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Rutkove SB, Chen ZZ, Pandeya S, Callegari S, Mourey T, Nagy JA, Nath AK. Surface Electrical Impedance Myography Detects Skeletal Muscle Atrophy in Aged Wildtype Zebrafish and Aged gpr27 Knockout Zebrafish. Biomedicines 2023; 11:1938. [PMID: 37509577 PMCID: PMC10377526 DOI: 10.3390/biomedicines11071938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Throughout a vertebrate organism's lifespan, skeletal muscle mass and function progressively decline. This age-related condition is termed sarcopenia. In humans, sarcopenia is associated with risk of falling, cardiovascular disease, and all-cause mortality. As the world population ages, projected to reach 2 billion older adults worldwide in 2050, the economic burden on the healthcare system is also projected to increase considerably. Currently, there are no pharmacological treatments for sarcopenia, and given the long-term nature of aging studies, high-throughput chemical screens are impractical in mammalian models. Zebrafish is a promising, up-and-coming vertebrate model in the field of sarcopenia that could fill this gap. Here, we developed a surface electrical impedance myography (sEIM) platform to assess skeletal muscle health, quantitatively and noninvasively, in adult zebrafish (young, aged, and genetic mutant animals). In aged zebrafish (~85% lifespan) as compared to young zebrafish (~20% lifespan), sEIM parameters (2 kHz phase angle, 2 kHz reactance, and 2 kHz resistance) robustly detected muscle atrophy (p < 0.000001, q = 0.000002; p = 0.000004, q = 0.000006; p = 0.000867, q = 0.000683, respectively). Moreover, these same measurements exhibited strong correlations with an established morphometric parameter of muscle atrophy (myofiber cross-sectional area), as determined by histological-based morphometric analysis (r = 0.831, p = 2 × 10-12; r = 0.6959, p = 2 × 10-8; and r = 0.7220; p = 4 × 10-9, respectively). Finally, the genetic deletion of gpr27, an orphan G-protein coupled receptor (GPCR), exacerbated the atrophy of skeletal muscle in aged animals, as evidenced by both sEIM and histology. In conclusion, the data here show that surface EIM techniques can effectively discriminate between healthy young and sarcopenic aged muscle as well as the advanced atrophied muscle in the gpr27 KO animals. Moreover, these studies show how EIM values correlate with cell size across the animals, making it potentially possible to utilize sEIM as a "virtual biopsy" in zebrafish to noninvasively assess myofiber atrophy, a valuable measure for muscle and gerontology research.
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Affiliation(s)
- Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (S.B.R.); (J.A.N.)
| | - Zsu-Zsu Chen
- Department of Endocrinology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Sarbesh Pandeya
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (S.B.R.); (J.A.N.)
| | - Santiago Callegari
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Tyler Mourey
- Zebrafish Core Facility, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Janice A. Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (S.B.R.); (J.A.N.)
| | - Anjali K. Nath
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Broad Institute, Cambridge, MA 02142, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
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Zubair AS, Salam S, Dimachkie MM, Machado PM, Roy B. Imaging biomarkers in the idiopathic inflammatory myopathies. Front Neurol 2023; 14:1146015. [PMID: 37181575 PMCID: PMC10166883 DOI: 10.3389/fneur.2023.1146015] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Idiopathic inflammatory myopathies (IIMs) are a group of acquired muscle diseases with muscle inflammation, weakness, and other extra-muscular manifestations. IIMs can significantly impact the quality of life, and management of IIMs often requires a multi-disciplinary approach. Imaging biomarkers have become an integral part of the management of IIMs. Magnetic resonance imaging (MRI), muscle ultrasound, electrical impedance myography (EIM), and positron emission tomography (PET) are the most widely used imaging technologies in IIMs. They can help make the diagnosis and assess the burden of muscle damage and treatment response. MRI is the most widely used imaging biomarker of IIMs and can assess a large volume of muscle tissue but is limited by availability and cost. Muscle ultrasound and EIM are easy to administer and can even be performed in the clinical setting, but they need further validation. These technologies may complement muscle strength testing and laboratory studies and provide an objective assessment of muscle health in IIMs. Furthermore, this is a rapidly progressing field, and new advances are going to equip care providers with a better objective assessment of IIMS and eventually improve patient management. This review discusses the current state and future direction of imaging biomarkers in IIMs.
