1
|
Forsting J, Rehmann R, Rohm M, Kocabas A, De Lorenzo A, Güttsches AK, Vorgerd M, Froeling M, Schlaffke L. Prospective longitudinal cohort study of quantitative muscle magnetic resonance imaging in a healthy control population. NMR IN BIOMEDICINE 2024:e5214. [PMID: 38982853 DOI: 10.1002/nbm.5214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 07/11/2024]
Abstract
Quantitative muscle magnetic resonance imaging (qMRI) is a valuable methodology for assessing muscular injuries and neuromuscular disorders. Notably, muscle diffusion tensor imaging (DTI) gives insights into muscle microstructural and macrostructural characteristics. However, the long-term reproducibility and robustness of these measurements remain relatively unexplored. The purpose of this prospective longitudinal cohort study was to assess the long-term robustness and range of variation of qMRI parameters, especially DTI metrics, in the lower extremity muscles of healthy controls under real-life conditions. Twelve volunteers (seven females, age 44.1 ± 12.1 years, body mass index 23.3 ± 2.0 kg/m2) underwent five leg muscle MRI sessions every 20 ± 4 weeks over a total period of 1.5 years. A multiecho gradient-echo Dixon-based sequence, a multiecho spin-echo T2-mapping sequence, and a spin-echo echo planar imaging diffusion-weighted sequence were acquired bilaterally with a Philips 3-T Achieva MR System using a 16-channel torso coil. Fifteen leg muscles were segmented in both lower extremities. qMRI parameters, including fat fraction (FF), water T2 relaxation time, and the diffusion metrics fractional anisotropy (FA) and mean diffusivity (MD), were evaluated. Coefficients of variance (wsCV) and intraclass correlation coefficients (ICCs) were calculated to assess the reproducibility of qMRI parameters. The standard error of measurement (SEM) and the minimal detectable change (MDC) were calculated to determine the range of variation. All tests were applied to all muscles and, subsequently, to each muscle separately. wsCV showed good reproducibility (≤ 10%) for all qMRI parameters in all muscles. The ICCs revealed excellent agreement between time points (FF = 0.980, water T2 = 0.941, FA = 0.952, MD = 0.948). Random measurement errors assessed by SEM and the MDC were low (< 12%). In conclusion, in this study, we showed that qMRI parameters in healthy volunteers living normal lives are stable over 18 months, thereby defining a benchmark for the expected range of variation over time.
Collapse
Affiliation(s)
- Johannes Forsting
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Robert Rehmann
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
- Department of Neurology, Klinikum Dortmund, University Witten-Herdecke, Dortmund, Germany
| | - Marlena Rohm
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Abdulhadi Kocabas
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Alice De Lorenzo
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Anne-Katrin Güttsches
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Matthias Vorgerd
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Martijn Froeling
- Department of Radiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Lara Schlaffke
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
2
|
Huang Y, Chen T, Hu Y, Li Z. Muscular MRI and magnetic resonance neurography in spinal muscular atrophy. Clin Radiol 2024:S0009-9260(24)00292-7. [PMID: 38945793 DOI: 10.1016/j.crad.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/08/2024] [Accepted: 06/03/2024] [Indexed: 07/02/2024]
Abstract
Spinal muscular atrophy (SMA) is an autosomal recessive genetic disease caused by the degeneration of the α-motor neurons in the anterior horn of the spinal cord. SMA is clinically characterized by progressive and symmetrical muscle weakness and muscle atrophy and ends up with systemic multisystem abnormalities. Quantitative MRI (qMRI) has the advantages of non-invasiveness, objective sensitivity, and high reproducibility, and has important clinical value in evaluating the severity of neuromuscular diseases and monitoring the efficacy of treatment. This article summarizes the clinical use of muscular MRI and magnetic resonance neurography in assessing the progress of SMA.
Collapse
Affiliation(s)
- Y Huang
- Department of Radiology, Shenzhen Childrens Hospital, Shantou University Medical College Affiliated Shenzhen Childrens Hospital, Shenzhen, China
| | - T Chen
- Department of Radiology, Shenzhen Childrens Hospital, Shantou University Medical College Affiliated Shenzhen Childrens Hospital, Shenzhen, China; Department of Radiology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Y Hu
- Department of Radiology, Shenzhen Childrens Hospital, Shantou University Medical College Affiliated Shenzhen Childrens Hospital, Shenzhen, China; Department of Radiology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Z Li
- Department of Radiology, Shenzhen Childrens Hospital, Shantou University Medical College Affiliated Shenzhen Childrens Hospital, Shenzhen, China.
