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Andreu-Caravaca L, Ramos-Campo DJ, Martos-Bonilla A, Rando-Martín A, Rubio-Arias JÁ. Sex differences in strength, functional capacity and mobility in patients with multiple sclerosis: An exploratory analysis. Mult Scler Relat Disord 2024; 87:105694. [PMID: 38796906 DOI: 10.1016/j.msard.2024.105694] [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] [Received: 01/18/2024] [Revised: 05/17/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Physical exercise programs are commonly designed without consideration for sex differences. Nevertheless, disease progression exhibits sex-specific patterns, resulting in different functionality and strength performances. OBJECTIVES To analyze sex differences in strength, functional capacity, and mobility, and to evaluate sex-dependent differences in leg strength in multiple sclerosis (MS) patients. METHODS A cross-sectional study was conducted with 35 participants (female: n = 19; Expanded Disability Status Scale (EDSS)= 3.0 ± 1.2, male: n = 16; EDSS= 3.3 ± 1.2). Body composition, maximal voluntary isometric contraction (MVIC), explosive strength (rate of force development, RFD), central activation ratio (CAR), functional capacity, and mobility were assessed. RESULTS Differences were observed between males and females (p = 0.001) in height, lean body mass and MVIC. No differences were observed in the other variables. Regarding the leg asymmetry, men showed higher values in the stronger leg for both MVIC (p < 0.001, d=large) and RFD, whereas women showed higher values only in RFD. Men with MS demonstrated a greater capacity to produce maximal strength than women with this disease. CONCLUSIONS The results found suggest that maximum strength differs between men and women in our sample of patients with multiple sclerosis. Furthermore, the weaker leg, regardless of sex, exhibits poorer results in explosive strength compared to the stronger leg. However, maximum strength only shows differences in men and not in women. Therefore, these findings should serve as a basis for rehabilitation professionals when planning training programs for this population.
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Affiliation(s)
- Luis Andreu-Caravaca
- Facultad de Deporte. UCAM, Universidad Católica de Murcia. Murcia. Spain; Sports Physiology Department, Faculty of Health Sciences. Universidad Católica de Murcia. Murcia. Spain
| | - Domingo J Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF. Madrid. Spain
| | - Ana Martos-Bonilla
- Health Research Centre, Department of Education, Faculty of Educational Sciences, HUM-628 Research Group, Universidad de Almería, Almería, Spain
| | - Alberto Rando-Martín
- Health Research Centre, Department of Education, Faculty of Educational Sciences, HUM-628 Research Group, Universidad de Almería, Almería, Spain
| | - Jacobo Á Rubio-Arias
- Health Research Centre, Department of Education, Faculty of Educational Sciences, HUM-628 Research Group, Universidad de Almería, Almería, Spain.
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Tang J, Dong Z, Yang L, Yang P, Zhao W, Deng L, Xue J, Cui Y, Li Q, Tang L, Sheng J, Zhang Y, Zhang H, Chen T, Dong B, Lv X. The relationship between prognosis and temporal muscle thickness in 102 patients with glioblastoma. Sci Rep 2024; 14:13958. [PMID: 38886495 PMCID: PMC11183225 DOI: 10.1038/s41598-024-64947-z] [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] [Received: 09/24/2023] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
Temporal muscle thickness measured on 3D MRI has recently been linked to prognosis in glioblastoma patients and may serve as an independent prognostic indicator. This single-center study looked at temporal muscle thickness and prognosis in patients with primary glioblastoma. Overall survival was the major study outcome. For a retrospective analysis from 2010 to 2020, clinical data from 102 patients with glioblastoma at the Department of Oncology Radiotherapy of the First Affiliated Hospital of Dalian Medical University were gathered. Fifty-five cases from 2016 to 2020 contained glioblastoma molecular typing data, of which 45 were IDH wild-type glioblastomas and were analysed separately. TMT was measured on enhanced T1-weighted magnetic resonance images in patients with newly diagnosed glioblastoma.Overall patient survival (OS) was calculated by the Kaplan-Meier method and survival curves were plotted using the log-rank-sum test to determine differences between groups, and multifactorial analyses were performed using a Cox proportional-risk model.The median TMT for 102 patients was 6.775 mm (range: 4.95-10.45 mm). Patients were grouped according to median TMT, and the median overall survival (23.0 months) was significantly longer in the TMT > median group than in the TMT median group (P 0.001; Log-rank test). Analysing 45 patients with IDH wild type alone, the median overall survival (12 months) of patients in the TMT > median group was significantly longer than that of patients in the TMT ≤ median group (8 months) (P < 0.001; Log-rank test).TMT can serve as an independent prognostic factor for glioblastoma.
