Noninvasive markers of functional nausea in children

儿童功能性恶心的无创标记物

• 批准号: 9977005
• 负责人: LEONARD A BRADSHAW
• 金额: $ 31.28万
• 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/9977005
• 关键词: Abdomen; Adolescent; Adult; Affect; Algorithms; American; Anatomy; Biophysics; Cardiac; Characteristics; Child; Childhood; Chronic; Clinical; Complex; 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; in silico; 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.

项目概要 胃电慢波介导胃肠合胞体中的神经肌肉相互作用 确定蠕动和消化的功能状态。数以百万计的患者就诊于胃肠病学家 每年都会出现与胃慢波心律失常相关的功能性胃肠道疾病。然而， 定量评估这种活动的非侵入性方法仍然难以捉摸。结构成像提供者 当功能障碍与解剖学变化相关时，CT 和超声波可能有用，但是 通常，胃部疾病的发生并不伴随结构异常。功能性恶心 (FN) 是一种胃肠道疾病 这种疾病影响着数百万美国人，尤其是青少年，但诊断在很大程度上仍然是排除性的 依靠症状学和其他正常的诊断检查。 FN 对于青少年来说很重要 因为它是普遍存在的、慢性的，会一直持续到成年并对患者的生活质量产生不利影响，但 了解病理生理学可能有助于在治疗可塑性时期进行干预。有能力 FN 研究因缺乏客观的临床测试来表征或测量恶心或预测其恶心而受到限制 对治疗或恶化因素的反应。胃电图 (EGG) 是一种可能的方法，但信号 腹部容积传导的质量和局限性以前限制了其在 时间动态的表征。我们的初步数据表明盲源分离应用于 多通道胃电图（EGG）可以表征胃慢波的传播，并且 胃磁图 (MGG)，测量胃磁场的时空特性 慢波，除了评估之外，还可以表征胃慢波的传播 它的频率和功率分布。此外，这些时空特征在 高血糖和胃轻瘫等功能性疾病。我们建议研究功能性恶心如何 通过使用多通道 EGG 和 MGG 记录，可以对青少年进行无创性表征。我们的 该提案的主要目的是开发 FN 的数学模型，将慢速中的功能差异关联起来 使用建模和实验方法对 FN 患者的恶心波进行表征 使用 EGG/MGG 分析 FN 的生物物理、临床和心理社会表型。我们将调查差异 标准四通道 EGG 和多通道 EGG/MGG 之间，评估慢波节律的变化和 FN 患者患病时 EGG 和 MGG 的传播模式，检查 EGG 和 MGG 之间的差异 FN 患者严重恶心的 MGG 特征，并将确定 MGG/EGG 慢波节律和 模式异常与心理功能和药物干预有关。的分析 慢波活动代表了第一个可生理量化的无创评估方法 与青少年功能性恶心相关的病理过程。