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Affourtit C, Carré JE. Mitochondrial involvement in sarcopenia. Acta Physiol (Oxf) 2024; 240:e14107. [PMID: 38304924 DOI: 10.1111/apha.14107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
Sarcopenia lowers the quality-of-life for millions of people across the world, as accelerated loss of skeletal muscle mass and function contributes to both age- and disease-related frailty. Physical activity remains the only proven therapy for sarcopenia to date, but alternatives are much sought after to manage this progressive muscle disorder in individuals who are unable to exercise. Mitochondria have been widely implicated in the etiology of sarcopenia and are increasingly suggested as attractive therapeutic targets to help restore the perturbed balance between protein synthesis and breakdown that underpins skeletal muscle atrophy. Reviewing current literature, we note that mitochondrial bioenergetic changes in sarcopenia are generally interpreted as intrinsic dysfunction that renders muscle cells incapable of making sufficient ATP to fuel protein synthesis. Based on the reported mitochondrial effects of therapeutic interventions, however, we argue that the observed bioenergetic changes may instead reflect an adaptation to pathologically decreased energy expenditure in sarcopenic muscle. Discrimination between these mechanistic possibilities will be crucial for improving the management of sarcopenia.
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Affiliation(s)
| | - Jane E Carré
- School of Biomedical Sciences, University of Plymouth, Plymouth, UK
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2
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Naëgel A, Ratiney H, Karkouri J, Kennouche D, Royer N, Slade JM, Morel J, Croisille P, Viallon M. Alteration of skeletal muscle energy metabolism assessed by phosphorus-31 magnetic resonance spectroscopy in clinical routine, part 1: Advanced quality control pipeline. NMR IN BIOMEDICINE 2023; 36:e5025. [PMID: 37797948 DOI: 10.1002/nbm.5025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 07/03/2023] [Accepted: 07/25/2023] [Indexed: 10/07/2023]
Abstract
Implementing a standardized phosphorus-31 magnetic resonance spectroscopy (31 P-MRS) dynamic acquisition protocol to evaluate skeletal muscle energy metabolism and monitor muscle fatigability, while being compatible with various longitudinal clinical studies on diversified patient cohorts, requires a high level of technicality and expertise. Furthermore, processing data to obtain reliable results also demands a great degree of expertise from the operator. In this two-part article, we present an advanced quality control approach for data acquired using a dynamic 31 P-MRS protocol. The aim is to provide decision support to the operator to assist in data processing and obtain reliable results based on objective criteria. We present here, in part 1, an advanced data quality control (QC) approach of a dynamic 31 P-MRS protocol. Part 2 is an impact study that will demonstrate the added value of the QC approach to explore data derived from two clinical populations that experience significant fatigue, patients with coronavirus disease 2019 and multiple sclerosis. In part 1, 31 P-MRS was performed using 3-T clinical MRI in 175 subjects from clinical and healthy control populations conducted in a University Hospital. An advanced data QC score (QCS) was developed using multiple objective criteria. The criteria were based on current recommendations from the literature enriched by new proposals based on clinical experience. The QCS was designed to indicate valid and corrupt data and guide necessary objective data editing to extract as much valid physiological data as possible. Dynamic acquisitions using an MR-compatible ergometer ran over a rest (40 s), exercise (2 min), and a recovery phase (6 min). Using QCS enabled rapid identification of subjects with data anomalies, allowing the user to correct the data series or reject them partially or entirely, as well as identify fully valid datasets. Overall, the use of the QCS resulted in the automatic classification of 45% of the subjects, including 58 participants who had data with no criterion violation and 21 participants with violations that resulted in the rejection of all dynamic data. The remaining datasets were inspected manually with guidance, allowing acceptance of full datasets from an additional 80 participants and recovery phase data from an additional 16 subjects. Overall, more anomalies occurred with patient data (35% of datasets) compared with healthy controls (15% of datasets). In conclusion, the QCS ensures a standardized data rejection procedure and rigorous objective analysis of dynamic 31 P-MRS data obtained from patients. This methodology contributes to efforts made to standardize 31 P-MRS practices that have been underway for a decade, with the goal of making it an empowered tool for clinical research.
