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

基本信息

批准号：
10626082
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
项目类别：
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/10626082
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 Early Diagnosis 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 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

项目摘要

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.

项目概要/摘要在怀孕和分娩期间，女性会经历骨盆软组织损伤，这种损伤与骨盆软组织损伤有关。出现症状性盆底疾病 (PFD)，包括盆腔器官脱垂、泌尿和粪便预防产伤和 PFD 后遗症的最大障碍之一是我们的尿失禁。缺乏对伤害何时以及如何发生的了解模拟模型表明足月分娩需要。对母亲盆底肌肉组织的拉伸程度大于骨骼肌正常情况下的拉伸程度因此，足月阴道分娩几乎会造成普遍的伤害。之前的研究已经使用解剖学和功能方法来探索这种神经肌肉损伤，但我们我们仍然缺乏对产妇盆底损伤和恢复模式的完整了解。对母亲软组织在怀孕期间发生的变化的了解有限，大概是为了促进我们的机构拥有用于生殖评估 (SARA) 的 SQUID 阵列，这是一种新颖的系统。和非侵入性工具来评估生物磁信号，例如由去极化产生的信号我们建议采用 SARA 系统来记录肌肉收缩产生的生物磁信号。产妇盆底提肛肌 (LAM) 并应用先进的信号处理技术将使用这些肌磁图 (MMG) 记录来提取和表征 LAM 电生理学。我们的项目将是第一个研究分娩前后母亲盆底神经肌肉功能的项目。综合运用MMG技术对母体LAM进行评估，我们将结合临床、解剖学和生理终点以提高我们对产妇骨盆肌肉适应和损伤恢复的了解使用综合协议的模式，我们通过该协议在小规模中展示了有希望的初步数据该提案是对 NIBIB 的 PAR-19-158 的回应。生物工程研究补助金，我们采用多学科综合团队方法来解决因此，关于产妇肌肉适应和产妇 LAM 损伤的知识匮乏，因此提供了一种我们的总体假设是 MMG 是未来伤害预防和康复研究创新的框架。将允许检测母体 LAM 在怀孕期间的适应情况并识别损伤和恢复情况目标 1：采用基于生物磁空间技术的系统来记录高时间。 MMG LAM 复合并应用先进的信号处理方法提取相关盆底肌肉目标 2：跟踪和表征与第三次分娩相比的提肌 MMG 信号的变化。怀孕三个月到产后早期和晚期目标 3：将 LAM 出生损伤和 MMG 模式关联起来。恢复并将 MMG 损伤证据与 PFD 症状和经会阴超声可见的损伤相关联。