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Chow BVY, Morgan C, Rae C, Warton DI, Novak I, Davies S, Lancaster A, Popovic GC, Rizzo RRN, Rizzo CY, Kyriagis M, Herbert RD, Bolsterlee B. Human lower leg muscles grow asynchronously. J Anat 2024; 244:476-485. [PMID: 37917014 PMCID: PMC10862152 DOI: 10.1111/joa.13967] [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: 05/04/2023] [Revised: 09/08/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
Muscle volume must increase substantially during childhood growth to generate the power required to propel the growing body. One unresolved but fundamental question about childhood muscle growth is whether muscles grow at equal rates; that is, if muscles grow in synchrony with each other. In this study, we used magnetic resonance imaging (MRI) and advances in artificial intelligence methods (deep learning) for medical image segmentation to investigate whether human lower leg muscles grow in synchrony. Muscle volumes were measured in 10 lower leg muscles in 208 typically developing children (eight infants aged less than 3 months and 200 children aged 5 to 15 years). We tested the hypothesis that human lower leg muscles grow synchronously by investigating whether the volume of individual lower leg muscles, expressed as a proportion of total lower leg muscle volume, remains constant with age. There were substantial age-related changes in the relative volume of most muscles in both boys and girls (p < 0.001). This was most evident between birth and five years of age but was still evident after five years. The medial gastrocnemius and soleus muscles, the largest muscles in infancy, grew faster than other muscles in the first five years. The findings demonstrate that muscles in the human lower leg grow asynchronously. This finding may assist early detection of atypical growth and allow targeted muscle-specific interventions to improve the quality of life, particularly for children with neuromotor conditions such as cerebral palsy.
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Affiliation(s)
- Brian V. Y. Chow
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
- School of Biomedical Sciences, University of New South WalesSydneyNew South WalesAustralia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent HealthThe University of SydneySydneyNew South WalesAustralia
| | - Caroline Rae
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
- School of Psychology, University of New South WalesSydneyNew South WalesAustralia
| | - David I. Warton
- School of Mathematics and StatisticsUniversity of New South WalesSydneyNew South WalesAustralia
- Evolution & Ecology Research CentreUniversity of New South WalesSydneyNew South WalesAustralia
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent HealthThe University of SydneySydneyNew South WalesAustralia
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Suzanne Davies
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
| | - Ann Lancaster
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
| | - Gordana C. Popovic
- Stats Central, Mark Wainwright Analytical CentreUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rodrigo R. N. Rizzo
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
- School of Biomedical Sciences, University of New South WalesSydneyNew South WalesAustralia
| | - Claudia Y. Rizzo
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
| | - Maria Kyriagis
- Rehab2Kids, Sydney Children's HospitalSydneyNew South WalesAustralia
| | - Robert D. Herbert
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
- School of Biomedical Sciences, University of New South WalesSydneyNew South WalesAustralia
| | - Bart Bolsterlee
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
- Graduate School of Biomedical Engineering, University of New South WalesSydneyNew South WalesAustralia
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Deschrevel J, Andries A, Maes K, Peeters J, van Opstal A, Jiang D, De Beukelaer N, Corvelyn M, Staut L, De Houwer H, Costamagna D, Desloovere K, Van Campenhout A, Gayan-Ramirez G. Histological analysis of the gastrocnemius muscle in preschool and school age children with cerebral palsy compared with age-matched typically developing children. Am J Physiol Cell Physiol 2024; 326:C573-C588. [PMID: 38105751 DOI: 10.1152/ajpcell.00344.2023] [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: 07/26/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 12/19/2023]
Abstract
Inconsistent alterations in skeletal muscle histology have been reported in adolescents with cerebral palsy (CP) and whether alterations are present in young children and differ from older children is not yet known. This study aimed to define histological alterations in the medial gastrocnemius (MG) of ambulant CP (gross-motor classification system, GMFCS I-III) stratified in two age groups (preschool children, PS: 2-5 and school age children, SA: 6-9-yr old) compared with age-matched typically developing (TD) children. We hypothesized that alterations in muscle microscopic properties are already present in PS-CP and are GMFCS level specific. Ultrasound guided percutaneous microbiopsies were collected in 46 CP (24-PS) and 45 TD (13-PS) children. Sections were stained to determine fiber cross-sectional area (fCSA) and proportion, capillary, and satellite cell amount. Average absolute and normalized fCSA were similar in CP and TD, but a greater percentage of smaller fibers was found in CP. Coefficient of variation (CV) was significantly larger in PS-CP-GMFCS I-II and for type I fiber. In SA-CP, all fiber types contributed to the higher CV. Type IIx proportion was higher and type I was lower in PS-CP-GMFCS-III and for all SA-CP. Reduced capillary-to-fiber ratio was present in PS-CP-GMFCS II-III and in all SA-CP. Capillary fiber density was lower in SA-CP. Capillary domain was enhanced in all CP, but capillary spatial distribution was maintained as was satellite cell content. We concluded that MG histological alterations are already present in very young CP but are only partly specific for GMFCS level and age.NEW & NOTEWORTHY Inconsistent histological alterations have been reported in children with cerebral palsy (CP) but whether they are present in very young and ambulant CP children and differ from those reported in old CP children is not known. This study highlighted for the first time that enhanced muscle fiber size variability and loss of capillaries are already present in very young CP children, even in the most ambulant ones, and these alterations seem to extend with age.