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Affiliation(s)
- Jinhai Tang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Zhenghao Dong
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lei Yang
- Department of Radiation Oncology, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ping Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Wanying Zhao
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Lvdan Deng
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Juan Xue
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yijie Cui
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Qizheng Li
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Lufan Tang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Junxiu Sheng
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yu Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Huimin Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Tongtong Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Bin Dong
- Department of Neurosurgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
| | - Xiupeng Lv
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
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Park KM, Lee HJ, Park BS, Wi JH, Kwon YU, Lee WH, Lee DA, Kim J. Temporal Muscle Thickness and Sarcopenia Components in Healthy Adults, Validated through Allgeun Diagnostic Tool. Healthcare (Basel) 2024; 12:1012. [PMID: 38786421 PMCID: PMC11121107 DOI: 10.3390/healthcare12101012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Sarcopenia, characterized by progressive muscle loss and functional decline, poses significant risks, including falls, impaired daily activities, and increased mortality. We developed Allgeun, a novel device that measures handgrip strength, muscle mass, and physical performance. This study aimed to investigate whether temporal muscle thickness (TMT) could be used as a sarcopenia marker and to evaluate the usability of Allgeun. This prospective study enrolled 28 participants without medical or neurological disorders. They underwent three-dimensional T1-weighted imaging using a 3 Tesla magnetic resonance imaging scanner. TMT was measured based on T1-weighted images by a board-certified neuroradiologist. Allgeun was used to measure the following three key components of sarcopenia: muscle strength (handgrip strength), muscle mass (calf and thigh circumference), and physical performance (five times the chair stand test). Correlation analysis was conducted between TMT and the results of the handgrip strength, calf and thigh circumferences, and chair stand tests. There were moderate positive correlations between TMT and calf circumference (r = 0.413, p = 0.029), thigh circumference (r = 0.486, p = 0.008), and handgrip strength (r = 0.444, p = 0.018). However, no significant correlation was observed between TMT and physical performance (r = -0.000, p = 0.998). Our findings underscore TMT's potential as an indicator of sarcopenia, particularly regarding muscle mass and strength. Additionally, we demonstrated that the new device, Allgeun, is useful for screening and diagnosing the severity of sarcopenia.
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Affiliation(s)
- Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Republic of Korea; (K.M.P.); (D.A.L.)
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Republic of Korea
| | - Bong Soo Park
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Republic of Korea;
| | - Jin-Hong Wi
- Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea;
| | - Yong-Uk Kwon
- Department of Orthopedic Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea;
| | - Won Hee Lee
- Department of Neurosurgery, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea;
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Republic of Korea; (K.M.P.); (D.A.L.)
| | - Jinseung Kim
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea
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Han JM, Kim DH, Lee BC. Association between the Thickness or Area of the Temporal Muscle and Skeletal Muscle Mass in Bioimpedance Analysis. Gerontology 2024:1-8. [PMID: 38657583 DOI: 10.1159/000539063] [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: 08/27/2023] [Accepted: 04/22/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Sarcopenia associated with stroke can significantly impact patient prognosis; however, the current standard diagnostic methods for sarcopenia are rarely used in stroke patients. Therefore, the aim of the current study was to investigate whether the temporal muscle thickness (TMT) or area (TMA) could serve as a surrogate marker for measuring skeletal muscle mass. METHODS This retrospective chart review study was conducted on 244 participants from March 2018 to February 2020. The TMT and TMA were measured at the supraorbital roof level using brain CT or T1-weighted MR imaging obtained from participants. The skeletal muscle mass and skeletal muscle index (SMI) and whole-body phase angle (WBPA) at 50 kHz were collected. Pearson correlation analysis was used to assess the relationship between the TMT or TMA and the results of the bioimpedance analysis. RESULTS The mean TMT showed significant positive correlations with skeletal muscle mass (male, r = 0.520; female, r = 0.706), SMI (male, r = 0.426; female, r = 0.582), and WBPA (male, r = 0.295; female, r = 0.232). The mean TMA showed significant positive correlations with skeletal muscle mass (male, r = 0.490; female, r = 0.657), SMI (male, r = 0.289; female, r = 0.473), and WBPA (male, r = 0.232; female, r = 0.243). CONCLUSION We observed moderate to strong positive correlations between body composition analysis measured by BIA and TMT or TMA, suggesting that TMT or TMA could serve as a reliable surrogate marker for identifying low skeletal muscle mass in cerebrovascular disease.