| |
Collapse
|
3
|
Li Y, Nie H, Xiang P, Shen W, Yan M, Yan C, Su S, Qian L, Liang Y, Tang W, Yang Z, Li Y, Chen Y. Disrupted individual-level morphological brain network in spinal muscular atrophy types 2 and 3. CNS Neurosci Ther 2024; 30:e14804. [PMID: 38887183 PMCID: PMC11183166 DOI: 10.1111/cns.14804] [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: 12/09/2023] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Spinal muscular atrophy (SMA) is one of the most common monogenic neuromuscular diseases, and the pathogenesis mechanisms, especially the brain network topological properties, remain unknown. This study aimed to use individual-level morphological brain network analysis to explore the brain neural network mechanisms in SMA. METHODS Individual-level gray matter (GM) networks were constructed by estimating the interregional similarity of GM volume distribution using both Kullback-Leibler divergence-based similarity (KLDs) and Jesen-Shannon divergence-based similarity (JSDs) measurements based on Automated Anatomical Labeling 116 and Hammersmith 83 atlases for 38 individuals with SMA types 2 and 3 and 38 age- and sex-matched healthy controls (HCs). The topological properties were analyzed by the graph theory approach and compared between groups by a nonparametric permutation test. Additionally, correlation analysis was used to assess the associations between altered topological metrics and clinical characteristics. RESULTS Compared with HCs, although global network topology remained preserved in individuals with SMA, brain regions with altered nodal properties mainly involved the right olfactory gyrus, right insula, bilateral parahippocampal gyrus, right amygdala, right thalamus, left superior temporal gyrus, left cerebellar lobule IV-V, bilateral cerebellar lobule VI, right cerebellar lobule VII, and vermis VII and IX. Further correlation analysis showed that the nodal degree of the right cerebellar lobule VII was positively correlated with the disease duration, and the right amygdala was negatively correlated with the Hammersmith Functional Motor Scale Expanded (HFMSE) scores. CONCLUSIONS Our findings demonstrated that topological reorganization may prioritize global properties over nodal properties, and disrupted topological properties in the cortical-limbic-cerebellum circuit in SMA may help to further understand the network pathogenesis underlying SMA.
Collapse
Affiliation(s)
- Yufen Li
- Department of RadiologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Huirong Nie
- Department of RadiologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Pei Xiang
- Department of RadiologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Wanqing Shen
- Department of Interventional OncologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Mengzhen Yan
- Department of Pediatric Intensive Care UnitThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Cui Yan
- Department of RadiologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Shu Su
- Department of RadiologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Long Qian
- Department of Biomedical Engineering, College of EngineeringPeking UniversityBeijingChina
| | - Yujian Liang
- Department of Pediatric Intensive Care UnitThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Wen Tang
- Department of Pediatric Intensive Care UnitThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Zhiyun Yang
- Department of RadiologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Yijuan Li
- Department of Pediatric Intensive Care UnitThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Yingqian Chen
- Department of RadiologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| |
Collapse
|
4
|
Li W, Hadizadeh M, Yusof A, Naharudin MN. Effects of isometric training and R.I.C.E. treatment on the arm muscle performance of swimmers with elbow pain. Sci Rep 2024; 14:4736. [PMID: 38413632 PMCID: PMC10899567 DOI: 10.1038/s41598-024-54789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024] Open
Abstract
The effects of IT and R.I.C.E. treatment on arm muscle performance in overhead athletes with elbow pain (EP) have been partially validated. However, there is a lack of research evidence regarding the efficacy of these two methods on arm muscle performance among swimmers with EP. The aim of this study was to investigate the trends and differences in the effects of IT and R.I.C.E. treatment on arm muscle performance among swimmers with EP. The main outcomes were the time effects and group effects of interventions on muscle voluntary contraction (MVC). Sixty elite freestyle swimmers from Tianjin, China, voluntarily participated in the study and completed a 10-week intervention program. Swimmers with EP in the IT group showed a positive trend in MVC, with an approximately 2% increase, whereas the MVC of subjects in the R.I.C.E. treatment group and control group decreased by approximately 4% and 5%, respectively. In comparison, the effects of the IT intervention on the MVC of the triceps and brachioradialis muscles in swimmers with EP were significant (p = 0.042 < 0.05, p = 0.027 < 0.05). The mean MVC value of the IT group (0.60) was greater than that of the other two groups (0.51, 0.50). IT has a beneficial impact on the MVC performance of the triceps and brachioradialis muscles in swimmers with EP. It is recommended that professionals consider incorporating IT into regular training routines to mitigate the risk of EP issues. Future research should examine the effectiveness of both interventions on hand-grip strength and completion time in 50-m freestyle swim drills in order for swimmers with EP to return to this sport.