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Affiliation(s)
- Adeel S. Zubair
- Division of Neuromuscular Diseases, Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
| | - Sharfaraz Salam
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Mazen M. Dimachkie
- Department of Neurology, The University of Kansas Medical Center, Kansas City, KS, United States
| | - Pedro M. Machado
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Centre for Rheumatology, Division of Medicine, University College London, London, United Kingdom
| | - Bhaskar Roy
- Division of Neuromuscular Diseases, Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
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Farid A, Golden E, Robicheau S, Hu A, Cheung K, Yu PB, Rutkove SB, Upadhyay J. Diminished muscle integrity in patients with fibrodysplasia ossificans progressiva assessed with at-home electrical impedance myography. Sci Rep 2022; 12:20908. [PMID: 36463382 PMCID: PMC9719538 DOI: 10.1038/s41598-022-25610-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 12/01/2022] [Indexed: 12/05/2022] Open
Abstract
Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare disorder involving skeletal dysplasia and heterotopic ossification (HO) of muscle and connective tissue. We aimed to define a novel biomarker in FOP that enables reliable assessment of musculoskeletal tissue integrity. Considering logistical difficulties that FOP patients often face, our goal was to identify an at-home biomarker technique. Electrical impedance myography (EIM) is a non-invasive, portable method that can inform on muscle health. 15 FOP patients (age 10-52) and 13 healthy controls were assessed. Using EIM, multiple muscle groups were characterized per participant in a 45-min period. The Cumulative Analogue Joint Involvement Scale (CAJIS) was implemented to determine mobility burden severity. We additionally evaluated physical activity levels via a Patient-Reported Outcomes Measurement Information System (PROMIS)-based questionnaire. Relative to controls, FOP patients demonstrated significantly lower regional and whole-body phase values at 50 kHz and 100 kHz, indicating more diseased muscle tissue. Lower whole-body phase and reactance values, and higher resistance values, were associated with greater FOP burden (CAJIS score range: 4-30) and lower physical activity levels at 50 kHz and 100 kHz. This study points to the potential utility of EIM as a clinical biomarker tool capable of characterizing muscle integrity in FOP.
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Affiliation(s)
- Alexander Farid
- grid.38142.3c000000041936754XDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115 USA
| | - Emma Golden
- grid.38142.3c000000041936754XDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115 USA
| | | | - Alice Hu
- grid.492584.6Myolex Inc, Boston, MA USA
| | - Kin Cheung
- BioSAS Consulting, Inc., Wellesley, MA USA
| | - Paul B. Yu
- grid.38142.3c000000041936754XDivision of Cardiology, Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Seward B. Rutkove
- grid.239395.70000 0000 9011 8547Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA USA
| | - Jaymin Upadhyay
- grid.38142.3c000000041936754XDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
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Wang H, Dai J, Wang C, Gao Z, Liu Y, Dai M, Zhao Z, Yang L, Tan G. Assessment of Low Back Pain in Helicopter Pilots Using Electrical Bio-Impedance Technique: A Feasibility Study. Front Neurosci 2022; 16:883348. [PMID: 35911977 PMCID: PMC9330605 DOI: 10.3389/fnins.2022.883348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Low back pain (LBP) is known to pose a serious threat to helicopter pilots. This study aimed to explore the potential of electrical bio-impedance (EBI) technique with the advantages of no radiation, non-invasiveness and low cost, which is intended to be used as a daily detection tool to assess LBP in primary aviation medical units. The LBP scales (severity) in 72 helicopter pilots were assessed using a pain questionnaire, while the bilateral impedance measurements of the lumbar muscle were carried out with a high precision EBI measurement system. Results showed that the modulus of lumbar muscle impedance increased with LBP scale whereas the phase angle decreased. For different LBP scales, significant differences were found in the modulus of lumbar muscle impedance sum on both sides (Zsum), as well as in the modulus and phase angle of lumbar muscle impedance difference between both sides (Zdiff and ϕdiff), respectively (P < 0.05). Moreover, Spearman’s correlation analysis manifested a strong correlation between Zsum and LBP scale (R = 0.692, P < 0.01), an excellent correlation between Zdiff and LBP scale (R = 0.86, P < 0.01), and a desirable correlation between ϕdiff and LBP scale (R = −0.858, P < 0.01). In addition, receiver operator characteristic analysis showed that for LBP prediction, the area under receiver operator characteristic curve of Zsum, Zdiff, and ϕdiff were 0.931, 0.992, and 0.965, respectively. These findings demonstrated that EBI could sensitively and accurately detect the state of lumbar muscle associated with LBP, which might be the potential tool for daily detection of LBP in primary aviation medical units.
