Age-related biology and diseases of muscle and nerve

Effects of short-term Nordic walking training on sarcopenia-related parameters in women with low bone mass: a preliminary study

Background

Several studies have demonstrated the positive effects of physical activity on skeletal muscle mass and muscle strength in women with osteoporosis. However, the impact of Nordic walking training on sarcopenia-related parameters in women with low bone mass remains unknown. Therefore, the purpose of this study was to evaluate the impact of 12 weeks of Nordic walking training on skeletal muscle index, muscle strength, functional mobility, and functional performance in women with low bone mass.

Materials and methods

The participants were 45 women, aged 63–79 years, with osteopenia or osteoporosis. The subjects were randomly assigned either to an experimental group (12 weeks of Nordic walking training, three times a week) or to a control group. Skeletal muscle mass and other body composition factors were measured with octapolar bioimpedance InBody 720 analyser. Knee extensor and flexor isometric muscle strength were measured using Biodex System 4 Pro™ dynamometers. This study also used a SAEHAN Digital Hand Dynamometer to measure handgrip muscle strength. The timed up-and-go test was used to measure functional mobility, and the 6-minute walk test was used to measure functional performance.

Results

Short-term Nordic walking training induced a significant increase in skeletal muscle mass (P=0.007), skeletal muscle index (P=0.007), strength index of the knee extensor (P=0.016), flexor (P<0.001), functional mobility (P<0.001), and functional performance (P<0.001) and a significant decrease in body mass (P=0<006), body mass index (P<0.001), and percent body fat (P<0.001) in participants. Regarding handgrip muscle strength, no improvement was registered (P=0.315). No significant changes in any of the analyzed parameters were observed in the control group.

Conclusion

Overall, short-term Nordic walking training induces positive changes in knee muscle strength and functional performance in women with low bone mass. This finding could be applied in clinical practice for intervention programs in women with osteopenia and osteoporosis.

Axonal degeneration in peripheral nerves in a case of Leber hereditary optic neuropathy

BACKGROUND

Leber hereditary optic neuropathy (LHON) is a mitochondrial DNA (mtDNA) genetic disorder characterized by profound bilateral loss of central vision due to selective loss of retinal ganglion cells. Most patients with LHON do not have complaints related to the peripheral nervous system. We investigated possible qualitative and quantitative histological changes in the peripheral nerve of a patient with LHON as compared to normal controls.

METHODS

Brachial plexus specimens were obtained at necropsy from a patient with LHON carrying the 3460/ND1 mtDNA mutation and age-matched controls without known history of neurological disease. The nerves were evaluated by light microscope coupled to a digital camera-based morphometric analysis and electron microscopy.

RESULTS

Extensive axonal degeneration of the large heavily myelinated fibers was found in the brachial plexus from the patient with LHON. In LHON nerve fascicles, we counted over 10 times as many degenerated profiles as found in the control nerve fascicles.

CONCLUSIONS

Microscopic examination of the brachial plexus in the patient with LHON clearly demonstrated a significant pattern of neurodegeneration. Our study suggests that peripheral neuropathy may be a subclinical feature associated with LHON.

Immune response and mitochondrial metabolism are commonly deregulated in DMD and aging skeletal muscle

Duchenne Muscular Dystrophy (DMD) is a complex process involving multiple pathways downstream of the primary genetic insult leading to fatal muscle degeneration. Aging muscle is a multifactorial neuromuscular process characterized by impaired muscle regeneration leading to progressive atrophy. We hypothesized that these chronic atrophying situations may share specific myogenic adaptative responses at transcriptional level according to tissue remodeling. Muscle biopsies from four young DMD and four AGED subjects were referred to a group of seven muscle biopsies from young subjects without any neuromuscular disorder and explored through a dedicated expression microarray. We identified 528 differentially expressed genes (out of 2,745 analyzed), of which 328 could be validated by an exhaustive meta-analysis of public microarray datasets referring to DMD and Aging in skeletal muscle. Among the 328 validated co-expressed genes, 50% had the same expression profile in both groups and corresponded to immune/fibrosis responses and mitochondrial metabolism. Generalizing these observed meta-signatures with large compendia of public datasets reinforced our results as they could be also identified in other pathological processes and in diverse physiological conditions. Focusing on the common gene signatures in these two atrophying conditions, we observed enrichment in motifs for candidate transcription factors that may coordinate either the immune/fibrosis responses (ETS1, IRF1, NF1) or the mitochondrial metabolism (ESRRA). Deregulation in their expression could be responsible, at least in part, for the same transcriptome changes initiating the chronic muscle atrophy. This study suggests that distinct pathophysiological processes may share common gene responses and pathways related to specific transcription factors.

Behavioral and cellular level changes in the aging somatosensory system

A study of the peripheral sensory system of young and aged Blk6 mice obtained from the National Institutes on Aging mouse colony is described. Behavioral assays showed male and female aged mice had decreased sensitivity to thermal stimuli. The receptor for the growth factor artemin (Artn), GFRalpha3, and the ion channel TRPV1, which is expressed by 95-99% of GFRalpha3-positive primary sensory neurons, was also decreased. Calcium imaging of isolated dorsal root ganglia neurons grown with nerve growth factor was used to test the in vitro effects of Artn on TRPV1 activation by capsaicin in young and old neurons. Artn potentiated initial TRPV1 responses to capsaicin in young and old neurons, but the percent of capsaicin responders following repeated exposure to capsaicin increased only in young neurons. The lack of change in aged neurons suggests that differences in TRPV1 responses occur with aging in the somatosensory system.

