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Surowiec RK, Does MD, Nyman JS. In Vivo Assessment of Bone Quality Without X-rays. Curr Osteoporos Rep 2024; 22:56-68. [PMID: 38227178 PMCID: PMC11050740 DOI: 10.1007/s11914-023-00856-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE OF REVIEW This review summarizes recent advances in the assessment of bone quality using non-X-ray techniques. RECENT FINDINGS Quantitative ultrasound (QUS) provides multiple measurements of bone characteristics based on the propagation of sound through bone, the attenuation of that sound, and different processing techniques. QUS parameters and model predictions based on backscattered signals can discriminate non-fracture from fracture cases with accuracy comparable to standard bone mineral density (BMD). With advances in magnetic resonance imaging (MRI), bound water and pore water, or a porosity index, can be quantified in several long bones in vivo. Since such imaging-derived measurements correlate with the fracture resistance of bone, they potentially provide new BMD-independent predictors of fracture risk. While numerous measurements of mineral, organic matrix, and bound water by Raman spectroscopy correlate with the strength and toughness of cortical bone, the clinical assessment of person's bone quality using spatially offset Raman spectroscopy (SORS) requires advanced spectral processing techniques that minimize contaminating signals from fat, skin, and blood. Limiting exposure of patients to ionizing radiation, QUS, MRI, and SORS has the potential to improve the assessment of fracture risk and track changes of new therapies that target bone matrix and micro-structure.
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Affiliation(s)
- Rachel K Surowiec
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Dr., West Lafayette, IN, 47907, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd., Indianapolis, IN, 46202, USA
| | - Mark D Does
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN, 37232, USA
- Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN, 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN, 37232, USA
- Department of Electrical Engineering and Computer Science, Vanderbilt University, 400 24th Ave. S., Nashville, TN, 37212, USA
| | - Jeffry S Nyman
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN, 37232, USA.
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN, 37232, USA.
- Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, 1211 Medical Center Dr., Nashville, TN, 37212, USA.
- Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, 37212, USA.
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Mehta K, Mohebbi M, Pasco JA, Williams LJ, Sui SX, Walder K, Ng BL, Gupta VB. A plasma protein signature associated with cognitive function in men without severe cognitive impairment. Alzheimers Res Ther 2023; 15:148. [PMID: 37658429 PMCID: PMC10472730 DOI: 10.1186/s13195-023-01294-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND A minimally invasive blood-based assessment of cognitive function could be a promising screening strategy to identify high-risk groups for the incidence of Alzheimer's disease. METHODS The study included 448 cognitively unimpaired men (mean age 64.1 years) drawn from the Geelong Osteoporosis Study. A targeted mass spectrometry-based proteomic assay was performed to measure the abundance levels of 269 plasma proteins followed by linear regression analyses adjusted for age and APOE ε4 carrier status to identify the biomarkers related to overall cognitive function. Furthermore, two-way interactions were conducted to see whether Alzheimer's disease-linked genetic variants or health conditions modify the association between biomarkers and cognitive function. RESULTS Ten plasma proteins showed an association with overall cognitive function. This association was modified by allelic variants in genes ABCA7, CLU, BDNF and MS4A6A that have been previously linked to Alzheimer's disease. Modifiable health conditions such as mood disorders and poor bone health, which are postulated to be risk factors for Alzheimer's disease, also impacted the relationship observed between protein marker levels and cognition. In addition to the univariate analyses, an 11-feature multianalyte model was created using the least absolute shrinkage and selection operator regression that identified 10 protein features and age associated with cognitive function. CONCLUSIONS Overall, the present study revealed plasma protein candidates that may contribute to the development of a blood-based screening test for identifying early cognitive changes. This study also highlights the importance of considering other risk factors in elucidating the relationship between biomarkers and cognition, an area that remains largely unexplored.
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Affiliation(s)
- Kanika Mehta
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mohammadreza Mohebbi
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Lana J Williams
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Sophia X Sui
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
| | - Ken Walder
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
| | - Boon Lung Ng
- Department of Geriatric Medicine, Barwon Health, Geelong, VIC, Australia
| | - Veer Bala Gupta
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia.
