In this mid-career patient-oriented research application, the candidate, Dr. Seward Rutkove, proposes to pursue his long-term career goal of improving the assessment techniques used in the evaluation of patients with neuromuscular disorders and mentoring promising new investigators in neuromuscular disease research. Over the past 8 years, his major research effort has been in the development of the new technique of electrical impedance myography (EIM). EIM is a non-invasive, painless, approach to assessing muscle through the surface application and measurement of high-frequency, low-intensity electrical current. His research group has been pursuing the development of this technique through 3 separate short-term goals all of which have been grant supported: 1) the development of improved EIM electronics/engineering;2) the development of an improved understanding of EIM theory;and 3) the clinical application, technology transfer, and dissemination of this technique. The environment supporting this work is rich and includes the Department of Neurology at Harvard Medical School/Beth Israel Deaconess Medical Center, where Dr. Rutkove is based. Dr. Rutkove has also established collaborations with engineers at Massachusetts Institute of Technology and physicists at Northeastern University, who have been assisting in device refinement and EIM theory development, respectively. In addition, this environment is especially conducive to the mentoring of new clinical investigators, with Dr. Rutkove already having substantial experience as a mentor. The research plan focuses on the blinded, prospective assessment of EIM versus EMG for use in the evaluation of two extremely common neuromuscular disorders: cervical and lumbosacral radiculopathy. The ultimate goal of this project is that of achieving Class I evidence supporting the value of the technique in the diagnosis of these neuromuscular conditions.
The specific aims of the plan include: 1) A prospective, blinded evaluation of EIM and EMG in the diagnosis of cervical and lumbosacral radiculopathy;2) a prospective, blinded evaluation of EIM and EMG in the evaluation of radiculopathy severity;3. a prospective, blinded comparison of EIM and EMG in assessing the acuteness/chronicity of radiculopathy. A rich, structured, mentoring plan is also provided, including the expectation that young investigator's take ownership of individual projects during their training with Dr. Rutkove. Should this research prove EIM to be an effective test for the initial assessment of radiculopathy, the requirement for the painful, invasive test of needle EMG will be substantially reduced or possibly eliminated. This would lead to improved assessment and care for individuals suffering from this very common malady. Regardless of the specific success of EIM, a group of young investigators will be thoroughly trained to pursue patient-oriented neuromuscular disease research.
|Pacheck, Adam; Mijailovic, Alex; Yim, Sung et al. (2016) Tongue electrical impedance in amyotrophic lateral sclerosis modeled using the finite element method. Clin Neurophysiol 127:1886-90|
|Sanchez, Benjamin; Pacheck, Adam; Rutkove, Seward B (2016) Guidelines to electrode positioning for human and animal electrical impedance myography research. Sci Rep 6:32615|
|McIlduff, Courtney; Yim, Sung; Pacheck, Adam et al. (2016) An improved electrical impedance myography (EIM) tongue array for use in clinical trials. Clin Neurophysiol 127:932-5|
|Narayanaswami, Pushpa; Geisbush, Thomas; Jones, Lyell et al. (2016) Critically re-evaluating a common technique: Accuracy, reliability, and confirmation bias of EMG. Neurology 86:218-23|
|Rutkove, Seward B (2015) Clinical Measures of Disease Progression in Amyotrophic Lateral Sclerosis. Neurotherapeutics 12:384-93|
|Sung, Minhee; Spieker, Andrew J; Narayanaswami, Pushpa et al. (2013) The effect of subcutaneous fat on electrical impedance myography when using a handheld electrode array: the case for measuring reactance. Clin Neurophysiol 124:400-4|
|Kortman, Hans G J; Wilder, Sarah C; Geisbush, Tom R et al. (2013) Age- and gender-associated differences in electrical impedance values of skeletal muscle. Physiol Meas 34:1611-22|
|Spieker, Andrew J; Narayanaswami, Pushpa; Fleming, Laura et al. (2013) Electrical impedance myography in the diagnosis of radiculopathy. Muscle Nerve 48:800-5|
|Rutkove, Seward B; Caress, James B; Cartwright, Michael S et al. (2012) Electrical impedance myography as a biomarker to assess ALS progression. Amyotroph Lateral Scler 13:439-45|
|Narayanaswami, Pushpa; Spieker, Andrew J; Mongiovi, Phillip et al. (2012) Utilizing a handheld electrode array for localized muscle impedance measurements. Muscle Nerve 46:257-63|
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