Collapse
Affiliation(s)
- Weihan Li
- Faculty of Sports and Exercise Science, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Maryam Hadizadeh
- Faculty of Sports and Exercise Science, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Ashril Yusof
- Faculty of Sports and Exercise Science, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | | |
Collapse
|
5
|
Lapp HS, Freigang M, Hagenacker T, Weiler M, Wurster CD, Günther R. Biomarkers in 5q-associated spinal muscular atrophy-a narrative review. J Neurol 2023; 270:4157-4178. [PMID: 37289324 PMCID: PMC10421827 DOI: 10.1007/s00415-023-11787-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/09/2023]
Abstract
5q-associated spinal muscular atrophy (SMA) is a rare genetic disease caused by mutations in the SMN1 gene, resulting in a loss of functional SMN protein and consecutive degeneration of motor neurons in the ventral horn. The disease is clinically characterized by proximal paralysis and secondary skeletal muscle atrophy. New disease-modifying drugs driving SMN gene expression have been developed in the past decade and have revolutionized SMA treatment. The rise of treatment options led to a concomitant need of biomarkers for therapeutic guidance and an improved disease monitoring. Intensive efforts have been undertaken to develop suitable markers, and numerous candidate biomarkers for diagnostic, prognostic, and predictive values have been identified. The most promising markers include appliance-based measures such as electrophysiological and imaging-based indices as well as molecular markers including SMN-related proteins and markers of neurodegeneration and skeletal muscle integrity. However, none of the proposed biomarkers have been validated for the clinical routine yet. In this narrative review, we discuss the most promising candidate biomarkers for SMA and expand the discussion by addressing the largely unfolded potential of muscle integrity markers, especially in the context of upcoming muscle-targeting therapies. While the discussed candidate biomarkers hold potential as either diagnostic (e.g., SMN-related biomarkers), prognostic (e.g., markers of neurodegeneration, imaging-based markers), predictive (e.g., electrophysiological markers) or response markers (e.g., muscle integrity markers), no single measure seems to be suitable to cover all biomarker categories. Hence, a combination of different biomarkers and clinical assessments appears to be the most expedient solution at the time.
Collapse
Affiliation(s)
- H S Lapp
- Department of Neurology, University Hospital Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - M Freigang
- Department of Neurology, University Hospital Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - T Hagenacker
- Department of Neurology and Center for Translational Neuro- and Behavioral Science (C-TNBS), University Medicine Essen, Essen, Germany
| | - M Weiler
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - C D Wurster
- Department of Neurology, University Hospital Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE) Ulm, Ulm, Germany
| | - René Günther
- Department of Neurology, University Hospital Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
- German Center for Neurodegenerative Diseases (DZNE) Dresden, Dresden, Germany.
| |
Collapse
|
6
|
Gallone A, Mazzi F, Bonanno S, Zanin R, Moscatelli M, Aquino D, Maggi L. Muscle quantitative MRI in adult SMA patients on nusinersen treatment: a longitudinal study. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2022; 41:76-83. [PMID: 35832502 PMCID: PMC9237750 DOI: 10.36185/2532-1900-074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
The recent approval of disease-modifying therapies for spinal muscular atrophy (SMA) raised the need of alternative outcome measures to evaluate treatment efficacy. In this study, we investigated the potential of muscle quantitative MRI (qMRI) as a biomarker of disease progression in adult SMA3 patients during nusinersen treatment. Six adult SMA3 patients (age ranging from 19 to 65 years) underwent 2-point Dixon muscle qMRI at beginning of nusinersen treatment (T0) and after 14 months (T14) to evaluate the muscle fat fraction (FF) at thigh and leg levels; patients were clinically assessed at T0 and T14 with the Hammersmith Functional Rating Scale Expanded (HFMSE), the Revised Upper Limb Module (RULM) and the 6-minute walk test (6MWT). At T0, vastus lateralis muscle displayed the highest mean FF (67.5%), while tibialis anterior was the most preserved one (mean FF = 35.2%). At T0, a slightly significant correlation of FF with HFMSE (p = 0.042) and disease duration (p = 0.042) at thigh level and only with HFMSE (p = 0.042) at leg level was found. At T14, no significant change of mean FF values at thigh and leg muscles was found compared to T0. Conversely, a statistically significant (p = 0.042) improvement of HFMSE was reported at T14. We observed no significant change of FF in thigh and leg muscles after 14 months of nusinersen therapy despite a significant clinical improvement of HFMSE. Further studies with longer follow-up and larger cohorts are needed to better investigate the role of qMRI as marker of disease progression in SMA patients.
Collapse
Affiliation(s)
- Annamaria Gallone
- Neuroimmunology and Neuromuscular Diseases Unit, Foundation IRCCS “Carlo Besta” Neurological Institute, Milan, Italy
| | - Federica Mazzi
- Neuroradiology Unit, Foundation IRCCS “Carlo Besta” Neurological Institute, Milan, Italy
| | - Silvia Bonanno
- Neuroimmunology and Neuromuscular Diseases Unit, Foundation IRCCS “Carlo Besta” Neurological Institute, Milan, Italy
| | - Riccardo Zanin
- Developmental Neurology, Foundation IRCCS “Carlo Besta” Neurological Institute, Milan, Italy
| | - Marco Moscatelli
- Neuroradiology Unit, Foundation IRCCS “Carlo Besta” Neurological Institute, Milan, Italy, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Domenico Aquino
- Neuroradiology Unit, Foundation IRCCS “Carlo Besta” Neurological Institute, Milan, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Diseases Unit, Foundation IRCCS “Carlo Besta” Neurological Institute, Milan, Italy,Correspondence Lorenzo Maggi Neuroimmunology and Neuromuscular Diseases; Foundation IRCCS “Carlo Besta” Neurological Institute, via Celoria 11, 20133 Milan, Italy. E-mail:
| |
Collapse
|