Fiber type and metabolic dependence of T2 increases in stimulated rat muscles

Mass spectrometry imaging reveals local metabolic changes in skeletal muscle due to chronic training

Muscle atrophy is a major health problem that needs effective prevention and treatment approaches. Chronic exercise, an effective treatment strategy for atrophy, promotes muscle hypertrophy, which leads to dynamic metabolic changes; however, the metabolic changes vary among myofiber types. To investigate local metabolic changes due to chronic exercise, we utilized comprehensive proteome and mass spectrometry (MS) imaging analyses. Our training model exhibited hypertrophic features only in glycolytic myofibers. The proteome analyses demonstrated that exercise promoted anabolic pathways, such as protein synthesis, and significant changes in lipid metabolism, but not in glucose metabolism. Furthermore, the fundamental energy sources, glycogen, neutral lipids, and ATP, were sensitive to exercise, and the changes in these sources differed between glycolytic and oxidative myofibers. MS imaging revealed that the lipid composition differs among myofibers; arachidonic acid might be an effective target for promoting lipid metabolism during muscle hypertrophy in oxidative myofibers.

Measuring Muscle Activity in Sprinters Using T2-Weighted Magnetic Resonance Imaging

PURPOSE

This study aimed to investigate the level of muscle activity during sprint running using T2-weighted magnetic resonance imaging.

METHODS

Fourteen male sprinters (age 21.2 [4.0] y; height 171.8 [4.2] cm, weight 65.5 [5.3] kg, 100-m personal record 11.01 [0.41] s; mean [SD]) performed 3 sets of three 60-m round-trip sprints. Before and after the round-trip sprints, 3 T magnetic resonance imaging scans were performed to obtain the T2 values of the 14 athletes' lower-extremity muscles.

RESULTS

After the 60-m round-trip sprints, the T2 value of the gluteus maximus, long head of biceps femoris, semitendinosus, semimembranosus, adductor brevis, adductor longus, adductor magnus, and gracilis increased significantly. The rate of change in the T2 values before and after the 60-m round-trip sprints was notably higher in the semitendinosus and gluteus maximus than in the other muscles.

CONCLUSIONS

These findings demonstrate the specific physiological metabolism of the lower-extremity muscles during fast sprinting. There are particularly high levels of muscle activity in the gluteus maximus and semitendinosus during sprint performance.

New setup for multi-parametric MRI in young and old rat gastrocnemius at 4.7 and 7 T during muscle stimulation

T₁ and T₂ relaxation times combined with ³¹ P spectroscopy have been proven efficient for muscular disease characterization as well as for pre- and post-muscle stimulation measurements. Even though ³¹ P spectroscopy can already be performed during muscle exercise, no method for T₁ and T₂ measurement enables this possibility. In this project, a complete setup and protocol for multi-parametrical MRI of the rat gastrocnemius before, during and after muscle stimulation at 4.7 and 7 T is presented. The setup is fully MRI compatible and is composed of a cradle, an electro-stimulator and an electronic card in order to synchronize MRI sequences with muscle stimulation. A 2D triggered radial-encoded Look-Locker sequence was developed, and enabled T₁ measurements in less than 2 min on stimulated muscle. Also, a multi-slice multi-echo sequence was adapted and synchronized for T₂ measurements as well as ³¹ P spectroscopy acquisitions in less than 4 min in both cases on stimulated muscle. Methods were validated on young rats using different stimulation paradigms. Then they were applied on older rats to compare quantification results, using the different stimulation paradigms, and allowed observation of metabolic changes related to aging with good reproducibility. The robustness of the whole setup shows wide application opportunities.

The time course of calf muscle fluid volume during prolonged running

Muscle fluid is essential for the biochemistry and the biomechanics of muscle contraction. Here, we provide evidence that muscle fluid volumes undergo significant changes during 75 min of moderate intensity (2.7 ± 0.4 m/s) running. Using MRI measurements at baseline and after 2.5, 5, 10, 15, 45 and 75 min, we found that the volumes of calf muscles (quantified through average cross-sectional area) in 18 young recreational runners increase (up to 9% in the gastrocnemii) at the beginning and decrease (below baseline levels) at later stages of running. However, the intensity of changes varied between analyzed muscles. We speculate that these changes are induced by muscle activity and dehydration-related changes in osmotic pressure gradients between intramuscular and extramuscular spaces. These findings highlight the complex nature of muscle fluid shifts during prolonged running exercise.

MRI Assessment of Swallow Muscle Activation with the Swallow Exercise Aid and with Conventional Exercises in Healthy Volunteers: An Explorative Biomechanical Study

Swallowing muscle strength exercises are effective in restoring swallowing function. In order to perform the exercises with progressive load, the swallow exercise aid (SEA) was developed. Precise knowledge on which muscles are activated with swallowing exercises, especially with the SEA, is lacking. This knowledge would aid in optimizing the training program to target the relevant swallowing muscles, if necessary. Three healthy volunteers performed the three SEA exercises (chin tuck against resistance, jaw opening against resistance and effortful swallow) and three conventional exercises [conventional effortful swallow (cES), Shaker and Masako] in supine position inside an MRI scanner. Fast muscle functional MRI scans (generating quantitative T2-maps) were made immediately before and after the exercises. Median T2 values at rest and after exercise were compared to identify activated muscles. After the three SEA exercises, the suprahyoid, infrahyoid, sternocleidomastoid, and lateral pterygoid muscles showed significant T2 value increase. After the Shaker, the lateral pterygoid muscles did not show such an increase, but the three other muscle groups did. The cES and Masako caused no significant increase in any of these muscle groups. During conventional (Shaker) exercises, the suprahyoid, infrahyoid, and sternocleidomastoid muscles are activated. During the SEA exercises, the suprahyoid, infrahyoid, sternocleidomastoid, and lateral pterygoid muscles are activated. The findings of this explorative study further support the potential of the SEA to improve swallowing rehabilitation.

Muscular recruitment is associated with muscular function and swelling following eccentric contractions of human elbow flexors

BACKGROUND

This study investigated the relationship between muscle fiber recruitment and the magnitude of muscle damage by isotonic eccentric contractions (ECCs).

METHODS

Ten healthy men (age: 27.2±6.0 y, height: 174. 0±5.3 cm, body mass 70.1±2.1 kg) were recruited in this study. Subjects performed 30 ECCs of the elbow flexors using a dumbbell adjusted to 40% and 80% one repetition maximum of each individual. The dependent variables maximal voluntary isometric contraction (MVC) torque, Range of Motion (ROM), delayed onset muscle soreness (DOMS), cross-sectional area (CSA) and transverse relaxation time (T2) of magnetic resonance imaging (MRI) were measured immediately before, immediately after and 1, 3, and 5 days after each exercise.

RESULTS

The decreased MVC and limited ROM were significantly greater for 80% than that 40% (P<0.05) at immediately after ECCs. However, no significant difference between 40% and 80% was found for DOMS. CSA at 5 days after ECCs was significantly higher 80% (P<0.05) than 40% (P<0.05). No significant changes in post T2 (acute T2) was found for 40%, but an increased acute T2 was observed in 80% (P<0.05). We found a significant correlation between the change in T2 at immediately after and MVC at immediately after (r=0.77, P<0.05). In addition, a significant correlation between the change in T2 at immediately after and change in CSA at 3 days after (r=-0.83, P<0.05) was found.

CONCLUSIONS

We conclude that the muscle strength loss and swelling following ECCs are related to the muscle fiber recruitment.