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Métrailler A, Hans D, Lamy O, Gonzalez Rodriguez E, Shevroja E. Heel quantitative ultrasound (QUS) predicts incident fractures independently of trabecular bone score (TBS), bone mineral density (BMD), and FRAX: the OsteoLaus Study. Osteoporos Int 2023:10.1007/s00198-023-06728-4. [PMID: 37154943 PMCID: PMC10382398 DOI: 10.1007/s00198-023-06728-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/16/2023] [Indexed: 05/10/2023]
Abstract
This study aimed to better define the role of heel-QUS in fracture prediction. Our results showed that heel-QUS predicts fracture independently of FRAX, BMD, and TBS. This corroborates its use as a case finding/pre-screening tool in osteoporosis management. INTRODUCTION Quantitative ultrasound (QUS) characterizes bone tissue based on the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Heel-QUS predicts osteoporotic fractures independently of clinical risk factors (CRFs) and bone mineral density (BMD). We aimed to investigate whether (1) heel-QUS parameters predict major osteoporotic fractures (MOF) independently of the trabecular bone score (TBS) and (2) the change of heel-QUS parameters over 2.5 years is associated with fracture risk. METHODS One thousand three hundred forty-five postmenopausal women from the OsteoLaus cohort were followed up for 7 years. Heel-QUS (SOS, BUA, and stiffness index (SI)), DXA (BMD and TBS), and MOF were assessed every 2.5 years. Pearson's correlation and multivariable regression analyses were used to determine associations between QUS and DXA parameters and fracture incidence. RESULTS During a mean follow-up of 6.7 years, 200 MOF were recorded. Fractured women were older, more treated with anti-osteoporosis medication; had lower QUS, BMD, and TBS; higher FRAX-CRF risk; and more prevalent fractures. TBS was significantly correlated with SOS (0.409) and SI (0.472). A decrease of one SD in SI, BUA or SOS increased the MOF risk by (OR(95%CI)) 1.43 (1.18-1.75), 1.19 (0.99-1.43), and 1.52 (1.26-1.84), respectively, after adjustment for FRAX-CRF, treatment, BMD, and TBS. We found no association between the change of QUS parameters in 2.5 years and incident MOF. CONCLUSION Heel-QUS predicts fracture independently of FRAX, BMD, and TBS. Thus, QUS represents an important case finding/pre-screening tool in osteoporosis management. The change in QUS over time was not associated with future fractures, making it inappropriate for patient monitoring.
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Affiliation(s)
- Antoine Métrailler
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Didier Hans
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Olivier Lamy
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Elena Gonzalez Rodriguez
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Enisa Shevroja
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland.
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Mehta K, Mohebbi M, Pasco JA, Williams LJ, Walder K, Ng BL, Gupta VB. Impact of Mood Disorder History and Bone Health on Cognitive Function Among Men Without Dementia. J Alzheimers Dis 2023; 96:381-393. [PMID: 37781798 DOI: 10.3233/jad-230140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
BACKGROUND Poor cognitive function, a major disabling condition of older age, is often considered a prodromal feature of dementia. High mortality and the lack of a cure for dementia have necessitated a focus on the identification of potentially modifiable risk factors. Mental and physical health conditions such as mood disorders and bone loss have been previously linked with poor cognition individually although their combined effect remains largely unknown. OBJECTIVE Considering the multifactorial nature of dementia pathology, we investigated whether mood disorders, bone health and their interaction are associated with cognitive function in a population-based sample of men. METHODS Four hundred and forty-two male participants were drawn from the Geelong Osteoporosis Study. Cognitive function was assessed using the CogState Brief Battery, which measured cognitive performance across four domains and was used to compute overall cognitive function. Mood disorders and hip bone mineral density (BMD) were determined using a semi-structured clinical interview and dual-energy X-ray absorptiometry, respectively. RESULTS Hip BMD (Bcoeff = 0.56, 95% CI: [0.07, 1.05], p = 0.025) but not mood disorder (Bcoeff = -0.50, 95% CI: [-0.20, 0.10], p = 0.529) was associated with overall cognitive function after accounting for potential confounders. Interaction effects were observed between the two exposures (Bcoeff = -1.37, 95% CI: [-2.49, -0.26], p = 0.016) suggesting that individuals without a mood disorder displayed better cognitive performance with increasing BMD, while those with a lifetime history of mood disorder displayed poorer cognitive function with increasing BMD. CONCLUSIONS These findings highlight the importance of exploring interactions among potentially modifiable health conditions associated with cognitive function.
