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.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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NST-2 Subcommittee (NST)
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Gwinn, Katrina
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Beth Israel Deaconess Medical Center
United States
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Ko, Frank C; Li, Jia; Brooks, Daniel J et al. (2018) Structural and functional properties of bone are compromised in amyotrophic lateral sclerosis mice. Amyotroph Lateral Scler Frontotemporal Degener 19:457-462
Kwon, H; Di Cristina, J F; Rutkove, S B et al. (2018) Recording characteristics of electrical impedance-electromyography needle electrodes. Physiol Meas 39:055005
Sanchez, Benjamin; Rutkove, Seward B (2017) Electrical Impedance Myography and Its Applications in Neuromuscular Disorders. Neurotherapeutics 14:107-118
Rutkove, Seward B; Pacheck, Adam; Sanchez, Benjamin (2017) Sensitivity distribution simulations of surface electrode configurations for electrical impedance myography. Muscle Nerve 56:887-895
Koppaka, Sisir; Shklyar, Irina; Rutkove, Seward B et al. (2016) Quantitative Ultrasound Assessment of Duchenne Muscular Dystrophy Using Edge Detection Analysis. J Ultrasound Med 35:1889-97
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
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 127:932-935
Rutkove, Seward B (2015) Clinical Measures of Disease Progression in Amyotrophic Lateral Sclerosis. Neurotherapeutics 12:384-93

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