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Affiliation(s)
- Jee Myung Han
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Du Hwan Kim
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Byung Chan Lee
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Republic of Korea
- Biomedical Research Institute, Chung-Ang University Hospital, Seoul, Republic of Korea
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Klingenschmid J, Krigers A, Pinggera D, Kerschbaumer J, Pichler N, Schoen V, Demetz M, Grams AE, Thomé C, Freyschlag CF. Temporal Muscle Thickness Compared to Functional Scales as a Prognostic Parameter in Patients with Brain Metastases. Cancers (Basel) 2024; 16:1660. [PMID: 38730613 PMCID: PMC11083987 DOI: 10.3390/cancers16091660] [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: 03/26/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Metastases are the most frequent intracranial malignant tumors in adults. While Karnofsky Performance Status (KPS) and Clinical Frailty Scale (CFS) are known to have significant impact on overall survival (OS), temporal muscle thickness (TMT) has been postulated to be a promising new parameter to estimate prognosis. Patients who received a resection of one to three brain metastases in our institution were included. Temporal muscle thickness was measured in preoperative MRI scans according to a standardized protocol. In 199 patients, the mean TMT was 7.5 mm (95CI 7.3-7.7) and the mean OS during follow-up was 31.3 months (95CI 24.2-38.3). There was no significant correlation of TMT and preoperative or follow-up CFS and KPS. While CFS and KPS did significantly correlate with OS (p < 0.001 for each), no correlation was demonstrated for TMT. CFS showed a superior prognostic value compared to KPS. TMT failed to show a significant impact on OS or patient performance, whereas the clinical scales (KPS and CFS) demonstrate a good correlation with OS. Due to its superiority over KPS, we strongly recommend the use of CFS to estimate OS in patients with brain metastases.
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Affiliation(s)
- Julia Klingenschmid
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
| | - Aleksandrs Krigers
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
| | - Daniel Pinggera
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
| | - Johannes Kerschbaumer
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
| | - Nadine Pichler
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
| | - Victoria Schoen
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
| | - Matthias Demetz
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
| | - Astrid E. Grams
- Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
| | - Christian F. Freyschlag
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.K.)
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Kim J, Lee H, Lee DA, Park KM. Sarcopenia and anti-seizure medication response in juvenile myoclonic epilepsy. Brain Behav 2024; 14:e3464. [PMID: 38468473 PMCID: PMC10928337 DOI: 10.1002/brb3.3464] [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] [Received: 01/22/2024] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 03/13/2024] Open
Abstract
INTRODUCTION This study aimed to investigate the presence of sarcopenia in patients with juvenile myoclonic epilepsy (JME) and the association between sarcopenia and response to anti-seizure medication (ASM) in patients with JME. METHODS We enrolled 42 patients with JME and 42 healthy controls who underwent brain magnetic resonance imaging with three-dimensional T1-weighted imaging. We measured the temporal muscle thickness (TMT), a radiographic marker for sarcopenia, using T1-weighted imaging. We compared the TMT between patients with JME and healthy controls and analyzed it according to the ASM response in patients with JME. We also performed a receiver operating characteristic (ROC) curve analysis to evaluate how well the TMT differentiated the groups. RESULTS The TMT in patients with JME did not differ from that in healthy controls (9.630 vs. 9.956 mm, p = .306); however, ASM poor responders had a lower TMT than ASM good responders (9.109 vs. 10.104 mm, p = .023). ROC curve analysis revealed that the TMT exhibited a poor performance in differentiating patients with JME from healthy controls, with an area under the ROC curve of .570 (p = .270), but good performance in differentiating between ASM good and poor responders, with an area under the ROC curve of .700 (p = .015). CONCLUSION The TMT did not differ between patients with JME and healthy controls; however, it was reduced in ASM poor responders compared to ASM good responders, suggesting a link between ASM response and sarcopenia in patients with JME. TMT can be used to investigate sarcopenia in various neurological disorders.