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Affiliation(s)
- Antoine Naëgel
- Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
- Siemens Healthcare SAS, Saint-Denis, France
| | - Hélène Ratiney
- Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - Jabrane Karkouri
- Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
- Siemens Healthcare SAS, Saint-Denis, France
- Wolfson Brain Imaging Center, University of Cambridge, Cambridge, UK
| | - Djahid Kennouche
- Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
- LIBM - Laboratoire Interuniversitaire de Biologie de la Motricité, Villeurbanne, France
| | - Nicolas Royer
- Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
- LIBM - Laboratoire Interuniversitaire de Biologie de la Motricité, Villeurbanne, France
| | - Jill M Slade
- Department of Radiology, Michigan State University, East Lansing, Michigan, USA
| | - Jérôme Morel
- Anaesthetics and Intensive Care Department, UJM-Saint-Etienne, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Etienne, France
| | - Pierre Croisille
- Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
- Radiology Department, UJM-Saint-Etienne, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Etienne, France
| | - Magalie Viallon
- Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
- Radiology Department, UJM-Saint-Etienne, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Etienne, France
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Wijma AG, Driessens H, Jeneson JAL, Janssen-Heijnen MLG, Willems TP, Klaase JM, Bongers BC. Cardiac and intramuscular adaptations following short-term exercise prehabilitation in unfit patients scheduled to undergo hepatic or pancreatic surgery: study protocol of a multinuclear MRI study. BMJ Open Gastroenterol 2023; 10:e001243. [PMID: 37996121 PMCID: PMC10668156 DOI: 10.1136/bmjgast-2023-001243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Short-term exercise prehabilitation programmes have demonstrated promising results in improving aerobic capacity of unfit patients prior to major abdominal surgery. However, little is known about the cardiac and skeletal muscle adaptations explaining the improvement in aerobic capacity following short-term exercise prehabilitation. METHODS AND ANALYSIS In this single-centre study with a pretest-post-test design, 12 unfit patients with a preoperative oxygen uptake (VO2) at the ventilatory anaerobic threshold ≤13 mL/kg/min and/or VO2 at peak exercise ≤18 mL/kg/min, who are scheduled to undergo hepatopancreatobiliary surgery at the University Medical Center Groningen (UMCG), the Netherlands, will be recruited. As part of standard care, unfit patients are advised to participate in a home-based exercise prehabilitation programme, comprising high-intensity interval training and functional exercises three times per week, combined with nutritional support, during a 4-week period. Pre-intervention and post-intervention, patients will complete a cardiopulmonary exercise test. Next to this, study participants will perform additional in-vivo exercise cardiac magnetic resonance (MR) imaging and phosphorus 31-MR spectroscopy of the quadriceps femoris muscle before and after the intervention to assess the effect on respectively cardiac and skeletal muscle function. ETHICS AND DISSEMINATION This study was approved in May 2023 by the Medical Research Ethics Committee of the UMCG (registration number NL83611.042.23, March 2023) and is registered in the ClinicalTrials.gov register. Results of this study will be submitted for presentation at (inter)national congresses and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05772819.
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Affiliation(s)
- Allard G Wijma
- Department of Surgery, Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Heleen Driessens
- Department of Surgery, Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeroen A L Jeneson
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maryska L G Janssen-Heijnen
- Department of Clinical Epidemiology, VieCuri Medical Center, Venlo, The Netherlands
- Department of Epidemiology, School for Oncology and Reproduction (GROW), Maastricht University, Maastricht, The Netherlands
| | - Tineke P Willems
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joost M Klaase
- Department of Surgery, Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bart C Bongers
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
- Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
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Habets LE, Bartels B, Asselman FL, Hooijmans MT, van den Berg S, Nederveen AJ, van der Pol WL, Jeneson JAL. Magnetic resonance reveals mitochondrial dysfunction and muscle remodelling in spinal muscular atrophy. Brain 2021; 145:1422-1435. [PMID: 34788410 PMCID: PMC9128825 DOI: 10.1093/brain/awab411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/24/2021] [Accepted: 10/08/2021] [Indexed: 11/14/2022] Open
Abstract