Muscle oxygenation during dynamic plantar flexion exercise: combining BOLD MRI with traditional physiological measurements

Blood-oxygen-level-dependent magnetic resonance imaging (BOLD MRI) has the potential to quantify skeletal muscle oxygenation with high temporal and high spatial resolution. The purpose of this study was to characterize skeletal muscle BOLD responses during steady-state plantar flexion exercise (i.e., during the brief rest periods between muscle contraction). We used three different imaging modalities (ultrasound of the popliteal artery, BOLD MRI, and near-infrared spectroscopy [NIRS]) and two different exercise intensities (2 and 6 kg). Six healthy men underwent three separate protocols of dynamic plantar flexion exercise on separate days and acute physiological responses were measured. Ultrasound studies showed the percent change in popliteal velocity from baseline to the end of exercise was 151 ± 24% during 2 kg and 589 ± 145% during 6 kg. MRI studies showed an abrupt decrease in BOLD signal intensity at the onset of 2 kg exercise, indicating deoxygenation. The BOLD signal was further reduced during 6 kg exercise (compared to 2 kg) at 1 min (-4.3 ± 0.7 vs. -1.2 ± 0.4%, P < 0.001). Similarly, the change in the NIRS muscle oxygen saturation in the medial gastrocnemius was -11 ± 4% at 2 kg and -38 ± 11% with 6 kg (P = 0.041). In conclusion, we demonstrate that BOLD signal intensity decreases during plantar flexion and this effect is augmented at higher exercise workloads.

Dynamic DTI (dDTI) shows differing temporal activation patterns in post-exercise skeletal muscles

OBJECT

To assess post-exercise recovery of human calf muscles using dynamic diffusion tensor imaging (dDTI).

MATERIALS AND METHODS

DTI data (6 directions, b = 0 and 400 s/mm²) were acquired every 35 s from seven healthy men using a 3T MRI, prior to (4 volumes) and immediately following exercise (13 volumes, ~7.5 min). Exercise consisted of 5-min in-bore repetitive dorsiflexion-eversion foot motion with 0.78 kg resistance. Diffusion tensors calculated at each time point produced maps of mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), and signal at b = 0 s/mm² (S₀). Region-of-interest (ROI) analysis was performed on five calf muscles: tibialis anterior (ATIB), extensor digitorum longus (EDL) peroneus longus (PER), soleus (SOL), and lateral gastrocnemius (LG).

RESULTS

Active muscles (ATIB, EDL, PER) showed significantly elevated initial MD post-exercise, while predicted inactive muscles (SOL, LG) did not (p < 0.0001). The EDL showed a greater initial increase in MD (1.90 × 10^-4mm²/s) than ATIB (1.03 × 10^-4mm²/s) or PER (8.79 × 10^-5 mm²/s) (p = 7.40 × 10^-4), and remained significantly elevated across more time points than ATIB or PER. Significant increases were observed in post-exercise EDL S₀ relative to other muscles across the majority of time points (p < 0.01 to p < 0.001).

CONCLUSIONS

dDTI can be used to differentiate exercise-induced changes between muscles. These differences are suggested to be related to differences in fiber composition.

Contribution of each masticatory muscle to the bite force determined by MRI using a novel metal-free bite force gauge and an index of total muscle activity

PURPOSE

To develop a metal-free bite force gauge that can monitor the bite force in a strong magnetic field and to analyze the correlations between bite-force and total T2 shift of the mastication muscles.

MATERIALS AND METHODS

The gauge used a micro-pressure sensor made of optical fiber. Ten subjects performed a 60-s isometric bite task at 40% of maximum clenching in various occlusal support conditions (intact dentition, right molar loss, or left molar loss). Spin-echo images were taken with a 1.5 Tesla scanner before and immediately after the task to correlate the bite force with the mean voxel count, mean shift in transverse relaxation time (ΔT2), and total T2 shift of each masticatory muscle.

RESULTS

Measurements of total T2 shift identified significant correlations between the bite force and activities of the superficial layer of the bilateral masseter muscle, regardless of the occlusion condition (intact dentition: left, P = 0.007 and right, P < 0.001; right molar loss: left, P = 0.02 and right, P = 0.021; and left molar loss: left, P = 0.022 and right, P = 0.049). In contrast, significant correlations were not detected between the bite force and mean ΔT2 (intact dentition: left, P = 0.102 and right, P = 0.053; right molar loss: left, P = 0.393 and right, P = 0.868; and left molar loss: left, P = 0.531 and right, P = 0.92).

CONCLUSION

Measurement of total T2 shift using a metal-free bite force gauge is a more sensitive index of individual muscle activity than mean ΔT2 during a bite task. J. MAGN. RESON. IMAGING 2016;44:804-813.

Inter- and intramuscular differences in training-induced hypertrophy of the quadriceps femoris: association with muscle activation during the first training session

The purpose of this study was to examine whether inter- and intramuscular differences in hypertrophy induced by resistance training correspond to differences in muscle activation during the first training session. Eleven young men completed 12 weeks of training intervention for knee extension. Before and after the intervention, T1-weighted magnetic resonance (MR) images were recorded to determine the volume and anatomical cross-sectional area (CSA) along the length of the individual muscles of the quadriceps femoris. The T2-weighted MR images were also acquired before and immediately after the first training session. The T2 was calculated for each pixel within the quadriceps femoris, from which the muscle activation was evaluated as %activated volume and area. The results showed that the %activated volume after the first training session was significantly higher in the vastus intermedius than the vastus medialis. However, the relative change in muscle volume after the training intervention was significantly greater in the rectus femoris than the vasti muscles (vastus lateralis, intermedius and medialis). Within the rectus femoris, both the %activated area and relative increase in CSA were significantly greater in the distal region than the proximal region. In contrast, the %activated area and relative increase in CSA of the vasti were nearly uniform along each muscle. These results suggest that the muscle activation during the first training session is associated with the intramuscular difference in hypertrophy induced by training intervention, but not with the intermuscular difference.

Age-related T2 changes in hindlimb muscles of mdx mice

INTRODUCTION

Magnetic resonance imaging (MRI) was used to monitor changes in the transverse relaxation time constant (T2) in lower hindlimb muscles of mdx mice at different ages.

METHODS

Young (5 weeks), adult (44 weeks), and old mdx (96 weeks), and age-matched control mice were studied. Young mdx mice were imaged longitudinally, whereas adult and old mdx mice were imaged at a single time-point.

RESULTS

Mean muscle T2 and percent of pixels with elevated T2 were significantly different between mdx and control mice at all ages. In young mdx mice, mean muscle T2 peaked at 7-8 weeks and declined at 9-11 weeks. In old mdx mice, mean muscle T2 was decreased compared with young and adult mice, which could be attributed to fibrosis.

CONCLUSIONS

MRI captured longitudinal changes in skeletal muscle integrity of mdx mice. This information will be valuable for pre-clinical testing of potential therapeutic interventions for muscular dystrophy.

Biceps femoris and semitendinosus--teammates or competitors? New insights into hamstring injury mechanisms in male football players: a muscle functional MRI study

BACKGROUND

The hamstring injury mechanism was assessed by investigating the exercise-related metabolic activity characteristics of the hamstring muscles using a muscle functional MRI (mfMRI) protocol.

METHODS

27 healthy male football players and 27 football players with a history of hamstring injuries (recovered and playing fully) underwent standardised mfMR Imaging. The mfMRI protocol consisted of a resting scan, a strenuous bilateral eccentric hamstring exercise and a postexercise scan. The exercise-related T2 increase or the signal intensity shift between both scans was used to detect differences in metabolic activation characteristics (1) between the different hamstring muscle bellies and (2) between the injury group and the control group.

RESULTS

A more symmetrical muscle recruitment pattern corresponding to a less economic hamstring muscle activation was demonstrated in the formerly injured group (p<0.05). The injured group also demonstrated a significantly lower strength endurance capacity during the eccentric hamstring exercise.

