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Mancero Castillo CS, Atashzar SF, Vaidyanathan R. 3D muscle networks based on vibrational mechanomyography. J Neural Eng 2023; 20:066008. [PMID: 37812933 DOI: 10.1088/1741-2552/ad017c] [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: 03/29/2023] [Accepted: 09/15/2023] [Indexed: 10/11/2023]
Abstract
Objective. Muscle network modeling maps synergistic control during complex motor tasks. Intermuscular coherence (IMC) is key to isolate synchronization underlying coupling in such neuromuscular control. Model inputs, however, rely on electromyography, which can limit the depth of muscle and spatial information acquisition across muscle fibers.Approach. We introduce three-dimensional (3D) muscle networks based on vibrational mechanomyography (vMMG) and IMC analysis to evaluate the functional co-modulation of muscles across frequency bands in concert with the longitudinal, lateral, and transverse directions of muscle fibers. vMMG is collected from twenty subjects using a bespoke armband of accelerometers while participants perform four hand gestures. IMC from four superficial muscles (flexor carpi radialis, brachioradialis, extensor digitorum communis, and flexor carpi ulnaris) is decomposed using matrix factorization into three frequency bands. We further evaluate the practical utility of the proposed technique by analyzing the network responses to various sensor-skin contact force levels, studying changes in quality, and discriminative power of vMMG.Main results. Results show distinct topological differences, with coherent coupling as high as 57% between specific muscle pairs, depending on the frequency band, gesture, and direction. No statistical decrease in signal strength was observed with higher contact force.Significance. Results support the usability vMMG as a tool for muscle connectivity analyses and demonstrate the use of IMC as a new feature space for hand gesture classification. Comparison of spectrotemporal and muscle network properties between levels of force support the robustness of vMMG-based network models to variations in tissue compression. We argue 3D models of vMMG-based muscle networks provide a new foundation for studying synergistic muscle activation, particularly in out-of-clinic scenarios where electrical recording is impractical.
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Affiliation(s)
| | - S Farokh Atashzar
- Department of Mechanical and Aerospace Engineering, Department of Electrical and Computer Engineering, New York University, New York, NY, United States of America
| | - Ravi Vaidyanathan
- Department of Mechanical Engineering, Imperial College London, London, United Kingdom
- UK Dementia Research Institute-CRT, Imperial College, London, United Kingdom
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Kuntawala DH, Martins F, Vitorino R, Rebelo S. Automatic Text-Mining Approach to Identify Molecular Target Candidates Associated with Metabolic Processes for Myotonic Dystrophy Type 1. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2283. [PMID: 36767649 PMCID: PMC9915907 DOI: 10.3390/ijerph20032283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Myotonic dystrophy type 1 (DM1) is an autosomal dominant hereditary disease caused by abnormal expansion of unstable CTG repeats in the 3' untranslated region of the myotonic dystrophy protein kinase (DMPK) gene. This disease mainly affects skeletal muscle, resulting in myotonia, progressive distal muscle weakness, and atrophy, but also affects other tissues and systems, such as the heart and central nervous system. Despite some studies reporting therapeutic strategies for DM1, many issues remain unsolved, such as the contribution of metabolic and mitochondrial dysfunctions to DM1 pathogenesis. Therefore, it is crucial to identify molecular target candidates associated with metabolic processes for DM1. In this study, resorting to a bibliometric analysis, articles combining DM1, and metabolic/metabolism terms were identified and further analyzed using an unbiased strategy of automatic text mining with VOSviewer software. A list of candidate molecular targets for DM1 associated with metabolic/metabolism was generated and compared with genes previously associated with DM1 in the DisGeNET database. Furthermore, g:Profiler was used to perform a functional enrichment analysis using the Gene Ontology (GO) and REAC databases. Enriched signaling pathways were identified using integrated bioinformatics enrichment analyses. The results revealed that only 15 of the genes identified in the bibliometric analysis were previously associated with DM1 in the DisGeNET database. Of note, we identified 71 genes not previously associated with DM1, which are of particular interest and should be further explored. The functional enrichment analysis of these genes revealed that regulation of cellular metabolic and metabolic processes were the most associated biological processes. Additionally, a number of signaling pathways were found to be enriched, e.g., signaling by receptor tyrosine kinases, signaling by NRTK1 (TRKA), TRKA activation by NGF, PI3K-AKT activation, prolonged ERK activation events, and axon guidance. Overall, several valuable target candidates related to metabolic processes for DM1 were identified, such as NGF, NTRK1, RhoA, ROCK1, ROCK2, DAG, ACTA, ID1, ID2 MYOD, and MYOG. Therefore, our study strengthens the hypothesis that metabolic dysfunctions contribute to DM1 pathogenesis, and the exploitation of metabolic dysfunction targets is crucial for the development of future therapeutic interventions for DM1.
