃慢波运动障碍有关的功能性GI疾病。然而， 无创的无创方法定量地评估该活动仍然难以捉摸。结构成像由 当功能障碍与解剖学变化相关联时，CT和超声很有用，但是 通常，胃部疾病没有伴随的结构异常。功能性恶心（FN）是GI 影响数百万美国人，尤其是青少年的疾病，但诊断仍然很大程度上排他性 依靠症状和原本正常的诊断检查。 FN对于青少年学习很重要 因为它无处不在，慢性，成年后的痕迹会影响患者的生活质量，但 了解病理生理可能会在治疗性可塑性时进行干预。能力 研究FN受到缺乏客观临床测试来表征或测量恶心或预测其的限制 对治疗或加剧因素的反应。电兼术（EGG）是一种可能的方法，但信号 腹部体积传导的质量和局限 时间动力学的表征。我们的初步数据表明，盲目分离应用于 多通道电量表（EGG）可以表征胃慢波的传播，并且 磁胃图（MGG），它测量胃中磁场的时空特性 慢波，还允许表征胃慢波的传播。 它的频率和功率分布。此外，这些时空特征在 高血糖和功能障碍，例如胃轻瘫。我们建议研究功能性恶心 青少年可以通过使用多通道卵和MGG记录来无创特征。我们的 该提案的主要目的是开发FN的数学模型，相关的功能差异 使用建模和实验方法在FN患者中患有恶心的波，并表征 使用Egg/MGG的FN的生物物理，临床和社会心理表型。我们将研究差异 在标准的四通道卵和多通道卵/MGG之间，评估慢波节奏的变化和 FN患者的卵和MGG与疾病的传播模式，检查卵和鸡蛋之间的差异 FN患者严重恶心的MGG特征，将决定MGG/Egg慢波节奏和 模式异常与心理功能和药理干预有关。分析 慢波活性代表了第一个在生理上可以量化的非侵入性评估方法 与青少年功能性恶心相关的病理过程。