CONCLUSIONS

These findings suggest that the vulnerability of the hamstring muscles to football-related injury is related to the complexity and close coherence in the synergistic muscle recruitment of the biceps femoris and the semitendinosus. Discrete differences in neuromuscular coordination and activity distribution, with the biceps femoris partly having to compensate for the lack of endurance capacity of the semitendinosus, probably increase the hamstring injury risk.

Matching of postcontraction perfusion to oxygen consumption across submaximal contraction intensities in exercising humans

Studying the magnitude and kinetics of blood flow, oxygen extraction, and oxygen consumption at exercise onset and during the recovery from exercise can lead to insights into both the normal control of metabolism and blood flow and the disturbances to these processes in metabolic and cardiovascular diseases. The purpose of this study was to examine the on- and off-kinetics for oxygen delivery, extraction, and consumption as functions of submaximal contraction intensity. Eight healthy subjects performed four 1-min isometric dorsiflexion contractions, with two at 20% MVC and two at 40% MVC. During one contraction at each intensity, relative perfusion changes were measured by using arterial spin labeling, and the deoxyhemoglobin percentage (%HHb) was estimated using the spin- and gradient-echo sequence and a previously published empirical calibration. For the whole group, the mean perfusion did not increase during contraction. The %HHb increased from ∼28 to 38% during contractions of each intensity, with kinetics well described by an exponential function and mean response times (MRTs) of 22.7 and 21.6 s for 20 and 40% MVC, respectively. Following contraction, perfusion increased ∼2.5-fold. The %HHb, oxygen consumption, and perfusion returned to precontraction levels with MRTs of 27.5, 46.4, and 50.0 s, respectively (20% MVC), and 29.2, 75.3, and 86.0 s, respectively (40% MVC). These data demonstrate in human subjects the varied recovery rates of perfusion and oxygen consumption, along with the similar rates of %HHb recovery, across these exercise intensities.

High-field (11.75T) multimodal MR imaging of exercising hindlimb mouse muscles using a non-invasive combined stimulation and force measurement device

We have designed and constructed an experimental set-up allowing electrical stimulation of hindlimb mouse muscles and the corresponding force measurements at high-field (11.75T). We performed high-resolution multimodal MRI (including T2 -weighted imaging, angiography and diffusion) and analysed the corresponding MRI changes in response to a stimulation protocol. Mice were tested twice over a 1-week period to investigate the reliability of mechanical measurements and T2 changes associated with the stimulation protocol. Additionally, angiographic images were obtained before and immediately after the stimulation protocol. Finally, multislice diffusion imaging was performed before, during and immediately after the stimulation session. Apparent diffusion coefficient (ADC) maps were calculated on the basis of diffusion weighted images (DWI). Both force production and T2 values were highly reproducible as illustrated by the low coefficient of variation (<8%) and high intraclass correlation coefficient (≥0.75) values. Maximum intensity projection angiographic images clearly showed a strong vascular effect resulting from the stimulation protocol. Although a motion sensitive imaging sequence was used (echo planar imaging) and in spite of the strong muscle contractions, motion artifacts were minimal for DWI recorded under exercising conditions, thereby underlining the robustness of the measurements. Mean ADC values increased under exercising conditions and were higher during the recovery period as compared with the corresponding control values. The proposed experimental approach demonstrates accurate high-field multimodal MRI muscle investigations at a preclinical level which is of interest for monitoring the severity and/or the progression of neuromuscular diseases but also for assessing the efficacy of potential therapeutic interventions.

Influence of thigh activation on the VO₂ slow component in boys and men

PURPOSE

During constant work rate exercise above the lactate threshold (LT), the initial rapid phase of pulmonary oxygen uptake (VO₂) kinetics is supplemented by an additional VO₂ slow component (VO₂Sc) which reduces the efficiency of muscular work. The VO₂Sc amplitude has been shown to increase with maturation but the mechanisms are poorly understood. We utilized the transverse relaxation time (T₂) of muscle protons from magnetic resonance imaging (MRI) to test the hypothesis that a lower VO₂ slow component (VO₂Sc) amplitude in children would be associated with a reduced muscle recruitment compared to adults.

METHODS

Eight boys (mean age 11.4 ± 0.4) and eight men (mean age 25.3 ± 3.3 years) completed repeated step transitions of unloaded-to-very heavy-intensity (U → VH) exercise on a cycle ergometer. MRI scans of the thigh region were acquired at rest and after VH exercise up to the VO₂Sc time delay (ScTD) and after 6 min. T₂ for each of eight muscles was adjusted in relation to cross-sectional area and then summed to provide the area-weighted ΣT₂ as an index of thigh recruitment.

RESULTS

There were no child/adult differences in the relative VO₂Sc amplitude [Boys 14 ± 7 vs. Men 18 ± 3 %, P = 0.15, effect size (ES) = 0.8] during which the change (∆) in area-weighted ΣT₂ between the ScTD and 6 min was not different between groups (Boys 1.6 ± 1.2 vs. Men 2.3 ± 1.1 ms, P = 0.27, ES = 0.6). A positive and strong correlation was found between the relative VO₂Sc amplitude and the magnitude of the area-weighted ∆ΣT₂ in men (r = 0.92, P = 0.001) but not in boys (r = 0.09, P = 0.84).

CONCLUSIONS

This study provides evidence to show that progressive muscle recruitment (as inferred from T₂ changes) contributes to the development of the VO₂Sc during intense submaximal exercise independent of age.

Difference in the recruitment of hip and knee muscles between back squat and plyometric squat jump

Athletes who aim to improve both muscular endurance and power often perform exercises that involve similar joint actions under different lifting conditions, such as changes in the load or speed, which are implemented at different times during a periodized exercise program or simultaneously. The prescribed exercises are considered to recruit the same muscles even if the lifting conditions differ to each other. The present study aimed to clarify this by examining whether the recruitment of individual hip and knee muscles during the squat exercise differs between lifting conditions adopted for muscular endurance and power training regimens. Moderately trained men performed back squats (BS), with a load of approximately 60% of one repetition maximum, as a muscular endurance training exercise, and they performed plyometric squat jumping (PSJ) for power training. During each exercise, the lower limb joint torques and the recruitment of five hip and knee muscles were determined with inverse-dynamics and T2-weighted magnetic resonance imaging, respectively. While the maximal and mean knee joint torques were greater during PSJ than during BS (p<0.01), the T2 values for the quadriceps femoris muscle did not differ between the exercises. In contrast, the T2 values of the gluteus maximus and hip adductor muscles were higher during PSJ (p<0.05) than during BS, although there was no significant difference in the mean hip extension torque between the two exercises. The current results indicate that the individual use of the agonist muscles differs between BS and PSJ, and it does not always correspond with the joint kinetics during the exercises. Therefore, in addition to the exercise type, the lifting condition should also be taken into consideration as a determinant of the major muscles trained during a resistance exercise.

Mechano- and metabosensitive alterations after injection of botulinum toxin into gastrocnemius muscle

This study was designed to investigate effects of motor denervation by Clostridium botulinum toxin serotype A (BoNT/A) on the afferent activity of fibers originating from the gastrocnemius muscle of rats. Animals were randomized in two groups, 1) untreated animals acting as control and 2) treated animals in which the toxin was injected in the left muscle. Locomotor activity was evaluated once per day during 12 days with a test based on footprint measurements of walking rats (sciatic functional index). At the end of the functional assessment period, electrophysiological tests were used to measure muscle properties, metabosensitive afferent fiber responses to chemical (KCl and lactic acid) injections, electrically induced fatigue (EIF), and mechanosensitive responses to tendon vibrations. Additionally, ventilatory response was recorded during repetitive muscle contractions. Then, rats were sacrificed, and the BoNT/A-injected muscles were weighed. Twelve days postinjection we observed a complete motor denervation associated with a significant muscle atrophy and loss of force to direct muscle stimulation. In the BoNT/A group, the metabosensitive responses to KCl injections were unaltered. However, we observed alterations in responses to EIF and to 1 mM of lactic acid (which induces the greatest activation). The ventilatory adjustments during repetitive muscle activation were abolished, and the mechanosensitive fiber responses to tendon vibrations were reduced. These results indicate that BoNT/A alters the sensorimotor loop and may induce insufficient motor and physiological adjustments in patients in whom a motor denervation with BoNT/A was performed.