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Mateus T, Costa A, Viegas D, Marques A, Herdeiro MT, Rebelo S. Outcome measures frequently used to assess muscle strength in patients with myotonic dystrophy type 1: a systematic review. Neuromuscul Disord 2021; 32:99-115. [PMID: 35031191 DOI: 10.1016/j.nmd.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
Measurement of muscle strength is fundamental for the management of patients with myotonic dystrophy type 1 (DM1). Nevertheless, guidance on this topic is somewhat limited due to heterogeneous outcome measures used. This systematic literature review aimed to summarize the most frequent outcome measures to assess muscle strength in patients with DM1. We searched on Pubmed, Web of Science and Embase databases. Observational studies using measures of muscle strength assessment in adult patients with DM1 were included. From a total of 80 included studies, 24 measured cardiac, 45 skeletal and 23 respiratory muscle strength. The most common method and outcome measures used to assess cardiac muscle strength were echocardiography and ejection fraction, for skeletal muscle strength were quantitative muscle test, manual muscle test and maximum isometric torque and medical research council and for respiratory muscle strength were manometry and maximal inspiratory and expiratory pressure. We successfully gathered the more consensual methods and measures to evaluate muscle strength in future clinical studies, particularly to test muscle strength response to treatments in patients with DM1. Future consensus on a set of measures to evaluate muscle strength (core outcome set), is important for these patients.
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Affiliation(s)
- Tiago Mateus
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Adriana Costa
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Diana Viegas
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory - Lab3R, Institute of Biomedicine (iBiMED), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Sandra Rebelo
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal.
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4
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Bora M, Yalçin A, Bulut N, Yilmaz Ö, Karaduman A, Topuz S, Alemdaroğlu-Gürbüz İ. Investigation of surface electromyography amplitude values during stair climbing task in children with Duchenne muscular dystrophy. Neurol Sci 2021; 43:2791-2801. [PMID: 34608577 DOI: 10.1007/s10072-021-05643-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aims of this study were (a) to examine the surface electromyography (sEMG) amplitude values of the lower limb muscles during stair climbing both between different functional levels of Duchenne muscular dystrophy (DMD), in comparison with healthy children, and (b) to investigate the relationships between sEMG amplitudes and physical performance. METHODS sEMG amplitudes of the lower limbs of twenty-one children with DMD between levels I and III according to the Brooke Lower Extremity Functional Classification Scale and eleven healthy peers were evaluated by using sEMG during stair climbing task. Physical performance was evaluated by 6-min walk test and ascending 4-step timed performance test. RESULTS The lower limb sEMG amplitude values of children with DMD were statistically higher than healthy children (p < 0.001). sEMG amplitudes of the right (p = 0.01) and left (p = 0.003) biceps femoris, the right (p < 0.001) and left (p = 0.001) gastrocnemius medialis, and the right vastus lateralis (p = 0.02) muscles were higher in children with levels 2-3 than those in level 1. Moderate-to-strong relations were found between the gastrocnemius medialis and biceps femoris sEMG amplitudes and physical performance assessments (p < 0.05). CONCLUSION Increased sEMG amplitude values in the lower limbs during stair climbing task are thought to be caused by the effort to compensate for progressive muscle weakness and are associated with lower physical performance in children with DMD. Further, sEMG amplitude values are determined to increase as the functional level deteriorates. CLINICAL TRIAL REGISTRATION NUMBER AND URL NCT04287582 ( https://clinicaltrials.gov/ct2/show/NCT04287582?term=merve+bora&draw=2&rank=1 ).
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Affiliation(s)
- Merve Bora
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - Ali Yalçin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - Numan Bulut
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - Öznur Yilmaz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - Ayşe Karaduman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Sogutozu, 06510, Çankaya/Ankara, Turkey
| | - Semra Topuz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - İpek Alemdaroğlu-Gürbüz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey.
