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Wilson VD, Bommart S, Passerieux E, Thomas C, Pincemail J, Picot MC, Mercier J, Portet F, Arbogast S, Laoudj-Chenivesse D. Muscle strength, quantity and quality and muscle fat quantity and their association with oxidative stress in patients with facioscapulohumeral muscular dystrophy: Effect of antioxidant supplementation. Free Radic Biol Med 2024; 219:112-126. [PMID: 38574978 DOI: 10.1016/j.freeradbiomed.2024.04.001] [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: 02/09/2024] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
The purpose of this study was to identify causes of quadriceps muscle weakness in facioscapulohumeral muscular dystrophy (FSHD). To this aim, we evaluated quadriceps muscle and fat volumes by magnetic resonance imaging and their relationships with muscle strength and oxidative stress markers in adult patients with FSHD (n = 32) and healthy controls (n = 7), and the effect of antioxidant supplementation in 20 of the 32 patients with FSHD (n = 10 supplementation and n = 10 placebo) (NCT01596803). Compared with healthy controls, the dominant quadriceps strength and quality (muscle strength per unit of muscle volume) were decreased in patients with FSHD. In addition, fat volume was increased, without changes in total muscle volume. Moreover, in patients with FSHD, the lower strength of the non-dominant quadriceps was associated with lower muscle quality compared with the dominant muscle. Antioxidant supplementation significantly changed muscle and fat volumes in the non-dominant quadriceps, and muscle quality in the dominant quadriceps. This was associated with improved muscle strength (both quadriceps) and antioxidant response. These findings suggest that quadriceps muscle strength decline may not be simply explained by atrophy and may be influenced also by the muscle intrinsic characteristics. As FSHD is associated with increased oxidative stress, supplementation might reduce oxidative stress and increase antioxidant defenses, promoting changes in muscle function.
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Affiliation(s)
- Vinicius Dias Wilson
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France; Centro Universitário Estácio de Belo Horizonte, Minas Gerais, Brazil.
| | - Sébastien Bommart
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France; Department of Radiology, CHU of Montpellier, Arnaud de Villeneuve Hospital, 34090, Montpellier, France.
| | - Emilie Passerieux
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France.
| | - Claire Thomas
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France; LBEPS, Univ Evry, IRBA, University Paris Saclay, 91025, Evry, France.
| | - Joël Pincemail
- Department of CREDEC, Department of Medical Chemistry, University Hospital of Liege, Sart Tilman, Liege, Belgium.
| | - Marie Christine Picot
- Department of Biostatistics and Epidemiology, University Hospital, Montpellier, France; CIC 1001-INSERM, Montpellier, France.
| | - Jacques Mercier
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France; Department of Clinical Physiology, CHU of Montpellier, Montpellier, France.
| | - Florence Portet
- Department of Clinical Physiology, CHU of Montpellier, Montpellier, France; U1061 INSERM, CHU de Montpellier, Montpellier University, France.
| | - Sandrine Arbogast
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France.
| | - Dalila Laoudj-Chenivesse
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France; Department of Clinical Physiology, CHU of Montpellier, Montpellier, France.
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Reyngoudt H, Baudin P, Caldas de Almeida Araújo E, Bachasson D, Boisserie J, Mariampillai K, Annoussamy M, Allenbach Y, Hogrel J, Carlier PG, Marty B, Benveniste O. Effect of sirolimus on muscle in inclusion body myositis observed with magnetic resonance imaging and spectroscopy. J Cachexia Sarcopenia Muscle 2024; 15:1108-1120. [PMID: 38613252 PMCID: PMC11154752 DOI: 10.1002/jcsm.13451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/09/2024] [Accepted: 01/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Finding sensitive clinical outcome measures has become crucial in natural history studies and therapeutic trials of neuromuscular disorders. Here, we focus on 1-year longitudinal data from quantitative magnetic resonance imaging (MRI) and phosphorus magnetic resonance spectroscopy (31P MRS) in a placebo-controlled study of sirolimus for inclusion body myositis (IBM), also examining their links to functional, strength, and clinical parameters in lower limb muscles. METHODS Quantitative MRI and 31P MRS data were collected at 3 T from a single site, involving 44 patients (22 on placebo, 22 on sirolimus) at baseline and year-1, and 21 healthy controls. Assessments included fat fraction (FF), contractile cross-sectional area (cCSA), and water T2 in global leg and thigh segments, muscle groups, individual muscles, as well as 31P MRS indices in quadriceps or triceps surae. Analyses covered patient-control comparisons, annual change assessments via standard t-tests and linear mixed models, calculation of standardized response means (SRM), and exploration of correlations between MRI, 31P MRS, functional, strength, and clinical parameters. RESULTS The quadriceps and gastrocnemius medialis muscles had the highest FF values, displaying notable heterogeneity and asymmetry, particularly in the quadriceps. In the placebo group, the median 1-year FF increase in the quadriceps was 3.2% (P < 0.001), whereas in the sirolimus group, it was 0.7% (P = 0.033). Both groups experienced a significant decrease in cCSA in the quadriceps after 1 year (P < 0.001), with median changes of 12.6% for the placebo group and 5.5% for the sirolimus group. Differences in FF and cCSA changes between the two groups were significant (P < 0.001). SRM values for FF and cCSA were 1.3 and 1.4 in the placebo group and 0.5 and 0.8 in the sirolimus group, respectively. Water T2 values were highest in the quadriceps muscles of both groups, significantly exceeding control values in both groups (P < 0.001) and were higher in the placebo group than in the sirolimus group. After treatment, water T2 increased significantly only in the sirolimus group's quadriceps (P < 0.01). Multiple 31P MRS indices were abnormal in patients compared to controls and remained unchanged after treatment. Significant correlations were identified between baseline water T2 and FF at baseline and the change in FF (P < 0.001). Additionally, significant correlations were observed between FF, cCSA, water T2, and functional and strength outcome measures. CONCLUSIONS This study has demonstrated that quantitative MRI/31P MRS can discern measurable differences between placebo and sirolimus-treated IBM patients, offering promise for future therapeutic trials in idiopathic inflammatory myopathies such as IBM.
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Affiliation(s)
- Harmen Reyngoudt
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
| | - Pierre‐Yves Baudin
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
| | | | - Damien Bachasson
- Neuromuscular Physiology and Evaluation Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueSorbonne UniversitéParisFrance
| | - Jean‐Marc Boisserie
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
| | - Kubéraka Mariampillai
- Department of Internal Medicine and Clinical Immunology, Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique‐Hôpitaux de ParisPitié‐Salpêtrière University HospitalParisFrance
- I‐MotionInstitute of MyologyParisFrance
| | | | - Yves Allenbach
- Department of Internal Medicine and Clinical Immunology, Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique‐Hôpitaux de ParisPitié‐Salpêtrière University HospitalParisFrance
| | - Jean‐Yves Hogrel
- Neuromuscular Physiology and Evaluation Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
| | | | - Benjamin Marty
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique‐Hôpitaux de ParisPitié‐Salpêtrière University HospitalParisFrance
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3
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Bittel AJ, Bittel DC, Gordish-Dressman H, Chen YW. Voluntary wheel running improves molecular and functional deficits in a murine model of facioscapulohumeral muscular dystrophy. iScience 2024; 27:108632. [PMID: 38188524 PMCID: PMC10770537 DOI: 10.1016/j.isci.2023.108632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/11/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
Endurance exercise training is beneficial for skeletal muscle health, but it is unclear if this type of exercise can target or correct the molecular mechanisms of facioscapulohumeral muscular dystrophy (FSHD). Using the FLExDUX4 murine model of FSHD characterized by chronic, low levels of pathological double homeobox protein 4 (DUX4) gene expression, we show that 6 weeks of voluntary, free wheel running improves running performance, strength, mitochondrial function, and sarcolemmal repair capacity, while slowing/reversing skeletal muscle fibrosis. These improvements are associated with restored transcriptional activity of gene networks/pathways regulating actin cytoskeletal signaling, vascular remodeling, inflammation, fibrosis, and muscle mass toward wild-type (WT) levels. However, FLExDUX4 mice exhibit blunted increases in mitochondrial content with training and persistent transcriptional overactivation of hypoxia, inflammatory, angiogenic, and cytoskeletal pathways. These results identify exercise-responsive and non-responsive molecular pathways in FSHD, while providing support for the use of endurance-type exercise as a non-invasive treatment option.