Changes in transverse relaxation time of quadriceps femoris muscles after active recovery exercises with different intensities

The purpose of this study was to examine the changes in the metabolic state of quadriceps femoris muscles using transverse relaxation time (T2), measured by muscle functional magnetic resonance (MR) imaging, after inactive or active recovery exercises with different intensities following high-intensity knee-extension exercise. Eight healthy men performed recovery sessions with four different conditions for 20 min after high-intensity knee-extension exercise on separate days. During the recovery session, the participants conducted a light cycle exercise for 20 min using a cycle (50%, 70% and 100% of the lactate threshold (LT), respectively: active recovery), and inactive recovery. The MR images of quadriceps femoris muscles were taken before the trial and after the recovery session every 30 min for 120 min. The percentage changes in T2 for the rectus femoris and vastus medialis muscles after the recovery session in 50% LT and 70% LT were significantly lower than those in either inactive recovery or 100% LT. There were no significant differences in those for vastus lateralis and vastus intermedius muscles among the four trials. The percentage changes in T2 of rectus femoris and vastus medialis muscles after the recovery session in 50% LT and 70% LT decreased to the values before the trial faster than those in either inactive recovery or 100% LT. Those of vastus lateralis and vastus intermedius muscles after the recovery session in 50% LT and 70% LT decreased to the values before the trial faster than those in 100% LT. Although the changes in T2 after active recovery exercises were not uniform in exercised muscles, the results of this study suggest that active recovery exercise with the intensities below LT are more effective to recover the metabolic state of quadriceps femoris muscles after intense exercise than with either intensity at LT or inactive recovery.

Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI

OBJECTIVES

After cessation of a low-back pain (LBP) episode, alterations in trunk muscle behavior, despite recovery from pain, have been hypothesized to play a pathogenic role in the recurrence of LBP. This study aimed to identify the presence of lumbar muscle dysfunction during the remission of recurrent LBP, while performing a low-load trunk-extension movement.

METHODS

Thirteen participants with unilateral recurrent LBP were tested at least 1 month after cessation of the previous LBP episode and were compared with a healthy control group without any history of LBP (n=13). Also, differences between previously painful and nonpainful sides were examined. Muscle functional magnetic resonance imaging, based on quantitative T2-imaging, was used to examine muscle tissue characteristics (T2 rest) and muscle recruitment (T2 shift) during prone trunk extension. The lumbar multifidus, erector spinae, quadratus lumborum, and psoas were bilaterally visualized on 2 lumbar levels using a T2-weighted (spin-echo multicontrast) magnetic resonance imaging sequence.

RESULTS

Linear mixed model analysis revealed a significantly lower T2 rest (P=0.044) and a significantly higher T2 shift (P=0.034) solely for the multifidus in the LBP group compared with the control group. No significant differences between pain sides were found.

DISCUSSION

Lower T2-rest values have been suggested to correlate with a conversion of the multifidus' fiber typing toward the glycolytic muscle spectrum. Elevated T2 shifts correspond with increased levels of metabolic activity in the multifidus in the LBP group, for which several hypotheses can be put forward. Taken together, these findings provide evidence of concurrent alterations in the multifidus structure and activity in individuals with unilateral recurrent LBP, despite being pain free and functionally recovered.

Quantitative MRI of vastus medialis, vastus lateralis and gluteus medius muscle workload after squat exercise: comparison between squatting with hip adduction and hip abduction

The aim of the present study was to evaluate the use MRI to quantify the workload of gluteus medius (GM), vastus medialis (VM) and vastus lateralis (VL) muscles in different types of squat exercises. Fourteen female volunteers were evaluated, average age of 22 ± 2 years, sedentary, without clinical symptoms, and without history of previous lower limb injuries. Quantitative MRI was used to analyze VM, VL and GM muscles before and after squat exercise, squat associated with isometric hip adduction and squat associated with isometric hip abduction. Multi echo images were acquired to calculate the transversal relaxation times (T2) before and after exercise. Mixed Effects Model statistical analysis was used to compare images before and after the exercise (ΔT2) to normalize the variability between subjects. Imaging post processing was performed in Matlab software. GM muscle was the least active during the squat associated with isometric hip adduction and VM the least active during the squat associated with isometric hip abduction, while VL was the most active during squat associated with isometric hip adduction. Our data suggests that isometric hip adduction during the squat does not increase the workload of VM, but decreases the GM muscle workload. Squat associated with isometric hip abduction does not increase VL workload.

Changes in muscle T2 and tissue damage after downhill running in mdx mice

INTRODUCTION

In this study we compared the effects of downhill or horizontal treadmill running on the magnetic resonance imaging (MRI) transverse relaxation time constant (T(2)) in mdx mice.

METHODS

Mice underwent either downhill (n = 11 mdx, n = 6 controls) or horizontal running (n = 9, mdx only) on a treadmill. MRI was conducted prior to exercise, immediately afterward (∽20 minutes), and then 24 and 48 hours after exercise.

RESULTS

A higher percentage of pixels with elevated T(2) in the lower hindlimb muscles was observed in the mdx mice compared with controls both pre-exercise (P < 0.001) and at each time-point after downhill running (P < 0.05), but not with horizontal running. The medial compartment muscles appeared to be the most susceptible to increased T(2).

CONCLUSIONS

Downhill running provides a stimulus for inducing acute changes in muscle T(2) in mdx mice. MRI is a non-invasive approach for examining acute muscle damage and recovery in multiple muscle groups simultaneously.

Effects of a single bout of isometric neuromuscular electrical stimulation on rat gastrocnemius muscle: a combined functional, biochemical and MRI investigation

While muscle damage resulting from electrically-induced muscle isometric contractions has been reported in humans, animal studies have failed to illustrate similar deleterious effects and it remains to be determined whether these conflicting results are related to differences regarding experimental procedures or to species. We have investigated in vivo, in rat gastrocnemius muscles, using experimental conditions as close as possible to those used in humans (i.e., muscle length, number of contractions, stimulated muscle), the effects of a single bout of neuromuscular electrical stimulation (NMES). Maximal tetanic force was measured before, immediately after and 1h and 1, 2, 3, 7 and 14 days after NMES. Magnetic resonance imaging measurements, including volume of gastrocnemius muscles and proton transverse relaxation time (T(2)) were performed at baseline and 3, 7, and 14 days after the NMES session. Control animals did not perform any exercise and measurements were recorded at the same time points. For both groups, blood creatine kinase (CK) activity was measured within the first 3 days that followed the initial evaluation. Maximal tetanic force decreased immediately after NMES whereas measurements performed 1h and the days afterwards were similar to the baseline values. CK activity, muscle volume and T(2) values were similar throughout the experimental protocol between the two groups. Under carefully controlled experimental conditions, isometric NMES per se did not induce muscle damage in rat gastrocnemius muscles on the contrary to what has been repeatedly reported in humans. Further experiments would then be warranted in order to clearly delineate these differences and to better understand the physiological events associated with muscle damage resulting from NMES-induced isometric contractions.

