# Electrophysiological and ultrasound quantitative biomarkers for myofascial pain

> **NIH NIH R61** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2022 · $2,351,578

## Abstract

Project Summary
 Myofascial pain syndrome (MPS) remains a poorly characterized entity. Although affecting millions of
individuals, we do not understand the basic underlying mechanisms of its development, persistence, and
response to therapy, including the use of common therapies such as trigger point (TrP) injection, dry needling,
and myofascial release. Improved methods of assessing MPS, both in its active and latent phases, and its
response to therapy are needed, not only to improve our diagnostic capabilities but also to better understand
MPS’ origins and for quantifying the effect of treatment. In this study, we propose to apply three methodologies
to the assessment of MPS and TrP quantification, two of which, to our knowledge, have never been used
before in this context. The first, electrical impedance myography (EIM), a recently developed method that
characterizes muscle tissue non-invasively using directed, very high-frequency, electrical current provides
insights into tissue histological features and structure non-invasively. It has been shown to be sensitive to
conditions in which muscle fibers are hypertrophied or atrophied or in which disease other pathological
changes, such as fibrosis, are present. An advantage of this technique is that it is entirely painless, rapid to
apply to discrete areas of muscle, and can even be performed at home. The second method, myofiber
threshold tracking (TT) excitability testing, assesses the relatively excitability of myofibers by using a single
small needle electrode to provide a conditioning stimulus followed by a test stimulus. The conditioning stimulus
increases the speed of conduction in the myofibers and can thus provide a convenient measure of excitability
within a TrP. It has already proven to be sensitive to a number of conditions impacting myofiber function. The
third method, ultrasound with shear wave elastography (SWE), has been studied to some extent in MPS
and provides insight into the rigidity of the muscle tissue and will provide a valuable comparator to these other
two technologies. In the R61 phase of the proposed work, we will study patients with both active and latent
MPS affecting the upper trapezius, as well as a group of healthy subjects with these three methodologies to
establish differences between groups, repeatability of the techniques, and the relationships across them (Aims
1a, 1b, and 1c, respectively) and their relationship to standard pain scores. After approval based on our
R61milestones, in the R33 phase (Aim 2), we will use all three methods in a clinical trial assessing the
effectiveness of TrP dry needling in a group of patients with active MPS affecting the upper trapezius. EIM
outcomes will serve as the primary outcome of interest, with data being collected both in the clinic and at
home. At the conclusion of this work, we will have established the use of these technologies for the
assessment MPS, providing new insights into underlying mechanisms and convenient n...

## Key facts

- **NIH application ID:** 10569720
- **Project number:** 1R61AT012284-01
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Seward B. Rutkove
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $2,351,578
- **Award type:** 1
- **Project period:** 2022-09-19 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10569720

## Citation

> US National Institutes of Health, RePORTER application 10569720, Electrophysiological and ultrasound quantitative biomarkers for myofascial pain (1R61AT012284-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10569720. Licensed CC0.

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