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Affiliation(s)
- Hang Wang
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Jing Dai
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Chunchen Wang
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Zhijun Gao
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yang Liu
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Meng Dai
- Department of Biomedical Engineering, Fourth Military Medical University, Xi’an, China
| | - Zhanqi Zhao
- Department of Biomedical Engineering, Fourth Military Medical University, Xi’an, China
- Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
| | - Lin Yang
- Department of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
- *Correspondence: Lin Yang,
| | - Guodong Tan
- Air Force Medical Center, Fourth Military Medical University, Beijing, China
- Guodong Tan,
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Ma Y, Liu W, Liang L, Ye J, Huang C, Zhuang T, Zhang G. Synergistic Antinociceptive Effects of Indomethacin-Pregabalin and Meloxicam-Pregabalin in Paclitaxel-Induced Neuropathic Pain. Biomedicines 2022; 10:biomedicines10061413. [PMID: 35740434 PMCID: PMC9219661 DOI: 10.3390/biomedicines10061413] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 01/05/2023] Open
Abstract
Neuropathic pain is often closely associated with nerve injury or inflammation, and the role of traditional nonsteroidal anti-inflammatory drugs as adjuvants for treating chemotherapy-induced peripheral neuropathic pain remains unclear. In this study, the potential synergistic antinociceptive effects of indomethacin–pregabalin and meloxicam–pregabalin were evaluated in paclitaxel-induced neuropathic pain and carrageenan-induced inflammatory pain in rodents. Although indomethacin and meloxicam alone only slightly relieved mechanical allodynia in the above two models, isobolographic analysis showed that the combination of indomethacin or meloxicam with pregabalin produced significant synergistic antinociceptive effects for paclitaxel-induced neuropathic pain (IN-PGB, experimental ED25 = [4.41 (3.13–5.82)] mg/kg, theoretical ED25 = [8.50 (6.62–10.32)] mg/kg; MEL-PGB, experimental ED25 = [3.96 (2.62–5.46)] mg/kg, theoretical ED25 = [7.52 (5.73–9.39)] mg/kg). In addition, MEL-PGB dosed via intraplantar injection into the left paw, intragastric injection, or intraperitoneal injection reversed paclitaxel-induced allodynia, indicating that they may act at multiple sites in the neuroaxis and periphery. However, indomethacin–pregabalin and meloxicam–pregabalin exerted antagonistic antiallodynic interactions in carrageenan-induced inflammatory pain in rats. Taken together, coadministration of indomethacin or meloxicam with pregabalin may possess potential therapeutic advantages for treating chemotherapy-induced neuropathic pain.
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Affiliation(s)
- Yurong Ma
- Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China; (Y.M.); (W.L.); (L.L.); (J.Y.); (C.H.)
- Jiangsu Key Laboratory of Marine Biological Resources and Environment, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Wenwen Liu
- Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China; (Y.M.); (W.L.); (L.L.); (J.Y.); (C.H.)
- Jiangsu Key Laboratory of Marine Biological Resources and Environment, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Lingzhi Liang
- Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China; (Y.M.); (W.L.); (L.L.); (J.Y.); (C.H.)
| | - Jiaqi Ye
- Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China; (Y.M.); (W.L.); (L.L.); (J.Y.); (C.H.)
| | - Chaonan Huang
- Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China; (Y.M.); (W.L.); (L.L.); (J.Y.); (C.H.)
| | - Tao Zhuang
- Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China; (Y.M.); (W.L.); (L.L.); (J.Y.); (C.H.)
- Jiangsu Key Laboratory of Marine Biological Resources and Environment, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
- Correspondence: (T.Z.); (G.Z.); Tel.: +86-27-87792235 (G.Z.)
| | - Guisen Zhang
- Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China; (Y.M.); (W.L.); (L.L.); (J.Y.); (C.H.)
- Jiangsu Key Laboratory of Marine Biological Resources and Environment, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
- Systems Biology Theme, Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China
- Correspondence: (T.Z.); (G.Z.); Tel.: +86-27-87792235 (G.Z.)