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Affiliation(s)
- Adam J. Bittel
- Center for Genetic Medicine Research, Children’s National Hospital, Washington, DC 20012, USA
| | - Daniel C. Bittel
- Center for Genetic Medicine Research, Children’s National Hospital, Washington, DC 20012, USA
| | | | - Yi-Wen Chen
- Center for Genetic Medicine Research, Children’s National Hospital, Washington, DC 20012, USA
- Department of Genomics and Precision Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
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4
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Engquist EN, Greco A, Joosten LAB, van Engelen BGM, Zammit PS, Banerji CRS. FSHD muscle shows perturbation in fibroadipogenic progenitor cells, mitochondrial function and alternative splicing independently of inflammation. Hum Mol Genet 2024; 33:182-197. [PMID: 37856562 PMCID: PMC10772042 DOI: 10.1093/hmg/ddad175] [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: 04/13/2023] [Revised: 09/25/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
Facioscapulohumeral muscular dystrophy (FSHD) is a prevalent, incurable myopathy. FSHD is highly heterogeneous, with patients following a variety of clinical trajectories, complicating clinical trials. Skeletal muscle in FSHD undergoes fibrosis and fatty replacement that can be accelerated by inflammation, adding to heterogeneity. Well controlled molecular studies are thus essential to both categorize FSHD patients into distinct subtypes and understand pathomechanisms. Here, we further analyzed RNA-sequencing data from 24 FSHD patients, each of whom donated a biopsy from both a non-inflamed (TIRM-) and inflamed (TIRM+) muscle, and 15 FSHD patients who donated peripheral blood mononucleated cells (PBMCs), alongside non-affected control individuals. Differential gene expression analysis identified suppression of mitochondrial biogenesis and up-regulation of fibroadipogenic progenitor (FAP) gene expression in FSHD muscle, which was particularly marked on inflamed samples. PBMCs demonstrated suppression of antigen presentation in FSHD. Gene expression deconvolution revealed FAP expansion as a consistent feature of FSHD muscle, via meta-analysis of 7 independent transcriptomic datasets. Clustering of muscle biopsies separated patients in an unbiased manner into clinically mild and severe subtypes, independently of known disease modifiers (age, sex, D4Z4 repeat length). Lastly, the first genome-wide analysis of alternative splicing in FSHD muscle revealed perturbation of autophagy, BMP2 and HMGB1 signalling. Overall, our findings reveal molecular subtypes of FSHD with clinical relevance and identify novel pathomechanisms for this highly heterogeneous condition.
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Affiliation(s)
- Elise N Engquist
- Randall Centre for Cell and Molecular Biophysics, King's College London, New Hunt's House, Guy's Campus, London SE1 1UL, United Kingdom
| | - Anna Greco
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
- Department of Internal Medicine, Radboud Institute of Molecular Life Sciences (RIMLS) and Radboud Center of Infectious Diseases (RCI), Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen 6525 GA, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud Institute of Molecular Life Sciences (RIMLS) and Radboud Center of Infectious Diseases (RCI), Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen 6525 GA, The Netherlands
- Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania
| | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Peter S Zammit
- Randall Centre for Cell and Molecular Biophysics, King's College London, New Hunt's House, Guy's Campus, London SE1 1UL, United Kingdom
| | - Christopher R S Banerji
- Randall Centre for Cell and Molecular Biophysics, King's College London, New Hunt's House, Guy's Campus, London SE1 1UL, United Kingdom
- The Alan Turing Institute, The British Library, 96 Euston Road, London NW1 2DB, United Kingdom
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5
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Mocciaro E, Runfola V, Ghezzi P, Pannese M, Gabellini D. DUX4 Role in Normal Physiology and in FSHD Muscular Dystrophy. Cells 2021; 10:3322. [PMID: 34943834 PMCID: PMC8699294 DOI: 10.3390/cells10123322] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 12/12/2022] Open
Abstract
In the last decade, the sequence-specific transcription factor double homeobox 4 (DUX4) has gone from being an obscure entity to being a key factor in important physiological and pathological processes. We now know that expression of DUX4 is highly regulated and restricted to the early steps of embryonic development, where DUX4 is involved in transcriptional activation of the zygotic genome. While DUX4 is epigenetically silenced in most somatic tissues of healthy humans, its aberrant reactivation is associated with several diseases, including cancer, viral infection and facioscapulohumeral muscular dystrophy (FSHD). DUX4 is also translocated, giving rise to chimeric oncogenic proteins at the basis of sarcoma and leukemia forms. Hence, understanding how DUX4 is regulated and performs its activity could provide relevant information, not only to further our knowledge of human embryonic development regulation, but also to develop therapeutic approaches for the diseases associated with DUX4. Here, we summarize current knowledge on the cellular and molecular processes regulated by DUX4 with a special emphasis on FSHD muscular dystrophy.
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Affiliation(s)
| | | | | | | | - Davide Gabellini
- Gene Expression and Muscular Dystrophy Unit, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132 Milano, Italy; (E.M.); (V.R.); (P.G.); (M.P.)
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6
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Gerhalter T, Marty B, Gast LV, Porzelt K, Heiss R, Uder M, Schwab S, Carlier PG, Nagel AM, Türk M. Quantitative 1H and 23Na muscle MRI in Facioscapulohumeral muscular dystrophy patients. J Neurol 2020; 268:1076-1087. [PMID: 33047224 PMCID: PMC7914168 DOI: 10.1007/s00415-020-10254-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 12/11/2022]
Abstract
Objective Our aim was to assess the role of quantitative 1H and 23Na MRI methods in providing imaging biomarkers of disease activity and severity in patients with Facioscapulohumeral muscular dystrophy (FSHD). Methods We imaged the lower leg muscles of 19 FSHD patients and 12 controls with a multimodal MRI protocol to obtain STIR-T2w images, fat fraction (FF), water T2 (wT2), water T1 (wT1), tissue sodium concentration (TSC), and intracellular-weighted sodium signal (inversion recovery (IR) and triple quantum filter (TQF) sequence). In addition, the FSHD patients underwent muscle strength testing. Results Imaging biomarkers related with water mobility (wT1 and wT2) and ion homeostasis (TSC, IR, TQF) were increased in muscles of FSHD patients. Muscle groups with FF > 10% had higher wT2, wT1, TSC, IR, and TQF values than muscles with FF < 10%. Muscles with FF < 10% resembled muscles of healthy controls for these MRI disease activity measures. However, wT1 was increased in few muscles without fat replacement. Furthermore, few STIR-negative muscles (n = 11/76) exhibited increased wT1, TSC, IR or TQF. Increased wT1 as well as 23Na signals were also present in muscles with normal wT2. Muscle strength was related to the mean FF and all imaging biomarkers of tibialis anterior except wT2 were correlated with dorsal flexion. Conclusion The newly evaluated imaging biomarkers related with water mobility (wT1) and ion homeostasis (TSC, IR, TQF) showed different patterns compared to the established markers like FF in muscles of FSHD patients. These quantitative biomarkers could thus contain valuable complementary information for the early characterization of disease progression. Electronic supplementary material The online version of this article (10.1007/s00415-020-10254-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Teresa Gerhalter
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany.
| | - Benjamin Marty
- NMR Laboratory, Institute of Myology, Paris, France
- NMR Laboratory, CEA/DRF, IBFJ/MIRCen, Paris, France
| | - Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Katharina Porzelt
- Department of Neurology, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Rafael Heiss
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Stefan Schwab
- Department of Neurology, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Pierre G Carlier
- NMR Laboratory, Institute of Myology, Paris, France
- NMR Laboratory, CEA/DRF, IBFJ/MIRCen, Paris, France
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Centre, Heidelberg, Germany
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Matthias Türk
- Department of Neurology, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
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7
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Giraudo C, Cavaliere A, Lupi A, Guglielmi G, Quaia E. Established paths and new avenues: a review of the main radiological techniques for investigating sarcopenia. Quant Imaging Med Surg 2020; 10:1602-1613. [PMID: 32742955 PMCID: PMC7378089 DOI: 10.21037/qims.2019.12.15] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/19/2019] [Indexed: 12/18/2022]
Abstract
Sarcopenia is a clinical condition mainly affecting the elderly that can be associated in a long run with severe consequences like malnutrition and frailty. Considering the progressive ageing of the world population and the socio-economic impact of this disease, much effort is devoted and has to be further focused on an early and accurate diagnostic assessment of muscle loss. Currently, several radiological techniques can be applied for evaluating sarcopenia. If dual-energy X-ray absorptiometry (DXA) is still considered the main tool and it is even recommended as reference by the most current guidelines of the European working group on sarcopenia in older people (EWGSOP), the role of ultrasound (US), computed tomography (CT), peripheral quantitative CT (pQCT), and magnetic resonance imaging (MRI) should not be overlooked. Indeed, such techniques can provide robust qualitative and quantitative information. In particular, regarding MRI, the use of sequences like diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS) and mapping that could provide further insights into the physiopathological features of sarcopenia, should be fostered. In an era pointing to the quantification and automatic evaluation of diseases, we call for future research extending the application of organ tailored protocols, taking advantage of the most recent technical developments.
