MRI reveals menstrually-related muscle edema that negatively affects athletic agility in young women

Needle electromyography does not meaningfully impact findings in MR-neurography/-myography

INTRODUCTION

Magnetic resonance neurography (MRN) and myography (MRM) are emerging imaging methods for detecting diseases of the peripheral nerve system (PNS). Most patients with PNS diseases also undergo needle electromyography (EMG). This study examined whether EMG led to lesions that were detectable using MRN/MRM and whether these lesions could impair image interpretation.

METHODS

Ten patients who underwent clinically indicated EMG were recruited. MRN/MRM was performed before and 2-6 h after EMG, and if achievable, 2-3 days later. T2 signal intensity (SI) of the tibialis anterior muscle (TA) was quantified, and sizes and SI of the new lesions were measured. Visual rating was performed independently by three neuroradiologists.

RESULTS

T2 lesions at the site of needle insertion, defined as focal edema, were detectable in 9/10 patients. The mean edema size was 31.72 mm2 (SD = 14.42 mm2 ) at the first follow-up. Susceptibility-weighted imaging lesions, defined as (micro) hematomas were detected in 5/10 patients (mean size, 23.85 mm2 [SD = 12.59 mm2 ]). General muscle SI of the TA did not differ between pre- and post-EMG examinations. Lesions size was relatively small, and the readers described image interpretation as not impaired by these lesions.

DISCUSSION

This study showed that focal edema and hematomas frequently occurred after needle EMG and could be observed using MRN/MRM. As general muscle SI was not affected and image interpretation was not impaired, we concluded that needle EMG did not interfere with MRN/MRM.

Whole and segmental body composition changes during mid-follicular and mid-luteal phases of the menstrual cycle in recreationally active young women

BACKGROUND

Changes in oestradiol and progesterone hormones and associated fluid retention during the menstrual cycle phases might affect body composition (BC) in women.

AIM

The main objectives of this study were to determine the changes in whole and segmental BC by dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance (BIA) during the mid-follicular (MFP) and mid-luteal (MLP) phases.

SUBJECTS AND METHODS

Thirty recreationally active young women participated in this study. BC was measured by DXA and BIA during MFP and MLP. A mixed linear model for repeated measures analysis was used to determine the differences between the two phases.

RESULTS

Body mass was higher during MLP than MFP, while total body water, total and segmental fat mass and fat percentages measured by both BIA and DXA were similar during the two phases. DXA-derived fat-free mass and soft lean mass in the android region were higher during MLP than MFP. Large variability in individual responses was evident.

CONCLUSION

On average, whole and segmental BC variables do not change significantly between MFP and MLP. However, given the large variability among the individual responses, it is suggested to perform repeated BC measurements during the same phase of the menstrual cycle.

Contemporaneous and temporal interrelationships between menstrual fluctuations in sex hormones and DXA estimates of body composition in a premenopausal female: a case study

The reliability of dual energy X-ray absorptiometry (DXA) to assess body composition is influenced by factors like hydration status. Hence, any factor affecting total body water (TBW) content, such as menstrual shifts in sex hormones, might influence DXA estimates of lean soft tissue (LST) and fat mass (FM). To address this possibility, interrelationships between menstrual fluctuations in sex hormones, LST and FM were examined in a premenopausal female. The participant was monitored over 40 consecutive days for LST, FM and TBW by bioelectrical impedance. Daily capillary blood samples were taken to track 17β-estradiol, progesterone, and luteinizing hormone (LH). Using a graphical vector autoregression model, variable interrelationships were tested in a contemporaneous network (same measurement window) and temporal network (next measurement window). In the contemporaneous network, LST was related to TBW (r=0.42) and FM (r=-0.34). The temporal network uncovered directional effects of TBW (r=0.14), FM (r=-0.59) and LST (r=-0.50) on progesterone concentration. Hormonal interrelationships also emerged in the temporal network, whereby LH (r=0.24) and 17β-estradiol (r=0.13) were related to progesterone, and each hormone was related (r=0.50-0.69) to itself. The menstrual profiling of a premenopausal female revealed interrelationships between body composition and water content, but sex hormone fluctuations did not correlate with TBW, FM and LST on the same day or following day in the hypothesized direction. The temporal between- and within-hormone linkages reflect those natural feedback loops that control hormone secretion.

Serum Creatine Kinase Increases after Acute Strength Training in College Athletes with Menstrual Irregularities

Chronic menstrual dysfunction and low female sex hormones adversely affect muscular performance in women but studies in college athletes are scarce. A cohort of 18 Japanese, female college athletes at the University of Tsukuba, Japan, were recruited and studied over 3 weeks under 2 conditions. One group had normal menstrual cycling (CYC, 9 athletes) while the other had irregular cycles (DYS, 9 athletes). Hormones and creatine kinase (CK) were measured from blood under both rest (RE) and exercise (EX) conditions. Biceps femoris tendon stiffness was measured by myometry. No differences in age, height, weight, menarche age, or one-repetition maximum weight existed between the groups. The DYS group had persistently low levels of estrogen and progesterone. In the CYC group, the CK level significantly increased at each point immediately post-exercise and 24 h post-exercise compared to pre-exercise in Weeks 1 and 2, and significantly increased at 24 h post-exercise compared to pre-exercise status in Week 3. The DYS group was significantly different only between pre-exercise and 24 h post-exercise over all 3 weeks. The DYS group also suffered from higher biceps femoris tendon stiffness at 24 h post-exercise. Chronic menstrual irregularities in Japanese college athletes increase muscle damage markers in the bloodstream and muscle stiffness after acute strength training.