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Effects of 4-weeks of elastic variable resistance training on the electrochemical and mechanical components of voluntary electromechanical delay durations. Eur J Appl Physiol 2021; 121:3313-3321. [PMID: 34432149 DOI: 10.1007/s00421-021-04791-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Literature is conflicted on whether electromechanical delay durations decrease following resistance training programs. Therefore, the aim of this study is to examine the contributions and durations of the electrochemical (EMDE-M) and mechanical (EMDM-F) components to the overall electromechanical delay (EMDE-F) during step isometric muscle actions following 4-weeks of structured, multi-joint, lower-body variable resistance training (VRT) program. METHODS Twelve men performed 4-weeks of VRT leg press training utilizing combination of steel plates (80% total load) and elastic bands (20% total load). Training consisted of 3 sets of 10 repetitions at a 10 repetition maximum load, 3 day week-1 for 4-weeks. EMDE-M, EMDM-F, and EMDE-F was measured at Baseline, Week-2, and Week-4 during voluntary step isometric muscle actions (20, 40, 60, 80, and 100% of maximal voluntary isometric contraction) from the vastus lateralis using electromyographic, mechanomyographic, and force signals. RESULTS The EMDE-M, EMDM-F, and EMDE-F exhibited decreases in duration following 4-weeks of VRT. In addition, EMDE-M contributed significantly less (42-47%) than EMDM-F (53-58%) to the total duration of EMDE-F across the 4-weeks of VRT. CONCLUSIONS These findings indicated that a structured, VRT program utilizing multi-joint exercise was sufficient to induce decreases in the electrochemical and mechanical processes associated with step isometric muscle contractions. In addition, the utilization of the electromyographic, mechanomyographic, and force signals were capable of quantifying electrochemical and mechanical component changes associated with voluntary muscle contraction. Thus, EMDE-M, EMDM-F, and EMDE-F can be useful in quantifying physiological changes in athletic, clinical, and applied research interventions.
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6
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Greene E, Thonhoff J, John BS, Rosenfield DB, Helekar SA. Multifocal Noninvasive Magnetic Stimulation of the Primary Motor Cortex in Type 1 Myotonic Dystrophy -A Proof of Concept Pilot Study. J Neuromuscul Dis 2021; 8:963-972. [PMID: 34250947 DOI: 10.3233/jnd-210690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Repeated neuromuscular electrical stimulation in type 1 Myotonic Dystrophy (DM1) has previously been shown to cause an increase in strength and a decrease in hyperexcitability of the tibialis anterior muscle. OBJECTIVE In this proof-of-principle study our objective was to test the hypothesis that noninvasive repetitive transcranial magnetic stimulation of the primary motor cortex (M1) with a new portable wearable multifocal stimulator causes improvement in muscle function in DM1 patients. METHODS We performed repetitive stimulation of M1, localized by magnetic resonance imaging, with a newly developed Transcranial Rotating Permanent Magnet Stimulator (TRPMS). Using a randomized within-patient placebo-controlled double-blind TRPMS protocol, we performed unilateral active stimulation along with contralateral sham stimulation every weekday for two weeks in 6 adults. Methods for evaluation of muscle function involved electromyography (EMG), hand dynamometry and clinical assessment using the Medical Research Council scale. RESULTS All participants tolerated the treatment well. While there were no significant changes clinically, EMG showed significant improvement in nerve stimulus-evoked compound muscle action potential amplitude of the first dorsal interosseous muscle and a similar but non-significant trend in the trapezius muscle, after a short exercise test, with active but not sham stimulation. CONCLUSIONS We conclude that two-week repeated multifocal cortical stimulation with a new wearable transcranial magnetic stimulator can be safely conducted in DM1 patients to investigate potential improvement of muscle strength and activity. The results obtained, if confirmed and extended by future safety and efficacy trials with larger patient samples, could offer a potential supportive TRPMS treatment in DM1.
