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Evans AR, Smith L, Bakhsheshian J, Anderson DB, Elliott JM, Shakir HJ, Smith ZA. Sarcopenia and the management of spinal disease in the elderly. GeroScience 2024:10.1007/s11357-024-01300-2. [PMID: 39138794 DOI: 10.1007/s11357-024-01300-2] [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: 06/03/2024] [Accepted: 07/22/2024] [Indexed: 08/15/2024] Open
Abstract
Sarcopenia, generally defined by the loss of skeletal mass and function, may disproportionately affect elderly individuals and heavily influence spinal disease. Muscle atrophy is associated with myriad clinical problems, including thoracic kyphosis, increased sagittal vertical axis (SVA), spinal implant failures, and postoperative complications. As such, the aim of this narrative review is to synthesize pertinent literature detailing the intersection between sarcopenia and the impact of sarcopenia on the management of spine disease. Specifically, we focus on the domains of etiology, diagnosis and assessment, impact on the cervical and lumbar spine, spinal augmentation procedures, neoplastic disease, whiplash injury, and recovery/prevention. A narrative review was conducted by searching the PubMed and Google Scholar databases from inception to July 12, 2024, for any cohort studies, systematic reviews, or randomized controlled trials. Case studies and conference abstracts were excluded. Diagnosis of sarcopenia relies on the assessment of muscle strength and quantity/quality. Strength may be assessed using clinical tools such as gait speed, timed up and go (TUG) test, or hand grip strength, whereas muscle quantity/quality may be assessed via computed tomography (CT scan), magnetic resonance imaging (MRI), and dual-energy X-ray absorptiometry (DXA scan). Sarcopenia has a generally negative impact on the clinical course of those undergoing cervical and lumbar surgery, and may be predictive of mortality in those with neoplastic spinal disease. In addition, severe acceleration-deceleration (whiplash) injuries may result in cervical extensor muscle atrophy. Intervention and recovery measures include nutrition or exercise therapy, although the evidence for nutritional intervention is lacking. Sarcopenia is a widely prevalent pathology in the advanced-age population, in which the diagnostic criteria, impact on spinal pathology, and recovery/prevention measures remain understudied. However, further understanding of this therapeutically challenging pathology is paramount, as surgical outcome may be heavily influenced by sarcopenia status.
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Affiliation(s)
- Alexander R Evans
- Department of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OK, 73104, USA
| | | | | | - David B Anderson
- Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia
| | - James M Elliott
- Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia
| | - Hakeem J Shakir
- Department of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OK, 73104, USA
| | - Zachary A Smith
- Department of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OK, 73104, USA.
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Parisien M, Buxbaum C, Granovsky Y, Yarnitsky D, Diatchenko L. Prospective Blood Transcriptomics Study in a Motor Vehicle Collision Cohort Identified a Protective Function of the SAMD15 Gene Against Chronic Pain. THE JOURNAL OF PAIN 2023; 24:1604-1616. [PMID: 37116672 DOI: 10.1016/j.jpain.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/05/2023] [Accepted: 04/20/2023] [Indexed: 04/30/2023]
Abstract
Traumatic brain injuries following motor vehicle collisions (MVCs) are ubiquitous. Surprisingly, there are no correlates between concussion impact force and long-term pain outcomes. To study the molecular underpinnings of chronic pain after MVC, we assembled a prospective cohort of 36 subjects that experienced MVC and suffered documented mild traumatic brain injuries. For each participant, a first blood sample was drawn within 72 hours of the collision, then a second one at the 6-month mark. Pain was also assessed at the second blood draw to determine if pain became chronic or resolved. Blood samples enabled transcriptomics analyses for immune cells. At the transcriptome-wide level, we found that Sterile Alpha Motif Domain Containing 15 (SAMD15) mRNA was significantly upregulated with time in subjects who resolved their pain whereas unregulated in those with persistent pain. Using several large publicly available datasets, such as the UK Biobank and the GTeX portal, we then linked elevated SAMD15 gene expression, elevated neutrophils cell counts, and decreased risk for chronic pain to increased dosage of the T allele at SNP rs4903580, situated within SAMD15's gene locus. The causality between the components of our model was established and supported by Mendelian randomization. Overall, our results support the role of SAMD15 as a potential gene effector for neutrophil-dependent chronic pain development. PERSPECTIVE: This article highlights the potential protective role of the SAMD15 gene against chronic pain following a mild traumatic brain injury. The expression of the gene is associated with a SNP rs4903580, which is itself associated with neutrophils counts as well as chronic pain in large genetic studies.