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Affiliation(s)
- Chiara Giraudo
- Radiology Institute, Department of Medicine—DIMED, University of Padova, Padova, Italy
| | - Annachiara Cavaliere
- Radiology Institute, Department of Medicine—DIMED, University of Padova, Padova, Italy
| | - Amalia Lupi
- Radiology Institute, Department of Medicine—DIMED, University of Padova, Padova, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, Scientific Institute “Casa Sollievo della Sofferenza” Hospital, University of Foggia, Foggia, Italy
| | - Emilio Quaia
- Radiology Institute, Department of Medicine—DIMED, University of Padova, Padova, Italy
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8
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Reyngoudt H, Marty B, Caldas de Almeida Araújo E, Baudin PY, Le Louër J, Boisserie JM, Béhin A, Servais L, Gidaro T, Carlier PG. Relationship between markers of disease activity and progression in skeletal muscle of GNE myopathy patients using quantitative nuclear magnetic resonance imaging and 31P nuclear magnetic resonance spectroscopy. Quant Imaging Med Surg 2020; 10:1450-1464. [PMID: 32676364 DOI: 10.21037/qims-20-39] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Quantitative nuclear magnetic resonance imaging (NMRI) is an objective and precise outcome measure for evaluating disease progression in neuromuscular disorders. We aimed to investigate predictive 'disease activity' NMR indices, including water T2 and 31P NMR spectroscopy (NMRS), and its relation to NMR markers of 'disease progression', such as the changes in fat fraction (ΔFat%) and contractile cross-sectional area (ΔcCSA), in GNE myopathy (GNEM) patients. Methods NMR was performed on a 3T clinical scanner, at baseline and at a 1-year interval, in 10 GNEM patients and 29 age-matched controls. Dixon-based fat-water imaging and water T2 mapping were acquired in legs and thighs, and in the dominant forearm. 31P NMRS was performed at the level of quadriceps and hamstring. Water T2 and 31P NMRS indices were determined for all muscle groups and visits. Correlations were performed with 'disease progression' indices ΔFat%, ΔcCSA and the muscle fat transformation rate (Rmuscle_transf). Results In quadriceps, known to be relatively preserved in GNEM, water T2 at baseline was significantly higher compared to controls, and correlated strongly with the one-year evolution of Fat% and cCSA and Rmuscle_transf. Various 31P NMRS indices showed significant differences in quadriceps and hamstring compared to controls and correlations existed between these indices and ΔFat%, ΔcCSA and Rmuscle_transf. Conclusions This study demonstrates that disease activity indices such as water T2 and 31P NMRS may predict disease progression in skeletal muscles of GNEM patients, and suggests that these measures may be considered to be valuable surrogate endpoints in the assessment of GNEM disease progression.
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Affiliation(s)
- Harmen Reyngoudt
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France.,NMR Laboratory, CEA, DRF, IBFJ, MIRCen, Paris, France
| | - Benjamin Marty
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France.,NMR Laboratory, CEA, DRF, IBFJ, MIRCen, Paris, France
| | - Ericky Caldas de Almeida Araújo
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France.,NMR Laboratory, CEA, DRF, IBFJ, MIRCen, Paris, France
| | - Pierre-Yves Baudin
- Consultants for Research in Imaging and Spectroscopy (C.R.I.S.), Tournai, Belgium
| | - Julien Le Louër
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France.,NMR Laboratory, CEA, DRF, IBFJ, MIRCen, Paris, France
| | - Jean-Marc Boisserie
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France.,NMR Laboratory, CEA, DRF, IBFJ, MIRCen, Paris, France
| | - Anthony Béhin
- Neuromuscular Reference Center, Institute of Myology, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - Laurent Servais
- Institute of Myology, Pitié-Salpêtrière Hospital (AP-HP), Paris, France.,I-Motion-Pediatric Clinical Trials Department, Trousseau Hospital (AP-HP), Paris, France.,Centre de référence des maladies Neuromusculaires, CHU, University of Liège, Liège, Belgium.,MDUK Oxford Neuromuscular Center, Department of Pediatrics, University of Oxford, Oxford, UK
| | - Teresa Gidaro
- Institute of Myology, Pitié-Salpêtrière Hospital (AP-HP), Paris, France.,I-Motion-Pediatric Clinical Trials Department, Trousseau Hospital (AP-HP), Paris, France
| | - Pierre G Carlier
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France.,NMR Laboratory, CEA, DRF, IBFJ, MIRCen, Paris, France
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9
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Meyerspeer M, Boesch C, Cameron D, Dezortová M, Forbes SC, Heerschap A, Jeneson JA, Kan HE, Kent J, Layec G, Prompers JJ, Reyngoudt H, Sleigh A, Valkovič L, Kemp GJ. 31 P magnetic resonance spectroscopy in skeletal muscle: Experts' consensus recommendations. NMR IN BIOMEDICINE 2020; 34:e4246. [PMID: 32037688 PMCID: PMC8243949 DOI: 10.1002/nbm.4246] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 05/07/2023]
Abstract
Skeletal muscle phosphorus-31 31 P MRS is the oldest MRS methodology to be applied to in vivo metabolic research. The technical requirements of 31 P MRS in skeletal muscle depend on the research question, and to assess those questions requires understanding both the relevant muscle physiology, and how 31 P MRS methods can probe it. Here we consider basic signal-acquisition parameters related to radio frequency excitation, TR, TE, spectral resolution, shim and localisation. We make specific recommendations for studies of resting and exercising muscle, including magnetisation transfer, and for data processing. We summarise the metabolic information that can be quantitatively assessed with 31 P MRS, either measured directly or derived by calculations that depend on particular metabolic models, and we give advice on potential problems of interpretation. We give expected values and tolerable ranges for some measured quantities, and minimum requirements for reporting acquisition parameters and experimental results in publications. Reliable examination depends on a reproducible setup, standardised preconditioning of the subject, and careful control of potential difficulties, and we summarise some important considerations and potential confounders. Our recommendations include the quantification and standardisation of contraction intensity, and how best to account for heterogeneous muscle recruitment. We highlight some pitfalls in the assessment of mitochondrial function by analysis of phosphocreatine (PCr) recovery kinetics. Finally, we outline how complementary techniques (near-infrared spectroscopy, arterial spin labelling, BOLD and various other MRI and 1 H MRS measurements) can help in the physiological/metabolic interpretation of 31 P MRS studies by providing information about blood flow and oxygen delivery/utilisation. Our recommendations will assist in achieving the fullest possible reliable picture of muscle physiology and pathophysiology.
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Affiliation(s)
- Martin Meyerspeer
- Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
- High Field MR CenterMedical University of ViennaViennaAustria
| | - Chris Boesch
- DBMR and DIPRUniversity and InselspitalBernSwitzerland
| | - Donnie Cameron
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CentreLeidenthe Netherlands
| | - Monika Dezortová
- MR‐Unit, Department of Diagnostic and Interventional RadiologyInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - Sean C. Forbes
- Department of Physical TherapyUniversity of FloridaGainesvilleFloridaUSA
| | - Arend Heerschap
- Department of Radiology and Nuclear MedicineRadboud University Medical CenterNijmegenThe Netherlands
| | - Jeroen A.L. Jeneson
- Department of RadiologyAmsterdam University Medical Center|site AMCAmsterdamthe Netherlands
- Cognitive Neuroscience CenterUniversity Medical Center GroningenGroningenthe Netherlands
- Center for Child Development and Exercise, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Hermien E. Kan
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CentreLeidenthe Netherlands
- Duchenne CenterThe Netherlands
| | - Jane Kent
- Department of KinesiologyUniversity of Massachusetts AmherstMAUSA
| | - Gwenaël Layec
- Department of KinesiologyUniversity of Massachusetts AmherstMAUSA
- Institute for Applied Life SciencesUniversity of MassachusettsAmherstMAUSA
| | | | - Harmen Reyngoudt
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of Myology AIM‐CEAParisFrance
| | - Alison Sleigh
- Wolfson Brain Imaging CentreUniversity of CambridgeCambridgeUK
- Wellcome Trust‐MRC Institute of Metabolic ScienceUniversity of CambridgeCambridgeUK
- NIHR/Wellcome Trust Clinical Research FacilityCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Ladislav Valkovič
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), RDM Cardiovascular Medicine, BHF Centre of Research ExcellenceUniversity of OxfordOxfordUK
- Department of Imaging MethodsInstitute of Measurement Science, Slovak Academy of SciencesBratislavaSlovakia
| | - Graham J. Kemp
- Department of Musculoskeletal Biology and Liverpool Magnetic Resonance Imaging Centre (LiMRIC)University of LiverpoolLiverpoolUK
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10
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Strijkers GJ, Araujo EC, Azzabou N, Bendahan D, Blamire A, Burakiewicz J, Carlier PG, Damon B, Deligianni X, Froeling M, Heerschap A, Hollingsworth KG, Hooijmans MT, Karampinos DC, Loudos G, Madelin G, Marty B, Nagel AM, Nederveen AJ, Nelissen JL, Santini F, Scheidegger O, Schick F, Sinclair C, Sinkus R, de Sousa PL, Straub V, Walter G, Kan HE. Exploration of New Contrasts, Targets, and MR Imaging and Spectroscopy Techniques for Neuromuscular Disease - A Workshop Report of Working Group 3 of the Biomedicine and Molecular Biosciences COST Action BM1304 MYO-MRI. J Neuromuscul Dis 2020; 6:1-30. [PMID: 30714967 PMCID: PMC6398566 DOI: 10.3233/jnd-180333] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Neuromuscular diseases are characterized by progressive muscle degeneration and muscle weakness resulting in functional disabilities. While each of these diseases is individually rare, they are common as a group, and a large majority lacks effective treatment with fully market approved drugs. Magnetic resonance imaging and spectroscopy techniques (MRI and MRS) are showing increasing promise as an outcome measure in clinical trials for these diseases. In 2013, the European Union funded the COST (co-operation in science and technology) action BM1304 called MYO-MRI (www.myo-mri.eu), with the overall aim to advance novel MRI and MRS techniques for both diagnosis and quantitative monitoring of neuromuscular diseases through sharing of expertise and data, joint development of protocols, opportunities for young researchers and creation of an online atlas of muscle MRI and MRS. In this report, the topics that were discussed in the framework of working group 3, which had the objective to: Explore new contrasts, new targets and new imaging techniques for NMD are described. The report is written by the scientists who attended the meetings and presented their data. An overview is given on the different contrasts that MRI can generate and their application, clinical needs and desired readouts, and emerging methods.