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Affiliation(s)
- Ericka Greene
- Stanley H. Appel Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Jason Thonhoff
- Stanley H. Appel Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Blessy S John
- Stanley H. Appel Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - David B Rosenfield
- Stanley H. Appel Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Santosh A Helekar
- Stanley H. Appel Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
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Mateus T, Almeida I, Costa A, Viegas D, Magalhães S, Martins F, Herdeiro MT, da Cruz e Silva OAB, Fraga C, Alves I, Nunes A, Rebelo S. Fourier-Transform Infrared Spectroscopy as a Discriminatory Tool for Myotonic Dystrophy Type 1 Metabolism: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073800. [PMID: 33917301 PMCID: PMC8038712 DOI: 10.3390/ijerph18073800] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022]
Abstract
Myotonic dystrophy type 1 (DM1) is a hereditary disease characterized by progressive distal muscle weakness and myotonia. Patients with DM1 have abnormal lipid metabolism and a high propensity to develop a metabolic syndrome in comparison to the general population. It follows that metabolome evaluation in these patients is crucial and may contribute to a better characterization and discrimination between DM1 disease phenotypes and severities. Several experimental approaches are possible to carry out such an analysis; among them is Fourier-transform infrared spectroscopy (FTIR) which evaluates metabolic profiles by categorizing samples through their biochemical composition. In this study, FTIR spectra were acquired and analyzed using multivariate analysis (Principal Component Analysis) using skin DM1 patient-derived fibroblasts and controls. The results obtained showed a clear discrimination between both DM1-derived fibroblasts with different CTG repeat length and with the age of disease onset; this was evident given the distinct metabolic profiles obtained for the two groups. Discrimination could be attributed mainly to the altered lipid metabolism and proteins in the 1800–1500 cm−1 region. These results suggest that FTIR spectroscopy is a valuable tool to discriminate both DM1-derived fibroblasts with different CTG length and age of onset and to study the metabolomic profile of patients with DM1.
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Affiliation(s)
- Tiago Mateus
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
| | - Idália Almeida
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
| | - Adriana Costa
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
| | - Diana Viegas
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
| | - Sandra Magalhães
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
- Department of Chemistry, Aveiro Institute of Materials (CICECO), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Filipa Martins
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
| | - Odete A. B. da Cruz e Silva
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
| | - Carla Fraga
- Neurology Department, Centro Hospitalar Tâmega e Sousa (CHTS), 4564-007 Penafiel, Portugal; (C.F.); (I.A.)
| | - Ivânia Alves
- Neurology Department, Centro Hospitalar Tâmega e Sousa (CHTS), 4564-007 Penafiel, Portugal; (C.F.); (I.A.)
| | - Alexandra Nunes
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
| | - Sandra Rebelo
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal; (T.M.); (I.A.); (A.C.); (D.V.); (S.M.); (F.M.); (M.T.H.); (O.A.B.d.C.eS.); (A.N.)
- Correspondence: ; Tel.: +351-924-406-306; Fax: +351-234-372-587
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Mateus T, Martins F, Nunes A, Herdeiro MT, Rebelo S. Metabolic Alterations in Myotonic Dystrophy Type 1 and Their Correlation with Lipin. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041794. [PMID: 33673200 PMCID: PMC7918590 DOI: 10.3390/ijerph18041794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 12/14/2022]
Abstract
Myotonic dystrophy type 1 (DM1) is an autosomal dominant hereditary and multisystemic disease, characterized by progressive distal muscle weakness and myotonia. Despite huge efforts, the pathophysiological mechanisms underlying DM1 remain elusive. In this review, the metabolic alterations observed in patients with DM1 and their connection with lipin proteins are discussed. We start by briefly describing the epidemiology, the physiopathological and systemic features of DM1. The molecular mechanisms proposed for DM1 are explored and summarized. An overview of metabolic syndrome, dyslipidemia, and the summary of metabolic alterations observed in patients with DM1 are presented. Patients with DM1 present clinical evidence of metabolic alterations, namely increased levels of triacylglycerol and low-density lipoprotein, increased insulin and glucose levels, increased abdominal obesity, and low levels of high-density lipoprotein. These metabolic alterations may be associated with lipins, which are phosphatidate phosphatase enzymes that regulates the triacylglycerol levels, phospholipids, lipid signaling pathways, and are transcriptional co-activators. Furthermore, lipins are also important for autophagy, inflammasome activation and lipoproteins synthesis. We demonstrate the association of lipin with the metabolic alterations in patients with DM1, which supports further clinical studies and a proper exploration of lipin proteins as therapeutic targets for metabolic syndrome, which is important for controlling many diseases including DM1.