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Affiliation(s)
- Kanika Mehta
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mohammadreza Mohebbi
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Lana J Williams
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Ken Walder
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
| | - Boon Lung Ng
- Department of Geriatric Medicine, Barwon Health, Geelong, VIC, Australia
| | - Veer Bala Gupta
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
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Behforootan S, Thorniley M, Minonzio JG, Boughton O, Karia M, Bhattacharya R, Hansen U, Cobb J, Abel R. Can guided wave ultrasound predict bone mechanical properties at the femoral neck in patients undergoing hip arthroplasty? J Mech Behav Biomed Mater 2022; 136:105468. [PMID: 36244325 DOI: 10.1016/j.jmbbm.2022.105468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/30/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
The bone quality of patients undergoing hip replacement surgery is poorly predicted by radiographs alone. With better bone quality information available to a surgeon, the operation can be performed more safely. The aim of this study was to investigate whether ultrasound signals of cortical bone at peripheral sites such as the tibia and radius can be used to predict the compressive mechanical properties of cortical bone at the femoral neck. We recruited 19 patients undergoing elective hip arthroplasty and assessed the radius and tibia of these patients with the Azalée guided wave ultrasound to estimate the porosity and thickness of the cortex. Excess bone tissues were collected from the femoral neck and the compressive mechanical properties of the cortex were characterised under a mechanical loading rig to determine stiffness, ultimate strength, and density. The correlations between the ultrasound measurements and mechanical properties were analysed using linear regression, Pearson correlation statistics, and multiple regression analysis. Cortical mechanical properties were weakly to moderately correlated with the ultrasound measurements at various sites (R2 = 0.00-0.36). The significant correlations found were not consistent across all 4 peripheral measurement sites. Additionally, weak to moderate ability of the ultrasound to predict mechanical properties at the neck of femur with multiple regression analysis was found (R2 = 0.00-0.48). Again, this was inconsistent across the different anatomical sites. Overall, the results demonstrate the need for ultrasound scans to be collected directly from clinically relevant sites such as the femoral neck due to the inconsistency of mechanical properties across various sites.
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Affiliation(s)
- Sara Behforootan
- MSK Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK.
| | - Madelaine Thorniley
- MSK Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
| | - Jean-Gabriel Minonzio
- Escuela de Ingeniería Informática, Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Valparaíso, Chile & Sorbonne Université, INSERM UMR S 1146, CNRS UMR 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Oliver Boughton
- MSK Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
| | - Monil Karia
- MSK Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
| | | | - Ulrich Hansen
- Department of Mechanical Engineering, Faculty of Engineering, Imperial College London, UK
| | - Justin Cobb
- MSK Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
| | - Richard Abel
- MSK Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
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Liu Q, Liu Z, Guo H, Liang J, Zhang Y. The progress in quantitative evaluation of callus during distraction osteogenesis. BMC Musculoskelet Disord 2022; 23:490. [PMID: 35610718 PMCID: PMC9128294 DOI: 10.1186/s12891-022-05458-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/19/2022] [Indexed: 12/22/2022] Open
Abstract
The manual monitoring of callus with digital radiography (X-ray) is the primary bone healing evaluation, assessing the number of bridged callus formations. However, this method is subjective and nonquantitative. Recently, several quantitative monitoring methods, which could assess the recovery of the structure and biomechanical properties of the callus at different stages and the process of bone healing, have been extensively investigated. These methods could reflect the bone mineral content (BMC), bone mineral density (BMD), stiffness, callus and bone metabolism at the site of bone lengthening. In this review, we comprehensively summarized the latest techniques for evaluating bone healing during distraction osteogenesis (DO): 1) digital radiography; 2) dual-energy X-ray scanning; 3) ultrasound; 4) quantitative computed tomography; 5) biomechanical evaluation; and 6) biochemical markers. This evidence will provide novel and significant information for evaluating bone healing during DO in the future.
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Affiliation(s)
- Qi Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Hunan Province, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ze Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Hunan Province, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hongbin Guo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Hunan Province, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jieyu Liang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Hunan Province, Changsha, 410008, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Hunan Province, Changsha, 410008, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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