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Affiliation(s)
- Marc Parisien
- Faculty of Dental Medicine and Oral Health Sciences, Department of Anesthesia, Faculty of Medicine and Health Sciences, Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Chen Buxbaum
- Department of Neurology, Rambam Health Care Campus, and Clinical Neurophysiology Lab, Faculty of Medicine, Technion, Haifa, Israel
| | - Yelena Granovsky
- Department of Neurology, Rambam Health Care Campus, and Clinical Neurophysiology Lab, Faculty of Medicine, Technion, Haifa, Israel
| | - David Yarnitsky
- Department of Neurology, Rambam Health Care Campus, and Clinical Neurophysiology Lab, Faculty of Medicine, Technion, Haifa, Israel
| | - Luda Diatchenko
- Faculty of Dental Medicine and Oral Health Sciences, Department of Anesthesia, Faculty of Medicine and Health Sciences, Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
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Lund N, Dahlqvist Leinhard O, Elliott JM, Peterson G, Borga M, Zsigmond P, Karlsson A, Peolsson A. Fatty infiltrate and neck muscle volume in individuals with chronic whiplash associated disorders compared to healthy controls - a cross sectional case-control study. BMC Musculoskelet Disord 2023; 24:181. [PMID: 36906537 PMCID: PMC10007742 DOI: 10.1186/s12891-023-06289-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/02/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND The underlying pathophysiological mechanisms of chronic Whiplash Associated Disorders (WAD) are not fully understood. More knowledge of morphology is needed to better understand the disorder, improve diagnostics and treatments. The aim was to investigate dorsal neck muscle volume (MV) and muscle fat infiltration (MFI) in relation to self-reported neck disability among 30 participants with chronic WAD grade II-III compared to 30 matched healthy controls. METHODS MV and MFI at spinal segments C4 through C7 in both sexes with mild- to moderate chronic WAD (n = 20), severe chronic WAD (n = 10), and age- and sex matched healthy controls (n = 30) was compared. Muscles: trapezius, splenius, semispinalis capitis and semispinalis cervicis were segmented by a blinded assessor and analyzed. RESULTS Higher MFI was found in right trapezius (p = 0.007, Cohen's d = 0.9) among participants with severe chronic WAD compared to healthy controls. No other significant difference was found for MFI (p = 0.22-0.95) or MV (p = 0.20-0.76). CONCLUSIONS There are quantifiable changes in muscle composition of right trapezius on the side of dominant pain and/or symptoms, among participants with severe chronic WAD. No other statistically significant differences were shown for MFI or MV. These findings add knowledge of the association between MFI, muscle size and self-reported neck disability in chronic WAD. TRIAL REGISTRATION NA. This is a cross-sectional case-control embedded in a cohort study.