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Affiliation(s)
| | | | | | | | - Sandra Rebelo
- Correspondence: ; Tel.: +351-924-406-306; Fax: +351-234-372-587
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Son J, Rymer WZ. Longer electromechanical delay in paretic triceps surae muscles during voluntary isometric plantarflexion torque generation in chronic hemispheric stroke survivors. J Electromyogr Kinesiol 2020; 56:102475. [PMID: 33242750 DOI: 10.1016/j.jelekin.2020.102475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/16/2020] [Accepted: 09/17/2020] [Indexed: 11/28/2022] Open
Abstract
Electromechanical delay (EMD) is the time delay between the onset of muscle activity and the onset of force/joint torque. This delay appears to be linked to muscular contraction efficiency. However, to our knowledge, limited evidence is available regarding the magnitude of the EMD in stroke-impaired muscles. Accordingly, this study aims to quantify the EMD in both paretic and non-paretic triceps surae muscles of chronic hemispheric stroke survivors, and to investigate whether the EMD is related to voluntary force-generating capacity in this muscle group. Nine male chronic stroke survivors were asked to perform isometric plantarflexion contractions at different force levels and at different ankle joint angles ranging from maximum plantarflexion to maximum dorsiflexion. The surface electromyograms were recorded from triceps surae muscles. The longest EMD among triceps surae muscles was chosen as the EMD for each side. Our results revealed that the EMD in paretic muscles was significantly longer than in non-paretic muscles. Moreover, both paretic and non-paretic muscles showed a negative correlation between the EMD and maximum torque-generating capacity. In addition, there was a strong positive relationship between the EMD and shear wave speed in paretic muscles as well as a negative relationship between the EMD and passive ankle joint range of motion. These findings imply that the EMD may be a useful biomarker, in part, associated with contractile and material properties in stroke-impaired muscles.
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Affiliation(s)
- Jongsang Son
- Shirley Ryan AbilityLab (formerly the Rehabilitation Institute of Chicago), Chicago, IL, United States; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
| | - William Zev Rymer
- Shirley Ryan AbilityLab (formerly the Rehabilitation Institute of Chicago), Chicago, IL, United States; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Antisense oligonucleotide and adjuvant exercise therapy reverse fatigue in old mice with myotonic dystrophy. MOLECULAR THERAPY. NUCLEIC ACIDS 2020; 23:393-405. [PMID: 33473325 PMCID: PMC7787993 DOI: 10.1016/j.omtn.2020.11.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/17/2020] [Indexed: 02/06/2023]
Abstract
Patients with myotonic dystrophy type 1 (DM1) identify chronic fatigue as the most debilitating symptom, which manifests in part as prolonged recovery after exercise. Clinical features of DM1 result from pathogenic gain-of-function activity of transcripts containing an expanded microsatellite CUG repeat (CUGexp). In DM1 mice, therapies targeting the CUGexp transcripts correct the molecular phenotype, reverse myotonia, and improve muscle pathology. However, the effect of targeted molecular therapies on fatigue in DM1 is unknown. Here, we use two mouse models of DM1, age-matched wild-type controls, an exercise-activity assay, electrical impedance myography, and therapeutic antisense oligonucleotides (ASOs) to show that exaggerated exercise-induced fatigue progresses with age, is unrelated to muscle fiber size, and persists despite correction of the molecular phenotype for 3 months. In old DM1 mice, ASO treatment combined with an exercise training regimen consisting of treadmill walking 30 min per day 6 days per week for 3 months reverse all measures of fatigue. Exercise training without ASO therapy improves some measures of fatigue without correction of the molecular pathology. Our results highlight a key limitation of ASO monotherapy for this clinically important feature and support the development of moderate-intensity exercise as an adjuvant for targeted molecular therapies of DM1.
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Siciliano G, Chico L, Lo Gerfo A, Simoncini C, Schirinzi E, Ricci G. Exercise-Related Oxidative Stress as Mechanism to Fight Physical Dysfunction in Neuromuscular Disorders. Front Physiol 2020; 11:451. [PMID: 32508674 PMCID: PMC7251329 DOI: 10.3389/fphys.2020.00451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/09/2020] [Indexed: 12/12/2022] Open
Abstract
Neuromuscular diseases (NMDs) are a group of often severely disabling disorders characterized by dysfunction in one of the main constituents of the motor unit, the cardinal anatomic-functional structure behind force and movement production. Irrespective of the different pathogenic mechanisms specifically underlying these disease conditions genetically determined or acquired, and the related molecular pathways involved in doing that, oxidative stress has often been shown to play a relevant role within the chain of events that induce or at least modulate the clinical manifestations of these disorders. Due to such a putative relevance of the imbalance of redox status occurring in contractile machinery and/or its neural drive in NMDs, physical exercise appears as one of the most important conditions able to positively interfere along an ideal axis, going from a deranged metabolic cell homeostasis in motor unit components to the reduced motor performance profile exhibited by the patient in everyday life. If so, it comes out that it would be important to identify a proper training program, suitable for load and type of exercise that is able to improve motor performance in adaptation and response to such a homeostatic imbalance. This review therefore analyzes the role of different exercise trainings on oxidative stress mechanisms, both in healthy and in NMDs, also including preclinical studies, to elucidate at which extent these can be useful to counteract muscle impairment associated to the disease, with the final aim of improving physical functions and quality of life of NMD patients.