Genetic therapy has changed the prognosis of hereditary proximal spinal muscular atrophy, although treatment efficacy has been variable. There is a clear need for deeper understanding of underlying causes of muscle weakness and exercise intolerance in patients with this disease to further optimize treatment strategies. Animal models suggest that in addition to motor neuron and associated musculature degeneration, intrinsic abnormalities of muscle itself including mitochondrial dysfunction contribute to the disease aetiology. To test this hypothesis in patients, we conducted the first in vivo clinical investigation of muscle bioenergetics. We recruited 15 patients and 15 healthy age and gender-matched control subjects in this cross-sectional clinico-radiological study. MRI and 31P magnetic resonance spectroscopy, the modality of choice to interrogate muscle energetics and phenotypic fibre-type makeup, was performed of the proximal arm musculature in combination with fatiguing arm-cycling exercise and blood lactate testing. We derived bioenergetic parameter estimates including: blood lactate, intramuscular pH and inorganic phosphate accumulation during exercise, and muscle dynamic recovery constants. A linear correlation was used to test for associations between muscle morphological and bioenergetic parameters and clinico-functional measures of muscle weakness. MRI showed significant atrophy of triceps but not biceps muscles in patients. Maximal voluntary contraction force normalized to muscle cross-sectional area for both arm muscles was 1.4-fold lower in patients than in controls, indicating altered intrinsic muscle properties other than atrophy contributed to muscle weakness in this cohort. In vivo31P magnetic resonance spectroscopy identified white-to-red remodelling of residual proximal arm musculature in patients on the basis of altered intramuscular inorganic phosphate accumulation during arm-cycling in red versus white and intermediate myofibres. Blood lactate rise during arm-cycling was blunted in patients and correlated with muscle weakness and phenotypic muscle makeup. Post-exercise metabolic recovery was slower in residual intramuscular white myofibres in patients demonstrating mitochondrial ATP synthetic dysfunction in this particular fibre type. This study provides the first in vivo evidence in patients that degeneration of motor neurons and associated musculature causing atrophy and muscle weakness in 5q spinal muscular atrophy type 3 and 4 is aggravated by disproportionate depletion of myofibres that contract fastest and strongest. Our finding of decreased mitochondrial ATP synthetic function selectively in residual white myofibres provides both a possible clue to understanding the apparent vulnerability of this particular fibre type in 5q spinal muscular atrophy types 3 and 4 as well as a new biomarker and target for therapy.
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Affiliation(s)
- Laura E Habets
- Centre for Child Development, Exercise and Physical Literacy, Wilhelmina Children's Hospital, University Medical Centre Utrecht, P.O. Box 85090 3508 AB Utrecht, The Netherlands
| | - Bart Bartels
- Centre for Child Development, Exercise and Physical Literacy, Wilhelmina Children's Hospital, University Medical Centre Utrecht, P.O. Box 85090 3508 AB Utrecht, The Netherlands
| | - Fay-Lynn Asselman
- UMC Utrecht Brain Centre, Department of Neurology and Neurosurgery, University Medical Centre Utrecht Brain Center, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Melissa T Hooijmans
- Department of Radiology & Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centre, location AMC, 1105 AZ Amsterdam, The Netherlands
| | - Sandra van den Berg
- Department of Radiology & Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centre, location AMC, 1105 AZ Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology & Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centre, location AMC, 1105 AZ Amsterdam, The Netherlands
| | - W Ludo van der Pol
- UMC Utrecht Brain Centre, Department of Neurology and Neurosurgery, University Medical Centre Utrecht Brain Center, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Jeroen A L Jeneson
- Centre for Child Development, Exercise and Physical Literacy, Wilhelmina Children's Hospital, University Medical Centre Utrecht, P.O. Box 85090 3508 AB Utrecht, The Netherlands
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Harper C, Gopalan V, Goh J. Exercise rescues mitochondrial coupling in aged skeletal muscle: a comparison of different modalities in preventing sarcopenia. J Transl Med 2021; 19:71. [PMID: 33593349 PMCID: PMC7885447 DOI: 10.1186/s12967-021-02737-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/04/2021] [Indexed: 01/07/2023] Open
Abstract
Skeletal muscle aging is associated with a decline in motor function and loss of muscle mass- a condition known as sarcopenia. The underlying mechanisms that drive this pathology are associated with a failure in energy generation in skeletal muscle, either from age-related decline in mitochondrial function, or from disuse. To an extent, lifelong exercise is efficacious in preserving the energetic properties of skeletal muscle and thus may delay the onset of sarcopenia. This review discusses the cellular and molecular changes in skeletal muscle mitochondria during the aging process and how different exercise modalities work to reverse these changes. A key factor that will be described is the efficiency of mitochondrial coupling—ATP production relative to O2 uptake in myocytes and how that efficiency is a main driver for age-associated decline in skeletal muscle function. With that, we postulate the most effective exercise modality and protocol for reversing the molecular hallmarks of skeletal muscle aging and staving off sarcopenia. Two other concepts pertinent to mitochondrial efficiency in exercise-trained skeletal muscle will be integrated in this review, including- mitophagy, the removal of dysfunctional mitochondrial via autophagy, as well as the implications of muscle fiber type changes with sarcopenia on mitochondrial function.