Absence of a significant extravascular contribution to the skeletal muscle BOLD effect at 3 T

Blood oxygenation level dependent (BOLD) contrast in skeletal may reflect the contributions of both intravascular and extravascular relaxation effects. The purpose of this study was to determine the significance of the extravascular BOLD effect in skeletal muscle at 3 T. In experiments, R(2)* was measured before and during arterial occlusion under the following conditions: (1) the leg extended and rotated (to vary the capillary orientation with respect to the amplitude of static field) and (2) with the blood's signal nulled using a multiecho vascular space occupancy experiment. In the leg rotation protocol, 3 min of arterial occlusion decreased oxyhemoglobin saturation from 67% to 45% and increased R(2)* from 34.2 to 36.6 sec(-1), but there was no difference in the R(2)* response to occlusion between the extended and rotated positions. Numerical simulations of intra- and extravascular BOLD effects corresponding to these conditions predicted that the intravascular BOLD contribution to the R(2)* change was always > 50 times larger than the extravascular BOLD contribution. Blood signal nulling eliminated the change in R(2)* caused by arterial occlusion. These data indicate that under these experimental conditions, the contribution of the extravascular BOLD effect to skeletal muscle R(2)* was too small to be practically important.

A method for detecting the temporal sequence of muscle activation during cycling using MRI

Surface electromyography (EMG) can assess muscle recruitment patterns during cycling, but has limited applicability to studies of deep muscle recruitment and electrically stimulated contractions. We determined whether muscle recruitment timing could be inferred from MRI-measured transverse relaxation time constant (T(2)) changes and a cycle ergometer modified to vary power as a function of pedal angle. Six subjects performed 6 min of single-leg cycling under two conditions (E0°-230° and E90°-230°), which increased the power from 0°-230° and 90-230° of the pedal cycle, respectively. The difference condition produced a virtual power output from 0-180° (V0°-180°). Recruitment was assessed by integrating EMG over the pedal cycle (IEMG) and as the (post-pre) exercise T(2) change (ΔT(2)). For E0°-230°, the mean IEMG for vastus medialis and lateralis (VM/VL; 49.3 ± 3.9 mV·s; mean ± SE) was greater (P < 0.05) than that for E90°-230° (17.9 ± 1.9 mV·s); the corresponding ΔT(2) values were 8.7 ± 1.0 and 1.4 ± 0.5 ms (P < 0.05). For E0°-230° and E90°-230°, the IEMG values for biceps femoris/long head (BF(L)) were 37.7 ± 5.4 and 27.1 ± 5.6 mV·s (P > 0.05); the corresponding ΔT(2) values were 0.9 ± 0.9 and 1.5 ± 0.9 ms (P > 0.05). MRI data indicated activation of the semitendinosus and BF/short head for E0°-230° and E90°-230°. For V0°-180°, ΔT(2) was 7.2 ± 0.9 ms for VM/VL and -0.6 ± 0.6 ms for BF(L); IEMG was 31.5 ± 3.7 mV·s for VM/VL and 10.6 ± 7.0 mV·s for BF(L). MRI and EMG data indicate VM/VL activity from 0 to 180° and selected hamstring activity from 90 to 230°. Combining ΔT(2) measurements with variable loading allows the spatial and temporal patterns of recruitment during cycling to be inferred from MRI data.

A strictly noninvasive MR setup dedicated to longitudinal studies of mechanical performance, bioenergetics, anatomy, and muscle recruitment in contracting mouse skeletal muscle

MR techniques have proven their ability to investigate skeletal muscle function in situ. Their benefit in terms of noninvasiveness is, however, lost in animal research, given that muscle stimulation and force output measurements are usually achieved using invasive surgical procedures, thereby excluding repeated investigations in the same animal. This study describes a new setup allowing strictly noninvasive investigations of mouse gastrocnemius muscle function using (1)H-MRI and (31)P-MR spectroscopy. Its originality is to integrate noninvasive systems for inducing muscle contraction through transcutaneous stimulation and for measuring mechanical performance with a dedicated ergometer. In order to test the setup, muscle function was investigated using a fatiguing stimulation protocol (6 min of repeated isometric contractions at 1.7 Hz). T(2)-weighted imaging demonstrated that transcutaneous stimulation mainly activated the gastrocnemius. Moreover, investigations repeated twice with a 7-day interval between bouts did show a high reproducibility in measurements with regard to changes in isometric force and energy metabolism. In conclusion, this setup enables us for the first time to access mechanical performance, energy metabolism, anatomy, and physiology strictly noninvasively in contracting mouse skeletal muscle. The possibility for implementing longitudinal studies opens up new perspectives in many research areas, including ageing, pharmaceutical research, and gene and cell therapy.

Effects of stimulation frequency and pulse duration on fatigue and metabolic cost during a single bout of neuromuscular electrical stimulation

We have investigated the effects of stimulation frequency and pulse duration on fatigue and energy metabolism in rat gastrocnemius muscle during a single bout of neuromuscular electrical stimulation (NMES). Electrical pulses were delivered at 100 Hz (1-ms pulse duration) and 20 Hz (5-ms pulse duration) for the high (HF) and low (LF) frequency protocols, respectively. As a standardization procedure, the averaged stimulation intensity, the averaged total charge, the initial peak torque, the duty cycle, the contraction duration and the torque-time integral were similar in both protocols. Fatigue was assessed using two testing trains delivered at a frequency of 100 Hz and 20 Hz before and after each protocol. Metabolic changes were investigated in vivo using 31P-magnetic resonance spectroscopy (31P-MRS) and in vitro in freeze-clamped muscles. Both LF and HF NMES protocols induced the same decrease in testing trains and metabolic changes. We conclude that, under carefully controlled and comparable conditions, the use of low stimulation frequency and long pulse duration do not minimize the occurrence of muscle fatigue or affect the corresponding stimulation-induced metabolic changes so that this combination of stimulation parameters would not be adequate in the context of rehabilitation.

Muscle functional magnetic resonance imaging and acute low back pain: a pilot study to characterize lumbar muscle activity asymmetries and examine the effects of osteopathic manipulative treatment

Background

Muscle functional magnetic resonance imaging (mfMRI) measures transverse relaxation time (T2), and allows for determination of the spatial pattern of muscle activation. The purposes of this pilot study were to examine whether MRI-derived T2 or side-to-side differences in T2 (asymmetries) differ in low back muscles between subjects with acute low back pain (LBP) compared to asymptomatic controls, and to determine if a single osteopathic manipulative treatment (OMT) session alters these T2 properties immediately and 48-hours after treatment.

Methods

Subjects with non-specific acute LBP (mean score on 1-10 visual analog score = 3.02 ± 2.81) and asymptomatic controls (n = 9/group) underwent an MRI, and subsequently the LBP subjects received OMT and then underwent another MRI. The LBP subjects reported back for an additional MRI 48-hours following their initial visit. T2 and T2 asymmetry were calculated from regions of interest for the psoas, quadratus lumborum (QL), multifidus, and iliocostalis lumborum/longissimus thoracis (IL/LT) muscles.

Results

No differences were observed between the groups when T2 was averaged for the left and right side muscles. However, the QL displayed a significantly greater T2 asymmetry in LBP subjects when compared to controls (29.1 ± 4.3 vs. 15.9 ± 4.1%; p = 0.05). The psoas muscle also displayed a relatively large, albeit non-significant, mean difference (22.7 ± 6.9 vs. 9.5 ± 2.8%; p = 0.11). In the subjects with LBP, psoas T2 asymmetry was significantly reduced immediately following OMT (25.3 ± 6.9 to 6.1 ± 1.8%, p = 0.05), and the change in LBP immediately following OMT was correlated with the change in psoas T2 asymmetry (r = 0.75, p = 0.02).

Conclusion

Collectively, this pilot work demonstrates the feasibility of mfMRI for quantification and localization of muscle abnormalities in patients with acute low back pain. Additionally, this pilot work provides insight into the mechanistic actions of OMT during acute LBP, as it suggests that it may attenuate muscle activity asymmetries of some of the intrinsic low back muscles.