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Affiliation(s)
| | - Ericky C.A. Araujo
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology & NMR Laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Noura Azzabou
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology & NMR Laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | | | - Andrew Blamire
- Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
| | - Jedrek Burakiewicz
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pierre G. Carlier
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology & NMR Laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Bruce Damon
- Vanderbilt University Medical Center, Nashville, USA
| | - Xeni Deligianni
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland & Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | | | - Arend Heerschap
- Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | | | | | | | - Benjamin Marty
- NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology & NMR Laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Armin M. Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany & Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Francesco Santini
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland & Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Olivier Scheidegger
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Fritz Schick
- University of Tübingen, Section on Experimental Radiology, Tübingen, Germany
| | | | | | | | - Volker Straub
- Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
| | | | - Hermien E. Kan
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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11
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Leung DG. Advancements in magnetic resonance imaging-based biomarkers for muscular dystrophy. Muscle Nerve 2019; 60:347-360. [PMID: 31026060 DOI: 10.1002/mus.26497] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 12/26/2022]
Abstract
Recent years have seen steady progress in the identification of genetic muscle diseases as well as efforts to develop treatment for these diseases. Consequently, sensitive and objective new methods are required to identify and monitor muscle pathology. Magnetic resonance imaging offers multiple potential biomarkers of disease severity in the muscular dystrophies. This Review uses a pathology-based approach to examine the ways in which MRI and spectroscopy have been used to study muscular dystrophies. Methods that have been used to quantitate intramuscular fat, edema, fiber orientation, metabolism, fibrosis, and vascular perfusion are examined, and this Review describes how MRI can help diagnose these conditions and improve upon existing muscle biomarkers by detecting small increments of disease-related change. Important challenges in the implementation of imaging biomarkers, such as standardization of protocols and validating imaging measurements with respect to clinical outcomes, are also described.
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Affiliation(s)
- Doris G Leung
- Center for Genetic Muscle Disorders, Hugo W. Moser Research Institute at Kennedy Krieger Institute, 716 North Broadway, Room 411, Baltimore, Maryland, 21205.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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12
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Tomas X, Milisenda JC, Garcia-Diez AI, Prieto-Gonzalez S, Faruch M, Pomes J, Grau-Junyent JM. Whole-body MRI and pathological findings in adult patients with myopathies. Skeletal Radiol 2019; 48:653-676. [PMID: 30377729 DOI: 10.1007/s00256-018-3107-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/12/2018] [Accepted: 10/22/2018] [Indexed: 02/08/2023]
Abstract
Magnetic resonance imaging (MRI) is considered the most sensitive and specific imaging technique for the detection of muscle diseases related to myopathies. Since 2008, the use of whole-body MRI (WBMRI) to evaluate myopathies has improved due to technical advances such as rolling table platform and parallel imaging, which enable rapid assessment of the entire musculoskeletal system with high-quality images. WBMRI protocols should include T1-weighted and short-tau inversion recovery (STIR), which provide the basic pulse sequences for studying myopathies, in order to detect fatty infiltration/muscle atrophy and muscle edema, respectively. High signal intensity in T1-weighted images shows chronic disease with fatty infiltration, whereas high signal intensity in STIR indicates an acute stage with muscle edema. Additional sequences such as diffusion-weighted imaging (DWI) can be readily incorporated into routine WBMRI study protocols. Contrast-enhanced sequences have not been done. This article reviews WBMRI as an imaging method to evaluate different myopathies (idiopathic inflammatory, dystrophic, non-dystrophic, metabolic, and channelopathies). WBMRI provides a comprehensive estimate of the total burden with a single study, seeking specific distribution patterns, including clinically silent involvement of muscle areas. Furthermore, WBMRI may help to select the "target muscle area" for biopsy during patient follow-up. It may be also be used to detect related and non-related pathological conditions, such as tumors.
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Affiliation(s)
- Xavier Tomas
- Department of Radiology (CDIC), Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain.
| | - Jose Cesar Milisenda
- Department of Internal Medicine, Hospital Clinic, Universitat de Barcelona (UB) and CIBERER, Villarroel 170, 08036, Barcelona, Spain
| | - Ana Isabel Garcia-Diez
- Department of Radiology (CDIC), Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain
| | - Sergio Prieto-Gonzalez
- Department of Autoimmune Diseases, Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain
| | - Marie Faruch
- Department of Radiology, Hopital Purpan, Centre Hospitalier Universitaire (CHU), Place du Docteur Baylac TSA 40031, 31059, Toulouse cedex 9, France
| | - Jaime Pomes
- Department of Radiology (CDIC), Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain
| | - Josep Maria Grau-Junyent
- Department of Internal Medicine, Hospital Clinic, Universitat de Barcelona (UB) and CIBERER, Villarroel 170, 08036, Barcelona, Spain
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13
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Paoletti M, Pichiecchio A, Cotti Piccinelli S, Tasca G, Berardinelli AL, Padovani A, Filosto M. Advances in Quantitative Imaging of Genetic and Acquired Myopathies: Clinical Applications and Perspectives. Front Neurol 2019; 10:78. [PMID: 30804884 PMCID: PMC6378279 DOI: 10.3389/fneur.2019.00078] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022] Open
Abstract
In the last years, magnetic resonance imaging (MRI) has become fundamental for the diagnosis and monitoring of myopathies given its ability to show the severity and distribution of pathology, to identify specific patterns of damage distribution and to properly interpret a number of genetic variants. The advances in MR techniques and post-processing software solutions have greatly expanded the potential to assess pathological changes in muscle diseases, and more specifically of myopathies; a number of features can be studied and quantified, ranging from composition, architecture, mechanical properties, perfusion, and function, leading to what is known as quantitative MRI (qMRI). Such techniques can effectively provide a variety of information beyond what can be seen and assessed by conventional MR imaging; their development and application in clinical practice can play an important role in the diagnostic process and in assessing disease course and treatment response. In this review, we briefly discuss the current role of muscle MRI in diagnosing muscle diseases and describe in detail the potential and perspectives of the application of advanced qMRI techniques in this field.
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Affiliation(s)
- Matteo Paoletti
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Anna Pichiecchio
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Stefano Cotti Piccinelli
- Unit of Neurology, Center for Neuromuscular Diseases, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Giorgio Tasca
- Neurology Department, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Alessandro Padovani
- Unit of Neurology, Center for Neuromuscular Diseases, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Massimiliano Filosto
- Unit of Neurology, Center for Neuromuscular Diseases, ASST Spedali Civili and University of Brescia, Brescia, Italy
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14
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Jungbluth H. Myopathology in times of modern imaging. Neuropathol Appl Neurobiol 2018; 43:24-43. [PMID: 28111795 DOI: 10.1111/nan.12385] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 01/17/2017] [Accepted: 01/23/2017] [Indexed: 12/14/2022]
Abstract
Over the last two decades, muscle (magnetic resonance) imaging has become an important complementary tool in the diagnosis and differential diagnosis of inherited neuromuscular disorders, particularly in conditions where the pattern of selective muscle involvement is often more predictive of the underlying genetic background than associated clinical and histopathological features. Following an overview of different imaging modalities, the present review will give a concise introduction to systematic image analysis and interpretation in genetic neuromuscular disorders. The pattern of selective muscle involvement will be presented in detail in conditions such as the congenital or myofibrillar myopathies where muscle imaging is particularly useful to inform the (differential) diagnosis, and in disorders such as Duchenne or fascioscapulohumeral muscular dystrophy where the diagnosis is usually made on clinical grounds but where detailed knowledge of disease progression on the muscle imaging level may inform better understanding of the natural history. Utilizing the group of the congenital myopathies as an example, selected case studies will illustrate how muscle MRI can be used to inform the diagnostic process in the clinico-pathological context. Future developments, in particular, concerning the increasing use of whole-body MRI protocols and novel quantitative fat assessments techniques potentially relevant as an outcome measure, will be briefly outlined.