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Affiliation(s)
- Nils Lund
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden. .,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
| | - Olof Dahlqvist Leinhard
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,AMRA Medical AB, Linköping, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - James M Elliott
- Faculty of Medicine and Health, School of Health Sciences, Northern Sydney Local Health District, The Kolling Institute, University of Sydney, St Leonards, NSW, Australia.,Feinberg School of Medicine, Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Gunnel Peterson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.,Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
| | - Magnus Borga
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,AMRA Medical AB, Linköping, Sweden.,Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Peter Zsigmond
- Department of Neurosurgery and Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Anette Karlsson
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linköping University, Linköping, Sweden
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Grondin F, Freppel S, Jull G, Gérard T, Caderby T, Peyrot N. Fat Infiltration of Multifidus Muscle Is Correlated with Neck Disability in Patients with Non-Specific Chronic Neck Pain. J Clin Med 2022; 11:jcm11195522. [PMID: 36233390 PMCID: PMC9571215 DOI: 10.3390/jcm11195522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/06/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Chronic non-specific neck pain (CINP) is common, but the etiology remains unclear. This study aimed to examine the relationship between cervical muscle composition (cervical multifidus and longus capitis/longus colli), morphometry, range of movement, muscle function, and disability severity (Neck Disability Index) in patients with CINP. Methods: From September 2020 to July 2021, subjects underwent cervical MRI and clinical tests (cervical range of motion, cranio-cervical flexion test, neck flexor, and extensor muscle endurance). MRI analysis comprised muscle cross-sectional area, volume, and fat infiltration of multifidus and longus colli between C4 and C7 levels. Results: Twenty-five participants were included. Multiple linear regression analysis indicated that NDI was positively correlated with the volume percentage of fat infiltration of the multifidus (B = 0.496), negatively correlated with fat-free muscle volume of the multifidus normalized by subject height (B = −0.230), and accounted for 32% of the variance. There was no relationship between neck disability and longus capitis/longus colli morphology. We also found no relationship between neck disability scores, neck flexor or extensor muscle endurance, or the outcome motor control test of craniocervical flexion (p > 0.05). Conclusions: Neck disability was moderately correlated with the percentage of fat volume in the multifidus muscle and fat-free volume of the multifidus. There was no relationship between NDI scores and muscle function test outcomes or any fat or volume measures pertaining to the longus colli muscle.
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Affiliation(s)
- Francis Grondin
- Laboratory IRISSE, EA4075, Faculty of Human and Environment Sciences, University of La Réunion, 97430 Le Tampon, France
- Neurosurgey Department, University Hospital of La Réunion, 97410 Saint-Pierre, France
- Correspondence: ; Tel.: +262-69-310-1725
| | - Sébastien Freppel
- Neurosurgey Department, University Hospital of La Réunion, 97410 Saint-Pierre, France
| | - Gwendolen Jull
- Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia
| | - Thomas Gérard
- Institute of Health Engineering, University of Picardie Jules Verne, 80000 Amiens, France
| | - Teddy Caderby
- Laboratory IRISSE, EA4075, Faculty of Human and Environment Sciences, University of La Réunion, 97430 Le Tampon, France
| | - Nicolas Peyrot
- Laboratory IRISSE, EA4075, Faculty of Human and Environment Sciences, University of La Réunion, 97430 Le Tampon, France
- Laboratory Movement Interactions Performance, MIP UR4334, Le Mans University, 72000 Le Mans, France
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Peolsson A, Karlsson A, Peterson G, Borén H, Zsigmond P, Elliott JM, Leinhard OD. Morphology and composition of the ventral neck muscles in individuals with chronic whiplash related disorders compared to matched healthy controls: a cross-sectional case-control study. BMC Musculoskelet Disord 2022; 23:867. [PMID: 36114530 PMCID: PMC9482301 DOI: 10.1186/s12891-022-05811-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/06/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND OBJECTIVE: Studies of cross-sectional area (CSA) (morphology) and muscle fat infiltration (MFI) (composition) in ventral neck muscles is scarce in patients with chronic whiplash associated disorders (WAD), especially for men and those with severe WAD compared with matched healthy controls. The aim was to compare CSA and MFI of sternocleidomastoid (SCM), longus capitis (LCA) and longus colli (LCO) in patients with chronic right-sided dominant moderate (Neck Disability Index: NDI < 40) or severe WAD (NDI ≥ 40), compared to age- and sex-matched healthy controls. METHODS Cross-sectional case-control study with blinded investigators. Thirty-one patients with chronic WAD (17 women and 14 men, mean age 40 years) (SD 12.6, range 20-62)) and 31 age- and sex-matched healthy controls underwent magnetic resonance imaging of ventral neck muscles segmental level C4. RESULTS Unique to the severe group was a larger magnitude of MFI in right SCM (p = 0.02) compared with healthy controls. There was no significant difference between the groups with regards to the other muscles and measures. CONCLUSIONS Individuals with severe right-sided dominant WAD have a higher MFI in the right SCM compared to healthy controls. No other differences were found between the groups. The present study indicates that there are changes in the composition of muscles on the side of greatest pain.