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Rutkove SB, Le M, Ruehr SA, Nagy JA, Semple C, Sanchez B. Design and pilot testing of a 26-gauge impedance-electromyography needle in wild-type and ALS mice. Muscle Nerve 2022; 65:702-708. [PMID: 35383969 DOI: 10.1002/mus.27551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION/AIMS Needle impedance-electromyography (iEMG) is a diagnostic modality currently under development that combines intramuscular electrical impedance with concentric electromyography (EMG) in a single needle. We designed, manufactured, and tested a prototype iEMG needle in a cohort of wild-type (WT) and SOD1G93A amyotrophic lateral sclerosis (ALS) mice to assess its ability to record impedance and EMG data. METHODS A new six-electrode, 26-gauge, iEMG needle was designed, manufactured and tested. Quantitative impedance and qualitative "gestalt" EMG were performed sequentially on bilateral quadriceps of 16-wk-old SOD1G93A ALS (N = 6) and WT (N = 6) mice by connecting the needle first to an impedance analyzer (with the animal at rest) and then to a standard EMG system (with the animal fully under anesthesia to measure spontaneous activity and briefly during awakening to measure voluntary activity). The needle remained in the muscle throughout the measurement period. RESULTS EMG data were qualitatively similar to that observed with a commercially available concentric EMG needle; fibrillation potentials were observed in 84% of the ALS mice and none of the WT mice; motor unit potentials were also readily identified. Impedance data revealed significant differences in resistance, reactance, and phase values between the two groups, with ALS animals having reduced reactance and resistance values. DISCUSSION This work demonstrates the feasibility of a single iEMG needle conforming to standard dimensions of size and function. Further progress of iEMG technology for enhanced neuromuscular diagnosis and quantification of disease status is currently in development.
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Affiliation(s)
- Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Mai Le
- Haystack Diagnostics, Inc, Lowell, Massachusetts, USA
| | | | - Janice A Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Carson Semple
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin Sanchez
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah, USA
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Altered electrical properties in skeletal muscle of mice with glycogen storage disease type II. Sci Rep 2022; 12:5327. [PMID: 35351934 PMCID: PMC8964715 DOI: 10.1038/s41598-022-09328-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/14/2022] [Indexed: 01/15/2023] Open
Abstract
Electrical impedance methods, including electrical impedance myography, are increasingly being used as biomarkers of muscle health since they measure passive electrical properties of muscle that alter in disease. One disorder, Pompe Disease (Glycogen storage disease type II (GSDII)), remains relatively unstudied. This disease is marked by dramatic accumulation of intracellular myofiber glycogen. Here we assessed the electrical properties of skeletal muscle in a model of GSDII, the Pompe6neo/6neo (Pompe) mouse. Ex vivo impedance measurements of gastrocnemius (GA) were obtained using a dielectric measuring cell in 30-week-old female Pompe (N = 10) and WT (N = 10) mice. Longitudinal and transverse conductivity, σ, and the relative permittivity, εr, and Cole–Cole complex resistivity parameters at 0 Hz and infinite frequency, ρo and ρ∞, respectively, and the intracellular resistivity, ρintracellular were determined from the impedance data. Glycogen content (GC) was visualized histologically and quantified biochemically. At frequencies > 1 MHz, Pompe mice demonstrated significantly decreased longitudinal and transverse conductivity, increased Cole–Cole parameters, ρo and ρo-ρ∞, and decreased ρintracellular. Changes in longitudinal conductivity and ρintracellular correlated with increased GC in Pompe animals. Ex vivo high frequency impedance measures are sensitive to alterations in intracellular myofiber features considered characteristic of GSDII, making them potentially useful measures of disease status.