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Affiliation(s)
- H Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK.,Randall Division of Cell and Molecular Biophysics, Muscle Signalling Section, London, UK.,Department of Clinical and Basic Neuroscience, IoPPN, King's College, London, UK
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15
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Ferguson MR, Poliachik SL, Budech CB, Gove NE, Carter GT, Wang LH, Miller DG, Shaw DW, Friedman SD. MRI change metrics of facioscapulohumeral muscular dystrophy: Stir and T1. Muscle Nerve 2018; 57:905-912. [DOI: 10.1002/mus.26038] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 12/04/2017] [Accepted: 12/09/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Mark R. Ferguson
- Department of Radiology; Seattle Children's Hospital, 4800 Sandpoint Way, Room: L-MA.6.226; Seattle Washington 98105 USA
- Department of Radiology; University of Washington; Seattle Washington USA
| | - Sandra L. Poliachik
- Department of Radiology; Seattle Children's Hospital, 4800 Sandpoint Way, Room: L-MA.6.226; Seattle Washington 98105 USA
| | - Christopher B. Budech
- Department of Radiology; Seattle Children's Hospital, 4800 Sandpoint Way, Room: L-MA.6.226; Seattle Washington 98105 USA
| | - Nancy E. Gove
- Center for Clinical and Translational Research, Seattle Children's Research Institute; Seattle Washington USA
| | | | - Leo H. Wang
- Department of Neurology; University of Washington; Seattle Washington USA
| | - Daniel G. Miller
- Genome Sciences, University of Washington; Seattle Washington USA
| | - Dennis W.W. Shaw
- Department of Radiology; Seattle Children's Hospital, 4800 Sandpoint Way, Room: L-MA.6.226; Seattle Washington 98105 USA
- Department of Radiology; University of Washington; Seattle Washington USA
| | - Seth D. Friedman
- Department of Radiology; Seattle Children's Hospital, 4800 Sandpoint Way, Room: L-MA.6.226; Seattle Washington 98105 USA
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16
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Leung DG, Wang X, Barker PB, Carrino JA, Wagner KR. Multivoxel proton magnetic resonance spectroscopy in facioscapulohumeral muscular dystrophy. Muscle Nerve 2018; 57:958-963. [PMID: 29266323 DOI: 10.1002/mus.26048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 12/11/2017] [Accepted: 12/15/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Facioscapulohumeral muscular dystrophy (FSHD) is a hereditary disorder that causes progressive muscle wasting. This study evaluates the use of proton magnetic resonance spectroscopy (1 H MRS) as a biomarker of muscle strength and function in FSHD. METHODS Thirty-six individuals with FSHD and 15 healthy controls underwent multivoxel 1 H MRS of a cross-section of the mid-thigh. Concentrations of creatine, intramyocellular and extramyocellular lipids, and trimethylamine (TMA)-containing compounds in skeletal muscle were calculated. Metabolite concentrations for individuals with FSHD were compared with those of controls. The relationship between metabolite concentrations and muscle strength was also examined. RESULTS The TMA/creatine (Cr) ratio in individuals with FSHD was reduced compared with controls. The TMA/Cr ratio in the hamstrings also showed a moderate linear correlation with muscle strength. DISCUSSION 1 H MRS offers a potential method of detecting early muscle pathology in FSHD prior to the development of fat infiltration. Muscle Nerve 57: 958-963, 2018.
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Affiliation(s)
- Doris G Leung
- Center for Genetic Muscle Disorders, Hugo W. Moser Research Institute at Kennedy Krieger Institute, 716 North Broadway, Room 411, Baltimore, Maryland, 21205, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Xin Wang
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Peter B Barker
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John A Carrino
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
| | - Kathryn R Wagner
- Center for Genetic Muscle Disorders, Hugo W. Moser Research Institute at Kennedy Krieger Institute, 716 North Broadway, Room 411, Baltimore, Maryland, 21205, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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17
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Marra MA, Heskamp L, Mul K, Lassche S, van Engelen BGM, Heerschap A, Verdonschot N. Specific muscle strength is reduced in facioscapulohumeral dystrophy: An MRI based musculoskeletal analysis. Neuromuscul Disord 2017; 28:238-245. [PMID: 29395674 DOI: 10.1016/j.nmd.2017.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/28/2017] [Accepted: 11/26/2017] [Indexed: 02/03/2023]
Abstract
The aim was to test whether strength per unit of muscle area (specific muscle strength) is affected in facioscapulohumeral dystrophy (FSHD) patients, as compared to healthy controls. Ten patients and ten healthy volunteers underwent an MRI examination and maximum voluntary isometric contraction measurements (MVICs) of the quadriceps muscles. Contractile muscle volume, as obtained from the MR images, was combined with the MVICs to calculate the physiological cross-sectional area (PCSA) and muscle strength using a musculoskeletal model. Subsequently, specific strength was calculated for each subject as muscle strength divided by total PCSA. FSHD patients had a reduced quadriceps muscle strength (median(1st quartile-3rd quartile): 2011 (905.4-2775) N vs. 5510 (4727-8321) N, p <0.001) and total PCSA (83.6 (62.3-124.8) cm2vs. 140.1(97.1-189.9) cm2, p = 0.015) compared to healthy controls. Furthermore, the specific strength of the quadriceps was significantly lower in patients compared to healthy controls (20.9 (14.7-24.0) N/cm2vs. 41.9 (38.3-49.0) N/cm2, p <0.001). Thus, even when correcting for atrophy and fatty infiltration, patients with FSHD generated less force per unit area of residual muscle tissue than healthy controls. Possible explanations include impaired force propagation due to fatty infiltration, reduced intrinsic force-generating capacity of the muscle fibers, or mitochondrial abnormalities leading to impaired energy metabolism.
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Affiliation(s)
- Marco A Marra
- Orthopaedic Research Laboratory, Radboud Institute for Health Sciences, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Linda Heskamp
- Department of Radiology and Nuclear Medicine, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Karlien Mul
- Department of Neurology, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Saskia Lassche
- Department of Neurology, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Baziel G M van Engelen
- Department of Neurology, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Arend Heerschap
- Department of Radiology and Nuclear Medicine, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Nico Verdonschot
- Orthopaedic Research Laboratory, Radboud Institute for Health Sciences, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Department of Biomechanical Engineering, University of Twente, Postbus 217, 7500 AE Enschede, The Netherlands
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18
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DeSimone AM, Pakula A, Lek A, Emerson CP. Facioscapulohumeral Muscular Dystrophy. Compr Physiol 2017; 7:1229-1279. [PMID: 28915324 DOI: 10.1002/cphy.c160039] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Facioscapulohumeral Muscular Dystrophy is a common form of muscular dystrophy that presents clinically with progressive weakness of the facial, scapular, and humeral muscles, with later involvement of the trunk and lower extremities. While typically inherited as autosomal dominant, facioscapulohumeral muscular dystrophy (FSHD) has a complex genetic and epigenetic etiology that has only recently been well described. The most prevalent form of the disease, FSHD1, is associated with the contraction of the D4Z4 microsatellite repeat array located on a permissive 4qA chromosome. D4Z4 contraction allows epigenetic derepression of the array, and possibly the surrounding 4q35 region, allowing misexpression of the toxic DUX4 transcription factor encoded within the terminal D4Z4 repeat in skeletal muscles. The less common form of the disease, FSHD2, results from haploinsufficiency of the SMCHD1 gene in individuals carrying a permissive 4qA allele, also leading to the derepression of DUX4, further supporting a central role for DUX4. How DUX4 misexpression contributes to FSHD muscle pathology is a major focus of current investigation. Misexpression of other genes at the 4q35 locus, including FRG1 and FAT1, and unlinked genes, such as SMCHD1, has also been implicated as disease modifiers, leading to several competing disease models. In this review, we describe recent advances in understanding the pathophysiology of FSHD, including the application of MRI as a research and diagnostic tool, the genetic and epigenetic disruptions associated with the disease, and the molecular basis of FSHD. We discuss how these advances are leading to the emergence of new approaches to enable development of FSHD therapeutics. © 2017 American Physiological Society. Compr Physiol 7:1229-1279, 2017.
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Affiliation(s)
- Alec M DeSimone
- Wellstone Muscular Dystrophy Program, Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Anna Pakula
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics and Genetics at Harvard Medical School, Boston, Massachusetts, USA
| | - Angela Lek
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics and Genetics at Harvard Medical School, Boston, Massachusetts, USA.,Australian Regenerative Medicine Institute, Monash University, Clayton, Victoria, Australia
| | - Charles P Emerson
- Wellstone Muscular Dystrophy Program, Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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19
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Short-TERM Neuromuscular Electrical Stimulation Training of the Tibialis Anterior Did Not Improve Strength and Motor Function in Facioscapulohumeral Muscular Dystrophy Patients. Am J Phys Med Rehabil 2017; 96:e56-e63. [PMID: 28129235 DOI: 10.1097/phm.0000000000000705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects on motor function, muscle strength, and endurance of short-term neuromuscular electrical stimulation training of the tibialis anterior muscles in patients with facioscapulohumeral muscular dystrophy type 1 (FSHD1) in comparison with healthy controls. DESIGN This prospective study included 10 patients with FSHD1 and 10 healthy participants. Maximal voluntary isometric contraction of ankle dorsiflexion and a 2-min sustained dorsiflexion maximal voluntary contraction with surface electromyography recordings of the tibialis anterior and the soleus muscles were measured and motor function clinical tests were performed before and after the training period. RESULTS No significant short term training effect was found in any of the investigated variables for either group, although a tendency towards an increase was noted for the manual muscle testing of the FSHD1. Patients with FSHD1 showed lower maximal voluntary contraction force and lower maximal tibialis anterior surface electromyography amplitude than healthy participants. During the 2-min sustained maximal voluntary contraction, the percentage of force loss was lower for the FSHD1 patients, suggesting that they were experiencing a lower amount of muscle fatigue compared to the healthy participant group. CONCLUSION The present neuromuscular electrical stimulation protocol was not strenuous enough and/or the parameters of stimulation were not adequate to improve dorsiflexion strength, muscle endurance, and motor function in FSHD1 patients and healthy participants.