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Affiliation(s)
- Jorieke Deschrevel
- Laboratory of Respiratory Diseases and Thoracic surgery, Department of Chronic Diseases and Metabolism, KU-Leuven, Leuven, Belgium
| | - Anke Andries
- Laboratory of Respiratory Diseases and Thoracic surgery, Department of Chronic Diseases and Metabolism, KU-Leuven, Leuven, Belgium
| | - Karen Maes
- Laboratory of Respiratory Diseases and Thoracic surgery, Department of Chronic Diseases and Metabolism, KU-Leuven, Leuven, Belgium
| | - Jules Peeters
- Laboratory of Respiratory Diseases and Thoracic surgery, Department of Chronic Diseases and Metabolism, KU-Leuven, Leuven, Belgium
| | - Axel van Opstal
- Laboratory of Respiratory Diseases and Thoracic surgery, Department of Chronic Diseases and Metabolism, KU-Leuven, Leuven, Belgium
| | - Dina Jiang
- Laboratory of Respiratory Diseases and Thoracic surgery, Department of Chronic Diseases and Metabolism, KU-Leuven, Leuven, Belgium
| | - Nathalie De Beukelaer
- Neurorehabilitation group, Department of Rehabilitation Sciences, KU-Leuven, Leuven, Belgium
| | - Marlies Corvelyn
- Stem Cell and Developmental Biology, Department of Development and Regeneration, KU-Leuven, Leuven, Belgium
| | - Lauraine Staut
- Neurorehabilitation group, Department of Rehabilitation Sciences, KU-Leuven, Leuven, Belgium
| | - Hannah De Houwer
- Pediatric Orthopedics, Department of Development and Regeneration, KU-Leuven, Leuven, Belgium
| | - Domiziana Costamagna
- Neurorehabilitation group, Department of Rehabilitation Sciences, KU-Leuven, Leuven, Belgium
- Stem Cell and Developmental Biology, Department of Development and Regeneration, KU-Leuven, Leuven, Belgium
- Exercise Physiology Research group, Department of Movement Sciences, KU-Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Neurorehabilitation group, Department of Rehabilitation Sciences, KU-Leuven, Leuven, Belgium
| | - Anja Van Campenhout
- Pediatric Orthopedics, Department of Development and Regeneration, KU-Leuven, Leuven, Belgium
| | - Ghislaine Gayan-Ramirez
- Laboratory of Respiratory Diseases and Thoracic surgery, Department of Chronic Diseases and Metabolism, KU-Leuven, Leuven, Belgium
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Chow BVY, Morgan C, Rae C, Novak I, Davies S, Herbert RD, Bolsterlee B. Three-dimensional skeletal muscle architecture in the lower legs of living human infants. J Biomech 2023; 155:111661. [PMID: 37290180 DOI: 10.1016/j.jbiomech.2023.111661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/01/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
Little is known about the skeletal muscle architecture of living humans at birth. In this study, we used magnetic resonance imaging (MRI) to measure the volumes of ten muscle groups in the lower legs of eight human infants aged less than three months. We then combined MRI and diffusion tensor imaging (DTI) to provide detailed, high-resolution reconstructions and measurements of moment arms, fascicle lengths, physiological cross-sectional areas (PCSAs), pennation angles and diffusion parameters of the medial (MG) and lateral gastrocnemius (LG) muscles. On average, the total lower leg muscle volume was 29.2 cm3. The largest muscle was the soleus muscle with a mean volume of 6.5 cm3. Compared to the LG muscles, the MG muscles had, on average, greater volumes (by ∼35%) and greater PCSAs (by ∼63%) but similar ankle-to-knee moment arm ratios (∼0.1 difference), fascicle lengths (∼5.7 mm difference) and pennation angles (∼2.7° difference). The MG data were compared with data previously collected from adults. The MG muscles of adults had, on average, a 63-fold greater volume, a 36-fold greater PCSA, and 1.7-fold greater fascicle length. This study demonstrates the feasibility of using MRI and DTI to reconstruct the three-dimensional architecture of skeletal muscles in living human infants. It is shown that, between infancy and adulthood, MG muscle fascicles grow primarily in cross-section rather than in length.
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Affiliation(s)
- Brian V Y Chow
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia; School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia
| | - Caroline Rae
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia; School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Suzanne Davies
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia
| | - Robert D Herbert
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia; School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Bart Bolsterlee
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia; Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW, Australia.
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