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Wang H, Zheng J, Yu Q, Fan Z, Lo WLA, Li L, Wang C. Electrical Properties of Lumbar Paraspinal Muscles in Young Adults With and Without Chronic Low Back Pain Based on Electrical Impedance Myography: A Cross-Sectional Study. Front Neurol 2022; 12:789589. [PMID: 35250793 PMCID: PMC8891446 DOI: 10.3389/fneur.2021.789589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/20/2021] [Indexed: 12/21/2022] Open
Abstract
Background Lumbar paraspinal muscle (LPM) is important in spinal stabilization in patients with chronic low back pain (CLBP). However, the electrical properties of LPM in patients with CLBP remain unclear. Electrical impedance myography (EIM) is a novel and non-invasive technique that provides a simple quantitative evaluation of electrical properties of the LPM. Purpose This study aimed to apply EIM to assess the electrical properties of the LPM between patients with CLBP and healthy control (HC). Methods Thirty participants (15 CLBP participants; 15 healthy controls) were enrolled in the study. Participants in the CLBP group were asked to complete the visual analog scale (VAS), Oswestry Disability Index (ODI), and Roland–Morris Disability Questionnaire (RDQ) to assess the pain intensity and disability in daily life. Independent sample t-tests were adopted to analyze the basic characteristics between the two groups. At 5, 50, 100, and 200 kHz current frequencies, the electrical properties were measured on each side of the LPM. The EIM parameters of resistance (R), reactance (X), phase angle (PA), and Z value were analyzed by one-way analysis of variance (ANOVA), with age as covariate. Spearman's rank correlation coefficient analysis was applied to explore the relationships between the questionnaires and the EIM parameters. Results The R and Z values of bilateral LPM in the CLBP group were significantly larger than those in the HC group; the PA decreased and the X did not change at these four tested current frequencies. At 5 kHz, Z and R on the right side were non-significantly different between patients and HCs. Correlation analysis showed that at 50 kHz, ODI and RDQ scores correlated negatively with the R of the bilateral LPM (r = 0.523, r = 0.581, respectively; p < 0.05). RDQ scores correlated positively with the PA of the right LPM (r = 0.521, p < 0.05). Conclusion The electrical properties of the bilateral LPM differed between CLBP participants and healthy individuals, regardless of the different frequencies used. These altered electrical properties of the LPM in the patients with CLBP correlated to some extent with disability in daily life.
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Affiliation(s)
- Hongjiang Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiaxuan Zheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ziyan Fan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Le Li
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
- *Correspondence: Le Li
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Chuhuai Wang
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Pandeya SR, Nagy JA, Riveros D, Semple C, Taylor RS, Sanchez B, Rutkove SB. Relationships between in vivo surface and ex vivo electrical impedance myography measurements in three different neuromuscular disorder mouse models. PLoS One 2021; 16:e0259071. [PMID: 34714853 PMCID: PMC8555802 DOI: 10.1371/journal.pone.0259071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
Electrical impedance myography (EIM) using surface techniques has shown promise as a means of diagnosing and tracking disorders affecting muscle and assessing treatment efficacy. However, the relationship between such surface-obtained impedance values and pure muscle impedance values has not been established. Here we studied three groups of diseased and wild-type (WT) animals, including a Duchenne muscular dystrophy model (the D2-mdx mouse), an amyotrophic lateral sclerosis (ALS) model (the SOD1 G93A mouse), and a model of fat-related atrophy (the db/db diabetic obese mouse), performing hind limb measurements using a standard surface array and ex vivo measurements on freshly excised gastrocnemius muscle. A total of 101 animals (23 D2-mdx, 43 ALS mice, 12 db/db mice, and corresponding 30 WT mice) were studied with EIM across a frequency range of 8 kHz to 1 MHz. For both D2-mdx and ALS models, moderate strength correlations (Spearman rho values generally ranging from 0.3-0.7, depending on the impedance parameter (i.e., resistance, reactance and phase) were obtained. In these groups of animals, there was an offset in frequency with impedance values obtained at higher surface frequencies correlating more strongly to impedance values obtained at lower ex vivo frequencies. For the db/db model, correlations were comparatively weaker and strongest at very high and very low frequencies. When combining impedance data from all three disease models together, moderate correlations persisted (with maximal Spearman rho values of 0.45). These data support that surface EIM data reflect ex vivo muscle tissue EIM values to a moderate degree across several different diseases, with the highest correlations occurring in the 10-200 kHz frequency range. Understanding these relationships will prove useful for future applications of the technique of EIM in the assessment of neuromuscular disorders.