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20
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Kalia V, Leung DG, Sneag DB, Del Grande F, Carrino JA. Advanced MRI Techniques for Muscle Imaging. Semin Musculoskelet Radiol 2017; 21:459-469. [PMID: 28772322 DOI: 10.1055/s-0037-1604007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractAdvanced magnetic resonance imaging (MRI) techniques can evaluate a wide array of muscle pathologies including acute or chronic muscle injury, musculotendinous response to injury, intramuscular collections and soft tissue masses, and others. In recent years, MRI has played a more important role in muscle disease diagnosis and monitoring. MRI provides excellent spatial and contrast resolution and helps direct optimal sites for muscle biopsy. Whole-body MRI now helps identify signature patterns of muscular involvement in large anatomical regions with relative ease. Quantitative MRI has advanced the evaluation and disease tracking of muscle atrophy and fatty infiltration in entities such as muscular dystrophies. Multivoxel magnetic resonance spectroscopy (MRS) now allows a more thorough, complete evaluation of a muscle of interest without the inherent sampling bias of single-voxel MRS or biopsy. Diffusion MRI allows quantification of muscle inflammation and capillary perfusion as well as muscle fiber tracking.
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Affiliation(s)
- Vivek Kalia
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
| | - Doris G Leung
- The Center for Genetic Muscle Disorders, Kennedy Krieger Institute, Baltimore, Maryland
| | - Darryl B Sneag
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
| | - Filippo Del Grande
- Servizio si Radiologia del Sottoceneri, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland
| | - John A Carrino
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
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21
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Hooijmans MT, Doorenweerd N, Baligand C, Verschuuren JJGM, Ronen I, Niks EH, Webb AG, Kan HE. Spatially localized phosphorous metabolism of skeletal muscle in Duchenne muscular dystrophy patients: 24-month follow-up. PLoS One 2017; 12:e0182086. [PMID: 28763477 PMCID: PMC5538641 DOI: 10.1371/journal.pone.0182086] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/12/2017] [Indexed: 12/29/2022] Open
Abstract
Objectives To assess the changes in phosphodiester (PDE)-levels, detected by 31P magnetic resonance spectroscopy (MRS), over 24-months to determine the potential of PDE as marker for muscle tissue changes in Duchenne Muscular Dystrophy (DMD) patients. Methods Spatially resolved phosphorous datasets were acquired in the right lower leg of 18 DMD patients (range: 5–15.4 years) and 12 age-matched healthy controls (range: 5–14 years) at three time-points (baseline, 12-months, and 24-months) using a 7T MR-System (Philips Achieva). 3-point Dixon images were acquired at 3T (Philips Ingenia) to determine muscle fat fraction. Analyses were done for six muscles that represent different stages of muscle wasting. Differences between groups and time-points were assessed with non-parametric tests with correction for multiple comparisons. Coefficient of variance (CV) were determined for PDE in four healthy adult volunteers in high and low signal-to-noise ratio (SNR) datasets. Results PDE-levels were significantly higher (two-fold) in DMD patients compared to controls in all analyzed muscles at almost every time point and did not change over the study period. Fat fraction was significantly elevated in all muscles at all time points compared to healthy controls, and increased significantly over time, except in the tibialis posterior muscle. The mean within subject CV for PDE-levels was 4.3% in datasets with high SNR (>10:1) and 5.7% in datasets with low SNR. Discussion and conclusion The stable two-fold increase in PDE-levels found in DMD patients in muscles with different levels of muscle wasting over 2-year time, including DMD patients as young as 5.5 years-old, suggests that PDE-levels may increase very rapidly early in the disease process and remain elevated thereafter. The low CV values in high and low SNR datasets show that PDE-levels can be accurately and reproducibly quantified in all conditions. Our data confirms the great potential of PDE as a marker for muscle tissue changes in DMD patients.
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Affiliation(s)
- M. T. Hooijmans
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
| | - N. Doorenweerd
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
- John Walton Muscular Dystrophy Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - C. Baligand
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | | | - I. Ronen
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - E. H. Niks
- Dept of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - A. G. Webb
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - H. E. Kan
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
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22
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Tayari N, Heerschap A, Scheenen TW, Kobus T. In vivo MR spectroscopic imaging of the prostate, from application to interpretation. Anal Biochem 2017; 529:158-170. [DOI: 10.1016/j.ab.2017.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 12/23/2016] [Accepted: 02/01/2017] [Indexed: 12/15/2022]
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23
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Hooijmans MT, Niks EH, Burakiewicz J, Verschuuren JJGM, Webb AG, Kan HE. Elevated phosphodiester and T 2 levels can be measured in the absence of fat infiltration in Duchenne muscular dystrophy patients. NMR IN BIOMEDICINE 2017; 30:e3667. [PMID: 27859827 DOI: 10.1002/nbm.3667] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/10/2016] [Accepted: 10/10/2016] [Indexed: 05/27/2023]
Abstract
Quantitative MRI and MRS are increasingly important as non-invasive outcome measures in therapy development for Duchenne muscular dystrophy (DMD). Many studies have focussed on individual measures such as fat fraction and metabolite levels in relation to age and functionality, but much less attention has been given to how these indices relate to each other. Here, we assessed spatially resolved metabolic changes in leg muscles of DMD patients, and classified muscles according to the degree of fat replacement compared with healthy controls. Quantitative MRI (three-point Dixon and multi-spin echo without fat suppression and a tri-exponential fit) and 2D-CSI 31 P MRS scans were obtained from 18 DMD patients and 12 healthy controls using a 3 T and a 7 T MR scanner. Metabolite levels, T2 values and fat fraction were individually assessed for five lower leg muscles. In muscles with extensive fat replacement, phosphodiester over adenosine triphosphate (PDE/ATP), inorganic phosphate over phosphocreatine, intracellular tissue pH and T2 were significantly increased compared with healthy controls. In contrast, in muscles without extensive fat replacement, only PDE/ATP and T2 values were significantly elevated. Overall, our results show that PDE levels and T2 values increase prior to the occurrence of fat replacement and remain elevated in later stages of the disease. This suggests that these individual measures could not only function as early markers for muscle damage but also reflect potentially reversible pathology in the more advanced stages.
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Affiliation(s)
- M T Hooijmans
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - E H Niks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Burakiewicz
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - J J G M Verschuuren
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - A G Webb
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - H E Kan
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
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24
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Magnetic resonance imaging patterns of muscle involvement in genetic muscle diseases: a systematic review. J Neurol 2016; 264:1320-1333. [PMID: 27888415 DOI: 10.1007/s00415-016-8350-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 11/16/2016] [Accepted: 11/17/2016] [Indexed: 12/25/2022]
Abstract
A growing body of the literature supports the use of magnetic resonance imaging as a potential biomarker for disease severity in the hereditary myopathies. We performed a systematic review of the medical literature to evaluate patterns of fat infiltration observed in magnetic resonance imaging studies of muscular dystrophy and congenital myopathy. Searches were performed using MEDLINE, EMBASE, and grey literature databases. Studies that described fat infiltration of muscles in patients with muscular dystrophy or congenital myopathy were selected for full-length review. Data on preferentially involved or spared muscles were extracted for analysis. A total of 2172 titles and abstracts were screened, and 70 publications met our criteria for inclusion in the systematic review. There were 23 distinct genetic disorders represented in this analysis. In most studies, preferential involvement and sparing of specific muscles were reported. We conclude that magnetic resonance imaging studies can be used to identify distinct patterns of muscle involvement in the hereditary myopathies. However, larger studies and standardized methods of reporting are needed to develop imaging as a diagnostic tool in these diseases.
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25
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Janssen BH, Lassche S, Hopman MT, Wevers RA, van Engelen BGM, Heerschap A. Monitoring creatine and phosphocreatine by (13)C MR spectroscopic imaging during and after (13)C4 creatine loading: a feasibility study. Amino Acids 2016; 48:1857-66. [PMID: 27401085 PMCID: PMC4974291 DOI: 10.1007/s00726-016-2294-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 07/01/2016] [Indexed: 12/28/2022]
Abstract
Creatine (Cr) supplementation to enhance muscle performance shows variable responses among individuals and different muscles. Direct monitoring of the supplied Cr in muscles would address these differences. In this feasibility study, we introduce in vivo 3D 13C MR spectroscopic imaging (MRSI) of the leg with oral ingestion of 13C4–creatine to observe simultaneously Cr and phosphocreatine (PCr) for assessing Cr uptake, turnover, and the ratio PCr over total Cr (TCr) in individual muscles. 13C MRSI was performed of five muscles in the posterior thigh in seven subjects (two males and two females of ~20 years, one 82-year-old male, and two neuromuscular patients) with a 1H/13C coil in a 3T MR system before, during and after intake of 15 % 13C4-enriched Cr. Subjects ingested 20 g Cr/day for 4 days in four 5 g doses at equal time intervals. The PCr/TCr did not vary significantly during supplementation and was similar for all subjects and investigated muscles (average 0.71 ± 0.07), except for the adductor magnus (0.64 ± 0.03). The average Cr turnover rate, assessed in male muscles, was 2.1 ± 0.7 %/day. The linear uptake rates of Cr were variable between muscles, although not significantly different. This assessment was possible in all investigated muscles of young male volunteers, but less so in muscles of the other subjects due to lower signal-to-noise ratio. Improvements for future studies are discussed. In vivo 13C MRSI after 13C–Cr ingestion is demonstrated for longitudinal studies of Cr uptake, turnover, and PCr/TCr ratios of individual muscles in one exam.
