1
|
Ferrara IR, Sadowsky CL. Muscle Mass as a Biomarker for Health Status and Function in Pediatric Individuals with Neuromuscular Disabilities: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:815. [PMID: 39062264 PMCID: PMC11276588 DOI: 10.3390/children11070815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/22/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024]
Abstract
This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in this analysis, articles must have had participants with an average age ≤21, focus on children with neuromuscular disabilities, and primarily examine relationships between muscle mass and any functional or health outcomes measure. Studies including typically developing children were used to contrast and enhance findings. Thirty-two studies were included, with 10,129 unique individuals represented: seventeen studies focused on healthy/typically developing children; seven on children with cerebral palsy; three on children with Duchenne muscular dystrophy; two on children with sarcopenia; and one study each on children with osteoporosis, congenital muscular dystrophy, and other various neurologic disorders. Thirteen studies assessed functional outcomes, ten assessed bone outcomes, and nine assessed other cardiovascular/metabolic outcomes. All of the included studies demonstrated relationships between muscle mass and respective outcomes in varying measures. The results of this review demonstrate that there is a consistently recognized relationship between muscle mass and important health outcomes in children, supporting clinically targeting muscle mass as a means to optimize desired outcomes.
Collapse
Affiliation(s)
- Isabella R. Ferrara
- International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, MD 21205, USA;
| | - Cristina L. Sadowsky
- International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, MD 21205, USA;
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| |
Collapse
|
2
|
Muntoni F, Byrne BJ, McMillan HJ, Ryan MM, Wong BL, Dukart J, Bansal A, Cosson V, Dreghici R, Guridi M, Rabbia M, Staunton H, Tirucherai GS, Yen K, Yuan X, Wagner KR. The Clinical Development of Taldefgrobep Alfa: An Anti-Myostatin Adnectin for the Treatment of Duchenne Muscular Dystrophy. Neurol Ther 2024; 13:183-219. [PMID: 38190001 PMCID: PMC10787703 DOI: 10.1007/s40120-023-00570-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/22/2023] [Indexed: 01/09/2024] Open
Abstract
INTRODUCTION Duchenne muscular dystrophy (DMD) is a genetic muscle disorder that manifests during early childhood and is ultimately fatal. Recently approved treatments targeting the genetic cause of DMD are limited to specific subpopulations of patients, highlighting the need for therapies with wider applications. Pharmacologic inhibition of myostatin, an endogenous inhibitor of muscle growth produced almost exclusively in skeletal muscle, has been shown to increase muscle mass in several species, including humans. Taldefgrobep alfa is an anti-myostatin recombinant protein engineered to bind to and block myostatin signaling. Preclinical studies of taldefgrobep alfa demonstrated significant decreases in myostatin and increased lower limb volume in three animal species, including dystrophic mice. METHODS This manuscript reports the cumulative data from three separate clinical trials of taldefgrobep alfa in DMD: a phase 1 study in healthy adult volunteers (NCT02145234), and two randomized, double-blind, placebo-controlled studies in ambulatory boys with DMD-a phase 1b/2 trial assessing safety (NCT02515669) and a phase 2/3 trial including the North Star Ambulatory Assessment (NSAA) as the primary endpoint (NCT03039686). RESULTS In healthy adult volunteers, taldefgrobep alfa was generally well tolerated and resulted in a significant increase in thigh muscle volume. Treatment with taldefgrobep alfa was associated with robust dose-dependent suppression of free myostatin. In the phase 1b/2 trial, myostatin suppression was associated with a positive effect on lean body mass, though effects on muscle mass were modest. The phase 2/3 trial found that the effects of treatment did not meet the primary endpoint pre-specified futility analysis threshold (change from baseline of ≥ 1.5 points on the NSAA total score). CONCLUSIONS The futility analysis demonstrated that taldefgrobep alfa did not result in functional change for boys with DMD. The program was subsequently terminated in 2019. Overall, there were no safety concerns, and no patients were withdrawn from treatment as a result of treatment-related adverse events or serious adverse events. TRIAL REGISTRATION NCT02145234, NCT02515669, NCT03039686.
Collapse
Affiliation(s)
- Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children, London, UK
- NIHR Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust, London, UK
| | | | - Hugh J McMillan
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | - Monique M Ryan
- Royal Children's Hospital, University of Melbourne, Murdoch Children's Research Institute, Melbourne, Australia
| | - Brenda L Wong
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | | | | | - Roxana Dreghici
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
- Solid Biosciences Inc., Cambridge, MA, USA
| | | | | | | | | | - Karl Yen
- Genentech Inc., South San Francisco, CA, USA
- Sanofi, Paris, France
| | | | - Kathryn R Wagner
- F. Hoffmann-La Roche Ltd, Basel, Switzerland.
- The Johns Hopkins School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
3
|
Garcia-Vicencio S, Ratel S, Chalchat E, Penailillo L, Kluka V, Fourot AV, Coudeyre E, Martin V. Combined Endurance and Strength or Only Endurance Training? Effects of Training Mode on Neuromuscular Characteristics and Functional Abilities in Obese Adolescent Girls Enrolled in a Weight-Reduction Program. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1450:143-159. [PMID: 37682428 DOI: 10.1007/5584_2023_782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
The aim of the present study was to examine whether combining strength and endurance training would promote better improvements in neuromuscular characteristics and functional abilities than endurance training alone in obese adolescent girls enrolled in a weight-reduction program. Twenty-four obese adolescent girls (12-15 years) volunteered to participate in a 9-month training program. Participants were allocated into two groups following either (i) combined training (endurance + strength; E+ST) or (ii) endurance training (ET) program. Absolute and specific maximal torque, muscle size, and maximal voluntary activation level (VA) of the knee extensor (KE) and plantar flexor (PF) muscles were assessed. Moreover, functional abilities such as balance and fatigability during a maximal isometric intermittent contraction test of the KE muscles were measured before and after the intervention. The force of the adductor pollicis (AP) muscles was used as a control to account for any effect of growth or mechanical unloading on neuromuscular properties and muscle size. While absolute and specific torque of the KE (+14.7 ± 12.1% and +14.4 ± 15.5%; p < 0.05) and PF (+19.2 ± 16.7% and +18.3 ± 17.5%; p < 0.001) muscles increased in the E+ST group, PF torque decreased, and KE torque did not change in the ET group (-22.6 ± 10.5% and -15.0 ± 17.2%; p < 0.001). Moreover, the VA of the KE muscles increased for the E+ST (+6.1 ± 5.6%; p < 0.01) group and decreased for the ET group (-5.4 ± 5.4%; p < 0.05). In contrast, VA remained similar in the PF muscles for both groups. The number of repetitions during the fatigability test increased in the ET group (38.4 ± 22.3 vs. 84.1 ± 33.3; p = 0.032) and was unchanged in the E+ST group (50.8 ± 14.1 vs. 54.2 ± 37.8), but it was associated with a higher force level. Moreover, balance improved in the E+ST group, but not in the ET group. To conclude, physical training combining strength and endurance training promoted larger improvement in neuromuscular characteristics and functional abilities than endurance training alone in obese adolescent girls. Greater neuromuscular adaptations resulting from the E+ST training may be beneficial for preserving or even increasing functional abilities and possibly induce greater engagement in the active lifestyle of obese adolescents. However, the endurance component seems necessary in training programs to reduce fatigability during daily living activities.
Collapse
Affiliation(s)
| | - Sébastien Ratel
- Université Clermont Auvergne, AME2P, Clermont-Ferrand, France
| | - Emeric Chalchat
- Université Clermont Auvergne, AME2P, Clermont-Ferrand, France
- Institut de Recherche Biomédicale des Armées, Bretigny-Sur-Orge, France
| | - Luis Penailillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Virginie Kluka
- Université Clermont Auvergne, AME2P, Clermont-Ferrand, France
| | | | - Emmanuel Coudeyre
- Clermont University Hospital, Clermont-Ferrand, France
- Université Clermont Auvergne, UNH, Clermont-Ferrand, France
- INRAE, CRNH Auvergne, Clermont-Ferrand, France
| | - Vincent Martin
- Université Clermont Auvergne, AME2P, Clermont-Ferrand, France
- Institut Universitaire de France (IUF), Paris, France
| |
Collapse
|
4
|
Garcia-Vicencio S, Martin V, Chalchat E, Penailillo L, Kluka V, Fourot AV, Coudeyre E, Ratel S. Sex-Related Neuromuscular Adaptations to Youth Obesity: Force, Muscle Mass, and Neural Issues. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1450:131-142. [PMID: 37698778 DOI: 10.1007/5584_2023_783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Young obese are generally stronger than their typically developing counterparts. Strength differences could be partly ascribed to nervous adaptations, due to the loading effect of carrying overweight. We hypothesized that central adaptations of the muscles highly involved in weight bearing, i.e., plantar flexors (PF) and knee extensors (KE) could be greater in girls than boys due to their reduced potential for muscle hypertrophy. Furthermore, it is possible that neuromuscular adaptations in weight-bearing muscles will be greater compared to the unloaded muscles such as the adductor pollicis (AP).Twenty-four non-obese and 21 obese (body mass index: 33 ± 4 kg·m-2) adolescent girls and boys (12-15 years) performed maximal voluntary isometric contractions (MVC) of the PF and KE muscles. Voluntary activation (VA), assessed with the twitch interpolation technique, the antagonist co-activation (Co-Act) level, and the normalized root-mean-square value (RMS) of the agonist muscles were measured to account for central adaptations.The results revealed a weight status effect (p < 0.001) on the absolute MVC torque and VA of both KE and PF muscles. Moreover, these differences were also related to the sex of the participants (p < 0.05) for the PF muscles. While the VA, absolute, and specific MVC torque were greater in obese compared with non-obese girls, no difference was found between boys. A similar Co-Act level was observed between groups, whatever the sex and muscle group considered. Finally, no significant differences were found for the AP regarding peripheral and neural factors.This study highlighted a favorable effect of obesity on the central mechanisms (i.e., VA) responsible for force production within the lower limb muscles. However, obesity-related central adaptation was only observed in girls for the PF muscles. Thus, the excess of body mass supported by the muscles involved in weight-bearing could act as a chronic training stimulus responsible for these adaptations in obese adolescents but mostly in girls.
Collapse
Affiliation(s)
| | - Vincent Martin
- Université Clermont Auvergne, AME2P, Clermont-Ferrand, France
- Institut Universitaire de France (IUF), Paris, France
| | - Emeric Chalchat
- Université Clermont Auvergne, AME2P, Clermont-Ferrand, France
- Institut de Recherche Biomédicale des Armées, Bretigny-Sur-Orge, France
| | - Luis Penailillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Virginie Kluka
- Université Clermont Auvergne, AME2P, Clermont-Ferrand, France
| | | | - Emmanuel Coudeyre
- Clermont University Hospital, Clermont-Ferrand, France
- Université Clermont Auvergne, UNH, Clermont-Ferrand, France
- INRAE, CRNH Auvergne, Clermont-Ferrand, France
| | - Sébastien Ratel
- Université Clermont Auvergne, AME2P, Clermont-Ferrand, France
| |
Collapse
|
5
|
McDonald C, Camino E, Escandon R, Finkel RS, Fischer R, Flanigan K, Furlong P, Juhasz R, Martin AS, Villa C, Sweeney HL. Draft Guidance for Industry Duchenne Muscular Dystrophy, Becker Muscular Dystrophy, and Related Dystrophinopathies - Developing Potential Treatments for the Entire Spectrum of Disease. J Neuromuscul Dis 2024; 11:499-523. [PMID: 38363616 DOI: 10.3233/jnd-230219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Background Duchenne muscular dystrophy (DMD) and related dystrophinopathies are neuromuscular conditions with great unmet medical needs that require the development of effective medical treatments. Objective To aid sponsors in clinical development of drugs and therapeutic biological products for treating DMD across the disease spectrum by integrating advancements, patient registries, natural history studies, and more into a comprehensive guidance. Methods This guidance emerged from collaboration between the FDA, the Duchenne community, and industry stakeholders. It entailed a structured approach, involving multiple committees and boards. From its inception in 2014, the guidance underwent revisions incorporating insights from gene therapy studies, cardiac function research, and innovative clinical trial designs. Results The guidance provides a deeper understanding of DMD and its variants, focusing on patient engagement, diagnostic criteria, natural history, biomarkers, and clinical trials. It underscores patient-focused drug development, the significance of dystrophin as a biomarker, and the pivotal role of magnetic resonance imaging in assessing disease progression. Additionally, the guidance addresses cardiomyopathy's prominence in DMD and the burgeoning field of gene therapy. Conclusions The updated guidance offers a comprehensive understanding of DMD, emphasizing patient-centric approaches, innovative trial designs, and the importance of biomarkers. The focus on cardiomyopathy and gene therapy signifies the evolving realm of DMD research. It acts as a crucial roadmap for sponsors, potentially leading to improved treatments for DMD.