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Affiliation(s)
- Sarbesh R. Pandeya
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Janice A. Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Daniela Riveros
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Carson Semple
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Rebecca S. Taylor
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Benjamin Sanchez
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah, United States of America
| | - Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
- * E-mail:
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Pandeya SR, Nagy JA, Riveros D, Semple C, Taylor RS, Mortreux M, Sanchez B, Kapur K, Rutkove SB. Estimating myofiber cross-sectional area and connective tissue deposition with electrical impedance myography: A study in D2-mdx mice. Muscle Nerve 2021; 63:941-950. [PMID: 33759456 PMCID: PMC8883327 DOI: 10.1002/mus.27240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/19/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Surface electrical impedance myography (sEIM) has the potential for providing information on muscle composition and structure noninvasively. We sought to evaluate its use to predict myofiber size and connective tissue deposition in the D2-mdx model of Duchenne muscular dystrophy (DMD). METHODS We applied a prediction algorithm, the least absolute shrinkage and selection operator, to select specific EIM measurements obtained with surface and ex vivo EIM data from D2-mdx and wild-type (WT) mice (analyzed together or separately). We assessed myofiber cross-sectional area histologically and hydroxyproline (HP), a surrogate measure for connective tissue content, biochemically. RESULTS Using WT and D2-mdx impedance values together in the algorithm, sEIM gave average root-mean-square errors (RMSEs) of 26.6% for CSA and 45.8% for HP, which translate into mean errors of ±363 μm2 for a mean CSA of 1365 μm2 and of ±1.44 μg HP/mg muscle for a mean HP content of 3.15 μg HP/mg muscle. Stronger predictions were obtained by analyzing sEIM data from D2-mdx animals alone (RMSEs of 15.3% for CSA and 34.1% for HP content). Predictions made using ex vivo EIM data from D2-mdx animals alone were nearly equivalent to those obtained with sEIM data (RMSE of 16.59% for CSA), and slightly more accurate for HP (RMSE of 26.7%). DISCUSSION Surface EIM combined with a predictive algorithm can provide estimates of muscle pathology comparable to values obtained using ex vivo EIM, and can be used as a surrogate measure of disease severity and progression and response to therapy.
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Affiliation(s)
- Sarbesh R. Pandeya
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Janice A. Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Daniela Riveros
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Carson Semple
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Rebecca S. Taylor
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Marie Mortreux
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Benjamin Sanchez
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah
| | - Kush Kapur
- Department of Neurology, Boston Childrenʼs Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Clark BC, Rutkove S, Lupton EC, Padilla CJ, Arnold WD. Potential Utility of Electrical Impedance Myography in Evaluating Age-Related Skeletal Muscle Function Deficits. Front Physiol 2021; 12:666964. [PMID: 34025454 PMCID: PMC8138591 DOI: 10.3389/fphys.2021.666964] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/13/2021] [Indexed: 12/19/2022] Open
Abstract
Skeletal muscle function deficits associated with advancing age are due to several physiological and morphological changes including loss of muscle size and quality (conceptualized as a reduction in the intrinsic force-generating capacity of a muscle when adjusted for muscle size). Several factors can contribute to loss of muscle quality, including denervation, excitation-contraction uncoupling, increased fibrosis, and myosteatosis (excessive levels of inter- and intramuscular adipose tissue and intramyocellular lipids). These factors also adversely affect metabolic function. There is a major unmet need for tools to rapidly and easily assess muscle mass and quality in clinical settings with minimal patient and provider burden. Herein, we discuss the potential for electrical impedance myography (EIM) as a tool to evaluate muscle mass and quality in older adults. EIM applies weak, non-detectible (e.g., 400 μA), mutifrequency (e.g., 1 kHz–1 MHz) electrical currents to a muscle (or muscle group) through two excitation electrodes, and resulting voltages are measured via two sense electrodes. Measurements are fast (~5 s/muscle), simple to perform, and unaffected by factors such as hydration that may affect other simple measures of muscle status. After nearly 2 decades of study, EIM has been shown to reflect muscle health status, including the presence of atrophy, fibrosis, and fatty infiltration, in a variety of conditions (e.g., developmental growth and maturation, conditioning/deconditioning, and obesity) and neuromuscular diseases states [e.g., amyotrophic lateral sclerosis (ALS) and muscular dystrophies]. In this article, we describe prior work and current evidence of EIM’s potential utility as a measure of muscle health in aging and geriatric medicine.