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Affiliation(s)
- Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Lucia Chico
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Annalisa Lo Gerfo
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Costanza Simoncini
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Erika Schirinzi
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
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Rampichini S, Vieira TM, Castiglioni P, Merati G. Complexity Analysis of Surface Electromyography for Assessing the Myoelectric Manifestation of Muscle Fatigue: A Review. ENTROPY (BASEL, SWITZERLAND) 2020; 22:E529. [PMID: 33286301 PMCID: PMC7517022 DOI: 10.3390/e22050529] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 01/13/2023]
Abstract
The surface electromyography (sEMG) records the electrical activity of muscle fibers during contraction: one of its uses is to assess changes taking place within muscles in the course of a fatiguing contraction to provide insights into our understanding of muscle fatigue in training protocols and rehabilitation medicine. Until recently, these myoelectric manifestations of muscle fatigue (MMF) have been assessed essentially by linear sEMG analyses. However, sEMG shows a complex behavior, due to many concurrent factors. Therefore, in the last years, complexity-based methods have been tentatively applied to the sEMG signal to better individuate the MMF onset during sustained contractions. In this review, after describing concisely the traditional linear methods employed to assess MMF we present the complexity methods used for sEMG analysis based on an extensive literature search. We show that some of these indices, like those derived from recurrence plots, from entropy or fractal analysis, can detect MMF efficiently. However, we also show that more work remains to be done to compare the complexity indices in terms of reliability and sensibility; to optimize the choice of embedding dimension, time delay and threshold distance in reconstructing the phase space; and to elucidate the relationship between complexity estimators and the physiologic phenomena underlying the onset of MMF in exercising muscles.
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Affiliation(s)
- Susanna Rampichini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (G.M.)
| | - Taian Martins Vieira
- Laboratorio di Ingegneria del Sistema Neuromuscolare (LISiN), Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, 10129 Turin, Italy
- PoliToBIOMed Lab, Politecnico di Torino, 10129 Turin, Italy
| | | | - Giampiero Merati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (G.M.)
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy;
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13
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Cè E, Longo S, Limonta E, Coratella G, Rampichini S, Esposito F. Peripheral fatigue: new mechanistic insights from recent technologies. Eur J Appl Physiol 2019; 120:17-39. [DOI: 10.1007/s00421-019-04264-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 11/12/2019] [Indexed: 12/12/2022]
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14
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Differences in electromechanical delay components induced by sex, age and physical activity level: new insights from a combined electromyographic, mechanomyographic and force approach. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-019-00563-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Roussel MP, Morin M, Gagnon C, Duchesne E. What is known about the effects of exercise or training to reduce skeletal muscle impairments of patients with myotonic dystrophy type 1? A scoping review. BMC Musculoskelet Disord 2019; 20:101. [PMID: 30836978 PMCID: PMC6402179 DOI: 10.1186/s12891-019-2458-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myotonic dystrophy type 1 (DM1) is a neuromuscular disease characterized by multisystemic involvements including a progressive loss of maximal muscle strength and muscle wasting. Poor lower-limb strength is an important factor explaining disrupted social participation of affected individuals. This review aims to map what is known about the effects of exercise and training programs undertaken to counteract skeletal muscle impairments in DM1 patients. METHODS Medline, CINAHL and EMBASE databases were searched. Regarding study eligibility, title and abstract of 704 studies followed by 45 full articles were reviewed according to the following eligibility criteria. Inclusion: (1) humans with DM1 and (2) experimental protocol relying on exercise or training. Exclusion: (1) studies that do not evaluate skeletal muscle responses or adaptations, (2) reviews covering articles already included and (3) pharmacological intervention at the same time of exercise or training program. RESULTS Twenty-one papers were selected for in-depth analysis. Different exercise or training protocols were found including: acute exercise, neuromuscular electric stimulation, strength training, aerobic training, balance training and multiple rehabilitation interventions. Seven studies reported clinical measurements only, five physiological parameters only and nine both types. CONCLUSION This scoping review offers a complete summary of the current scientific literature on the effect of exercise and training in DM1 and a framework for future studies based on the concomitant evaluation of the several outcomes in present literature. Although there were a good number of studies focusing on clinical measurements, heterogeneity between studies does not allow to identify what are the adequate training parameters to obtain exercise or training-induced positive impacts on muscle function. Scientific literature is even more scarce regarding physiological parameters, where much more research is needed to understand the underlying mechanisms of exercise response in DM1.