Collapse
Affiliation(s)
| | - Eric Camino
- Parent Project Muscular Dystrophy, Washington, DC, USA
| | - Rafael Escandon
- DGBI Consulting, LLC, Bainbridge Island, Washington, DC, USA
| | | | - Ryan Fischer
- Parent Project Muscular Dystrophy, Washington, DC, USA
| | - Kevin Flanigan
- Center for Experimental Neurotherapeutics, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Pat Furlong
- Parent Project Muscular Dystrophy, Washington, DC, USA
| | - Rose Juhasz
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Ann S Martin
- Parent Project Muscular Dystrophy, Washington, DC, USA
| | - Chet Villa
- Trinity Health Michigan, Grand Rapids, MI, USA
| | - H Lee Sweeney
- Cincinnati Children's Hospital Medical Center within the UC Department of Pediatrics, Cincinnati, OH, USA
| |
Collapse
|
6
|
Wong BL, Summer S, Horn PS, Rutter MM, Rybalsky I, Tian C, Shellenbarger KC, Kalkwarf HJ. Appendicular lean mass index changes in patients with Duchenne muscular dystrophy and Becker muscular dystrophy. J Cachexia Sarcopenia Muscle 2023; 14:2804-2812. [PMID: 37878526 PMCID: PMC10751441 DOI: 10.1002/jcsm.13357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION Mutations in the 79 exons of the dystrophin gene result in muscle wasting and weakness of varying clinical severity, ranging from severe/typical Duchenne muscular dystrophy (DMD) to intermediate DMD and mild Becker muscular dystrophy (BMD), depending on the frameshift of the mutation. We previously reported that males with DMD have progressively declining appendicular lean mass (ALM) and ALM index (ALMI) with age and worsening functional motor ability compared with healthy controls. These indices have not been studied in patients with intermediate DMD and BMD phenotypes and across DMD genotypes. In this study, we compared age-related trajectories of ALM and ALMI of patients who had (1) BMD without functional mobility deficits with patients who had DMD at different stages of disease and healthy controls; (2) a DMD intermediate phenotype with patients who had a typical DMD phenotype; and (3) DMD categorized by genotype. METHODS We conducted a retrospective review of ALM and ALMI data from 499 patients (ages 5-23 years) with DMD (466 typical and 33 intermediate) and 46 patients (ages 5-21 years) with BMD (without functional mobility deficits and functional mobility score of 1). Patients were grouped according to age reflecting disease stage (ages 5 to <7, 7 to <10, 10 to <14, and 14 to <20 years) and genotype (mutations in exons 1-30, 31-44, 45-62, and 63-79). RESULTS ALM and ALMI trajectories of patients with BMD paralleled those of healthy controls until adolescence, in contrast to patients with DMD. ALMI Z-scores of patients with BMD remained within ±2 SD without decline while those of patients with DMD fell below -2 SD around age 12 years. Patients with BMD had increasing ALM and ALMI with age, with peak accrual between ages 10 to <14 years. ALMI declined after age 14 years for those with intermediate DMD compared with 10 years for patients with typical DMD. Patients with mutations in exons 63-79 had a greater decline in ALMI as compared with those with other genotypes after age 10 years. CONCLUSIONS Age-related changes in ALMI in patients with BMD and intermediate DMD differ from those with typical DMD, reflecting their clinical phenotypes. ALM and ALMI should be further studied in patients with BMD and DMD subtypes for their potential value as surrogate markers to characterize the severity of BMD and DMD and inform clinical care decisions and clinical trial designs.
Collapse
Affiliation(s)
- Brenda L. Wong
- Department of Pediatrics and Neurology, DMD ProgramUniversity of Massachusetts Chan Medical SchoolWorcesterMAUSA
| | - Suzanne Summer
- Clinical Translational Research CenterCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
| | - Paul S. Horn
- Division of NeurologyCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOHUSA
| | - Meilan M. Rutter
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOHUSA
- Division of EndocrinologyCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
| | - Irina Rybalsky
- Division of NeurologyCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
| | - Cuixia Tian
- Division of NeurologyCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOHUSA
| | - Karen C. Shellenbarger
- Department of Pediatrics and Neurology, DMD ProgramUniversity of Massachusetts Chan Medical SchoolWorcesterMAUSA
| | - Heidi J. Kalkwarf
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOHUSA
- Division of Gastroenterology, Hepatology and NutritionCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
| |
Collapse
|
7
|
Wang LH, Leung DG, Wagner KR, Lowry SJ, McDermott MP, Eichinger K, Higgs K, Walker M, Lewis L, Martens WB, Mul K, Sansone VA, Shieh P, Elsheikh B, LoRusso S, Butterfield RJ, Johnson N, Preston MR, Messina C, Carraro E, Tawil R, Statland J. Lean tissue mass measurements by dual-energy X-ray absorptiometry and associations with strength and functional outcome measures in facioscapulohumeral muscular dystrophy. Neuromuscul Disord 2023; 33:63-68. [PMID: 37400350 PMCID: PMC10527411 DOI: 10.1016/j.nmd.2023.06.008] [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: 05/08/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
Facioscapulohumeral muscular dystrophy (FSHD) is a slowly progressive disease of skeletal muscle. Dual energy X-ray absorptiometry (DEXA) is a widely available, cost-effective and sensitive technique for measuring whole body and regional lean tissue mass and has been used in prior clinical trials in neuromuscular diseases. The Clinical Trial Readiness to Solve Barriers to Drug Development in FSHD (ReSolve) study is a prospective, longitudinal, observational multisite study. We obtained concurrent DEXA scans and functional outcome measurements in 185 patients with FSHD at the baseline visit. We determined the associations between lean tissue mass in the upper and lower extremities and corresponding clinical outcome measures. There were moderate correlations between upper and lower extremity lean tissue mass and their corresponding strengths and function. Lean tissue mass obtained by DEXA scan may be useful as a biomarker in future clinical trials in FSHD.
Collapse
Affiliation(s)
- Leo H Wang
- University of Washington, Department of Neurology, WA, USA.
| | - Doris G Leung
- Kennedy Krieger Institute, The Johns Hopkins School of Medicine, MD, USA
| | - Kathryn R Wagner
- Kennedy Krieger Institute, The Johns Hopkins School of Medicine, MD, USA
| | | | - Michael P McDermott
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, NY, USA; University of Rochester Medical Center, Department of Neurology, NY, USA
| | - Katy Eichinger
- University of Rochester Medical Center, Department of Neurology, NY, USA
| | - Kiley Higgs
- University of Kansas Medical Center, Department of Neurology, KS, USA
| | - Michaela Walker
- University of Kansas Medical Center, Department of Neurology, KS, USA
| | - Leann Lewis
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, NY, USA
| | - William B Martens
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, NY, USA
| | | | - Valeria A Sansone
- The NEMO Clinical Center, Neurorehabilitation Unit, University of Milan, Department of Neurology, Milan, Italy
| | - Perry Shieh
- University of California, Los Angeles, CA, USA
| | | | | | | | | | | | - Carmelo Messina
- Galeazzi Institute, Radiology Department, University of Milan, Italy
| | - Elena Carraro
- The NEMO Clinical Center, Neurorehabilitation Unit, University of Milan, Department of Neurology, Milan, Italy
| | - Rabi Tawil
- University of Rochester Medical Center, Department of Neurology, NY, USA
| | - Jeff Statland
- University of Kansas Medical Center, Department of Neurology, KS, USA
| |
Collapse
|
8
|
Madrid DA, Knapp RA, Lynch D, Clemens P, Weaver AA, Puwanant A. Associations between lower extremity muscle fat fraction and motor performance in myotonic dystrophy type 2: A pilot study. Muscle Nerve 2023; 67:506-514. [PMID: 36938823 PMCID: PMC10898809 DOI: 10.1002/mus.27821] [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: 03/24/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Abstract
INTRODUCTION/AIMS Although muscle structure measures from magnetic resonance imaging (MRI) have been used to assess disease severity in muscular dystrophies, little is known about how these measures are affected in myotonic dystrophy type 2 (DM2). We aim to characterize lower extremity muscle fat fraction (MFF) as a potential biomarker of disease severity, and evaluate its relationship with motor performance in DM2. METHODS 3-Tesla MRIs were obtained from nine patients with DM2 and six controls using a T1W-Dixon protocol. To calculate MFF, muscle volumes were segmented from proximal, middle, and distal regions of the thigh and calf. Associations between MFF and motor performance were calculated using Spearman's correlations (ρ). RESULTS Mean age of DM2 participants was 62 ± 11 y (89% female), and mean symptom duration was 20 ± 12 y. Compared to controls, the DM2 group had significantly higher MFF in the thigh and the calf segments (p-value = .002). The highest MFF at the thigh in DM2 was located in the posterior compartment (39.7 ± 12.9%) and at the calf was the lateral compartment (31.5 ± 8.7%). In the DM2 group, we found a strong correlation between the posterior thigh MFF and the 6-min walk test (ρ = -.90, p-value = .001). The lateral calf MFF was also strongly correlated with the step test (ρ = -0.82, p-value = .006). DISCUSSION Our pilot data suggest a potential correlation between lower extremity MFF and some motor performance tests in DM2. Longitudinal studies with larger sample sizes are required to validate MFF as a marker of disease severity in DM2.
Collapse
Affiliation(s)
- Diana A Madrid
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27101, USA
| | - Rebecca A Knapp
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27101, USA
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, 27109, USA
| | - Delanie Lynch
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27101, USA
| | - Paula Clemens
- Department of Neurology, University of Pittsburgh School of Medicine and Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania, 15213, USA
| | - Ashley A Weaver
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27101, USA
| | - Araya Puwanant
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, USA
| |
Collapse
|
9
|
Zygmunt AM, Wong BL, Horn PS, Lambert J, Bange JE, Rybalsky I, Chouteau W, Tian C. A longitudinal study of creatine kinase and creatinine levels in Duchenne muscular dystrophy. Muscle Nerve 2023; 67:138-145. [PMID: 36444146 DOI: 10.1002/mus.27760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION/AIMS Management of Duchenne muscular dystrophy (DMD) has entered an era featuring novel treatments. Trackable noninvasive biomarkers could improve disease progression monitoring and drug effect detection. Our aim in this study was to measure changes in selected noninvasive biomarkers and assess their relationship to age and motor function. METHODS We retrospectively studied 555 patients with DMD who had at least 12 months of treatment of glucocorticoids and were not enrolled in trials of potential disease-modifying therapies. We extracted biomarker data of serum creatine kinase (CK), serum creatinine (Cr), urine Cr, and urine Cr/urine osmolality (osm), as well as functional data for age at loss of ambulation and Functional Motor Scale (FMS) values from patients' clinical records. Data were analyzed using linear mixed-model analyses. RESULTS CK, serum Cr, urine Cr, and urine Cr/urine osm all decreased with declining motor function. CK consistently decreased and FMS score consistently worsened with age without clear inflection points. There was an increased odds ratio for LOA with lower values of CK, serum Cr, urine Cr, and urine Cr/urine osm, most notably for urine Cr. DISCUSSION Although individual biomarker values are challenging to directly apply clinically, our study has demonstrated that trends over time may complement functional measures in the assessment of individuals with DMD. Future studies could elucidate predictive utility of these biomarkers in assessing motor function changes in DMD.
Collapse
Affiliation(s)
- Alexander M Zygmunt
- Division of Neurology, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Brenda L Wong
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Paul S Horn
- Division of Neurology, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Joshua Lambert
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama
| | - Jean E Bange
- Division of Neurology, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Irina Rybalsky
- Division of Neurology, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Wendy Chouteau
- Division of Neurology, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Cuixia Tian
- Division of Neurology, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| |
Collapse
|
10
|
Sherlock SP, Palmer J, Wagner KR, Abdel-Hamid HZ, Tian C, Mah JK, Muntoni F, Guglieri M, Butterfield RJ, Charnas L, Marraffino S. Dual-energy X-ray absorptiometry measures of lean body mass as a biomarker for progression in boys with Duchenne muscular dystrophy. Sci Rep 2022; 12:18762. [PMID: 36335191 PMCID: PMC9637094 DOI: 10.1038/s41598-022-23072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
We evaluated whether whole-body dual-energy X-ray absorptiometry (DXA) measures of lean body mass can be used as biomarkers for disease progression and treatment effects in patients with Duchenne muscular dystrophy. This post hoc analysis utilized data from a randomized, 2-period study of domagrozumab versus placebo in 120 ambulatory boys with DMD. DXA measures of lean body mass were obtained from the whole body (excluding head), arms, legs and appendicular skeleton at baseline and every 16 weeks. Treatment effects on DXA measures for domagrozumab versus placebo were assessed at Week 49. At Week 49, domagrozumab statistically significantly increased lean body mass versus placebo in the appendicular skeleton (p = 0.050) and arms (p < 0.001). The relationship between lean body mass at Week 49 and functional endpoints at Week 97 was evaluated. Changes in lean body mass at Week 49 in all regions except arms were significantly correlated with percent change from baseline in 4-stair climb (4SC) at Week 97. DXA-derived percent lean mass at Week 49 also correlated with 4SC and North Star Ambulatory Assessment at Week 97. These data indicate that whole-body DXA measures can be used as biomarkers for treatment effects and disease progression in patients with DMD, and warrant further investigation.Trial registration: ClinicalTrials.gov, NCT02310763; registered 8 December 2014.
