Development of Analysis Tools to Enhance Magnetomyographic Assessment of Pelvic Floor Muscles

开发分析工具以增强盆底肌肉肌磁图评估

• 批准号: 10443695
• 负责人: Hari Eswaran
• 金额: $ 34.2万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10443695
• 关键词: Address; Adult; Affect; Anatomy; Biomedical Engineering; Birth; Birth trauma; Bladder Control; Brain; Cesarean section; Classification; Clinical; Complex; Data; Detection; Development; Discipline of obstetrics; Electromagnetic Fields; Electromyography; Electrophysiology (science); Event; Fecal Incontinence; Female; First Pregnancy Trimester; Future; Goals; Gravid; Human; Injury; Institution; Intestines; Knowledge; Magnetic Resonance Imaging; Maps; Measures; Methodology; Methods; Muscle; Muscle Contraction; National Institute of Biomedical Imaging and Bioengineering; Nulliparity; Organ; Participant; Pathway interactions; Pattern; Pelvic Floor Disorders; Pelvic Floor Muscle; Pelvic floor structure; Pelvis; Physiological; Postpartum Period; Predisposition; Pregnancy; Pregnancy Trimesters; Protocols documentation; Proxy; Recovery; Research; Research Project Grants; Risk; Severities; Signal Transduction; Skeletal Muscle; Soft Tissue Injuries; Stretching; Symptoms; System; Techniques; Technology; Third Pregnancy Trimester; Time; Trauma; Urinary Incontinence; Uterine Contraction; Uterus; Vagina; Vaginal delivery procedure; Woman; Work; antenatal; base; clinical predictors; clinically significant; cohort; disorder risk; experience; fetal; imaging study; improved; injury prevention; injury recovery; innovation; innovative technologies; insight; levator ani muscle; long-term sequelae; models and simulation; multidisciplinary; neuromuscular; neuromuscular function; novel; novel strategies; pelvic organ prolapse; pregnant; prevent; primipara; reproductive; response; signal processing; soft tissue; sphincter ani muscle structure; tool; ultrasound

Project Summary/Abstract During pregnancy and delivery women experience pelvic soft tissue injury. This injury is associated with the development of symptomatic pelvic floor disorders (PFDs) including pelvic organ prolapse, urinary, and fecal incontinence. One of the biggest barriers to preventing birth injury and the subsequent sequelae of PFDs is our lack of understanding of when and how injury occurs. Simulation models suggest that term delivery requires stretch to the maternal pelvic floor musculature to a degree greater than that which skeletal muscle can normally undergo without sustaining injury. Thus, with term vaginal birth, near universal injury would be expected. Previous studies have used anatomic and functional methodology to explore this neuromuscular injury, but we continue to lack a complete understanding of maternal pelvic floor injury and recovery patterns. We also possess limited knowledge of the changes which maternal soft tissues undergo during pregnancy, presumably to facilitate atraumatic birth. Our institution houses the SQUID Array for Reproductive Assessment (SARA) system, a novel and noninvasive tool to assess biomagnetic signals such as those created by depolarization occurring with muscle contraction. We propose to adapt SARA system to record the biomagnetic signals generated by the levator ani muscles (LAMs) of the maternal pelvic floor and apply advanced signal processing techniques to extract and characterize the LAM electrophysiology. These magnetomyographic (MMG) recordings will be used to study maternal pelvic floor neuromuscular function before and after delivery. Our project will be the first to comprehensively use MMG technology to assess the maternal LAMs. We will combine clinical, anatomic, and physiologic endpoints to improve our knowledge of maternal pelvic muscular adaptations and injury recovery patterns using a comprehensive protocol with which we have demonstrated promising preliminary data in small cohorts of nulligravidas and nulliparous gravidas. This proposal is in response to NIBIB’s PAR-19-158 Bioengineering Research Grants, where we apply a multidisciplinary integrative team approach to address the paucity of knowledge regarding maternal muscular adaptations and maternal LAM injury thus provide a framework for future innovation in injury prevention and recovery research. Our overall hypothesis is that MMG will allow detection of maternal LAMs adaptation during pregnancy and identification of injury and recovery patterns postpartum. Aim 1: To adapt biomagnetic technology based system to record high spatial temporal MMG LAM complex and apply advanced signal processing methods to extract relevant pelvic floor muscle parameters. Aim 2: To track and characterize changes in levator MMG signals with parturition comparing 3rd trimester pregnancy to early and late postpartum. Aim 3: To correlate MMG patterns of LAM birth injury and recovery and associate MMG evidence of injury with PFD symtpoms and injury visible by transperineal US.

项目摘要/摘要 在怀孕和分娩期间，妇女遭受骨盆软组织损伤。这种伤害与 有症状的骨盆底疾病（PFD）的发展，包括骨盆脱垂，尿和粪便 失禁。防止出生损伤和随后的PFD后遗症的最大障碍之一是我们 缺乏对何时以及如何发生伤害的理解。模拟模型表明，期限交付需要 延伸到母体骨盆底肌肉，高于骨骼肌肉通常可以 不受伤害而发生的情况。随着阴道诞生的任期，预计将接近普遍伤害。 先前的研究使用解剖和功能方法来探索这种神经肌肉损伤，但我们 继续缺乏对母体骨盆底损伤和恢复模式的完全了解。我们也拥有 有限的了解物质软组织在怀孕期间发生的变化，大概是为了促进 狂暴的出生。我们的机构设有鱿鱼阵列进行生殖评估（SARA）系统，这是一种新颖 和无创的工具来评估生物磁信号，例如由沉积物产生的信号 肌肉收缩。我们建议调整萨拉系统以记录由 母体骨盆底的Levator ANI肌肉（LAM），并将高级信号处理技术应用于 提取并表征LAM电生理学。这些磁性学（MMG）的录音将被使用 在分娩前后研究母体骨盆底神经肌肉功能。我们的项目将是第一个 全面使用MMG技术评估母型肿瘤。我们将结合临床，解剖和 生理终点，以提高我们对母体骨盆肌肉适应和损伤恢复的了解 使用综合协议的模式，我们已经证明了小规模的有希望的初步数据 Nulligravidas和Nulliparous Gravidas的同类。该提议是对尼比布的第19杆158杆的回应 生物工程研究补助金，我们在其中采用多学科综合团队方法来解决 因此，关于母体肌肉适应和孕产妇损伤的知识很少 预防和恢复研究中未来创新的未来创新框架。我们的总体假设是MMG 将允许在怀孕期间检测出母性肿瘤的适应性，并鉴定出伤害和恢复 产后模式。目标1：适应基于生物磁技术的系统以记录高空间临时性 MMG LAM复合物并应用高级信号处理方法来提取相关的骨盆底肌肉 参数。 AIM 2：跟踪和表征Levator MMG信号的变化与分区比较第三 妊娠至产后晚期和晚期。目标3：将LAM出生损伤的MMG模式与 恢复和关联的MMG证据证明了PFD同胞的损伤和跨性质美国可见的伤害。