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Affiliation(s)
- Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.,Department of Biomedical Sciences, Ohio University, Athens, OH, United States.,Division of Geriatric Medicine, Ohio University, Athens, OH, United States
| | - Seward Rutkove
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | | | - Carlos J Padilla
- Department of Neurology, Ohio State University, Columbus, OH, United States
| | - W David Arnold
- Department of Neurology, Ohio State University, Columbus, OH, United States
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12
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Pandeya SR, Nagy JA, Riveros D, Semple C, Taylor RS, Mortreux M, Sanchez B, Kapur K, Rutkove SB. Predicting myofiber cross-sectional area and triglyceride content with electrical impedance myography: A study in db/db mice. Muscle Nerve 2021; 63:127-140. [PMID: 33063867 PMCID: PMC8891989 DOI: 10.1002/mus.27095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/02/2020] [Accepted: 10/11/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Electrical impedance myography (EIM) provides insight into muscle composition and structure. We sought to evaluate its use in a mouse obesity model characterized by myofiber atrophy. METHODS We applied a prediction algorithm, ie, the least absolute shrinkage and selection operator (LASSO), to surface, needle array, and ex vivo EIM data from db/db and wild-type mice and assessed myofiber cross-sectional area (CSA) histologically and triglyceride (TG) content biochemically. RESULTS EIM data from all three modalities provided acceptable predictions of myofiber CSA with average root mean square error (RMSE) of 15% in CSA (ie, ±209 μm2 for a mean CSA of 1439 μm2 ) and TG content with RMSE of 30% in TG content (ie, ±7.3 nmol TG/mg muscle for a mean TG content of 25.4 nmol TG/mg muscle). CONCLUSIONS EIM combined with a predictive algorithm provides reasonable estimates of myofiber CSA and TG content without the need for biopsy.
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Affiliation(s)
- Sarbesh R. Pandeya
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Janice A. Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Daniela Riveros
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Carson Semple
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Rebecca S. Taylor
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Marie Mortreux
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Benjamin Sanchez
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah
| | - Kush Kapur
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Semple C, Riveros D, Sung DM, Nagy JA, Rutkove SB, Mortreux M. Using Electrical Impedance Myography as a Biomarker of Muscle Deconditioning in Rats Exposed to Micro- and Partial-Gravity Analogs. Front Physiol 2020; 11:557796. [PMID: 33041858 PMCID: PMC7522465 DOI: 10.3389/fphys.2020.557796] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/25/2020] [Indexed: 12/12/2022] Open
Abstract
As astronauts prepare to undertake new extra-terrestrial missions, innovative diagnostic tools are needed to better assess muscle deconditioning during periods of weightlessness and partial gravity. Electrical impedance myography (EIM) has been used to detect muscle deconditioning in rodents exposed to microgravity during spaceflight or using the standard ground-based model of hindlimb unloading via tail suspension (HU). Here, we used EIM to assess muscle changes in animals exposed to two new models: hindlimb suspension using a pelvic harness (HLS) and a partial weight-bearing (PWB) model that mimics partial gravity (including Lunar and Martian gravities). We also used a simple needle array electrode in lieu of surface or ex vivo EIM approaches previously employed. Our HLS results confirmed earlier findings obtained after spaceflight and tail suspension. Indeed, one EIM measure (i.e., phase-slope) that was previously reported as highly sensitive, was significantly decreased after HLS (day 0: 14.60 ± 0.97, day 7: 11.03 ± 0.81, and day 14: 10.13 ± 0.55 | Deg/MHz|, p < 0.0001), and was associated with a significant decrease in muscle grip force. Although EIM parameters such as 50 kHz phase, reactance, and resistance remained variable over 14 days in PWB animals, we identified major PWB-dependent effects at 7 days. Moreover, the data at both 7 and 14 days correlated to previously observed changes in rear paw grip force using the same PWB model. In conclusion, our data suggest that EIM has the potential to serve as biomarker of muscle deconditioning during exposure to both micro- and partial- gravity during future human space exploration.
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Affiliation(s)
- Carson Semple
- Department of Neurology, Harvard Medical School - Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Daniela Riveros
- Department of Neurology, Harvard Medical School - Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Dong-Min Sung
- Department of Neurology, Harvard Medical School - Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Janice A Nagy
- Department of Neurology, Harvard Medical School - Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Seward B Rutkove
- Department of Neurology, Harvard Medical School - Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Marie Mortreux
- Department of Neurology, Harvard Medical School - Beth Israel Deaconess Medical Center, Boston, MA, United States
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