Transverse relaxation and magnetization transfer in skeletal muscle: effect of pH

Exercise increases the intracellular T(2) (T(2,i)) of contracting muscles. The mechanism(s) for the T(2,i) increase have not been fully described, and may include increased intracellular free water and acidification. These changes may alter chemical exchange processes between intracellular free water and proteins. In this study, the hypotheses were tested that (a) pH changes T(2,i) by affecting the rate of magnetization transfer (MT) between free intracellular water and intracellular proteins, and (b) the magnitude of the T(2,i) effect depends on acquisition mode (localized or nonlocalized) and echo spacing. Frog gastrocnemius muscles were excised and their intracellular pH was either kept at physiological pH (7.0) or modified to model exercising muscle (pH 6.5). The intracellular transverse relaxation rate (R(2,i) = 1/T(2,i)) always decreased in the acidic muscles, but the changes were greater when measured using more rapid refocusing rates. The MT rate from the macromolecular proton pool to the free water proton pool, its reverse rate, and the spin-lattice relaxation rate of water decreased in acidic muscles. It is concluded that intracellular acidification alters the R(2,i) of muscle water in a refocusing rate-dependent manner, and that the R(2,i) changes are correlated with changes in the MT rate between macromolecules and free intracellular water.

Fiber type composition of cadaveric human rotator cuff muscles

STUDY DESIGN

Descriptive cadaveric laboratory study.

OBJECTIVE

To identify the fiber type composition of the rotator cuff and teres major muscles in human subjects.

BACKGROUND

The rotator cuff is commonly injured in athletics and is a major focus of sports medicine. Although the anatomy and architecture of each muscle have been described in great detail, these muscles have never been fiber typed using immunohistochemistry or gel electrophoresis. Fiber typing is important in modeling function, exercise training, and rehabilitation.

METHODS AND MEASURES

We harvested tissue samples for all 4 rotator cuff muscles, as well as the teres major muscle from cadavers. Tissues were frozen in liquid nitrogen and sectioned. Cryosections were labeled with commercially available antibodies against fast and slow isoforms of myosin heavy chain (MHC). We also harvested fresh (unembalmed) tissue from deceased subjects and labeled tissue sections with antibodies against fast or slow MHC and wheat germ agglutinin. Gel electrophoresis followed by silver staining was also used to identify and quantify MHC isoforms in fresh tissue samples.

RESULTS

All of the muscles were of mixed fiber type composition. As a whole, 44% of rotator cuff fibers labeled positively for slow MHC, with slow MHC content of 54% in supraspinatus, 41% in infraspinatus, 49% in teres minor, 38% in subscapularis, and 40% in teres major. Mixed MHC isoform distribution was confirmed by SDS-PAGE, which also indicated that the IIa and IIx isoforms were roughly equally present across the muscles.

CONCLUSIONS

Human rotator cuff muscles, at least in older subjects, have a mixed fiber type. Because we only examined older subjects, we must limit our interpretation to this population.

Spatial heterogeneity in the muscle functional MRI signal intensity time course: effect of exercise intensity

It has previously been observed that during isometric dorsiflexion exercise, the time course of T2-weighted signal intensity (SI) changes is spatially heterogeneous. The purpose of this study was to test the hypothesis that this spatial heterogeneity would increase at higher contraction intensities. Eight subjects performed 90-s isometric dorsiflexion contractions at 30% and 60% of maximum voluntary contraction (MVC) while T2-weighted (repetition time/echo time=4000/35 ms) images were acquired. SI was measured before, during and after the contractions in regions of interest (ROIs) in the extensor digitorum longus (EDL) muscle and the deep and superficial compartments of the tibialis anterior (D-TA and S-TA, respectively). For all ROIs at 30% MVC, SI changes were similar. The maximum postcontraction SI was greater than the SI during exercise. At 60% MVC, SI changes during contraction were greater in the S-TA than in the D-TA and EDL. For the EDL and D-TA, the maximum postcontraction SI was greater than those during exercise. For the S-TA, the maximum postcontraction change was greater than the changes at t=8, 20 and 56 s but not the end-exercise value. We conclude that spatial heterogeneity increases during more intense dorsiflexion contractions, possibly reflecting regional differences in perfusion or neural activation of the muscle.

Comparative MRI analysis of T2 changes associated with single and repeated bouts of downhill running leading to eccentric-induced muscle damage

Although the exact mechanisms are still unclear, it is commonly acknowledged that acute eccentric exercise alters muscle performance, whereas the repetition of successive bouts leads to the disappearance of the deleterious signs. To clarify this issue, we measured blood creatine kinase and lactate dehydrogenase activities and proton transverse relaxation time (T2) in various leg muscles 72 h after single and repeated bouts of exhausting downhill running sessions (-15 degrees , 1.5 km/h) with either 4 or 7 days elapsed between bouts. After a single exercise bout, T2 and enzyme activities initially increased and recovered rapidly. When exercise bouts were repeated over a short time period (4 days), initial changes did not recover and endurance time throughout additional exercise sessions was significantly reduced. On the contrary, with a longer resting time between exercises (7 days), the endurance time of additional running sessions was significantly longer and muscle changes (T2 increase, muscle edema, and enzyme activity changes) slowly and completely reversed. Significant correlations were found between T2 changes and enzyme activities. T2 changes in the soleus and gastrocnemius muscle heads were differently affected by lengthening contractions, suggesting a muscle specificity and indicating that muscle alterations might be linked to different anatomical properties, such as fiber pennation angles, typology, and/or the exhausting nature of the downhill running sessions. We documented a "less muscle injury" effect due to the repetition of exercise bouts at a low frequency (i.e., 1 session per week) in accordance with the delayed muscle inflammation. This effect was not observed when the between-exercise resting time was shorter.

Absolute and relative contributions of BOLD effects to the muscle functional MRI signal intensity time course: effect of exercise intensity

The time course of exercise-induced T(2)-weighted signal intensity (SI) changes contains an initial rise, early dip, and secondary rise. The purposes of this study were to test the hypothesis that the secondary rise occurs earlier during more intense contractions, and to determine the contribution of BOLD contrast to the SI changes. Eight subjects performed 90-s isometric dorsiflexion contractions at 30% and 60% of maximum voluntary contraction (MVC) while T(2)-weighted (TR/TE = 4000 ms/35 ms) images were acquired and total hemoglobin ([THb]) and oxy-Hb saturation (%HbO(2)) were measured. At 30% MVC, [THb] remained constant and %HbO(2) decreased from 66.3% (standard error [SEM] = 2.6%) to 32.4% (SEM = 6.4%). At t = 88 s, SI increased by approximately 8% and was greater than at t = 8 and 56 s. At 60% MVC, [THb] remained constant and %HbO(2) decreased from 70.2% (SEM = 2.3%) to 40.4% (SEM = 5.4%). SI increased by approximately 17% and at t = 56 and 88 s was greater than at t = 8 and 20 s. The absolute contribution of calculated BOLD effects was -1% at 30% and 60% MVC. The relative contribution was greater at 30% than at 60% MVC (up to -26% and -10%, respectively). We conclude that the secondary rise occurs earlier at 60% MVC and that the relative contribution of BOLD effects is greater during less intense contractions.

Use of imaging to assess normal and adaptive muscle function

Physical therapists must be able to determine the activity and passive properties of the musculoskeletal system in order to accurately plan and evaluate therapeutic measures. Discussed in this article are imaging methods that not only allow for the measurement of muscle activity but also allow for the measurement of cellular processes and passive mechanical properties noninvasively and in vivo. The techniques reviewed are T1- and T2-weighted magnetic resonance (MR) imaging, MR spectroscopy, cine-phase-contrast MR imaging, MR elastography, and ultrasonography. At present, many of these approaches are expensive and not readily available in physical therapy clinics but can be found at medical centers. However, there are ways of using these techniques to provide important knowledge about muscle function. This article proposes creative ways in which to use these techniques as evaluative tools.