Morphometric aspects of peripheral nerves in adults and the elderly

There have been inconsistencies among reports of age-related differences in human peripheral nerves (PNs). For such studies, normal control values are necessary. Moreover, the diversity of methods employed makes it difficult to compare results. We used the same histological procedures and methods to measure 12 PNs: 8 in the cranial nerves, 2 motor nerves in the lower limb, and 2 nerves in the autonomic system. We performed a morphometric analysis of nerve fibers and estimated the change in the total number (TN) and average transverse area (ATA) of myelinated axons from adulthood to old age. The spinal nerves demonstrated notable age-related changes in TN and ATA. Most of the cranial nerves also demonstrated notable age-related changes in TN and ATA. However, some nerves demonstrated no such age-related changes and were affected more by other factors. With regards to the autonomic nerves, the lesser splanchnic nerve indicated age-related changes in TN, but the greater splanchnic nerve indicated no age-related changes in either TN or ATA. The autonomic nerves were affected not only by the aging process but also by the pathological changes to the peripheral tissues that they innervate.

The H reflex from the abductor brevis hallucis muscle in healthy subjects

In order to evaluate the clinical applicability of a neurophysiological technique, information is required about the effect of technical and subjective factors on the measured parameters, and whether these measures are reliable. The reliability of measurement of a given parameter is inversely related to the variability shown by a set of measurements of that parameter made on the same subject under similar conditions. Reliable measures are fundamental to the clinical utility of any technique. We evaluated the reliability using the intraclass correlation coefficient (ICC), and assessed both single-point and test-retest normal limits for H-reflex parameters of abductor brevis hallucis (ABH). The H reflex from the ABH muscle was recorded in 36 of 43 subjects, but could not be elicited in 7 of 11 subjects who were >60 years of age. The Hmax latency increased as height increased, whereas Hmax amplitude and Hmax/Mmax amplitude ratio decreased as age and height increased. The Hmax latency and Hmax/Mmax amplitude ratio, but not Hmax amplitude, proved to be reliable. The usefulness of the H reflex from ABH in the evaluation of S2 radiculopathies is described.

Pathophysiologie und Rehabilitation der erektilen Dysfunktion nach nerverhaltender radikaler Prostatektomie

Radical prostatectomy is the current standard procedure for locally confined prostate cancer and accounts for the largest portion of invasive therapies. However, a major drawback of this approach remains the frequently ensuing postoperative erectile dysfunction. This aspect represents a frequent cause of fear and concern both for the patients and their partners and has a significant impact on the choice of therapy.After bilateral sparing of the neurovascular bundles, an average of 50% of the patients is likely to complain of erectile dysfunction. It is only in the course of the first 2 years after prostatectomy that rehabilitation of erectile dysfunction can be expected. It is all the more crucial to begin with rehabilitation therapy of the erectile tissue at an early postoperative stage to the prevent an irretrievable loss of erectile function. Application of PDE-5 inhibitors as well as prostaglandins, phentolamine, or papaverine can help to induce and to support penile blood perfusion and oxygenation, thus preserving structure and function of the corpora cavernosa. All efforts must be directed towards keeping the erectile function at the level ascertained prior to the intervention.

Transcriptional profiling identifies extensive downregulation of extracellular matrix gene expression in sarcopenic rat soleus muscle

The direction of change in skeletal muscle mass differs between young and old individuals, growing in young animals and atrophying in old animals. The purpose of the experiment was to develop a statistically conservative list of genes whose expression differed significantly between young growing and old atrophying (sarcopenic) skeletal muscles, which may be contributing to physical frailty. Gene expression levels of >24,000 transcripts were determined in soleus muscle samples from young (3-4 mo) and old (30-31 mo) rats. Age-related differences were determined using a Student's t-test (alpha of 0.05) with a Bonferroni adjustment, which yielded 682 probe sets that differed significantly between young (n = 25) and old (n = 20) animals. Of 347 total decreases in aged/sarcopenic muscle relative to young muscles, 199 were functionally identified; the major theme being that 24% had a biological role in the extracellular matrix and cell adhesion. Three themes were observed from 213 of the 335 total increases in sarcopenic muscles whose functions were documented in databases: 1) 14% are involved in immune response; 2) 9% play a role in proteolysis, ubiquitin-dependent degradation, and proteasome components; and 3) 7% act in stress/antioxidant responses. A total of 270 differentially expressed genes and ESTs had unknown/unclear functions. By decreasing the sample sizes of young and old animals from 25 x 20 to 15 x 15, 10 x 10, and 5 x 5 observations, we observed 682, 331, 73, and 3 statistically different mRNAs, respectively. Use of large sample size and a Bonferroni multiple testing adjustment in combination yielded increased statistical power, while protecting against false positives. Finally, multiple mRNAs that differ between young growing and old, sarcopenic muscles were identified and may highlight new candidate mechanisms that regulate skeletal muscle mass during sarcopenia.

Myopathies in the elderly

Muscle disease symptoms and myopathies are not uncommon in the elderly. Inflammatory and noninflammatory myopathies lead to proximal extremity or axial weakness and are superimposed on the intrinsic changes that occur in muscle with aging (sarcopenia). This article surveys the more common myopathies in the elderly based on a review of the process of sarcopenia, and how these age-related changes in muscle structure and function affect the results of the standard assessments of muscle disease in the elderly.