Collapse
Affiliation(s)
| | | | - Kathryn R Wagner
- Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Hoda Z Abdel-Hamid
- Division of Child Neurology, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Cuixia Tian
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Jean K Mah
- Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Michela Guglieri
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle, UK
| | | | | | | |
Collapse
|
11
|
Dietvorst C, Bot D, van der Holst M, Niks E. The Relation Between Nutritional Intake and Weight in 4–18 Year Old Patients with DMD: What could possibly be done to prevent weight gain? J Neuromuscul Dis 2022; 9:701-711. [DOI: 10.3233/jnd-220796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Overweight is a common problem in Duchenne muscular dystrophy (DMD) and is associated with reduced mobility and quality of life. The influence of nutritional intake on (over)weight is unclear. Objective: To investigate weight and energy and macronutrients intake compared to age-specific requirements in DMD patients (4–18 years). Methods: We assessed weight and body mass index (BMI) and the amount of energy (kcal/day) and macronutrients based on self-reported nutrition diaries. Nutritional intake was compared to requirements for 3 age-groups according to the Dutch Healthy Diet Guideline (4–8/9–13/14–18 years) using a student’s t-test, and relations with age and BMI were investigated by means of Pearson’s correlations. Results: Forty-eight patients participated, 22 ambulatory, median age 10.8 years. The majority used corticosteroids (N = 41). Overweight (BMI z-score > 2.07) was present in 19 patients; 6% (4–8 years), 73% (9–13 years) and 47% (14–18 years). Overweight was more common in non-ambulatory (61.6%) than ambulatory patients (13.6%). Patients aged 4–8 received 290 kcal/day more than required (p < 0.001). Patients aged 9–13 received 349 kcal/day (p = 0.005) less than required. Overall, intake of fibre, nuts, meat/fish/eggs/legumes and dairy was lower than recommended (p < 0.05). The difference between energy intake versus requirement correlated moderately to age (r = –0.549, p < 0.001) and BMI (r = –0.562, p < 0.001). Conclusions: Overweight was found especially in patients aged 9–18 even though they received less energy than required. Younger patients (4–8) had good weight but consumed more energy than required. All patients did not consume enough fibre, nuts, meat/fish/eggs/legumes and dairy. Limiting energy and increasing fibre/protein intake at an early age may prevent overweight at a later age.
Collapse
Affiliation(s)
- C.A.W. Dietvorst
- Department of Dietetics and Social Work, Leiden University Medical Center, Leiden, The Netherlands
| | - D. Bot
- Department of Dietetics and Social Work, Leiden University Medical Center, Leiden, The Netherlands
| | - M. van der Holst
- Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - E.H. Niks
- Department of Neurology, Leiden, The Netherlands
| |
Collapse
|
12
|
Kikuchi K, Satake M, Furukawa Y, Terui Y. Assessment of body composition, metabolism, and pulmonary function in patients with myotonic dystrophy type 1. Medicine (Baltimore) 2022; 101:e30412. [PMID: 36086756 PMCID: PMC10980380 DOI: 10.1097/md.0000000000030153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/05/2022] [Indexed: 11/25/2022] Open
Abstract
Abnormal body composition in myotonic dystrophy type 1 (DM1) are affected by energy intake above resting energy expenditure (REE). We aim to investigate the characteristics and relationship between body composition, REE, and pulmonary function in patients with DM1, and to examine their changes in 1 year. The study design was a single-center, cross-sectional, and longitudinal study of body composition, REE characteristics, and pulmonary function. Twenty-one male patients with DM1 and 16 healthy volunteers were registered in the study. Body composition was measured using dual-energy X-ray absorptiometry (DEXA). Fat mass (FM) index (kg/m2), fat-FM index (kg/m2), and skeletal mass index (kg/m2) were calculated. The measurements were taken breath by breath with a portable indirect calorimeter. The REE was calculated using the oxygen intake (VO2) and carbon dioxide output (VCO2) in the Weir equation. Basal energy expenditure (BEE) was calculated by substituting height, weight, and age into the Harris-Benedict equation. The study enrolled male patients with DM1 (n = 12) and healthy male volunteers (n = 16). Patients with DM1 (n = 7) and healthy volunteers (n = 14) could be followed in 1 year. The body composition of patients with DM1 was significantly higher in the FM index and significantly lower in the fat-FM index and skeletal mass index. The REE of patients with DM1 was significantly lower and was not associated with body composition. Patients with DM1 had poor metabolism that was not related to body composition. FM was high and lean body mass was low.
Collapse
Affiliation(s)
- Kazuto Kikuchi
- Department of Physical Therapy, Akita Rehabilitation College, Akita, Japan
| | - Masahiro Satake
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Yutaka Furukawa
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Yoshino Terui
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| |
Collapse
|
13
|
Barp A, Carraro E, Goggi G, Lizio A, Zanolini A, Messina C, Perego S, Verdelli C, Lombardi G, Sansone VA, Corbetta S. Body composition and myokines in a cohort of patients with Becker muscular dystrophy. Muscle Nerve 2022; 66:63-70. [PMID: 35474226 PMCID: PMC9321020 DOI: 10.1002/mus.27565] [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: 10/20/2021] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 11/13/2022]
Abstract
Introduction/Aims Becker muscular dystrophy (BMD) is an X‐linked disease leading to muscle wasting and weakness. The decrease in lean body mass (LBM) in Duchenne muscular dystrophy, has shown correlation with loss of muscle function and bone density (BD). Myokines (including irisin) are hormones secreted by skeletal muscle that allow crosstalk between muscle and bone. The present study analyzed body composition and circulating myokine levels in a cohort of BMD patients; moreover, the association between dual energy X‐ray absorptiometry (DXA) parameters, functional motor assessments, and myokine levels was investigated. Methods All patients underwent DXA, blood samples for myokine assays, and functional motor assessments. A group of healthy controls (HCs) was also included. Results Thirty BMD patients, median age at evaluation 36.0 y [26.0–41.0], were included. Twenty‐nine patients underwent whole‐body DXA. Median value of total body Z‐score was −0.70. The prevalence of low skeletal muscle mass defined as appendicular skeletal muscle mass index (ASMMI) < 7.59 kg/m2 was 83%. Irisin levels were significantly lower in BMD compared to HCs (p = .03). All DXA parameters showed significant correlation with the functional motor assessments, in particular the h2‐standardized lean mass lower limb index (p = .0006); h2‐standardized total fat mass showed negative correlations with North Star Ambulatory Assessment and 6 min walk test (p = .03). Discussion DXA is a useful tool to evaluate body composition in BMD patients; the decrease in BD and LBM is associated with a reduction of motor function in BMD.
Collapse
Affiliation(s)
- Andrea Barp
- Neurorehabilitation Unit, NeMO Clinical Center, University of Milan, Milan, Italy
| | - Elena Carraro
- Neurorehabilitation Unit, NeMO Clinical Center, University of Milan, Milan, Italy
| | - Giovanni Goggi
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Andrea Lizio
- Neurorehabilitation Unit, NeMO Clinical Center, University of Milan, Milan, Italy
| | - Alice Zanolini
- Neurorehabilitation Unit, NeMO Clinical Center, University of Milan, Milan, Italy
| | | | - Silvia Perego
- Laboratory of Experimental Biochemistry & Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Chiara Verdelli
- Laboratory of Experimental Endocrinology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry & Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Athletics, Strength and Conditioning, Poznań University of Physical Education, Poznań, Poland
| | - Valeria Ada Sansone
- Neurorehabilitation Unit, NeMO Clinical Center, University of Milan, Milan, Italy
| | - Sabrina Corbetta
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgery and Dental Sciences, University of Milan, Milan, Italy
| |
Collapse
|
14
|
Knee flexor and extensor torque ratio in elderly men and women with and without obesity: a cross-sectional study. Aging Clin Exp Res 2022; 34:209-214. [PMID: 33991332 DOI: 10.1007/s40520-021-01884-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/07/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND With aging and obesity lower limb torque deteriorates. Importantly, the ratio between knee flexor (KF) and extensor (KE) torque is an indicator of joint stability. AIMS We compared KF torque and KF/KE ratio in older subjects of both sexes with obesity (OB) or without (NOB) obesity. METHODS The maximal torque during KE and KF isokinetic contractions were evaluated at: 60, 90, 150, 180 and 210 deg/s in 89 elderly (68 ± 5 years) subjects with NOB (BMI < 30 kg/m2) and OB (BMI ≥ 30 kg/m2). Values were normalised for body weight (BW) and leg lean mass (i.e., muscle quality). RESULTS At all speeds men had higher absolute KF values (P < 0.001). When values were normalised for BW, sex differences remain in favour of men (P < 0.001) with lower values in both groups with OB than NOB (P < 0.001). Muscle quality and KF/KE ratio were lower in OB than NOB (P < 0.001). CONCLUSIONS The KF torque and KF/KE ratio decline with aging and with OB. In all groups, the KF/KE ratio was below the joint stability threshold. Thus, exercise physiologists should include exercises designed to train both KE and KF in older subjects with OB.
Collapse
|
15
|
Buckon CE, Sienko SE, Fowler EG, Bagley AM, Staudt LA, Sison-Williamson M, Heberer KR, McDonald CM, Sussman MD. A Longitudinal Study of Quantitative Muscle Strength and Functional Motor Ability in Ambulatory Boys with Duchenne Muscular Dystrophy. J Neuromuscul Dis 2021; 9:321-334. [PMID: 34924398 DOI: 10.3233/jnd-210704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Duchenne muscular dystrophy (DMD) is an X-linked recessive genetic disorder, that is characterized by progressive muscle degeneration and loss of ambulation between 7-13 years of age. Novel pharmacological agents targeting the genetic defects and disease mechanisms are becoming available; however, corticosteroid (CS) therapy remains the standard of care. OBJECTIVE The purpose of this longitudinal study was to elucidate the effect of CS therapy on the rate of muscle strength and gross motor skill decline in boys with DMD and assess the sensitivity of selected outcome measures. METHODS Eighty-four ambulatory boys with DMD (49-180 months), 70 on CS, 14 corticosteroid naïve (NCS), participated in this 8-year multi-site study. Outcomes included; isokinetic dynamometry, the Standing (STD) and Walking/Running/jumping (WRJ) dimensions of the Gross Motor Function Measure (GMFM), and Timed Function Tests (TFTs). Nonlinear mixed modeling procedures determined the rate of change with age and the influence of steroids. RESULTS Despite CS therapy the rate of decline in strength with age was significant in all muscle groups assessed. CS therapy significantly slowed decline in knee extensor strength, as the NCS group declined at 3x the rate of the CS group. Concurrently, WRJ skills declined in the NCS group at twice the rate of the CS group. 4-stair climb and 10 meter walk/run performance was superior in the boys on CS therapy. CONCLUSION CS therapy slowed the rate of muscle strength decline and afforded longer retention of select gross motor skills in boys on CS compared to boys who were NCS. Isokinetic dynamometry, Walk/Run/Jump skills, and select TFTs may prove informative in assessing the efficacy of new therapeutics in ambulatory boys with DMD.
Collapse
Affiliation(s)
| | | | - Eileen G Fowler
- Department of Orthopaedics, University of California, Los Angeles, CA, California
| | - Anita M Bagley
- Shriners Hospitals for Children, Northern California, CA, California
| | - Loretta A Staudt
- Department of Orthopaedics, University of California, Los Angeles, CA, California
| | | | - Kent R Heberer
- Department of Orthopaedics, University of California, Los Angeles, CA, California
| | - Craig M McDonald
- Department of Physical Medicine, University of California Davis Medical Center, Sacramento, CA, California
| | | |
Collapse
|
16
|
Dupuit M, Rance M, Morel C, Bouillon P, Boscaro A, Martin V, Vazeille E, Barnich N, Chassaing B, Boisseau N. Impact of Concurrent Training on Body Composition and Gut Microbiota in Postmenopausal Women with Overweight or Obesity. Med Sci Sports Exerc 2021; 54:517-529. [PMID: 34628447 DOI: 10.1249/mss.0000000000002809] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Menopause tends to be associated with an increased risk of obesity and abdominal fat mass (FM) and is associated with lower intestinal species diversity. The aim of this study was to determine the effects of a high-intensity interval training and resistance training (HIIT + RT) program on body composition and intestinal microbiota composition in overweight or obese postmenopausal women. METHODS Participants (n = 17) were randomized in two groups: HIIT + RT group (3 × / week, 12 weeks) and control group without any training. Dual-energy X-ray absorptiometry was used to measure whole-body and abdominal/visceral FM and fat-free mass. Intestinal microbiota composition was determined by 16S rRNA gene sequencing at baseline and at the study end, and the diet controlled. RESULTS Compared with sedentary controls, physical fitness (Maximal Oxygen Consumption, Peak Power Output) increased, total abdominal and visceral FM decreased, and segmental muscle mass increased in the training group. Although the HIIT + RT protocol did not modify α-diversity and taxonomy, it significantly influenced microbiota composition. Moreover, various intestinal microbiota members were correlated with HIIT + RT-induced body composition changes, and baseline microbiota composition predicted the response to the HIIT + RT program. CONCLUSIONS HIIT + RT is an effective modality to reduce abdominal/visceral FM and improve physical capacity in non-dieting overweight or obese postmenopausal women. Training modified intestinal microbiota composition and the response to training seems to depend on the initial microbiota profile. More studies are needed to determine whether microbiota composition could predict the individual training response.