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Affiliation(s)
- Jinseung Kim
- Department of Family MedicineBusan Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Ho‐Joon Lee
- Department of RadiologyHaeundae Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Dong Ah Lee
- Department of NeurologyHaeundae Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Kang Min Park
- Department of NeurologyHaeundae Paik HospitalInje University College of MedicineBusanRepublic of Korea
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Kim J, Lee HJ, Lee DA, Park KM. Sarcopenia in patients with isolated rapid eye movement sleep behavior disorder. Sleep Med 2024; 114:189-193. [PMID: 38215670 DOI: 10.1016/j.sleep.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/17/2023] [Accepted: 01/03/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVES Evaluating of sarcopenia is important for promoting healthy aging, preventing functional decline, reducing the risk of falls and fractures, and improving overall quality of life. This study aimed to investigate sarcopenia in patients with isolated rapid eye movement sleep behavior disorder (RBD) using temporal muscle thickness (TMT) measurement. METHODS This investigation was retrospectively conducted at a single tertiary hospital. We recruited patients diagnosed with isolated RBD confirmed by polysomnography and clinical history and healthy participants as controls. Patients with isolated RBD and healthy controls underwent brain MRI scans, including three-dimensional T1-weighted imaging. We measured TMT, a radiographic marker of sarcopenia, based on the T1-weighted imaging. We compared the TMT between the groups and performed receiver operating characteristic (ROC) curve analysis to evaluate how well the TMT differentiated patients with isolated RBD from healthy controls. We also conducted a correlation analysis between the TMT and clinical factors. RESULTS Our study included 28 patients with isolated RBD and 30 healthy controls. There was a significant difference in the TMT of both groups. The TMT was reduced in patients with isolated RBD than in healthy controls (11.843 vs. 10.420 mm, p = 0.002). In the ROC curve analysis, the TMT exhibited good performance in differentiating patients with isolated RBD from healthy controls, with an area under the curve of 0.708. Furthermore, age was negatively correlated with TMT in patients with isolated RBD (r = -0.453, p = 0.015). CONCLUSION We demonstrate that TMT is reduced in patients with isolated RBD compared with healthy controls, confirming sarcopenia in patients with isolated RBD. The result suggests an association between neurodegeneration and sarcopenia. TMT can be used to evaluate sarcopenia in sleep disorders.
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Affiliation(s)
- Jinseung Kim
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Republic of Korea
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
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Janović A, Miličić B, Antić S, Bracanović Đ, Marković-Vasiljković B. Feasibility of using cross-sectional area of masticatory muscles to predict sarcopenia in healthy aging subjects. Sci Rep 2024; 14:2079. [PMID: 38267441 PMCID: PMC10808244 DOI: 10.1038/s41598-024-51589-4] [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] [Received: 11/01/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024] Open
Abstract
Determination of sarcopenia is crucial in identifying patients at high risk of adverse health outcomes. Recent studies reported a significant decline in masticatory muscle (MM) function in patients with sarcopenia. This study aimed to analyze the cross-sectional area (CSA) of MMs on computed tomography (CT) images and to explore their potential to predict sarcopenia. The study included 149 adult subjects retrospectively (59 males, 90 females, mean age 57.4 ± 14.8 years) who underwent head and neck CT examination for diagnostic purposes. Sarcopenia was diagnosed on CT by measuring CSA of neck muscles at the C3 vertebral level and estimating skeletal muscle index. CSA of MMs (temporal, masseter, medial pterygoid, and lateral pterygoid) were measured bilaterally on reference CT slices. Sarcopenia was diagnosed in 67 (45%) patients. Univariate logistic regression analysis demonstrated a significant association between CSA of all MMs and sarcopenia. In the multivariate logistic regression model, only masseter CSA, lateral pterygoid CSA, age, and gender were marked as predictors of sarcopenia. These parameters were combined in a regression equation, which showed excellent sensitivity and specificity in predicting sarcopenia. The masseter and lateral pterygoid CSA can be used to predict sarcopenia in healthy aging subjects with a high accuracy.