Effects of Menstrual Cycle Phase on Fluid Regulation during Walking Exercise

To elucidate the fluid regulation in different menstrual cycle phases during exercise. Sex hormones affect fluid regulation in different ways. Moreover, the renin angiotensin-aldosterone system is activated in the luteal phase in rest. However, there are limited studies on fluid regulation affected by such hormone excretion in the menstrual cycle during exercise, especially during a light walking exercise. A non-invasive method using urine samples to determine menstrual cycle phases was used, and the follicular and luteal phases were successfully confirmed in 10 participants (age, 21 ± 1 years; body mass index, 20.5 ± 2.1 kg/m2). The experimental exercise sessions consisted of 5-min standing and 15-min walking at 2 km/h on 15% slope (approximately 8.3°) on a treadmill. Each participant carried a backpack weighing 5% of her own weight, and performed three sessions of walking exercise. Urine aldosterone excretion was significantly higher in the luteal than in the follicular phase before and after walking (p < 0.05). Urinary excretion of aldosterone was five times higher in the luteal than in the follicular phase before and after walking exercise. Heart rates during walking, after rest, and after recovery were all significantly higher in the luteal than in the follicular phase (p < 0.05). The participants' ratings of perceived exertion during the first and third session of walking in the luteal phase was not higher than that at the follicular phase. The results of our study suggested that increased activity of the renin-angiotensin-aldosterone system in the luteal phase of the menstrual cycle might be further activated during exercise. This may increase the circulatory load, which is reflected as increased heart rate. These results suggested that premenopausal women may better take into account a possibility of an increased circulatory load in the luteal phase even when they perform light exercise.

Assessment of Salivary Nitric Oxide Levels in Elite University Athletes in Japan: Findings From a Cross Sectional Study Design

Background

High-intensity exercise affects the level of salivary nitric oxide (NO) with an impact on oxidative stress such as a reactive nitrogen-oxide species. However, in athletes with high-intensity training, the relationship between salivary NO levels and oxidative stress is yet to be clear. Additionally, the association of salivary NO levels and the common health disorders of athletes is unknown. Thus, the aim of this cross-sectional study was to clarify the relationship between salivary NO levels and oxidative stress, and the health/medical disorders existing in elite class university athletes.

Methods

In 250 athletes (males, 151 and females, 99) from undergraduate levels of Japanese University, we investigated the relationship between levels of salivary NO and oxidative stress markers: derived reactive oxygen species (d-ROMs) and biological antioxidant potential (BAP), and also examined that whether salivary NO levels are associated with diseases.

Results

There were no significant association between the levels of salivary NO and oxidative stress markers (such as d-ROM and BAP). From the questionnaire, asthma was the most prevalent as evident from medical history of the athletes. Additionally, the salivary NO levels were higher (520 ± 43 µmol/L vs. 375 ± 13 µmol/L, P < 0.05) in the asthma group (n = 9) than in the non-asthma group (n = 241). We determined the optimal cut-off value (P = 0.019) of the salivary NO levels for asthma was 425 µmol/L, with a sensitivity of 88.9% and specificity of 61.8% (area under the curve (AUC), 0.73).

Conclusions

Our results suggest that the high levels of salivary NO in trained university athletes in Japan may potentially predict asthma. And this salivary NO level is not associated with markers of oxidative stress and existing diseases in athletes studied here.

Risk of female athlete triad development in Japanese collegiate athletes is related to sport type and competitive level

Introduction

Menstrual dysfunction, musculoskeletal injury, and poor nutrition combine to form the female athlete triad (FAT), which results in serious health consequences for affected athletes. To this point, the risk factors of this phenomenon have not been fully explored in Japanese female college athletes. Additionally, the effect of competitive level on FAT risk factors has also not been reported. Therefore, we aimed to examine FAT risk factors in Japanese female athletes of various sports as well as examine the impact of competitive level on FAT.

Methods

A Japanese-language survey was completed by 531 athletes and 20 nonathletes at two Japanese universities and answers with regard to menstrual status, musculoskeletal injury, nutrition, and other variables were analyzed based on classification of the sports into nine distinct groups based on activity type. Sport intensity, training volume, and competitive levels were used to further classify each sport. One-way ANOVA and the Bonferroni post hoc test using SPSS were carried out to analyze significance for relationships between sport intensity and FAT risk factors. Additionally, the relationship between competitive level and FAT risk factors was analyzed by ANOVA and Bonferroni post hoc tests.

Results

Sport intensity was positively correlated with a delay in menarche as well as dysmenorrhea and poor nutrition while musculoskeletal injury was correlated with repetitive, high-training volume sports. Lower competitive levels increased dysmenorrhea but did not impact injury status or nutrition.

Conclusion

Sport intensity and training volume, but not competitive level, are the critical factors affecting FAT risk in Japanese female college athletes.