Dual gradient-echo MRI of post-contraction changes in skeletal muscle blood volume and oxygenation

Analysis of post-contraction MRI signal intensity (SI) transients may allow noninvasive studies of microvascular reactivity and blood oxygenation recovery. The purpose of this study was to determine the physiological basis for post-contraction changes in short-echo (6 ms) and long-echo (46 ms) gradient-echo (GRE) MRI signals (S(6) and S(46), respectively). Six healthy subjects were studied with the use of dual GRE MRI and near-infrared spectroscopy (NIRS). S(6), S(46), total hemoglobin concentration ([THb]), and oxyhemoglobin saturation (%HbO(2)) were measured before, during, and after 2 and 8 s dorsiflexion maximal voluntary contractions, and 5 min of proximal arterial occlusion. The changes in S(6) and [THb] after the 2-s contractions were similar to those following 8-s contractions, but changes in %HbO(2) and S(46) were greater following 8-s contractions than after the 2-s contractions. [THb] and S(6) did not change during and following 5 min of arterial occlusion, but %HbO(2) and S(46) were both significantly depressed at similar occlusion durations. Also, distance measures indicated similarity between S(6) and [THb] and between S(46) and %HbO(2). We conclude that following brief human skeletal muscle contractions, changes in S(6) primarily reflect changes in blood volume and changes in S(46) primarily reflect changes in blood oxygenation.

Leg muscles differ in spatial activation patterns with differing levels of voluntary plantarflexion activity in humans

BACKGROUND/AIMS

The purpose of this study was to investigate the differential activity between and within individual muscles commonly grouped as plantarflexors. Much of the previous information gathered on plantarflexor activity has been attained using electromyographic recordings. In this study, we used magnetic resonance imaging which allowed us to look at spatial differences in activation.

METHODS

Twenty-two human subjects exercised under four different conditions - combinations of loads of 25 or 65% of maximum voluntary contraction (MVC) and the direction of plantarflexion at a sagittal and off-sagittal angle. Before and after each exercise condition, T2-weighted magnetic resonance images were collected. Regions of interest were drawn around the lateral gastrocnemius (LG), medial gastrocnemius (MG), soleus (SOL), peroneus longus (PER) and tibialis anterior (TA) muscles and analyzed for differences.

RESULTS

Significant increases in T2 relaxation times during 25% MVC conditions were found for PER and, during the 65% MVC, for all four muscles considered plantarflexors (LG, MG, SOL, PER). No significant differences were found between sagittal and off-sagittal conditions. Within LG and MG, greater increases in T2 times with exercise were found in proximal regions compared with distal regions.

CONCLUSION

These results are consistent with suggestions that individual members of muscle groups are capable of differential activity and that for at least some muscles, such differential activity may exist within subvolumes of individual muscles.

Mapping activation levels of skeletal muscle in healthy volunteers: an MRI study

PURPOSE

To use muscle functional MRI (mfMRI) to compare activation levels within and among triceps surae (TS) muscles.

MATERIALS AND METHODS

Seven healthy males performed five sets of 10 repetitions of a unilateral heel-raise exercise. T2-weighted images were obtained before and immediately after the exercise. Pixels that showed T2 greater than the mean +1 SD of the region of interest (ROI) in pre-exercise images and lower than the mean +1 SD of the ROI in post-exercise images were identified. The remaining T2 values in the post-exercise images were assigned to five categories indicated by color: red (highest level of activation), yellow, green, sky blue, and blue (lowest level of activation). The images were then used to construct three-dimensional (3D) images from which the volumes at each level of activation were determined.

RESULTS

Within each of the TS muscles the % activated volumes with low and moderate levels of activation were larger than those with a high level of activation (P < 0.05). The % activated volumes with a high level of activation were larger in the medial gastrocnemius than the soleus (Sol; P < 0.05). The Sol had a larger % activated volume with a low level of activation than the lateral gastrocnemius (P < 0.05). Each activation level was nonuniformly distributed along the length within each TS muscle.

CONCLUSION

There is substantial variation in the level of activation within and among the TS muscles; however, the activation level is mainly in the moderate to low range in all three muscles.

Dynamic MRS and MRI of skeletal muscle function and biomechanics

MR is a powerful technique for studying the biomechanical and functional properties of skeletal muscle in vivo in health and disease. This review focuses on 31P, 1H and 13C MR spectroscopy for assessment of the dynamics of muscle metabolism and on dynamic 1H MRI methods for non-invasive measurement of the biomechanical and functional properties of skeletal muscle. The information thus obtained ranges from the microscopic level of the metabolism of the myocyte to the macroscopic level of the contractile function of muscle complexes. The MR technology presented plays a vital role in achieving a better understanding of many basic aspects of muscle function, including the regulation of mitochondrial activity and the intricate interplay between muscle fiber organization and contractile function. In addition, these tools are increasingly being employed to establish novel diagnostic procedures as well as to monitor the effects of therapeutic and lifestyle interventions for muscle disorders that have an increasing impact in modern society.

Changes in muscle T2 relaxation properties following spinal cord injury and locomotor training

Magnetic resonance (MR) is frequently used to study structural and biochemical properties of skeletal muscle. Changes in proton transverse relaxation (T2) properties have been used to study muscle cellular damage, as well as muscle activation during exercise protocols. In this study, we implemented MR imaging to characterize the T2 relaxation properties of rat hindlimb muscles following spinal cord injury (SCI) and locomotor training. After moderate midthoracic contusion SCI, Sprague-Dawley rats were assigned to either treadmill training, cycle training or an untrained group. T2 weighted images were obtained and mean muscle T2 times were calculated in the tibialis anterior, soleus, and gastrocnemius (GAS) muscles at pre-injury as well as at 1, 2, 4, 8, and 12 weeks post-injury. Following SCI, hindlimb muscles in untrained animals showed a significant increase in muscle T2, with the most dramatic shift (+5.46 ms) observed in soleus muscle at 1 week post-SCI. Subsequently, all muscle groups showed a spontaneous recovery in muscle T2 with normalized T2 values in the GAS and tibilias anterior muscles at 4 weeks and the soleus at 12 weeks post-SCI. Both training paradigms, treadmill and cycling training, accelerated the recovery of soleus muscle T2. As a result, soleus muscle T2 recovered back to pre-injury values within 3 weeks of training in both training groups. Finally, in vitro histological assessments of rat skeletal muscles demonstrated that there was no apparent muscle injury in any of the muscles studied at 1 week post-SCI.

New experimental setup for studying strictly noninvasively skeletal muscle function in rat using 1H-magnetic resonance (MR) imaging and 31P-MR spectroscopy

Traditional setups for in situ MR investigation of skeletal muscle function in animals use invasive systems for muscle stimulation and force measurement. These systems require surgical preparation and therefore exclude repetitive investigations on the same animal. This article describes a new experimental setup allowing strictly noninvasive MR investigations of muscle function in contracting rat gastrocnemius muscle using 1H-MR imaging and 31P-MR spectroscopy. The novelty of this setup is the integration of two noninvasive systems allowing muscle contraction by transcutaneous stimulation and force measurement with a dedicated ergometer. Muscle function was investigated in 20 rats (275-300 g) through a fatiguing stimulation protocol, either with this noninvasive setup (n = 10) or with a traditional MR setup (n = 10). T2-weighted images demonstrated that transcutaneous stimulation activated mainly the gastrocnemius muscle. Moreover, the changes in force development and in energy metabolism obtained with the noninvasive setup were qualitatively and quantitatively similar to those obtained with the traditional setup. This noninvasive setup is thus suitable for investigating skeletal muscle function in situ. It offers the possibility to repeat investigations in the same animal, avoiding individual variability and enabling longitudinal follow-up studies. This opens up new perspectives in various research areas including pharmaceutical research.

