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Drs. Rutkove and Wainger

Seward B. Rutkove, M.D.
Professor of Neurology
Beth Israel Deaconess Medical Center

Brian J. Wainger, M.D., Ph.D.
Assistant Professor of Anaesthesia
Massachusetts General Hospital

Project: A Neuronal Electrical Excitability Recording System for Improved Diagnosis and Biomarker Assessment of the Therapeutic Impact of Drugs in Peripheral Sensory and Pain Disorders

Distal sensory polyneuropathies are diseases of the peripheral nerves; they can cause both neuronal hyper-excitability and pain, as well as hypo-excitability and numbness. Affecting 1-3% in the general population and 7% of older adults, distal sensory polyneuropathies produce an assortment of symptoms that include tingling, hypersensitivity and chronic pain, sensory loss, and gait instability. To date, most FDA-approved pharmacological agents provide symptomatic management of the associated pain, but these generally do not modify the disorder itself. With few exceptions, there are no approved medications to improve sensory function. And a major problem in developing new therapies is that patient self-reporting of pain or numbness can be variable, and there are not easily obtainable quantitative measures of neuronal hyper- or hypo-excitability.

Seward Rutkove, along with Roy Freeman and Courtney McIlduff at Beth Israel Deaconess Medical Center, will collaborate with Brian Wainger at Massachusetts General Hospital to develop a new instrument for quantitative measurement of peripheral nerve function. Based on previous work by Hugh Bostock at University College London, the device will directly measure the electrical activity of peripheral nerves in encoding sensation and pain. It will be optimized for use by staff not highly skilled in electrophysiology, and so will facilitate clinical trials of therapies to reduce pain or boost sensation. By enabling quantitative measurement of symptoms, trials can be carried out with fewer patients and in less time. Moreover, the system will provide insights into the mechanisms of the therapy’s effect on ameliorating pain or improving sensation.