Collapse
Affiliation(s)
- Marine Dupuit
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, Clermont-Ferrand, France Center of Resources, Expertise and Performance in Sports (CREPS), Bellerive-sur-Allier, France Department of Cardiology, Vichy Hospital, Vichy, France University Institute of France (IUF), Paris, France Department of Cardiology, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France Microbes, Intestine, Inflammation and Susceptibility of the Host (M2iSH), UMR 1071, USC INRAE 2018, Université Clermont Auvergne, Clermont-Ferrand, France Inserm U1016, Team 'Mucosal microbiota in chronic inflammatory diseases', CNRS UMR 8104, Paris University, Paris, France Human Nutrition Research Center of Auvergne - Rhône-Alpes (CNRH-AURA), Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Evans WJ, Shankaran M, Smith EC, Morris C, Nyangau E, Bizieff A, Matthews M, Mohamed H, Hellerstein M. Profoundly lower muscle mass and rate of contractile protein synthesis in boys with Duchenne muscular dystrophy. J Physiol 2021; 599:5215-5227. [PMID: 34569076 DOI: 10.1113/jp282227] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/15/2021] [Indexed: 12/29/2022] Open
Abstract
Boys with Duchenne muscular dystrophy (DMD) experience a progressive loss of functional muscle mass, with fibrosis and lipid accumulation. Accurate evaluation of whole-body functional muscle mass (MM) in DMD patients has not previously been possible and the rate of synthesis of muscle proteins remains unexplored. We used non-invasive, stable isotope-based methods from plasma and urine to measure the fractional rate of muscle protein synthesis (FSR) functional muscle mass (MM), and fat free mass (FFM) in 10 DMD (6-17 years) and 9 age-matched healthy subjects. An oral dose of D3 creatine in 70% 2 H2 O was administered to determine MM and FFM followed by daily 70% 2 H2 O to measure protein FSR. Functional MM was profoundly reduced in DMD subjects compared to controls (17% vs. 41% of body weight, P < 0.0001), particularly in older, non-ambulant patients in whom functional MM was extraordinarily low (<13% body weight). We explored the urine proteome to measure FSR of skeletal muscle-derived proteins. Titin, myosin light chain and gelsolin FSRs were substantially lower in DMD subjects compared to controls (27%, 11% and 40% of control, respectively, P < 0.0001) and were strongly correlated. There were no differences in muscle-derived sarcoplasmic proteins FSRs (creatine kinase M-type and carbonic anhydrase-3) measured in plasma. These data demonstrate that both functional MM, body composition and muscle protein synthesis rates can be quantified non-invasively and are markedly different between DMD and control subjects and suggest that the rate of contractile but not sarcoplasmic protein synthesis is affected by a lack of dystrophin. KEY POINTS: Duchenne muscular dystrophy (DMD) results in a progressive loss of functional skeletal muscle but total body functional muscle mass or rates of muscle protein synthesis have not previously been assessed in these patients. D3 -creatine dilution was used to measure total functional muscle mass and oral 2 H2 O was used to examine the rates of muscle protein synthesis non-invasively in boys with DMD and healthy controls using urine samples. Muscle mass was profoundly lower in DMD compared to control subjects, particularly in older, non-ambulant patients. The rates of contractile protein synthesis but not sarcoplasmic proteins were substantially lower in DMD. These results may provide non-invasive biomarkers for disease progression and therapeutic efficacy in DMD and other neuromuscular diseases.
Collapse
Affiliation(s)
- William J Evans
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA.,Department of Medicine, Duke Medical Center, Durham, NC, USA
| | - Mahalakshmi Shankaran
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Edward C Smith
- Department of Pediatrics, Duke Medical Center, Durham, NC, USA
| | | | - Edna Nyangau
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Alec Bizieff
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Marcy Matthews
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Hussein Mohamed
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Marc Hellerstein
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| |
Collapse
|
18
|
Fayssoil A, Chaffaut C, Prigent H, Laforet P, Clair B, Orlikowski D, Ogna A, Chevret S, Meng P, Annane D, Lofaso F, Crenn P. Nutritional status, swallowing disorders, and respiratory prognosis in adult Duchenne muscular dystrophy patients. Pediatr Pulmonol 2021; 56:2146-2154. [PMID: 33939888 DOI: 10.1002/ppul.25430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/16/2021] [Accepted: 04/12/2021] [Indexed: 11/08/2022]
Abstract
Malnutrition and swallowing disorders are common in Duchenne muscular dystrophy (DMD) patients. We assessed, in adult DMD with home mechanical ventilation (HMV) and cough assist device, its prevalence and the relationships with respiratory muscle strength and long-term respiratory prognosis. We reviewed the patients (n = 117, age 18-39 years [median 24]), followed in a reference center, from 2006 to 2015, to obtain clinical baseline, nutritional status, vital capacity (VC), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP). The median body mass index (BMI) was low (15.6 kg/m²). Included patients had severe restrictive respiratory function with a median VC of 10.5% [7-17] of the predicted value. All patients were on HMV. Prevalence of malnutrition, swallowing disorders, and gastrostomy were respectively 62%, 34%, and 11%. BMI and serum albumin level were significantly associated with MIP, MEP, and VC. The 1-year/5-years cumulative incidences of respiratory events (pulmonary sepsis and acute respiratory distress) were, respectively, 20.7%/44.5%. Using univariate analysis, predictive factors for respiratory events were swallowing disorders (p = .001), transthyretinemia (p = .034), MIP (p = .039), and MEP (p = .03) but not BMI or albuminemia. Using multivariate analysis, only swallowing disorders remained significantly associated with respiratory events (OR = 4.2, IC 95% 1.31-12.2, p = .01). In conclusion, this study highlights the interrelationships between nutritional intake, swallowing function, airway clearance, and respiratory function in adult DMD. A multidisciplinary approach focusing on these previous factors is essential to optimize DMD patient health.
Collapse
Affiliation(s)
- Abdallah Fayssoil
- Service de Médecine intensive et Réanimation/Unité de ventilation à domicile, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,CRMR des maladies neuromusculaires Nord-Est-Ile de France, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Service de cardiologie, Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Hôpital Ambroise Paré, AP-HP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France.,Centre d'Investigation clinique (CIC) 1429 INSERM, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Cendrine Chaffaut
- Service de Biostatistiques et Information Médicale (SBIM), Hôpital Saint Louis, APHP, Université Paris, Paris, France
| | - Helene Prigent
- CRMR des maladies neuromusculaires Nord-Est-Ile de France, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Centre d'Investigation clinique (CIC) 1429 INSERM, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Service de Physiologie-Explorations fonctionnelles, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Pascal Laforet
- CRMR des maladies neuromusculaires Nord-Est-Ile de France, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Centre d'Investigation clinique (CIC) 1429 INSERM, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Service de Neurologie/Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Bernard Clair
- Service de Médecine intensive et Réanimation/Unité de ventilation à domicile, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,CRMR des maladies neuromusculaires Nord-Est-Ile de France, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - David Orlikowski
- Service de Médecine intensive et Réanimation/Unité de ventilation à domicile, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,CRMR des maladies neuromusculaires Nord-Est-Ile de France, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Centre d'Investigation clinique (CIC) 1429 INSERM, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Adam Ogna
- Service de Médecine intensive et Réanimation/Unité de ventilation à domicile, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Sylvie Chevret
- Service de Biostatistiques et Information Médicale (SBIM), Hôpital Saint Louis, APHP, Université Paris, Paris, France
| | - Paris Meng
- Service de Médecine intensive et Réanimation/Unité de ventilation à domicile, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Djillali Annane
- Service de Médecine intensive et Réanimation/Unité de ventilation à domicile, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,CRMR des maladies neuromusculaires Nord-Est-Ile de France, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Centre d'Investigation clinique (CIC) 1429 INSERM, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Frederic Lofaso
- CRMR des maladies neuromusculaires Nord-Est-Ile de France, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Centre d'Investigation clinique (CIC) 1429 INSERM, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Service de Physiologie-Explorations fonctionnelles, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Pascal Crenn
- CRMR des maladies neuromusculaires Nord-Est-Ile de France, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Centre d'Investigation clinique (CIC) 1429 INSERM, Hôpital Raymond Poincaré, APHP, Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Unité de Nutrition clinique transversale, Hôpital Raymond Poincaré, APHP Université Paris Saclay/UFR Simone Veil-Santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| |
Collapse
|
19
|
Muollo V, Rossi AP, Zignoli A, Teso M, Milanese C, Cavedon V, Zamboni M, Schena F, Capelli C, Pogliaghi S. Full characterisation of knee extensors' function in ageing: effect of sex and obesity. Int J Obes (Lond) 2021; 45:895-905. [PMID: 33526852 DOI: 10.1038/s41366-021-00755-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/18/2020] [Accepted: 01/12/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND/OBJECTIVES Muscle function is a marker of current and prospective health/independence throughout life. The effects of sex and obesity (OB) on the loss of muscle function in ageing remain unresolved, with important implications for the diagnosis/monitoring of sarcopenia. To characterise in vivo knee extensors' function, we compared muscles torque and power with isometric and isokinetic tests in older men (M) and women (W), with normal range (NW) of body mass index (BMI) and OB. SUBJECTS/METHODS In 70 sedentary older M and W (69 ± 5 years), NW and OB (i.e. BMI < 30 kg m-2 and ≥30 kg m-2, respectively) we tested the right knee's extensor: (i) isometric torque at 30°, 60°, 75° and 90° knee angles, and (ii) isokinetic concentric torque at 60, 90, 150, 180 and 210° s-1 angular speeds. Maximal isometric T-angle, maximal isokinetic knee-extensor torque-velocity, theoretical maximal shortening velocity, maximal power, optimal torque and velocity were determined in absolute units, normalised by body mass (BM) and right leg lean mass (LLMR) and compared over sex, BMI categories and angle or angular speeds by three-way ANOVA. RESULTS In absolute units, relative to BM and LLMR, sex differences were found in favour of M for all parameters of muscle function (main effect for sex, p < 0.05). OB did not affect either absolute or relative to LLMR isometric and isokinetic muscle function (main effect for BMI, p > 0.05); however, muscle function indices, when adjusted for BM, were lower in both M and W with OB compared to NW counterparts (p < 0.05). CONCLUSIONS We confirmed sex differences in absolute, relative to BM and LLMR muscle function in favour of men. While overall muscle function and muscle contractile quality is conserved in individuals with class I OB, muscle function normalised for BM, which defines the ability to perform independently and safely the activities of daily living, is impaired in comparison with physiological ageing.
Collapse
Affiliation(s)
| | - Andrea P Rossi
- Department of Medicine, Section of Geriatrics, Healthy Aging Center Verona, Verona, Italy
| | - Andrea Zignoli
- Department of Industrial Engineering, University of Trento, Trento, Italy
| | - Massimo Teso
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Chiara Milanese
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Valentina Cavedon
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Department of Medicine, Section of Geriatrics, Healthy Aging Center Verona, Verona, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy.,Sport Mountain and Health Research Center (CeRiSM), University of Verona, Rovereto, Italy
| | - Carlo Capelli
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Silvia Pogliaghi
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy.
| |
Collapse
|
20
|
Summer SS, Wong BL, Rutter MM, Horn PS, Tian C, Rybalsky I, Shellenbarger KC, Kalkwarf HJ. Age-related changes in appendicular lean mass in males with Duchenne muscular dystrophy: A retrospective review. Muscle Nerve 2020; 63:231-238. [PMID: 33104257 DOI: 10.1002/mus.27107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/19/2020] [Accepted: 10/24/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Appendicular lean mass (ALM) trajectory in males with Duchenne muscular dystrophy (DMD) has potential applicability for treatment and research and has not been characterized. METHODS This chart review included longitudinal data on 499 males with DMD receiving glucocorticoids and 693 controls, ages 5 to 22.9 y. ALM (kg) was measured by dual energy x-ray absorptiometry (DXA). Appendicular lean mass index (ALMI, kg/m2 ) was calculated for height adjustment. Reference centiles were generated using data from healthy controls, and ALM and ALMI Z-scores were calculated for patients with DMD. Generalized linear models were used to estimate median Z-scores by age and functional mobility status (FMS) score. ALM velocity by age was modeled using superimposition, translation and rotation (SITAR). RESULTS Compared to controls, males with DMD had lower ALM from an early age. ALMI Z-scores dropped below 0 at age 8 y or FMS of 2, and below -2.0 at age 13 y or FMS of 3 (P < .05). Age at peak ALM velocity was similar in both groups, but the magnitude was higher in controls (3.5 vs. 0.7 kg/y, P < .0001). Patients with DMD had a transient loss of ALM around age 12 y, an increase at age 14 y, then a further decline at age 16 y, remaining low thereafter. CONCLUSIONS Males with DMD have progressive decline in lean mass with age and worsening functional mobility. DXA measurement of ALM may be useful for monitoring lean mass status in patients with DMD, providing valuable information for individual treatment plans and research endeavors.