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Affiliation(s)
- Marie-Pier Roussel
- Département des sciences de la santé, physiothérapie, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, Quebec, G7H 2B1, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, 2230 rue de l'Hôpital, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 2230 rue de l'Hôpital, Saguenay, Québec, Canada., Longueuil, Québec, Canada
| | - Marika Morin
- Département des sciences de la santé, physiothérapie, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, Quebec, G7H 2B1, Canada
| | - Cynthia Gagnon
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, 2230 rue de l'Hôpital, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 2230 rue de l'Hôpital, Saguenay, Québec, Canada., Longueuil, Québec, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Québec, Canada
| | - Elise Duchesne
- Département des sciences de la santé, physiothérapie, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, Quebec, G7H 2B1, Canada. .,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, 2230 rue de l'Hôpital, Saguenay, Québec, Canada. .,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 2230 rue de l'Hôpital, Saguenay, Québec, Canada., Longueuil, Québec, Canada.
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Cè E, Longo S, McCoy E, Bisconti AV, Tironi D, Limonta E, Rampichini S, Rabuffetti M, Esposito F. Acute effects of direct inhibitory pressure over the biceps brachii myotendinous junction on skeletal muscle activation and force output. J Electromyogr Kinesiol 2017; 37:25-34. [PMID: 28866370 DOI: 10.1016/j.jelekin.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/27/2017] [Accepted: 08/08/2017] [Indexed: 01/21/2023] Open
Abstract
Force (F) reduction is reported with myotendinous junction (MTJ) manipulation. Autogenic inhibition reflex (AIR) activation is supposed to be the main mechanism. Still, its role remains unclear. The study aimed at assessing the effects of MTJ direct inhibitory pressure (DIP) on neuromuscular activation and F in the elbow flexor (agonist) and extensor (antagonist) muscles. After maximum voluntary contraction (MVC) assessment, thirty-five participants randomly performed submaximal contractions at 20, 40, 60, and 80% MVC. Electromyographic (EMG), mechanomyographic (MMG), and F signals were recorded. Protocol was repeated under (i) DIP (10-s pressure on the biceps brachii MTJ) with the elbow at 120° (DIP120), (ii) DIP with the elbow at 180° (DIP180), and (iii) without DIP (Ctrl). Electromechanical delay (EMD) components, EMG and MMG root mean square (RMS), and rate of force development (RFD) were calculated. Independently from the angle, DIP induced decrements in MVC, RFD, and RMS of EMG and MMG signals and lengthened the EMD components in agonist muscles (P<0.05). The DIP-induced decrease in F output of the agonist muscles seems to be possibly due to a concomitant impairment of the neuromuscular activation and a transient decrease in stiffness. After DIP, the antagonist muscle displayed no changes; therefore, the intervention of AIR remains questionable.
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Affiliation(s)
- Emiliano Cè
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via G. Colombo 71, 20133 Milan, Italy
| | - Stefano Longo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via G. Colombo 71, 20133 Milan, Italy.
| | - Emily McCoy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via G. Colombo 71, 20133 Milan, Italy; Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, United States
| | - Angela Valentina Bisconti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via G. Colombo 71, 20133 Milan, Italy
| | - Davide Tironi
- IRCCS Don Gnocchi Foundation, Via Capecelatro 66, 20148 Milan, Italy
| | - Eloisa Limonta
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via G. Colombo 71, 20133 Milan, Italy
| | - Susanna Rampichini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via G. Colombo 71, 20133 Milan, Italy
| | - Marco Rabuffetti
- IRCCS Don Gnocchi Foundation, Via Capecelatro 66, 20148 Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via G. Colombo 71, 20133 Milan, Italy; IRCCS Don Gnocchi Foundation, Via Capecelatro 66, 20148 Milan, Italy
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