Novel Electrical Impedance Methodology to Understand Functional Dysphagia

了解功能性吞咽困难的新型电阻抗方法

• 批准号: 10004028
• 负责人: RAVINDER K. MITTAL
• 金额: $ 49.09万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10004028
• 关键词: Air; Algorithms; Area; Barium swallow; Bathing; Biomechanics; Bolus Infusion; Caliber; Characteristics; Clinical; Clinical Research; Colon; Computer software; Contracts; Deglutition; Deglutition Disorders; Diagnosis; Dimensions; Elements; Esophagus; Esophagus motility; Etiology; Fluoroscopy; Gastroesophageal reflux disease; Gastrointestinal tract structure; Goals; Human; Image; Intestines; Intrinsic factor; Laboratories; Large Intestine; Laws; Limb structure; Liquid substance; Manometry; Measurement; Measures; Mechanics; Methodology; Methods; Monitor; Motor; Motor Activity; Movement; Muscle; Nutcracker Esophagus; Oral; Organ; Patients; Peristalsis; Phase; Plant Roots; Play; Preparation; Property; Radiation exposure; Reflex action; Relaxation; Research; Resolution; Roentgen Rays; Role; Side; Small Intestines; Structure; Sturnus vulgaris; Surrogate Markers; Symptoms; Techniques; Testing; Transducers; Travel; Tube; Tubular formation; Validation; Water; Width; clinical examination; clinical practice; electric impedance; gastrointestinal; in vivo; innovation; motility disorder; novel; pressure; programs; solid state; tool; treatment strategy

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.

标题：了解“功能性吞咽困难”的新型电阻抗方法 抽象的 与蠕动相关的运动活动负责有序推进吞咽物质 整个胃肠道（GI）道。给推注通过管状有效移动 胃肠道的结构，需要收缩大块后面的GI管（上升收缩） 在推注前放松（下降放松），从本质上讲，这是两个基本要素 蠕动反射（肠法）。胃肠道的收缩可以相对容易地记录 压力或高分辨率测压（HRM）。另一方面，即使在2015年，尚不清楚如何记录 常规临床食管测量期间，蠕动反射的松弛肢。正常食管 蠕动运输过程中的尺寸尚不清楚。多重腔内阻抗（MII）技术；一直是 在近25年的使用中，在口头和可靠方向上监视液体和空气的运动 食管。我们实验室的最新研究表明，MII可以测量腔横截面面积（CSA）或 蠕动运输过程中食管延伸。我们建议食管扩张是 MII可以准确地测量蠕动和延伸的降低的替代标记 技术。 拟议的研究有5个主要目标。第一的;记录腔CSA的动态变化 MII测量中的蠕动期间食道：然后将该方法纳入软件 将允许测量高分辨率扩张和高分辨率收缩的程序作为一部分 使用一种新算法的蠕动。我们预见，这样的程序将成为 临床食管运动测试。第二;我们建议检验与合同类似的假设 蠕动反射的抑制阶段也以蠕动方式传播食道。第三;我们将研究 食道扩张与收缩幅度，速度和其他参数之间的关系 食管蠕动。第四;最重要的是，我们将测试缺乏膨胀/缺陷的假设 食道抑制是“功能性吞咽困难”的原因。第五;最后，我们将确定 功能性吞咽困难患者的食管延伸不良。该建议在其应用中具有创新性 （常规临床研究期间的记录抑制作用从未在常规食管运动中进行 研究）。我们专注于使用MII来量化推注传输过程中的管腔延伸，以及核心作用 生物阻抗可以在食管运动测试中发挥作用。拟议的项目可能有可能 通过添加另一个功能强大的工具以及诊断方法的测量法，可以彻底改变食道运动测试 与蠕动反射的扩张/抑制阶段异常相关的运动障碍。