Collapse
Affiliation(s)
- Suzanne S Summer
- Center for Clinical and Translational Science and Training, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Brenda L Wong
- DMD Program, Department of Pediatrics and Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Meilan M Rutter
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Paul S Horn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Cuixia Tian
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Irina Rybalsky
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - K Courtney Shellenbarger
- DMD Program, Department of Pediatrics and Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Heidi J Kalkwarf
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| |
Collapse
|
21
|
Jacques MF, Onambele-Pearson GL, Reeves ND, Stebbings GK, Dawson EA, Stockley RC, Edwards B, Morse CI. 12-Month changes of muscle strength, body composition and physical activity in adults with dystrophinopathies. Disabil Rehabil 2020; 44:1847-1854. [PMID: 32853037 DOI: 10.1080/09638288.2020.1808087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Muscular dystrophy (MD) is an umbrella term for muscle wasting conditions, for which longitudinal changes in function and body composition are well established in children with Duchenne (DMD), however, changes in adults with DMD and Beckers (BMD), respectively, remain poorly reported. This study aims to assess 12-month changes in lower-limb strength, muscle size, body composition and physical activity in adults with Muscular Dystrophy (MD). METHODS Adult males with Duchenne MD (DMD; N = 15) and Beckers MD (BMD; N = 12) were assessed at baseline and 12-months for body composition (Body fat and lean body mass (LBM)), Isometric maximal voluntary contraction (Knee-Extension (KEMVC) and Plantar-Flexion (PFMVC)) and physical activity (tri-axial accelerometry). RESULTS 12-Month change in strength was found as -19% (PFMVC) and -14% (KEMVC) in DMD. 12-Month change in strength in BMD, although non-significant, was explained by physical activity (R2=0.532-0.585). Changes in LBM (DMD) and body fat (BMD) were both masked by non-significant changes in body mass. DISCUSSION 12-Month changes in adults with DMD appear consistent with paediatric populations. Physical activity appears important for muscle function maintenance. Specific monitoring of body composition, and potential co-morbidities, within adults with MD is highlighted.Implications for rehabilitationQuantitative muscle strength assessment shows progressive muscle weakness in adults with Duchenne Muscular Dystrophy is comparable to paediatric reports (-14 to -19%).Physical activity should be encouraged in adults with Beckers Muscular Dystrophy, anything appears better than nothing.Body composition, rather than body mass, should be monitored closely to identify any increase in body fat.
Collapse
Affiliation(s)
- Matthew F Jacques
- Faculty of Science and Engineering, School of Healthcare Science, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Gladys L Onambele-Pearson
- Faculty of Science and Engineering, School of Healthcare Science, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Neil D Reeves
- Faculty of Science and Engineering, School of Healthcare Science, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Georgina K Stebbings
- Faculty of Science and Engineering, School of Healthcare Science, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ellen A Dawson
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Rachel C Stockley
- School of Nursing, University of Central Lancashire, Preston, United Kingdom
| | - Bryn Edwards
- The Neuromuscular Centre, Winsford, Cheshire, United Kingdom
| | - Christopher I Morse
- Faculty of Science and Engineering, School of Healthcare Science, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| |
Collapse
|
22
|
Goemans N, Wong B, Van den Hauwe M, Signorovitch J, Sajeev G, Cox D, Landry J, Jenkins M, Dieye I, Yao Z, Hossain I, Ward SJ. Prognostic factors for changes in the timed 4-stair climb in patients with Duchenne muscular dystrophy, and implications for measuring drug efficacy: A multi-institutional collaboration. PLoS One 2020; 15:e0232870. [PMID: 32555695 PMCID: PMC7302444 DOI: 10.1371/journal.pone.0232870] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 04/22/2020] [Indexed: 12/25/2022] Open
Abstract
The timed 4-stair climb (4SC) assessment has been used to measure function in Duchenne muscular dystrophy (DMD) practice and research. We sought to identify prognostic factors for changes in 4SC, assess their consistency across data sources, and the extent to which prognostic scores could be useful in DMD clinical trial design and analysis. Data from patients with DMD in the placebo arm of a phase 3 trial (Tadalafil DMD trial) and two real-world sources (Universitaire Ziekenhuizen, Leuven, Belgium [Leuven] and Cincinnati Children's Hospital Medical Center [CCHMC]) were analyzed. One-year changes in 4SC completion time and velocity (stairs/second) were analyzed. Prognostic models included age, height, weight, steroid use, and multiple timed function tests and were developed using multivariable regression, separately in each data source. Simulations were used to quantify impacts on trial sample size requirements. Data on 1-year changes in 4SC were available from the Tadalafil DMD trial (n = 92) Leuven (n = 67), and CCHMC (n = 212). Models incorporating multiple timed function tests, height, and weight significantly improved prognostic accuracy for 1-year change in 4SC (R2: 29%-36% for 4SC velocity, and 29%-34% for 4SC time) compared to models including only age, baseline 4SC and steroid duration (R2:8%-17% for 4SC velocity and 2%-13% for 4SC time). Measures of walking and rising ability contributed important prognostic information for changes in 4SC. In a randomized trial with equal allocation to treatment and placebo, adjustment for such a prognostic score would enable detection (at 80% power) of a treatment effect of 0.25 stairs/second with 100–120 patients, compared to 170–190 patients without prognostic score adjustment. Combining measures of ambulatory function doubled prognostic accuracy for 1-year changes in 4SC completion time and velocity. Randomized clinical trials incorporating a validated prognostic score could reduce sample size requirements by approximately 40%. Knowledge of important prognostic factors can also inform adjusted comparisons to external controls.
Collapse
Affiliation(s)
- Nathalie Goemans
- Department of Child Neurology, University Hospitals Leuven, Leuven, Belgium
- * E-mail:
| | - Brenda Wong
- Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, United States of America
| | | | - James Signorovitch
- Analysis Group Inc., Boston, Massachusetts, United States of America
- The Collaborative Trajectory Analysis Project, Cambridge, Massachusetts, United States of America
| | - Gautam Sajeev
- Analysis Group Inc., Boston, Massachusetts, United States of America
| | - David Cox
- Eli Lilly and Company, Indianapolis, Indiana, United States of America
| | - John Landry
- Eli Lilly and Company, Toronto, Ontario, Canada
| | | | - Ibrahima Dieye
- Analysis Group Inc., Boston, Massachusetts, United States of America
| | - Zhiwen Yao
- Analysis Group Inc., Boston, Massachusetts, United States of America
| | - Intekhab Hossain
- Analysis Group Inc., Boston, Massachusetts, United States of America
| | - Susan J. Ward
- The Collaborative Trajectory Analysis Project, Cambridge, Massachusetts, United States of America
| | | |
Collapse
|
23
|
Rutkove SB. Electrical impedance myography: MRI-like data without the need for MRI. Muscle Nerve 2020; 61:554-556. [PMID: 32052459 DOI: 10.1002/mus.26832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/03/2020] [Accepted: 02/09/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| |
Collapse
|
24
|
Evidence of muscle loss delay and improvement of hyperinsulinemia and insulin resistance in Duchenne muscular dystrophy supplemented with omega-3 fatty acids: A randomized study. Clin Nutr 2019; 38:2087-2097. [DOI: 10.1016/j.clnu.2018.10.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 10/15/2018] [Accepted: 10/20/2018] [Indexed: 12/31/2022]
|
25
|
Effects of in-season enhanced negative work-based vs traditional weight training on change of direction and hamstrings-to-quadriceps ratio in soccer players. Biol Sport 2019; 36:241-248. [PMID: 31624418 PMCID: PMC6786325 DOI: 10.5114/biolsport.2019.87045] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/25/2019] [Accepted: 06/27/2019] [Indexed: 11/25/2022] Open
Abstract
The present study investigated the effects of in-season enhanced negative work-based training (ENT) vs weight training in the change of direction (COD), sprinting and jumping ability, muscle mass and strength in semi-professional soccer players. Forty male soccer players participated in the eight-week, 1 d/w intervention consisting of 48 squat repetitions for ENT using a flywheel device (inertia=0.11 kg·m-2) or weight training (80%1 RM) as a control group (CON). Agility T-test, 20+20 m shuttle, 10 m and 30 m sprint, squat jump (SJ) and countermovement jump (CMJ), lean mass, quadriceps and hamstrings strength and the hamstrings-to-quadriceps ratio were measured. Time on agility T-test and 20+20 m shuttle decreased in ENT (effect-size =-1.44, 95% CI -2.24/-0.68 and -0.75, -1.09/-0.42 respectively) but not in CON (-0.33, -0.87/0.19 and -0.13, -0.58/0.32). SJ and CMJ height increased in both ENT (0.71, 0.45/0.97 and 0.65, 0.38/0.93) and CON (0.41, 0.23/0.60 and 0.36, 0.12/0.70). Overall, quadriceps and hamstrings strength increased in both ENT and CON (0.38/0.79), but the hamstrings-to-quadriceps ratio increased in ENT (0.31, 0.22/0.40) but not in CON (0.03, -0.18/0.24). Lean mass increased in both ENT (0.41, 0.26/0.57) and CON (0.29, 0.14/0.44). The repeated negative actions performed in ENT may have led to improvements in braking ability, a key point in COD performance. Semi-professional soccer players may benefit from in-season ENT to enhance COD and the negative-specific adaptations in muscle strength and hamstrings-to-quadriceps ratio.
Collapse
|
26
|
Venturelli M, Villa F, Ruzzante F, Tarperi C, Rudi D, Milanese C, Cavedon V, Fonte C, Picelli A, Smania N, Calabria E, Skafidas S, Layec G, Schena F. Neuromuscular and Muscle Metabolic Functions in MELAS Before and After Resistance Training: A Case Study. Front Physiol 2019; 10:503. [PMID: 31105594 PMCID: PMC6498991 DOI: 10.3389/fphys.2019.00503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022] Open
Abstract
Mitochondrial encephalomyopathy, lactic acidosis, and recurrent stroke-like episodes syndrome (MELAS) is a rare degenerative disease. Recent studies have shown that resistant training (RT) can ameliorate muscular force in mitochondrial diseases. However, the effects of RT in MELAS are unknown. The aim of this case report was to investigate the effects of RT on skeletal muscle and mitochondrial function in a 21-years old patient with MELAS. RT included 12 weeks of RT at 85% of 1 repetition maximum. Body composition (DXA), in vivo mitochondrial respiration capacity (mVO2) utilizing Near-infrared spectroscopy on the right plantar-flexor muscles, maximal voluntary torque (MVC), electrically evoked resting twitch (EET) and maximal voluntary activation (VMA) of the right leg extensors (LE) muscles were measured with the interpolated twitch technique. The participant with MELAS exhibited a marked increase in body mass (1.4 kg) and thigh muscle mass (0.3 kg). After the training period MVC (+5.5 Nm), EET (+2.1 N⋅m) and VMA (+13.1%) were ameliorated. Data of mVO2 revealed negligible changes in the end-exercise mVO2 (0.02 mM min-1), Δ mVO2 (0.09 mM min-1), while there was a marked amelioration in the kinetics of mVO2 (τ mVO2; Δ70.2 s). This is the first report of RT-induced ameliorations on skeletal muscle and mitochondrial function in MELAS. This case study suggests a preserved plasticity in the skeletal muscle of a patient with MELAS. RT appears to be an effective method to increase skeletal muscle function, and this effect is mediated by both neuromuscular and mitochondrial adaptations.
Collapse
Affiliation(s)
- Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Department of Internal Medicine, Division of Geriatrics, The University of Utah, Salt Lake City, UT, United States
| | - Federica Villa
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Ruzzante
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cantor Tarperi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Doriana Rudi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Valentina Cavedon
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cristina Fonte
- Neuromotor and Cognitive Rehabilitation Research Centre, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Centre, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Centre, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elisa Calabria
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Spyros Skafidas
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gwenael Layec
- Department of Kinesiology, University of Massachusetts, Amherst MA, United States
- Institute for Applied Life Sciences, University of Massachusetts, Amherst, MA, United States
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| |
Collapse
|
27
|
Naro F, Venturelli M, Monaco L, Toniolo L, Muti E, Milanese C, Zhao J, Richardson RS, Schena F, Reggiani C. Skeletal Muscle Fiber Size and Gene Expression in the Oldest-Old With Differing Degrees of Mobility. Front Physiol 2019; 10:313. [PMID: 30971947 PMCID: PMC6443969 DOI: 10.3389/fphys.2019.00313] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 03/07/2019] [Indexed: 12/22/2022] Open
Abstract
The oldest-old, in the ninth and tenth decades of their life, represent a population characterized by neuromuscular impairment, which often implies a loss of mobility and independence. As recently documented by us and others, muscle atrophy and weakness are accompanied by an unexpected preservation of the size and contractile function of skeletal muscle fibers. This suggests that, while most fibers are likely lost with their respective motoneurons, the surviving fibers are well preserved. Here, we investigated the mechanisms behind this fiber preservation and the relevance of physical activity, by comparing a group of 6 young healthy controls (YG: 22-28 years) with two groups of oldest-old (81-96 years), one able to walk (OW: n = 6, average 86 years) and one confined to a wheelchair (ONW n = 9, average 88 years). We confirmed previous results of fiber preservation and, additionally, observed a shift in fiber type, toward slow predominance in OW and fast predominance in ONW. Myonuclear density was increased in muscles of ONW, compared to YG and OW, potentially indicative of an ongoing atrophy process. We analyzed, by RT-qPCR, the expression of genes relevant for fiber size and type regulation in a biopsy sample from the vastus lateralis. In all oldest-old both myostatin and IGF-1 expression were attenuated compared to YG, however, in ONW two specific IGF-1 isoforms, IGF-1EA and MGF, demonstrated a further significant decrease compared to OW. Surprisingly, atrogenes (MURF1 and atrogin) expression was also significantly reduced compared to YG and this was accompanied by a close to statistically significantly attenuated marker of autophagy, LC3. Among the determinants of the metabolic fiber type, PGC1α was significantly reduced in both OW and ONW compared to YG, while AMPK was down-regulated only in ONW. We conclude that, in contrast to the shift of the balance in favor of pro-atrophy factors found by other studies in older adults (decreased IGF-1, increase of myostatin, increase of atrogenes), in the oldest-old the pro-atrophy factors also appear to be down-regulated, allowing a partial recovery of the proteostasis balance. Furthermore, the impact of muscle activity, as a consequence of lost or preserved walking ability, is limited.
