Dynamic Ultrasound to Enhance Understanding of Carpal Tunnel Syndrome

Project: Research project

Description

Carpal tunnel syndrome (CTS), is the most common peripheral neuropathy, but currently
there are no biomarkers to help guide treatment or to predict patient specific outcomes.
We hypothesize that ultrasound detectable variations in nerve, tendon and
subsynovial connective tissue (SSCT) mobility in patients with CTS may be useful
clinically as functional biomarkers that correlate with, and thereby serve as
predictors for, treatment response. To test this hypothesis, we propose a clinical
study in which patients presenting for treatment of CTS will be monitored by ultrasound
and by clinical assessment before and after surgical and non-surgical treatment. We will
correlate the clinical outcomes with the initial ultrasound motion patterns that we have
found to be most variable in CTS patients. We will also test the hypothesis that
successful treatment results in a change towards normal in the affected
ultrasound variables. There are 4 Specific Aims. Aim 1 is to assess the ability of the functional
biomarkers we have identified (the ratio of SSCT to tendon motion, dorsal nerve motion,
and changes in nerve shape with motion) to predict outcome after steroid injection in
patients with CTS. Aim 2 is to assess the ability of the functional biomarkers we have
identified to predict outcome after surgery in patients with CTS. Aim 3 is to test our
secondary hypothesis that treatment response after both injection and surgery correlates
with a change towards normal in the affected ultrasound variables. Aim 4 is to, using the
results from Aims 1-3, identify additional biomarkers that may correlate with treatment
outcome, and to identify any composite clinical and biomarker measures that may
improve the ability to predict outcome after treatment for CTS. If these aims are achieved, functional biomarkers will, for the first time, be
available to tailor treatment for specific patients with CTS. This new US tool can be
rapidly translated into clinical use, since the equipment is commonly available and the
new algorithms could be rapidly disseminated.
StatusActive
Effective start/end date9/1/148/31/19

Funding

  • National Institutes of Health: $349,800.00
  • National Institutes of Health: $349,800.00
  • National Institutes of Health: $349,800.00

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Carpal Tunnel Syndrome
Biomarkers
Tendons
Therapeutics
Connective Tissue
Injections
Peripheral Nervous System Diseases
Steroids
Equipment and Supplies

ASJC

  • Medicine(all)