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Affiliation(s)
- Barbara H Janssen
- Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Saskia Lassche
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria T Hopman
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ron A Wevers
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Arend Heerschap
- Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
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26
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Rutledge O, Kwak T, Cao P, Zhang X. Design and test of a double-nuclear RF coil for (1)H MRI and (13)C MRSI at 7T. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2016; 267:15-21. [PMID: 27078089 PMCID: PMC4862922 DOI: 10.1016/j.jmr.2016.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 03/09/2016] [Accepted: 04/02/2016] [Indexed: 05/20/2023]
Abstract
RF coil operation at the ultrahigh field of 7T is fraught with technical challenges that limit the advancement of novel human in vivo applications at 7T. In this work, a hybrid technique combining a microstrip transmission line and a lumped-element L-C loop coil to form a double-nuclear RF coil for proton magnetic resonance imaging and carbon magnetic resonance spectroscopy at 7T was proposed and investigated. Network analysis revealed a high Q-factor and excellent decoupling between the coils. Proton images and localized carbon spectra were acquired with high sensitivity. The successful testing of this novel double-nuclear coil demonstrates the feasibility of this hybrid design for double-nuclear MR imaging and spectroscopy studies at the ultrahigh field of 7T.
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Affiliation(s)
- Omar Rutledge
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA
| | - Tiffany Kwak
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA
| | - Peng Cao
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA
| | - Xiaoliang Zhang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA; UCSF - UC Berkeley Joint Graduate Group in Bioengineering, San Francisco & Berkeley, CA, USA; California Institute for Quantitative Biosciences (QB3), San Francisco, CA, USA.
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27
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Tasca G, Monforte M, Ottaviani P, Pelliccioni M, Frusciante R, Laschena F, Ricci E. Magnetic resonance imaging in a large cohort of facioscapulohumeral muscular dystrophy patients: Pattern refinement and implications for clinical trials. Ann Neurol 2016; 79:854-864. [DOI: 10.1002/ana.24640] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/31/2016] [Accepted: 03/14/2016] [Indexed: 01/11/2023]
Affiliation(s)
| | - Mauro Monforte
- Institute of Neurology; Catholic University School of Medicine; Rome
| | | | - Marco Pelliccioni
- Italian Union against Muscular Dystrophy (UILDM), Rome Section; Rome Italy
| | | | | | - Enzo Ricci
- Institute of Neurology; Catholic University School of Medicine; Rome
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28
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Damon BM, Li K, Bryant ND. Magnetic resonance imaging of skeletal muscle disease. HANDBOOK OF CLINICAL NEUROLOGY 2016; 136:827-42. [PMID: 27430444 DOI: 10.1016/b978-0-444-53486-6.00041-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neuromuscular diseases often exhibit a temporally varying, spatially heterogeneous, and multifaceted pathology. The goals of this chapter are to describe and evaluate the use of quantitative magnetic resonance imaging (MRI) methods to characterize muscle pathology. The following criteria are used for this evaluation: objective measurement of continuously distributed variables; clear and well-understood relationship to the pathology of interest; sensitivity to improvement or worsening of clinical status; and the measurement properties of accuracy and precision. Two major classes of MRI methods meet all of these criteria: (1) MRI methods for measuring muscle contractile volume or cross-sectional area by combining structural MRI and quantitative fat-water MRI; and (2) an MRI method for characterizing the edema caused by inflammation, the measurement of the transverse relaxation time constant (T2). These methods are evaluated with respect to the four criteria listed above and examples from neuromuscular disorders are provided. Finally, these methods are summarized and synthesized and recommendations for additional quantitative MRI developments are made.
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Affiliation(s)
- Bruce M Damon
- Vanderbilt University Institute of Imaging Science and the Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA; Departments of Biomedical Engineering and Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA.
| | - Ke Li
- Vanderbilt University Institute of Imaging Science and the Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Nathan D Bryant
- Vanderbilt University Institute of Imaging Science and the Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
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29
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Leung DG, Carrino JA, Wagner KR, Jacobs MA. Whole-body magnetic resonance imaging evaluation of facioscapulohumeral muscular dystrophy. Muscle Nerve 2015; 52:512-20. [PMID: 25641525 DOI: 10.1002/mus.24569] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 12/22/2014] [Accepted: 01/07/2015] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Facioscapulohumeral muscular dystrophy (FSHD) is a hereditary disorder that causes progressive muscle wasting. Increasing knowledge of the pathophysiology of FSHD has stimulated interest in developing biomarkers of disease severity. METHODS Two groups of MRI scans were analyzed: whole-body scans from 13 subjects with FSHD; and upper and lower extremity scans from 34 subjects with FSHD who participated in the MYO-029 clinical trial. Muscles were scored for fat infiltration and edema-like changes. Fat infiltration scores were compared with muscle strength and function. RESULTS The analysis revealed a distinctive pattern of both frequent muscle involvement and frequent sparing in FSHD. Averaged fat infiltration scores for muscle groups in the legs correlated with quantitative muscle strength and 10-meter walk times. CONCLUSIONS Advances in MRI technology allow for acquisition of rapid, high-quality, whole-body imaging in diffuse muscle disease. This technique offers a promising disease biomarker in FSHD and other muscle diseases.
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Affiliation(s)
- Doris G Leung
- Center for Genetic Muscle Disorders, The Hugo W. Moser Research Institute, Kennedy Krieger Institute, 707 North Broadway, 400A, Baltimore, Maryland, 21205, USA
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John A Carrino
- Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
| | - Kathryn R Wagner
- Center for Genetic Muscle Disorders, The Hugo W. Moser Research Institute, Kennedy Krieger Institute, 707 North Broadway, 400A, Baltimore, Maryland, 21205, USA
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael A Jacobs
- Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Sidney Kimmel Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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30
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Wokke BH, Hooijmans MT, van den Bergen JC, Webb AG, Verschuuren JJ, Kan HE. Muscle MRS detects elevated PDE/ATP ratios prior to fatty infiltration in Becker muscular dystrophy. NMR IN BIOMEDICINE 2014; 27:1371-7. [PMID: 25196814 DOI: 10.1002/nbm.3199] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 05/27/2023]
Abstract
Becker muscular dystrophy (BMD) is characterized by progressive muscle weakness. Muscles show structural changes (fatty infiltration, fibrosis) and metabolic changes, both of which can be assessed using MRI and MRS. It is unknown at what stage of the disease process metabolic changes arise and how this might vary for different metabolites. In this study we assessed metabolic changes in skeletal muscles of Becker patients, both with and without fatty infiltration, quantified via Dixon MRI and (31) P MRS. MRI and (31) P MRS scans were obtained from 25 Becker patients and 14 healthy controls using a 7 T MR scanner. Five lower-leg muscles were individually assessed for fat and muscle metabolite levels. In the peroneus, soleus and anterior tibialis muscles with non-increased fat levels, PDE/ATP ratios were higher (P < 0.02) compared with controls, whereas in all muscles with increased fat levels PDE/ATP ratios were higher compared with healthy controls (P ≤ 0.05). The Pi /ATP ratio in the peroneus muscles was higher in muscles with increased fat fractions (P = 0.005), and the PCr/ATP ratio was lower in the anterior tibialis muscles with increased fat fractions (P = 0.005). There were no other significant changes in metabolites, but an increase in tissue pH was found in all muscles of the total group of BMD patients in comparison with healthy controls (P < 0.05). These findings suggest that (31) P MRS can be used to detect early changes in individual muscles of BMD patients, which are present before the onset of fatty infiltration.
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Affiliation(s)
- B H Wokke
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
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31
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Friedman SD, Poliachik SL, Otto RK, Carter GT, Budech CB, Bird TD, Miller DG, Shaw DWW. Longitudinal features of STIR bright signal in FSHD. Muscle Nerve 2014; 49:257-60. [PMID: 23720194 DOI: 10.1002/mus.23911] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 04/26/2013] [Accepted: 05/13/2013] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Magnetic resonance imaging of muscle shows short tau-inversion recovery (STIR) brightness in autosomal dominant facioscapulohumeral muscular dystrophy (FSHD1) suggestive of active inflammation/injury. We measured the longitudinal stability/progression of this potential disease biomarker. METHODS Nine subjects underwent calf MRI imaging over 2 years. Two radiologists evaluated qualitative muscle changes. RESULTS In 3/9 subjects, calf muscles demonstrated moderate/severe STIR hyperintensity at Time 1 that had progressed to fatty replacement 2 years later (Time 2). In the remaining subjects, moderate/severe muscle STIR abnormalities, when present, were consistent between exams. Mild STIR+ elevations had roughly similar patterns between exams. CONCLUSIONS Moderate/severe STIR hyperintensities often foreshadow fatty replacement over a 2-year interval. Whether longer time courses are required to observe muscle degeneration and fatty replacement in some subjects remains to be explored.