Collapse
Affiliation(s)
- Fabio Naro
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Lucia Monaco
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Luana Toniolo
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Ettore Muti
- Monsignor Arrigo Mazzali Foundation, Mantova, Italy
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Jia Zhao
- Division of Geriatrics, Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States.,Department of Nutrition and Integrative Physiology, The University of Utah, Salt Lake City, UT, United States.,Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center, Salt Lake City, UT, United States
| | - Russell S Richardson
- Division of Geriatrics, Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States.,Department of Nutrition and Integrative Physiology, The University of Utah, Salt Lake City, UT, United States.,Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center, Salt Lake City, UT, United States
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Padua, Italy.,Institute for Kinesiology Research, Science and Research Center of Koper, Koper, Slovenia
| |
Collapse
|
28
|
Bernabe-García M, Rodríguez-Cruz M, Atilano S, Cruz-Guzmán ODR, Almeida-Becerril T, Calder PC, González J. Body composition and body mass index in Duchenne muscular dystrophy: Role of dietary intake. Muscle Nerve 2018; 59:295-302. [PMID: 30194761 DOI: 10.1002/mus.26340] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2018] [Indexed: 01/31/2023]
Abstract
INTRODUCTION In Duchenne muscular dystrophy (DMD) muscle is replaced by adipose tissue. The role of dietary intake (DI) in DMD has not been evaluated. In this study we examined body composition, body mass index (BMI), and adequacy of DI in patients with DMD and evaluated the influence of DI on body composition. METHODS Patients (n = 101; age 3-18 years; BMI 11.8-29.5 kg/m2 ) completed a dietary recall to determine DI and then underwent dual-energy X-ray absorptiometry to determine body composition. RESULTS Preschool-age and school-age boys with DMD had high total energy intake. Protein intake per kilogram exceeded recommendations. As age increased, the percentage of boys with abnormal BMI and fat mass increased, while lean mass decreased. Dietary intake did not predict body fat or lean mass. DISCUSSION Age-dependent changes in BD in boys with DMD may be due to endogenous metabolic factors related to the underlying disease process and to disease-related mobility impairments. Muscle Nerve 59:295-302, 2019.
Collapse
Affiliation(s)
- Mariela Bernabe-García
- Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Avenida Cuauhtémoc No. 330, Col. Doctores, Delegación Cuauhtémoc, 06725, Ciudad de México, México
| | - Maricela Rodríguez-Cruz
- Laboratorio de Nutrición Molecular, Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Salvador Atilano
- Laboratorio de Nutrición Molecular, Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Oriana Del Rocío Cruz-Guzmán
- Laboratorio de Nutrición Molecular, Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Tomás Almeida-Becerril
- Laboratorio de Nutrición Molecular, Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Julia González
- Laboratorio de Nutrición Molecular, Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| |
Collapse
|
29
|
Jacques MF, Onambele‐Pearson GL, Reeves ND, Stebbings GK, Smith J, Morse CI. Relationships between muscle size, strength, and physical activity in adults with muscular dystrophy. J Cachexia Sarcopenia Muscle 2018; 9:1042-1052. [PMID: 30338901 PMCID: PMC6240748 DOI: 10.1002/jcsm.12347] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/30/2018] [Accepted: 08/19/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Muscular dystrophy (MD) is characterized by progressive muscle wasting and weakness, yet few comparisons to non-MD controls (CTRL) of muscle strength and size in this adult population exist. Physical activity (PA) is promoted to maintain health and muscle strength within MD; however, PA reporting in adults with MD is limited to recall data, and its impact on muscle strength is seldom explored. METHODS This study included 76 participants: 16 non-MD (CTRL, mean age 35.4), 15 Duchenne MD (DMD, mean age 24.2), 18 Becker's MD (BMD, mean age 42.4), 13 limb-girdle MD (LGMD, mean age 43.1), and 14 facioscapulohumeral MD (mean age 47.7). Body fat (%) and lean body mass (LBM) were measured using bioelectrical-impedance. Gastrocnemius medialis (GM) anatomical cross-sectional area (ACSA) was determined using B-mode ultrasound. Isometric maximal voluntary contraction (MVC) was assessed during plantar flexion (PFMVC) and knee extension (KEMVC). PA was measured for seven continuous days using triaxial accelerometry and was expressed as daily average minutes being physically active (TPAmins ) or average daily percentage of waking hours being sedentary (sedentary behaviour). Additionally, 10 m walk time was assessed. RESULTS Muscular dystrophy groups had 34-46% higher body fat (%) than CTRL. DMD showed differences in LBM with 21-28% less LBM than all other groups. PFMVC and KEMVC were 36-75% and 24-92% lower, respectively, in MD groups than CTRL. GM ACSA was 47% and 39% larger in BMD and LGMD, respectively, compared with CTRL. PFMVC was associated with GM ACSA in DMD (P = 0.026, R = 0.429) and CTRL (P = 0.015, R = 0.553). MD groups were 14-38% more sedentary than CTRL groups, while DMD were more sedentary than BMD (14%), LGMD (8%), and facioscapulohumeral MD (14%). Sedentary behaviour was associated with LBM in DMD participants (P = 0.021, R = -0.446). TPAmins was associated with KEMVC (P = 0.020, R = 0.540) in BMD participants, while TPAmins was also the best predictor of 10 m walk time (P < 0.001, R2 = 0.540) in ambulant MD, revealed by multiple linear regression. CONCLUSIONS Quantified muscle weakness and impaired 10 m walking time is reported in adults with MD. Muscle weakness and 10 m walk time were associated with lower levels of TPA in adults with MD. Higher levels of sedentary behaviour were associated with reduced LBM in DMD. These findings suggest a need for investigations into patterns of PA behaviour, and relevant interventions to reduce sedentary behaviour and encourage PA in adults with MD regardless of impairment severity.
Collapse
Affiliation(s)
- Matthew F. Jacques
- Research Centre for Musculoskeletal Science and Sports Medicine, School of Healthcare Science, Faculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| | - Gladys L. Onambele‐Pearson
- Research Centre for Musculoskeletal Science and Sports Medicine, School of Healthcare Science, Faculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| | - Neil D. Reeves
- Research Centre for Musculoskeletal Science and Sports Medicine, School of Healthcare Science, Faculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| | - Georgina K. Stebbings
- Research Centre for Musculoskeletal Science and Sports Medicine, School of Healthcare Science, Faculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| | | | - Christopher I. Morse
- Research Centre for Musculoskeletal Science and Sports Medicine, School of Healthcare Science, Faculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| |
Collapse
|
30
|
Integrative effects of dystrophin loss on metabolic function of the mdx mouse. Sci Rep 2018; 8:13624. [PMID: 30206270 PMCID: PMC6134145 DOI: 10.1038/s41598-018-31753-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 08/13/2018] [Indexed: 11/23/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a disease marked by the development of skeletal muscle weakness and wasting. DMD results from mutations in the gene for the cytoskeletal protein dystrophin. The loss of dystrophin expression is not limited to muscle weakness but has multiple systemic consequences. Managing the nutritional requirements is an important aspect of the clinical care of DMD patients and is complicated by the poor understanding of the role of dystrophin, and dystrophic processes, in regulating metabolism. Here, we show that mdx mice, a genetic model of DMD, have significantly reduced fat mass relative to wild type C57BL/10. The alteration in body composition is independent of the presence of skeletal muscle disease, as it is still present in mice with transgenic expression of a fully-functional dystrophin in skeletal muscle. Furthermore, mdx mice do not increase their fat mass or body weight when housed under thermoneutral conditions, in marked contrast to C57BL/10 mice. We also demonstrated that mdx mice have significantly reduced fat metabolism and altered glucose uptake. These significant metabolic changes in dystrophic mice implicate dystrophin as an important regulator of metabolism. Understanding the metabolic functions of dystrophin is important for managing the nutritional needs of DMD patients.
Collapse
|
31
|
Coratella G, Beato M, Milanese C, Longo S, Limonta E, Rampichini S, Cè E, Bisconti AV, Schena F, Esposito F. Specific Adaptations in Performance and Muscle Architecture After Weighted Jump-Squat vs. Body Mass Squat Jump Training in Recreational Soccer Players. J Strength Cond Res 2018; 32:921-929. [PMID: 29420390 DOI: 10.1519/jsc.0000000000002463] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Coratella, G, Beato, M, Milanese, C, Longo, S, Limonta, E, Rampichini, S, Cè, E, Bisconti, AV, Schena, F, and Esposito, F. Specific adaptations in performance and muscle architecture after weighted jump-squat vs. body mass squat jump training in recreational soccer players. J Strength Cond Res 32(4): 921-929, 2018-The aim of the present study was to compare the effects of weighted jump-squat training (WJST) vs. body mass squat jump training (BMSJT) on quadriceps' muscle architecture, lower-limb lean-mass (LM) and muscle strength, performance in change of direction (COD), and sprint and jump in recreational soccer players. Forty-eight healthy soccer players participated in an offseason randomized controlled trial. Before and after an 8-week training intervention, vastus lateralis pennation angle, fascicle length, muscle thickness, LM, squat 1RM, quadriceps and hamstrings isokinetic peak torque, agility T-test, 10-and 30-m sprints, and squat-jump (SJ) were measured. Although similar increases were observed in muscle thickness, fascicle length increased more in WJST (Effect size [ES] = 1.18, 0.82-1.54) than in BMSJT (ES = 0.54, 0.40-0.68), and pennation angle increased only in BMSJT (ES = 1.03, 0.78-1.29). Greater increases in LM were observed in WJST (ES = 0.44, 0.29-0.59) than in BMSJT (ES = 0.21, 0.07-0.37). The agility T-test (ES = 2.95, 2.72-3.18), 10-m (ES = 0.52, 0.22-0.82), and 30-m sprints (ES = 0.52, 0.23-0.81) improved only in WJST, whereas SJ improved in BMSJT (ES = 0.89, 0.43-1.35) more than in WJST (ES = 0.30, 0.03-0.58). Similar increases in squat 1RM and peak torque occurred in both groups. The greater inertia accumulated within the landing phase in WJST vs. BMSJT has increased the eccentric workload, leading to specific eccentric-like adaptations in muscle architecture. The selective improvements in COD in WJST may be related to the increased braking ability generated by the enhanced eccentric workload.
Collapse
Affiliation(s)
- Giuseppe Coratella
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Marco Beato
- Faculty of Health and Science, Department of Science and Technology, University of Suffolk, Ipswich, United Kingdom
| | - Chiara Milanese
- Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Stefano Longo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Eloisa Limonta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Susanna Rampichini
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Emiliano Cè
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Angela V Bisconti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Federico Schena
- Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
32
|
Chagarlamudi H, Corbett A, Stoll M, Bibat G, Grosmann C, Matichak Stock C, Stinson N, Shapiro J, Wagner KR. Bone health in facioscapulohumeral muscular dystrophy: A cross-sectional study. Muscle Nerve 2017; 56:1108-1113. [DOI: 10.1002/mus.25619] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Hema Chagarlamudi
- Center for Genetic Muscle Disorders; Kennedy Krieger Institute; Baltimore Maryland USA
| | | | - Marion Stoll
- Molecular Medicine Laboratory; Concord Hospital; Concord New South Wales Australia
| | - Genila Bibat
- Center for Genetic Muscle Disorders; Kennedy Krieger Institute; Baltimore Maryland USA
| | - Carla Grosmann
- Center for Genetic Muscle Disorders; Kennedy Krieger Institute; Baltimore Maryland USA
- Rady Children's Hospital and Department of Neurosciences; University of California San Diego School of Medicine; San Diego California USA
| | - Carly Matichak Stock
- Center for Genetic Muscle Disorders; Kennedy Krieger Institute; Baltimore Maryland USA
| | - Nikia Stinson
- Center for Genetic Muscle Disorders; Kennedy Krieger Institute; Baltimore Maryland USA
| | - Jay Shapiro
- Osteogenesis Imperfecta Department; Kennedy Krieger Institute; Baltimore Maryland USA
| | - Kathryn R. Wagner
- Center for Genetic Muscle Disorders; Kennedy Krieger Institute; Baltimore Maryland USA
- Department of Neurology; The Johns Hopkins School of Medicine; Baltimore Maryland USA
- Department of Neuroscience; The Johns Hopkins School of Medicine; Baltimore Maryland USA
| |
Collapse
|
33
|
Doulgeraki AE, Athanasopoulou HI, Katsalouli MS, Petrocheilou GM, Paspati IN, Monopolis IK. Body composition of patients with Duchenne muscular dystrophy: the Greek experience. Acta Neurol Belg 2016; 116:565-572. [PMID: 26680652 DOI: 10.1007/s13760-015-0582-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/01/2015] [Indexed: 11/28/2022]
Abstract
Greece ranks among the first countries suffering from the obesity epidemic globally. The aim of the study was to evaluate body composition in Greek patients with Duchenne muscular dystrophy (DMD). We hypothesized that able-bodied patients would not differ from controls, in terms of adiposity, based on clinical observations during everyday practice. STUDY DESIGN Cross-sectional study of steroid-dependent DMD subjects, who underwent dual-energy X-ray absorptiometry and laboratory metabolic bone profile evaluation. Forty-two patients and thirty-one controls were studied. Overall, DMD subjects were shorter (height Z-score = -1.4, p = 0.01). Their bone mineral density (BMD) was low (lumbar spine BMD Z-score = -1.2, p < 0.01, subcranial total body BMD Z-score = -1.8, p < 0.01). Lean tissue mass (LTM) was also decreased (LTM Z-score = -2.2, p < 0.01). The above findings were more pronounced in adolescence. Regarding adiposity, increased fat mass (FM) was found only in pubertal DMD patients (FM Z-score = 1.4, p < 0.01), whereas prepubertal, able-bodied patients did not differ from controls, thus confirming the initial hypothesis. Finally, 65 % of DMD subjects had increased bone resorption markers and 57 % had suboptimal vitamin D levels. The importance of using native population as controls for body composition analysis is highlighted. In Greece, abnormal body composition in DMD patients is more striking when loss of ambulation occurs and not during the prepubertal period, due to the concurrent presence of obesity in the pediatric population. Thus, adolescents with this neuromuscular disorder should be targeted toward prompt lifestyle interventions.