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Affiliation(s)
- Colin Harper
- Clinical Translation Unit (CTU), Tulane University, New Orleans, USA
| | - Venkatesh Gopalan
- Agency for Science, Technology & Research (A*STAR), Singapore Bioimaging Consortium (SBIC), Singapore, Singapore
| | - Jorming Goh
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore. .,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Centre for Healthy Longevity, National University Health System (NUHS), Singapore, Singapore.
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Haeufle DFB, Siegel J, Hochstein S, Gussew A, Schmitt S, Siebert T, Rzanny R, Reichenbach JR, Stutzig N. Energy Expenditure of Dynamic Submaximal Human Plantarflexion Movements: Model Prediction and Validation by in-vivo Magnetic Resonance Spectroscopy. Front Bioeng Biotechnol 2020; 8:622. [PMID: 32671034 PMCID: PMC7332772 DOI: 10.3389/fbioe.2020.00622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/21/2020] [Indexed: 11/30/2022] Open
Abstract
To understand the organization and efficiency of biological movement, it is important to evaluate the energy requirements on the level of individual muscles. To this end, predicting energy expenditure with musculoskeletal models in forward-dynamic computer simulations is currently the most promising approach. However, it is challenging to validate muscle models in-vivo in humans, because access to the energy expenditure of single muscles is difficult. Previous approaches focused on whole body energy expenditure, e.g., oxygen consumption (VO2), or on thermal measurements of individual muscles by tracking blood flow and heat release (through measurements of the skin temperature). This study proposes to validate models of muscular energy expenditure by using functional phosphorus magnetic resonance spectroscopy (31P-MRS). 31P-MRS allows to measure phosphocreatine (PCr) concentration which changes in relation to energy expenditure. In the first 25 s of an exercise, PCr breakdown rate reflects ATP hydrolysis, and is therefore a direct measure of muscular enthalpy rate. This method was applied to the gastrocnemius medialis muscle of one healthy subject during repetitive dynamic plantarflexion movements at submaximal contraction, i.e., 20% of the maximum plantarflexion force using a MR compatible ergometer. Furthermore, muscle activity was measured by surface electromyography (EMG). A model (provided as open source) that combines previous models for muscle contraction dynamics and energy expenditure was used to reproduce the experiment in simulation. All parameters (e.g., muscle length and volume, pennation angle) in the model were determined from magnetic resonance imaging or literature (e.g., fiber composition), leaving no free parameters to fit the experimental data. Model prediction and experimental data on the energy supply rates are in good agreement with the validation phase (<25 s) of the dynamic movements. After 25 s, the experimental data differs from the model prediction as the change in PCr does not reflect all metabolic contributions to the energy expenditure anymore and therefore underestimates the energy consumption. This shows that this new approach allows to validate models of muscular energy expenditure in dynamic movements in vivo.