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32
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Janssen BH, Voet NBM, Nabuurs CI, Kan HE, de Rooy JWJ, Geurts AC, Padberg GW, van Engelen BGM, Heerschap A. Distinct disease phases in muscles of facioscapulohumeral dystrophy patients identified by MR detected fat infiltration. PLoS One 2014; 9:e85416. [PMID: 24454861 PMCID: PMC3891814 DOI: 10.1371/journal.pone.0085416] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 11/26/2013] [Indexed: 11/18/2022] Open
Abstract
Facioscapulohumeral muscular dystrophy (FSHD) is an untreatable disease, characterized by asymmetric progressive weakness of skeletal muscle with fatty infiltration. Although the main genetic defect has been uncovered, the downstream mechanisms causing FSHD are not understood. The objective of this study was to determine natural disease state and progression in muscles of FSHD patients and to establish diagnostic biomarkers by quantitative MRI of fat infiltration and phosphorylated metabolites. MRI was performed at 3T with dedicated coils on legs of 41 patients (28 men/13 women, age 34-76 years), of which eleven were re-examined after four months of usual care. Muscular fat fraction was determined with multi spin-echo and T1 weighted MRI, edema by TIRM and phosphorylated metabolites by 3D (31)P MR spectroscopic imaging. Fat fractions were compared to clinical severity, muscle force, age, edema and phosphocreatine (PCr)/ATP. Longitudinal intramuscular fat fraction variation was analyzed by linear regression. Increased intramuscular fat correlated with age (p<0.05), FSHD severity score (p<0.0001), inversely with muscle strength (p<0.0001), and also occurred sub-clinically. Muscles were nearly dichotomously divided in those with high and with low fat fraction, with only 13% having an intermediate fat fraction. The intramuscular fat fraction along the muscle's length, increased from proximal to distal. This fat gradient was the steepest for intermediate fat infiltrated muscles (0.07±0.01/cm, p<0.001). Leg muscles in this intermediate phase showed a decreased PCr/ATP (p<0.05) and the fastest increase in fatty infiltration over time (0.18±0.15/year, p<0.001), which correlated with initial edema (p<0.01), if present. Thus, in the MR assessment of fat infiltration as biomarker for diseased muscles, the intramuscular fat distribution needs to be taken into account. Our results indicate that healthy individual leg muscles become diseased by entering a progressive phase with distal fat infiltration and altered energy metabolite levels. Fat replacement then relatively rapidly spreads over the whole muscle.
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Affiliation(s)
- Barbara H. Janssen
- Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
- * E-mail:
| | - Nicoline B. M. Voet
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christine I. Nabuurs
- Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hermien E. Kan
- Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jacky W. J. de Rooy
- Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alexander C. Geurts
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - George W. Padberg
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Arend Heerschap
- Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
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Clinical trial preparedness in facioscapulohumeral dystrophy: outcome measures and patient access: 8-9 April 2013, Leiden, The Netherlands. Neuromuscul Disord 2013; 24:79-85. [PMID: 24011701 DOI: 10.1016/j.nmd.2013.07.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 07/15/2013] [Accepted: 07/22/2013] [Indexed: 12/30/2022]
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Masciullo M, Iannaccone E, Bianchi MLE, Santoro M, Conte G, Modoni A, Monforte M, Tasca G, Laschena F, Ricci E, Silvestri G. Myotonic dystrophy type 1 and de novo FSHD mutation double trouble: a clinical and muscle MRI study. Neuromuscul Disord 2013; 23:427-31. [PMID: 23466272 DOI: 10.1016/j.nmd.2013.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 11/05/2012] [Accepted: 02/01/2013] [Indexed: 12/17/2022]
Abstract
Here we describe the first case of myotonic dystrophy type 1 (DM1) associated with facio-scapulo-humeral dystrophy (FSHD). From a clinical point of view, the patient displayed a pattern of muscle involvement reminiscent of both disorders, including hand-grip myotonia, facial, axial and distal limbs muscle weakness as well as a bilateral winged scapula associated with atrophy of the pectoralis major muscle and lumbar lordosis; pelvic muscles were mostly spared. An extensive muscle MRI assessment including neck, shoulder, abdominal, pelvic and lower limb muscles documented radiological features typical of DM1 and FSDH. Molecular genetic studies confirmed that the proband carried both a pathologically expanded DMPK allele, inherited from his father, and a de novo shortened D4Z4 repeat fragment at 4q35 locus.
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35
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Tasca G, Pescatori M, Monforte M, Mirabella M, Iannaccone E, Frusciante R, Cubeddu T, Laschena F, Ottaviani P, Ricci E. Different molecular signatures in magnetic resonance imaging-staged facioscapulohumeral muscular dystrophy muscles. PLoS One 2012; 7:e38779. [PMID: 22719944 PMCID: PMC3374833 DOI: 10.1371/journal.pone.0038779] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 05/10/2012] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common muscular dystrophies and is characterized by a non-conventional genetic mechanism activated by pathogenic D4Z4 repeat contractions. By muscle Magnetic Resonance Imaging (MRI) we observed that T2-short tau inversion recovery (T2-STIR) sequences identify two different conditions in which each muscle can be found before the irreversible dystrophic alteration, marked as T1-weighted sequence hyperintensity, takes place. We studied these conditions in order to obtain further information on the molecular mechanisms involved in the selective wasting of single muscles or muscle groups in this disease. METHODS Histopathology, gene expression profiling and real time PCR were performed on biopsies from FSHD muscles with different MRI pattern (T1-weighted normal/T2-STIR normal and T1-weighted normal/T2-STIR hyperintense). Data were compared with those from inflammatory myopathies, dysferlinopathies and normal controls. In order to validate obtained results, two additional FSHD samples with different MRI pattern were analyzed. RESULTS Myopathic and inflammatory changes characterized T2-STIR hyperintense FSHD muscles, at variance with T2-STIR normal muscles. These two states could be easily distinguished from each other by their transcriptional profile. The comparison between T2-STIR hyperintense FSHD muscles and inflammatory myopathy muscles showed peculiar changes, although many alterations were shared among these conditions. CONCLUSIONS At the single muscle level, different stages of the disease correspond to the two MRI patterns. T2-STIR hyperintense FSHD muscles are more similar to inflammatory myopathies than to T2-STIR normal FSHD muscles or other muscular dystrophies, and share with them upregulation of genes involved in innate and adaptive immunity. Our data suggest that selective inflammation, together with perturbation in biological processes such as neoangiogenesis, lipid metabolism and adipokine production, may contribute to the sequential bursts of muscle degeneration that involve individual muscles in an asynchronous manner in this disease.
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Affiliation(s)
| | - Mario Pescatori
- Department of Bioinformatics, Erasmus MC, Rotterdam, The Netherlands
- Crosslinks BV, Rotterdam, The Netherlands
- Porto Conte Ricerche Srl, Tramariglio, Alghero (SS), Italy
| | - Mauro Monforte
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
| | | | | | - Roberto Frusciante
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
| | | | - Francesco Laschena
- Department of Radiology, Istituto Dermopatico dell’Immacolata IRCCS, Rome, Italy
| | | | - Enzo Ricci
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
- * E-mail:
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Asymmetric bidirectional transcription from the FSHD-causing D4Z4 array modulates DUX4 production. PLoS One 2012; 7:e35532. [PMID: 22536400 PMCID: PMC3334996 DOI: 10.1371/journal.pone.0035532] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 03/17/2012] [Indexed: 01/08/2023] Open
Abstract
Facioscapulohumeral Disease (FSHD) is a dominantly inherited progressive myopathy associated with aberrant production of the transcription factor, Double Homeobox Protein 4 (DUX4). The expression of DUX4 depends on an open chromatin conformation of the D4Z4 macrosatellite array and a specific haplotype on chromosome 4. Even when these requirements are met, DUX4 transcripts and protein are only detectable in a subset of cells indicating that additional constraints govern DUX4 production. Since the direction of transcription, along with the production of non-coding antisense transcripts is an important regulatory feature of other macrosatellite repeats, we developed constructs that contain the non-coding region of a single D4Z4 unit flanked by genes that report transcriptional activity in the sense and antisense directions. We found that D4Z4 contains two promoters that initiate sense and antisense transcription within the array, and that antisense transcription predominates. Transcriptional start sites for the antisense transcripts, as well as D4Z4 regions that regulate the balance of sense and antisense transcripts were identified. We show that the choice of transcriptional direction is reversible but not mutually exclusive, since sense and antisense reporter activity was often present in the same cell and simultaneously upregulated during myotube formation. Similarly, levels of endogenous sense and antisense D4Z4 transcripts were upregulated in FSHD myotubes. These studies offer insight into the autonomous distribution of muscle weakness that is characteristic of FSHD.
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Current world literature. Curr Opin Neurol 2011; 24:511-6. [PMID: 21900773 DOI: 10.1097/wco.0b013e32834be5c1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jacqueline M. The identification of Landouzy-Dejerine disease: an investigative history. Neuromuscul Disord 2011; 21:291-7. [PMID: 21316966 DOI: 10.1016/j.nmd.2011.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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