Collapse
Affiliation(s)
- Artemis E Doulgeraki
- Department of Bone and Mineral Metabolism, Institute of Child Health, "Agia Sophia" Children's Hospital, 115 27, Goudi, Athens, Greece.
| | - Helen I Athanasopoulou
- Department of Bone and Mineral Metabolism, Institute of Child Health, "Agia Sophia" Children's Hospital, 115 27, Goudi, Athens, Greece
| | | | - Glykeria M Petrocheilou
- Department of Bone and Mineral Metabolism, Institute of Child Health, "Agia Sophia" Children's Hospital, 115 27, Goudi, Athens, Greece
| | - Ioanna N Paspati
- Department of Orthopedics, "Penteli" Children's Hospital, Athens, Greece
| | - Ioannis K Monopolis
- Department of Statistics, Institute of Child Health, "Agia Sophia" Children's Hospital, Athens, Greece
| |
Collapse
|
34
|
Sedehizadeh S, Brook JD, Maddison P. Body composition and clinical outcome measures in patients with myotonic dystrophy type 1. Neuromuscul Disord 2016; 27:286-289. [PMID: 28082208 DOI: 10.1016/j.nmd.2016.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/20/2016] [Accepted: 11/10/2016] [Indexed: 11/16/2022]
Abstract
Myotonic Dystrophy type 1 (DM1) is the most common form of adult onset muscular dystrophy. In this study we compared body composition in DM1 and matched controls and evaluated the relationship between these parameters and clinical outcome measures in DM1 patients. In addition we established the sensitivity to change of these measures in a prospective 18 month longitudinal study of the DM1 patient cohort. Clinical data, manual muscle testing (MMT), quantitative muscle testing (QMT) of ankle dorsiflexion, bilateral grip dynamometry, 6 minute walk test and a DM1 functional rating scale (DM1-Activ) were collected at baseline (n = 38) and 18 month follow-up (n = 36). The case-control analysis was performed comparing baseline data with 31 anthropometrically matched controls. Dual-energy X-ray absorptiometry (DEXA) was used to obtain regional measurements of fat-free mass index (FFMI) and fat mass index (FMI) and demonstrated significant reduction of FFMI in the legs (left p = 0.004; right p = 0.017) and trunk (p < 0.0001) and increased FMI localised to the trunk (p < 0.0001) in DM1 patients compared to controls. Regional left and right arm FFMI and FMI significantly positively and negatively correlated with grip strength and both total FFMI (p = 0.0009) and FMI (p = 0.02) decreased and increased by 0.38 kg/m2 and 0.31 kg/m2 respectively after 18 month follow-up. DEXA is likely to provide a useful secondary outcome measurement of disease progression in addition to muscle strength and timed functional tasks in clinical trials.
Collapse
Affiliation(s)
- Saam Sedehizadeh
- Department of Neurology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - J David Brook
- School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Paul Maddison
- Department of Neurology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| |
Collapse
|
35
|
Yoshikawa N, Shimizu N, Uehara M, Oda A, Matsumiya R, Matsubara E, Kobayashi H, Hosono O, Kuribara-Souta A, Baba H, Nagamura F, Kiryu S, Tanaka H. The effects of bolus supplementation of branched-chain amino acids on skeletal muscle mass, strength, and function in patients with rheumatic disorders during glucocorticoid treatment. Mod Rheumatol 2016; 27:508-517. [PMID: 27678151 DOI: 10.1080/14397595.2016.1213480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To test the effects of bolus supplementation of branched-chain amino acids (BCAA) on skeletal muscle mass, strength, and function in patients with rheumatic disorders taking glucocorticoid (GC). METHODS Patients with rheumatic disorders treated with prednisolone (≥10 mg/day) were randomized to ingest additional daily 12 g of BCAA (n = 9) or not (n = 9) for 12 weeks. At baseline, and 4, 8, and 12 weeks, they underwent bioelectrical impedance analysis, muscle strength and functional tests, and computed tomography analysis for cross-sectional area of mid-thigh muscle. RESULTS Disease activities of the patients were well controlled and daily GC dose was similarly reduced in both groups. Limb muscle mass was recovered in both groups. Whole-body muscle mass and muscle strength and functional mobility were increased only in BCAA (+) group. The effects of BCAA supplementation on recovering skeletal muscle mass were prominent in particular muscles including biceps femoris muscle. CONCLUSIONS This trial is the first-in-man clinical trial to demonstrate that BCAA supplementation might be safe and, at least in part, improve skeletal muscle mass, strength, and function in patients with rheumatic disorders treated with GC.
Collapse
Affiliation(s)
| | - Noriaki Shimizu
- a Department of Rheumatology and Allergy.,b Division of Rheumatology, Center for Antibody and Vaccine Therapy
| | | | - Aya Oda
- a Department of Rheumatology and Allergy
| | | | | | | | | | | | | | | | - Shigeru Kiryu
- d Department of Radiology , IMSUT Hospital, Institute of Medical Science, the University of Tokyo , Shirokanedai , Minato-ku , Tokyo , Japan
| | - Hirotoshi Tanaka
- a Department of Rheumatology and Allergy.,b Division of Rheumatology, Center for Antibody and Vaccine Therapy
| |
Collapse
|
36
|
Dual-energy X-ray absorptiometry body composition in patients with secondary osteoporosis. Eur J Radiol 2016; 85:1493-8. [PMID: 27048946 DOI: 10.1016/j.ejrad.2016.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/18/2016] [Accepted: 03/19/2016] [Indexed: 12/25/2022]
Abstract
Due to the tight relationship between bone and soft tissues, there has been an increased interest in body composition assessment in patients with secondary osteoporosis as well as other pathological conditions. Dual-energy X-ray absorptiometry (DXA) is primarily devoted to the evaluation of bone mineral status, but continuous scientific advances of body composition software made DXA a rapid and easily available technique to assess body composition in terms of fat mass and lean mass. As a result, the International Society for Clinical Densitometry (ISCD) recently developed Official Positions regarding the use of this technique for body composition analysis. According to ISCD paper, indications are mainly limited to three conditions: HIV patients treated with antiretroviral agents associated with a risk of lipoatrophy; obese patients undergoing treatment for high weight loss; patients with sarcopenia or muscle weakness. Nevertheless, there are several other interesting clinical applications that were not included in the ISCD position paper, such as body composition assessment in patients undergoing organ transplantation, pulmonary disease as well as all those chronic condition that may lead to malnutrition. In conclusion, DXA body composition offers new diagnostic and research possibilities for a variety of diseases; due to its high reproducibility, DXA has also the potential to monitor body composition changes with pharmacological, nutritional or physic therapeutic interventions. ISCD addressed and recommended a list of clinical condition, but the crescent availability of DXA scans and software improvements may open the use of DXA to other indication in the next future. This article provides an overview of DXA body composition indications in the management of secondary osteoporosis and other clinical indications in adults.
Collapse
|
37
|
Hafner P, Bonati U, Erne B, Schmid M, Rubino D, Pohlman U, Peters T, Rutz E, Frank S, Neuhaus C, Deuster S, Gloor M, Bieri O, Fischmann A, Sinnreich M, Gueven N, Fischer D. Improved Muscle Function in Duchenne Muscular Dystrophy through L-Arginine and Metformin: An Investigator-Initiated, Open-Label, Single-Center, Proof-Of-Concept-Study. PLoS One 2016; 11:e0147634. [PMID: 26799743 PMCID: PMC4723144 DOI: 10.1371/journal.pone.0147634] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 01/05/2016] [Indexed: 12/31/2022] Open
Abstract
Altered neuronal nitric oxide synthase function in Duchenne muscular dystrophy leads to impaired mitochondrial function which is thought to be one cause of muscle damage in this disease. The study tested if increased intramuscular nitric oxide concentration can improve mitochondrial energy metabolism in Duchenne muscular dystrophy using a novel therapeutic approach through the combination of L-arginine with metformin. Five ambulatory, genetically confirmed Duchenne muscular dystrophy patients aged between 7–10 years were treated with L-arginine (3 x 2.5 g/d) and metformin (2 x 250 mg/d) for 16 weeks. Treatment effects were assessed using mitochondrial protein expression analysis in muscular biopsies, indirect calorimetry, Dual-Energy X-Ray Absorptiometry, quantitative thigh muscle MRI, and clinical scores of muscle performance. There were no serious side effects and no patient dropped out. Muscle biopsy results showed pre-treatment a significantly reduced mitochondrial protein expression and increased oxidative stress in Duchenne muscular dystrophy patients compared to controls. Post-treatment a significant elevation of proteins of the mitochondrial electron transport chain was observed as well as a reduction in oxidative stress. Treatment also decreased resting energy expenditure rates and energy substrate use shifted from carbohydrates to fatty acids. These changes were associated with improved clinical scores. In conclusion pharmacological stimulation of the nitric oxide pathway leads to improved mitochondria function and clinically a slowing of disease progression in Duchenne muscular dystrophy. This study shall lead to further development of this novel therapeutic approach into a real alternative for Duchenne muscular dystrophy patients.
Collapse
Affiliation(s)
- Patricia Hafner
- Division of Neuropaediatrics, University of Basel Children's Hospital, Basel, Switzerland.,Department of Neurology, University of Basel Hospital, Basel, Switzerland
| | - Ulrike Bonati
- Division of Neuropaediatrics, University of Basel Children's Hospital, Basel, Switzerland
| | - Beat Erne
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Maurice Schmid
- Division of Neuropaediatrics, University of Basel Children's Hospital, Basel, Switzerland
| | - Daniela Rubino
- Division of Neuropaediatrics, University of Basel Children's Hospital, Basel, Switzerland
| | - Urs Pohlman
- Division of Neuropaediatrics, University of Basel Children's Hospital, Basel, Switzerland
| | - Thomas Peters
- Interdisciplinary Center of Nutritional and Metabolic Diseases, St. Claraspital, Basel, Basel, Switzerland
| | - Erich Rutz
- Paediatric Orthopaedic Department, University of Basel Children's Hospital, Basel, Switzerland
| | - Stephan Frank
- Division of Neuropathology, Institute of Pathology, University of Basel Hospital, Basel, Switzerland
| | - Cornelia Neuhaus
- Therapy Department, University of Basel Children's Hospital, Basel, Switzerland
| | - Stefanie Deuster
- Hospital Pharmacy, University of Basel Hospital, Basel, Switzerland
| | - Monika Gloor
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland
| | - Oliver Bieri
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland
| | - Arne Fischmann
- Division of Neuroradiology, University of Basel Hospital, Basel, Switzerland
| | - Michael Sinnreich
- Department of Neurology, University of Basel Hospital, Basel, Switzerland.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Nuri Gueven
- Pharmacy, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Dirk Fischer
- Division of Neuropaediatrics, University of Basel Children's Hospital, Basel, Switzerland.,Department of Neurology, University of Basel Hospital, Basel, Switzerland
| |
Collapse
|
38
|
Coratella G, Milanese C, Schena F. Cross-education effect after unilateral eccentric-only isokinetic vs dynamic constant external resistance training. SPORT SCIENCES FOR HEALTH 2015. [DOI: 10.1007/s11332-015-0244-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
39
|
Kluka V, Martin V, Vicencio SG, Jegu AG, Cardenoux C, Morio C, Coudeyre E, Ratel S. Effect of muscle length on voluntary activation level in children and adults. Med Sci Sports Exerc 2015; 47:718-24. [PMID: 25083726 DOI: 10.1249/mss.0000000000000463] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of the present study was to compare the effect of muscle length on the level of voluntary activation (VA) at short and long muscle lengths between children and adults. METHODS Thirteen prepubertal boys (10.2 ± 1.1 yr) and 10 men (23.9 ± 2.9 yr) performed 5-s maximal isometric voluntary contractions of the knee extensor muscles at three muscular angles (20°, 90°, 100°; 0°, full extension) interspersed with at least 60-s passive recovery periods. Single magnetic stimulations were delivered to the femoral nerve during maximal isometric voluntary contractions to determine the level of VA using the twitch interpolation technique. The specific torque was calculated as the absolute torque divided by thigh muscle mass, as assessed using dual-energy x-ray absorptiometry. Finally, the theoretical specific torque that could be produced with a complete (i.e., 100%) activation level (specific torque at 100% VA) was estimated from the values of specific torque and VA. RESULTS Results showed a higher specific torque in adults at 90° and 100° but not at 20°. Accordingly, VA was significantly higher in adults at 90° (94% ± 4% vs 88% ± 8%, P < 0.05) and 100° (93% ± 6% vs 86% ± 8%, P < 0.05), whereas no significant difference was observed at 20°. Interestingly, the specific torque at 100% VA was not different between groups whatever the joint angle. CONCLUSIONS The lower ability of children to fully activate their motor units at long muscle length could account for their lower specific torque because no difference in theoretical specific torque was observed between groups at 90° and 100°.