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Affiliation(s)
- Anneli Peolsson
- grid.5640.70000 0001 2162 9922Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linköping University, Linköping, Sweden ,grid.5640.70000 0001 2162 9922Department of Health, Medicine & Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden ,grid.5640.70000 0001 2162 9922Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Anette Karlsson
- grid.5640.70000 0001 2162 9922Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Gunnel Peterson
- grid.5640.70000 0001 2162 9922Department of Health, Medicine & Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden ,grid.8993.b0000 0004 1936 9457Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Hanna Borén
- grid.5640.70000 0001 2162 9922Department of Health, Medicine & Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Peter Zsigmond
- grid.5640.70000 0001 2162 9922Department of Neurosurgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - James M. Elliott
- grid.1013.30000 0004 1936 834XThe University of Sydney and the Northern Sydney Local Health District, The Kolling Institute, St. Leonards, NSW Sydney, Australia
| | - Olof Dahlqvist Leinhard
- grid.5640.70000 0001 2162 9922Department of Health, Medicine & Caring Sciences, Linköping University, Linköping, Sweden
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Sabina S, Panico A, Mincarone P, Leo CG, Garbarino S, Grassi T, Bagordo F, De Donno A, Scoditti E, Tumolo MR. Expression and Biological Functions of miRNAs in Chronic Pain: A Review on Human Studies. Int J Mol Sci 2022; 23:ijms23116016. [PMID: 35682695 PMCID: PMC9181121 DOI: 10.3390/ijms23116016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 02/01/2023] Open
Abstract
Chronic pain is a major public health problem and an economic burden worldwide. However, its underlying pathological mechanisms remain unclear. MicroRNAs (miRNAs) are a class of small noncoding RNAs that post-transcriptionally regulate gene expression and serve key roles in physiological and pathological processes. This review aims to synthesize the human studies examining miRNA expression in the pathogenesis of chronic primary pain and chronic secondary pain. Additionally, to understand the potential pathophysiological impact of miRNAs in these conditions, an in silico analysis was performed to reveal the target genes and pathways involved in primary and secondary pain and their differential regulation in the different types of chronic pain. The findings, methodological issues and challenges of miRNA research in the pathophysiology of chronic pain are discussed. The available evidence suggests the potential role of miRNA in disease pathogenesis and possibly the pain process, eventually enabling this role to be exploited for pain monitoring and management.
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Affiliation(s)
- Saverio Sabina
- Institute of Clinical Physiology, National Research Council, Via Monteroni, 73100 Lecce, Italy; (S.S.); (C.G.L.); (M.R.T.)
| | - Alessandra Panico
- Department of Biological and Environmental Sciences and Technology, University of Salento, Via Monteroni, 73100 Lecce, Italy; (A.P.); (T.G.); (A.D.D.)
| | - Pierpaolo Mincarone
- Institute for Research on Population and Social Policies, National Research Council, c/o ex Osp. Di Summa, Piazza Di Summa, 72100 Brindisi, Italy;
| | - Carlo Giacomo Leo
- Institute of Clinical Physiology, National Research Council, Via Monteroni, 73100 Lecce, Italy; (S.S.); (C.G.L.); (M.R.T.)
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, 16132 Genoa, Italy;
| | - Tiziana Grassi
- Department of Biological and Environmental Sciences and Technology, University of Salento, Via Monteroni, 73100 Lecce, Italy; (A.P.); (T.G.); (A.D.D.)
| | - Francesco Bagordo
- Department of Pharmacy-Pharmaceutical Science, University of Bari Aldo Moro, Via Edoardo Orabona, 70126 Bari, Italy;
| | - Antonella De Donno
- Department of Biological and Environmental Sciences and Technology, University of Salento, Via Monteroni, 73100 Lecce, Italy; (A.P.); (T.G.); (A.D.D.)
| | - Egeria Scoditti
- Institute of Clinical Physiology, National Research Council, Via Monteroni, 73100 Lecce, Italy; (S.S.); (C.G.L.); (M.R.T.)
- Correspondence: ; Tel.: +39-(08)-3229-8860
| | - Maria Rosaria Tumolo
- Institute of Clinical Physiology, National Research Council, Via Monteroni, 73100 Lecce, Italy; (S.S.); (C.G.L.); (M.R.T.)
- Department of Biological and Environmental Sciences and Technology, University of Salento, Via Monteroni, 73100 Lecce, Italy; (A.P.); (T.G.); (A.D.D.)
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