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Affiliation(s)
- Daniel F B Haeufle
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johannes Siegel
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Motion and Exercise Science, Institute of Sport and Movement Science, University of Stuttgart, Stuttgart, Germany
| | - Stefan Hochstein
- Motion Science, Institute of Sport Science, Martin-Luther-University Halle, Halle, Germany
| | - Alexander Gussew
- Department of Radiology, University Hospital Halle (Saale), Halle, Germany
| | - Syn Schmitt
- Computational Biophysics and Biorobotics, Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany.,Stuttgart Center of Simulation Science, University of Stuttgart, Stuttgart, Germany
| | - Tobias Siebert
- Department of Motion and Exercise Science, Institute of Sport and Movement Science, University of Stuttgart, Stuttgart, Germany
| | - Reinhard Rzanny
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Norman Stutzig
- Department of Motion and Exercise Science, Institute of Sport and Movement Science, University of Stuttgart, Stuttgart, Germany
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Penasso H, Thaller S. Model-based analysis of fatigued human knee extensors : Effects of isometrically induced fatigue on Hill-type model parameters and ballistic contractions. Eur J Appl Physiol 2018; 118:1447-1461. [PMID: 29730804 PMCID: PMC6028922 DOI: 10.1007/s00421-018-3875-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/23/2018] [Indexed: 02/05/2023]
Abstract
This study investigated the effect of isometrically induced fatigue on Hill-type muscle model parameters and related task-dependent effects. Parameter identification methods were used to extract fatigue-related parameter trends from isometric and ballistic dynamic maximum voluntary knee extensions. Nine subjects, who completed ten fatiguing sets, each consisting of nine 3 s isometric maximum voluntary contractions with 3 s rest plus two ballistic contractions with different loads, were analyzed. Only at the isometric task, the identified optimized model parameter values of muscle activation rate and maximum force generating capacity of the contractile element decreased from [Formula: see text] to [Formula: see text] Hz and from [Formula: see text] to [Formula: see text] N, respectively. For all tasks, the maximum efficiency of the contractile element, mathematically related to the curvature of the force-velocity relation, increased from [Formula: see text] to [Formula: see text]. The model parameter maximum contraction velocity decreased from [Formula: see text] to [Formula: see text] m/s and the stiffness of the serial elastic element from [Formula: see text] to [Formula: see text] N/mm. Thus, models of fatigue should consider fatigue dependencies in active as well as in passive elements, and muscle activation dynamics should account for the task dependency of fatigue.
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Affiliation(s)
- Harald Penasso
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria.
| | - Sigrid Thaller
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
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8
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Neuberger U, Kickingereder P, Helluy X, Fischer M, Bendszus M, Heiland S. Accuracy of 1H magnetic resonance spectroscopy for quantification of 2-hydroxyglutarate using linear combination and J-difference editing at 9.4 T. Z Med Phys 2017; 27:300-309. [DOI: 10.1016/j.zemedi.2017.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 01/28/2017] [Accepted: 04/19/2017] [Indexed: 11/27/2022]
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9
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Hooijmans MT, Doorenweerd N, Baligand C, Verschuuren JJGM, Ronen I, Niks EH, Webb AG, Kan HE. Spatially localized phosphorous metabolism of skeletal muscle in Duchenne muscular dystrophy patients: 24-month follow-up. PLoS One 2017; 12:e0182086. [PMID: 28763477 PMCID: PMC5538641 DOI: 10.1371/journal.pone.0182086] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/12/2017] [Indexed: 12/29/2022] Open
Abstract
Objectives To assess the changes in phosphodiester (PDE)-levels, detected by 31P magnetic resonance spectroscopy (MRS), over 24-months to determine the potential of PDE as marker for muscle tissue changes in Duchenne Muscular Dystrophy (DMD) patients. Methods Spatially resolved phosphorous datasets were acquired in the right lower leg of 18 DMD patients (range: 5–15.4 years) and 12 age-matched healthy controls (range: 5–14 years) at three time-points (baseline, 12-months, and 24-months) using a 7T MR-System (Philips Achieva). 3-point Dixon images were acquired at 3T (Philips Ingenia) to determine muscle fat fraction. Analyses were done for six muscles that represent different stages of muscle wasting. Differences between groups and time-points were assessed with non-parametric tests with correction for multiple comparisons. Coefficient of variance (CV) were determined for PDE in four healthy adult volunteers in high and low signal-to-noise ratio (SNR) datasets. Results PDE-levels were significantly higher (two-fold) in DMD patients compared to controls in all analyzed muscles at almost every time point and did not change over the study period. Fat fraction was significantly elevated in all muscles at all time points compared to healthy controls, and increased significantly over time, except in the tibialis posterior muscle. The mean within subject CV for PDE-levels was 4.3% in datasets with high SNR (>10:1) and 5.7% in datasets with low SNR. Discussion and conclusion The stable two-fold increase in PDE-levels found in DMD patients in muscles with different levels of muscle wasting over 2-year time, including DMD patients as young as 5.5 years-old, suggests that PDE-levels may increase very rapidly early in the disease process and remain elevated thereafter. The low CV values in high and low SNR datasets show that PDE-levels can be accurately and reproducibly quantified in all conditions. Our data confirms the great potential of PDE as a marker for muscle tissue changes in DMD patients.
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Affiliation(s)
- M. T. Hooijmans
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
| | - N. Doorenweerd
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
- John Walton Muscular Dystrophy Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - C. Baligand
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | | | - I. Ronen
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - E. H. Niks
- Dept of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - A. G. Webb
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - H. E. Kan
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
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