Collapse
Affiliation(s)
- Virginie Kluka
- 1EA 3533, Laboratory of Metabolic Adaptations during Exercise in Physiological and Pathological Conditions (AME2P), Clermont University, Blaise Pascal University, Aubière, FRANCE; 2Department of Movement Sciences, Oxylane Research, Villeneuve d'Ascq, FRANCE; 3Clermont University Hospital, Clermont-Ferrand, FRANCE; 4INRA, Human Nutrition Unit (UMR 1019), CRNH Auvergne, Clermont-Ferrand, FRANCE; and 5Clermont University, Auvergne University, Clermont-Ferrand, FRANCE
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Coratella G, Milanese C, Schena F. Unilateral eccentric resistance training: A direct comparison between isokinetic and dynamic constant external resistance modalities. Eur J Sport Sci 2015; 15:720-6. [DOI: 10.1080/17461391.2015.1060264] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
41
|
The bigger, the stronger? Insights from muscle architecture and nervous characteristics in obese adolescent girls. Int J Obes (Lond) 2015; 40:245-51. [PMID: 26285605 DOI: 10.1038/ijo.2015.158] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 07/08/2015] [Accepted: 08/03/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Young obese youth are generally stronger than lean youth. This has been linked to the loading effect of excess body mass, acting as a training stimulus comparable to strength training. Whether this triggers specific adaptations of the muscle architecture (MA) and voluntary activation (VA) that could account for the higher strength of obese subjects remains unknown. METHODS MA characteristics (that is, pennation angle (PA), fascicle length (FL) and muscle thickness (MT)) and muscle size (that is, anatomical cross-sectional area (ACSA)) of the knee extensor (KE) and plantar flexor (PF) muscles were evaluated in 12 obese and 12 non-obese adolescent girls (12-15 years). Maximal isometric torque and VA of the KE and PF muscles were also assessed. RESULTS Results revealed higher PA (P<0.05), greater MT (P<0.001), ACSA (P<0.01), segmental lean mass (P<0.001) and VA (P<0.001) for KE and PF muscles in obese girls. Moreover, obese individuals produced a higher absolute torque than their lean counterparts on the KE (224.6±39.5 vs 135.7±32.7 N m, respectively; P<0.001) and PF muscles (73.3±16.5 vs 44.5±6.2 N m; P<0.001). Maximal voluntary contraction (MVC) was correlated to PA for the KE (r=0.46-0.57, P<0.05-0.01) and PF muscles (r=0.45-0.55, P<0.05-0.01). MVC was also correlated with VA (KE: r=0.44, P<0.05; PF: r=0.65, P<0.001) and segmental lean mass (KE: r=0.48, P<0.05; PF: r=0.57, P<0.01). CONCLUSIONS This study highlighted favorable muscular and nervous adaptations to obesity that account for the higher strength of obese youth. The excess of body mass supported during daily activities could act as a chronic training stimulus responsible for these adaptations.
Collapse
|
42
|
Davis J, Samuels E, Mullins L. Nutrition Considerations in Duchenne Muscular Dystrophy. Nutr Clin Pract 2015; 30:511-21. [PMID: 25977513 DOI: 10.1177/0884533615586202] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Duchenne muscular dystrophy (DMD) is a serious degenerative muscular disease affecting males. Diagnosis usually occurs in childhood and is confirmed through genetic testing and/or muscle biopsy. Accompanying the disease are several nutrition-related concerns: growth, body composition, energy and protein requirements, constipation, swallowing difficulties, bone health, and complementary medicine. This review article addresses the nutrition aspects of DMD.
Collapse
|
43
|
|
44
|
Canapari CA, Barrowman N, Hoey L, Walker SW, Townsend E, Tseng BS, Katz SL. Truncal fat distribution correlates with decreased vital capacity in Duchenne muscular dystrophy. Pediatr Pulmonol 2015; 50:63-70. [PMID: 24644236 DOI: 10.1002/ppul.23004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/20/2013] [Accepted: 01/10/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder associated with progressive muscle weakness and respiratory failure. Oral corticosteroids are the mainstay of treatment, but are associated with obesity with a central distribution. This study is designed to determine the relationship between body mass index, central adiposity, and lung function in subjects with DMD. METHODS Retrospective fat distribution data was obtained in boys with DMD from studies using dual X-ray absorptiometry (DXA). Fat distribution data was reviewed at two tertiary academic institutions and compared with concurrent height, weight, body mass index (BMI), measures of lung function, and sleep study data when available. Truncal fat mass used as a measure of central adiposity. RESULTS Forty-four subjects (age 12.0 ± 3.4 years) were included. Mean BMI was 22.1 ± 5.9 kg/m(2) . Sixty-eight percent (30 patients) were on corticosteroid therapy. Truncal fat mass percentage was inversely correlated with forced vital capacity (% predicted FVC) (Pearson coefficient -0.37, P = 0.01). Linear regression showed that truncal fat distribution, but not total fat mass, age or corticosteroid use negatively predicted FVC (r(2) = 0.24, P = 0.048). BMI had a positive effect (P = 0.04). However, fat distribution did not predict the rate of change of lung function in a smaller sample. Fat distribution, BMI, or age did not predict measures of sleep disordered breathing. CONCLUSIONS Truncal fat distribution is a significant predictor of lower vital capacity in boys with DMD, whereas BMI has a positive effect.
Collapse
Affiliation(s)
- Craig A Canapari
- Yale New Haven Children's Hospital, Yale University, New Haven, Connecticut
| | | | | | | | | | | | | |
Collapse
|
45
|
Merlini L, Vagheggini A, Cocchi D. Sarcopenia and sarcopenic obesity in patients with muscular dystrophy. Front Aging Neurosci 2014; 6:274. [PMID: 25339901 PMCID: PMC4188124 DOI: 10.3389/fnagi.2014.00274] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/21/2014] [Indexed: 01/07/2023] Open
Abstract
Aging sarcopenia and muscular dystrophy (MD) are two conditions characterized by lower skeletal muscle quantity, lower muscle strength, and lower physical performance. Aging is associated with a peculiar alteration in body composition called “sarcopenic obesity” characterized by a decrease in lean body mass and increase in fat mass. To evaluate the presence of sarcopenia and obesity in a cohort of adult patients with MD, we have used the measurement techniques considered golden standard for sarcopenia that is for muscle mass dual-energy X-ray absorptiometry (DXA), for muscle strength hand-held dynamometry (HHD), and for physical performance gait speed. The study involved 14 adult patients with different types of MD. We were able to demonstrate that all patients were sarcopenic obese. We showed, in fact, that all were sarcopenic based on appendicular lean, fat and bone free, mass index (ALMI). In addition, all resulted obese according to the percentage of body fat determined by DXA in contrast to their body mass index ranging from underweight to obese. Skeletal muscle mass determined by DXA was markedly reduced in all patients and correlated with residual muscle strength determined by HHD, and physical performances determined by gait speed and respiratory function. Finally, we showed that ALMI was the best linear explicator of muscle strength and physical function. Altogether, our study suggests the relevance of a proper evaluation of body composition in MD and we propose to use, both in research and practice, the measurement techniques that has already been demonstrated effective in aging sarcopenia.
Collapse
Affiliation(s)
- Luciano Merlini
- Laboratory of Musculoskeletal Cell Biology, Istituto Ortopedico Rizzoli , Bologna , Italy
| | | | - Daniela Cocchi
- Department of Statistical Sciences, University of Bologna , Bologna , Italy
| |
Collapse
|
46
|
Kim S, Valdez R. Metabolic risk factors in U.S. youth with low relative muscle mass. Obes Res Clin Pract 2014; 9:125-32. [PMID: 25890427 DOI: 10.1016/j.orcp.2014.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/09/2014] [Accepted: 05/24/2014] [Indexed: 12/17/2022]
Abstract
AIMS To examine the association between relative muscle mass (RMM) and nine risk factors for cardiovascular disease and diabetes (CVD/DM) in U.S. youth. METHODS We used a sample representative of the U.S. population of youth, aged 8-20 years (NHANES 1999-2004). We compared the prevalence of adverse levels of nine CVD/DM risk factors between youths in the lowest quartile of RMM and their peers in the remaining quartiles, controlling for age, sex, and race/ethnicity. We also examined variations in the adjusted prevalence of these risk factors along the entire range of RMM. RESULTS The adjusted prevalence of adverse levels of risk factors among youths in the lowest quartile of RMM was significantly higher for seven of the nine risk factors examined compared with their peers in the other quartiles. Over the entire range of RMM, the adjusted prevalence of adverse levels of each of these seven risk factors decreased gradually with increasing RMM values (all p for trend <0.001). CONCLUSIONS RMM and prevalence of adverse risk factors for CVD/DM are highly and inversely associated in U.S. youth. Among youth with low RMM, the risk of these chronic diseases could be significantly high later in life.
Collapse
Affiliation(s)
- Sunkyung Kim
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Rodolfo Valdez
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| |
Collapse
|
47
|
Influence of a two-year steroid treatment on body composition as measured by dual X-ray absorptiometry in boys with Duchenne muscular dystrophy. Neuromuscul Disord 2014; 24:467-73. [DOI: 10.1016/j.nmd.2014.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 02/25/2014] [Accepted: 03/01/2014] [Indexed: 11/18/2022]
|
48
|
West NA, Yang ML, Weitzenkamp DA, Andrews J, Meaney FJ, Oleszek J, Miller LA, Matthews D, DiGuiseppi C. Patterns of growth in ambulatory males with Duchenne muscular dystrophy. J Pediatr 2013; 163:1759-1763.e1. [PMID: 24103921 DOI: 10.1016/j.jpeds.2013.08.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 05/31/2013] [Accepted: 08/07/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To provide weight-for-age, height-for-age, and body mass index-for-age growth reference standards for ambulatory, steroid-naïve males, ages 2-12 years, with Duchenne muscular dystrophy (DMD) and to compare these growth curves to the 2000 Centers for Disease Control and Prevention growth charts for boys, which serve as references of physical size and growth for the general male pediatric population in the US. STUDY DESIGN Through a multi-state population-based surveillance of individuals with muscular dystrophy, a total of 1877 weight and 1544 height measurements ascertained during 1985-2010 from 513 males with DMD were obtained retrospectively from medical record review. Cases were classified as DMD if loss of ambulation occurred before the 12th birthday or, if younger than 12 years and still ambulating, the earliest symptoms of dystrophinopathy occurred before the 6th birthday. Each growth chart was constructed using 5 percentiles: 10th, 25th, 50th, 75th, and 90th. Smoothing procedures were applied in 2 stages to the irregular plots of the empirical percentile values. RESULTS A set of growth curves, derived from a large cohort of male youth with DMD, are presented. These curves demonstrate that DMD males are shorter and tend to the extremes of weight and body mass index compared with the general male pediatric population in the US. CONCLUSION Charts representing the pattern of growth in ambulatory, steroid-naïve males with DMD can facilitate monitoring of growth and early detection of unusual growth patterns. Use of these growth standards also will assist in monitoring responses to corticosteroid treatment.
Collapse
Affiliation(s)
- Nancy A West
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO.
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Rose MR. 188th ENMC International Workshop: Inclusion Body Myositis, 2-4 December 2011, Naarden, The Netherlands. Neuromuscul Disord 2013; 23:1044-55. [PMID: 24268584 DOI: 10.1016/j.nmd.2013.08.007] [Citation(s) in RCA: 242] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/13/2013] [Accepted: 08/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- M R Rose
- Dept of Neurology, Kings College Hospital, Denmark Hill, London SE5 9RS, United Kingdom.
| | | |
Collapse
|
50
|
McDonald CM, Henricson EK, Abresch RT, Han JJ, Escolar DM, Florence JM, Duong T, Arrieta A, Clemens PR, Hoffman EP, Cnaan A. The cooperative international neuromuscular research group Duchenne natural history study--a longitudinal investigation in the era of glucocorticoid therapy: design of protocol and the methods used. Muscle Nerve 2013; 48:32-54. [PMID: 23677550 PMCID: PMC4147958 DOI: 10.1002/mus.23807] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2013] [Indexed: 12/21/2022]
Abstract
UNLABELLED Contemporary natural history data in Duchenne muscular dystrophy (DMD) is needed to assess care recommendations and aid in planning future trials. METHODS The Cooperative International Neuromuscular Research Group (CINRG) DMD Natural History Study (DMD-NHS) enrolled 340 individuals, aged 2-28 years, with DMD in a longitudinal, observational study at 20 centers. Assessments obtained every 3 months for 1 year, at 18 months, and annually thereafter included: clinical history; anthropometrics; goniometry; manual muscle testing; quantitative muscle strength; timed function tests; pulmonary function; and patient-reported outcomes/health-related quality-of-life instruments. RESULTS Glucocorticoid (GC) use at baseline was 62% present, 14% past, and 24% GC-naive. In those ≥6 years of age, 16% lost ambulation over the first 12 months (mean age 10.8 years). CONCLUSIONS Detailed information on the study methodology of the CINRG DMD-NHS lays the groundwork for future analyses of prospective longitudinal natural history data. These data will assist investigators in designing clinical trials of novel therapeutics.
Collapse
Affiliation(s)
- Craig M McDonald
- Department of Physical Medicine & Rehabilitation, School of Medicine, University of California, Davis, 4860 Y Street, Suite 3850, Sacramento, California 95817, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|