Muscle activation and its distribution within human triceps surae muscles

The purposes of this study were 1) to quantify the volume of activated parts within a whole muscle and 2) to examine activated area distributions along the length of muscle. Seven male subjects performed five sets of 10 repetitions of a single-leg calf-raise exercise with the knee fully extended. Transverse relaxation time (T2)-weighted spin echo images were acquired before and immediately after the exercise. A range of pixels with a T2 greater than the mean +1 SD of the region of interest (ROI) from the preexercise image and pixels with a T2 lower than the mean + SD of the ROI from the postexercise image were defined as “active” muscle. The active muscle images were three dimensionally reconstructed, from which the volume of the activated muscle was determined for individual triceps surae (TS) muscles. Our data indicate that ∼46% of the medial gastrocnemius (MG) muscle was activated during the exercise, with activation of the lateral gastrocnemius (LG) and soleus (Sol) muscles being ∼35%. In the MG, distal portions had a greater percentage area of activated muscle than the proximal portions ( P < 0.05), which was consistent with the results regarding electromyogram activity. In contrast, regional activation differences were not observed in the LG and Sol. These findings suggest that the amounts of activated muscle and its distribution would be different among TS muscles.

Neuromuscular activation of triceps surae using muscle functional MRI and EMG

PURPOSE

The aim of the present study was to clarify the neuromuscular activation patterns among individual triceps surae (TS) muscles during a repetitive plantarflexion using muscle functional magnetic resonance imaging (MRI) (mfMRI) and electromyography (EMG).

METHODS

Six healthy men participated in this study, performing 5 sets of 10 repetitions of a calf-raise exercise bilaterally, unilaterally, and unilaterally with an additional 15% of body-weight load. The transverse relaxation times (T2) in the medial gastrocnemius (MG), lateral gastrocnemius (LG), and soleus (SOL) muscles were measured from mfMR images obtained with the subject at rest and immediately after exercise; integrated EMG (iEMG) activity was recorded from the same muscles during exercise using surface electrodes.

RESULTS

There was remarkable correspondence between the changes in T2 values and iEMG activity under the three different workloads for individual TS muscles. In addition, changes in T2 value that occurred as a function of increasing exercise loads were linearly correlated with iEMG activity in the MG (r=0.58, P<0.05) and SOL (r=0.63, P<0.01), but not in the LG.

CONCLUSIONS

These results suggest that 1) mfMRI signals and iEMG activity correlate with workload in individual TS muscles, 2) mfMRI signals are associated with neuromuscular activity reflected in iEMG in the MG and SOL but not in the LG, and 3) these relationships are associated with neuromuscular and metabolic factors during exercise.

In vivo MR investigation of skeletal muscle function in small animals

In vivo 31P-MRS investigations have been widely used in small animals to study skeletal muscle function under normal and pathological conditions. Paradoxically in these studies, the benefit provided by 31P-MRS in terms of non-invasiveness is lost because of the utilization of experimental setups that integrate invasive devices for inducing muscle contractions and for measuring mechanical performance. These traditional methodologies, which require surgical preparations, have obvious limitations regarding repeatability in the same animal. The purpose of this review is to highlight the technical aspects of the in vivo MR investigations of skeletal muscle function in small animal models. We will more particularly address the issue related to the invasiveness of different procedures used so far in order to show finally that a further step into non-invasiveness can be achieved, in particular with the support of muscle functional 1H-MRI.

Metabolic and vascular support for the role of myoglobin in humans: a multiparametric NMR study

In human muscle the role of myoglobin (Mb) and its relationship to factors such as muscle perfusion and metabolic capacity are not well understood. We utilized nuclear magnetic resonance (NMR) to simultaneously study the Mb concentration ([Mb]), perfusion, and metabolic characteristics in calf muscles of athletes trained long term for either sprint or endurance running after plantar flexion exercise and cuff ischemia. The acquisitions for 1H assessment of Mb desaturation and concentration, arterial spin labeling measurement of muscle perfusion, and 31P spectroscopy to monitor high-energy phosphate metabolites were interleaved in a 4-T magnet. The endurance-trained runners had a significantly elevated [Mb] (0.28 ± 0.06 vs. 0.20 ± 0.03 mmol/kg). The time constant of creatine rephosphorylation (τPCr), an indicator of oxidative capacity, was both shorter in the endurance-trained group (34 ± 6 vs. 64 ± 20 s) and negatively correlated with [Mb] across all subjects ( r = 0.58). The time to reach maximal perfusion after cuff release was also both shorter in the endurance-trained group (306 ± 74 vs. 560 ± 240 s) and negatively correlated with [Mb] ( r = 0.56). Finally, Mb reoxygenation rate tended to be higher in the endurance-trained group and was positively correlated with τPCr ( r = 0.75). In summary, these NMR data reveal that [Mb] is increased in human muscle with a high oxidative capacity and a highly responsive vasculature, and the rate at which Mb resaturates is well correlated with the rephosphorylation rate of Cr, each of which support a teleological role for Mb in O2 transport within highly oxidative human skeletal muscle.

Physiological basis of muscle functional MRI: predictions using a computer model

Muscle functional MRI (mfMRI) has been proposed as a tool for noninvasively measuring the metabolic and hemodynamic responses to muscle activation, but its theoretical basis remains unclear. One challenge is that it is difficult to isolate individually those variables affecting the magnitude and temporal pattern of the mfMRI response. Therefore, the purpose of this study was to develop a computer model of how physiological factors altered during exercise affect the mfMRI signal intensity time course and then predict the contributions made by individual factors. A model muscle containing 39,204 fibers was defined. The fiber-type composition and neural activation strategies were designed to represent isometric contractions of the human anterior tibialis muscle, for which published mfMRI data exist. Sustained isometric contractions at 25 and 40% maximum voluntary contraction were modeled, as were the vascular (capillary recruitment, blood oxygen extraction) and metabolic (lactate accumulation, phosphocreatine hydrolysis, pH) responses. The effects on the transverse relaxation of MRI signal were estimated, and the mfMRI signal intensity time course was measured from simulated images. The model data agreed well qualitatively with published experimental data, and at long exercise durations the quantitative agreement was also good. The model was then used to predict that NMR relaxation effects secondary to blood volume and oxygenation changes, plus the creatine kinase reaction, dominate the mfMRI time course at short exercise durations (up to approximately 45 s) and that effects secondary to glycolysis are the main contributors at later times.

MRI evaluation of topical heat and static stretching as therapeutic modalities for the treatment of eccentric exercise-induced muscle damage

The aim of this study was to monitor the effects of topical heat and/or static stretch treatments on the recovery of muscle damage by eccentric exercise. For this purpose, 32 untrained male subjects performed intense eccentric knee extension exercise, followed by 2 weeks of treatment (heat, stretch, heat plus stretch) or no treatment (control, n=8/group). Isometric strength testing, pain ratings, and multi-echo magnetic resonance imaging of the thigh were performed before and at 2, 3, 4, 8, and 15 days following the exercise. Increased T2 relaxation time, muscle swelling, pain ratings, and strength loss confirmed significant muscle damage during the post-exercise period. Pain ratings and muscle volume recovered to baseline by 15 days, although muscle strength remained lower [77 (4) vs. 95 (3) kg pre-exercise, mean (SE)] and T2 values higher [32.2 (0.8) vs. 28.6 (0.2) ms pre-exercise]. Our results indicate that heat and/or static stretching does not consistently reduce soreness, swelling or muscle damage. The practical implication of our findings is that clinicians should be aware that prescribing heat and/or static stretching following intense eccentric or unaccustomed exercise will not enhance the recovery of damaged muscles.