Diaphragm Dysfunction
Conditions
Keywords
Diaphragm, Ultrafast ultrasound imaging, Electrophysiology, Cervical magnetic stimulation, Electromyography
Brief summary
The aims of the current study are as follows: i) Investigate the relationships between indices derived from ultrafast ultrasound imaging and Pditw, ii) Investigate the relationships between indices derived from ultrafast ultrasound imaging and diaphragm EMG, iii) Investigate the performance of ultrafast ultrasound for the diagnosis of diaphragm dysfunction, iv) Investigate the ability of ultrafast ultrasound imaging to decipher the cause of diaphragm dysfunction i.e. contractility alteration and/or phrenic nerves conduction defect.
Detailed description
The Neuromuscular Physiology and Evaluation Laboratory of the Institute of Myology recently reported that artificially stimulated diaphragm contraction may be captured and quantified using ultrafast ultrasound imaging. By filming the diaphragm at very high frame rate, one may extract ultrasound indices such as diaphragm thickening fraction and diaphragm tissue velocity. The same team showed that these indices, in particular, maximal diaphragm tissue velocity were strongly reliable and related to Pditw in healthy subjects. This approach bridges the gap between non-volitional (that are commonly combined with internal pressure measurements) and non-invasive procedures. Whether the relationships between indices derived from ultrafast ultrasound and Pditw exist in patients presenting with actual or suspicion of diaphragm dysfunction remains to be specifically investigated. Similarly, the potential of this approach for the diagnosis of phrenic conduction abnormalities remains to be assessed as it may help to circumvent confounding factors associated with surface EMG.
Interventions
DIAGNOSTIC_TESTTransdiaphragmatic pressure measurement
Ultrafast ultrasound imaging of the diaphragm during artificially evoked responses
DIAGNOSTIC_TESTEMG
Surface electromyography of the diaphragm for phrenic nerve conduction study
Sponsors
Institut de Myologie, France
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Patients with confirmed or suspected diaphragm dysfunction undergoing transdiaphragmatic pressure measurement in response to phrenic neurostimulation as part of their follow-up or diagnostic. During this examination, ultrafast ultrasound imaging will be performed in diaphragm to capture elicited responses to assess the relationship between the variables derived from the ultrasound of the diaphragm and the variables usually measured during the evaluation of the transdiaphragmatic twitch pressure.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \> 18 years old * Patients with confirmed diaphragm dysfunction or suspicion * Written informed consent * Able to comply with all protocol requirements * Affiliate or beneficiary of a social security scheme
Exclusion criteria
* Known allergy to latex * Known allergy to Lidocaine or similar product * Pacemaker * Guardianship/trusteeship * Pregnant or nursing women
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Significant relationship between maximal diaphragm tissue velocity and transdiaphragmatic twitch pressure | Through study completion, an average of 6 months |
Secondary
| Measure | Time frame |
|---|---|
| Significant relationship between the diaphragm tissue latency and EMG latency | Through study completion, an average of 6 months |
| Accurate discrimination between patients with or without diaphragm dysfunction using metrics derived from ultrafast ultrasound | Through study completion, an average of 6 months |
| Accurate discrimination between patients with or without phrenic conduction abnormality using metrics derived from ultrafast ultrasound | Through study completion, an average of 6 months |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORDamien BACHASSON, PhD
Institute ofMyology
Outcome results
None listed