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Affiliation(s)
- Aleksa Janović
- School of Dental Medicine, Center for Diagnostic Imaging, University of Belgrade, 6 Rankeova, 11000, Belgrade, Republic of Serbia.
| | - Biljana Miličić
- School of Dental Medicine, Department of Statistics, University of Belgrade, 2 dr Subotića, 11000, Belgrade, Republic of Serbia
| | - Svetlana Antić
- School of Dental Medicine, Center for Diagnostic Imaging, University of Belgrade, 6 Rankeova, 11000, Belgrade, Republic of Serbia
| | - Đurđa Bracanović
- School of Dental Medicine, Center for Diagnostic Imaging, University of Belgrade, 6 Rankeova, 11000, Belgrade, Republic of Serbia
| | - Biljana Marković-Vasiljković
- School of Dental Medicine, Center for Diagnostic Imaging, University of Belgrade, 6 Rankeova, 11000, Belgrade, Republic of Serbia
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Zeng X, Zhang L, Zhang Y, Jia S, Lin T, Zhao X, Huang X. Prevalence and prognostic value of baseline sarcopenia in hematologic malignancies: a systematic review. Front Oncol 2023; 13:1308544. [PMID: 38162495 PMCID: PMC10755879 DOI: 10.3389/fonc.2023.1308544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Background The correlation between sarcopenia and hematological malignancy prognosis is still controversial. Design: A systematic review and meta-analysis. Objectives: To explore sarcopenia's prevalence and prognostic value in hematologic malignancies. Data sources and methods We searched Embase, MEDLINE, and Cochrane Library through Ovid SP using an appropriate search strategy on August 28, 2022, and updated the search results on January 9, 2023. Study quality was assessed using the Newcastle-Ottawa scale. The pooled prevalence of sarcopenia was calculated with a 95% confidence interval (CI). Relationships between sarcopenia and prognostic value were expressed as hazard ratio (HR) and 95% CI. HR means the probability of something undesirable, i.e., death or disease progression. Results The search identified more than 3992 studies, and 21 (3354 patients, median or mean age ranging from 36 to 78 years) were finally included. The risk of bias in the studies was low to medium. All included studies were diagnosed based on low muscle mass (LMM). Muscle mass was assessed mainly through imaging technologies, and different cut-offs were applied to determine LMM. The prevalence of sarcopenia was 44.5%, which could fluctuate by age. Subgroup analysis showed that older people had a higher sarcopenic rate than the non-elderly group. Sarcopenia resulted in an inferior prognosis [overall survival: HR 1.821, 95% CI 1.415-2.343; progression-free survival: HR 1.703, 95% CI 1.128-2.571). Conclusion Sarcopenia has a prevalence of over 30% in malignant hematologic patients and is associated with a poorer prognosis. Future studies with a standardized sarcopenia diagnostic criterion were needed to investigate sarcopenia's prevalence and prognostic effects in hematologic malignancies.
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Affiliation(s)
- Xiaofeng Zeng
- The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Liying Zhang
- The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Zhang
- Sichuan University Library, Sichuan University, Chengdu, China
| | - Shuli Jia
- The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Taiping Lin
- The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xuman Zhao
- The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoli Huang
- The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Zapaishchykova A, Liu KX, Saraf A, Ye Z, Catalano PJ, Benitez V, Ravipati Y, Jain A, Huang J, Hayat H, Likitlersuang J, Vajapeyam S, Chopra RB, Familiar AM, Nabavidazeh A, Mak RH, Resnick AC, Mueller S, Cooney TM, Haas-Kogan DA, Poussaint TY, Aerts HJWL, Kann BH. Automated temporalis muscle quantification and growth charts for children through adulthood. Nat Commun 2023; 14:6863. [PMID: 37945573 PMCID: PMC10636102 DOI: 10.1038/s41467-023-42501-1] [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: 07/21/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023] Open
Abstract
Lean muscle mass (LMM) is an important aspect of human health. Temporalis muscle thickness is a promising LMM marker but has had limited utility due to its unknown normal growth trajectory and reference ranges and lack of standardized measurement. Here, we develop an automated deep learning pipeline to accurately measure temporalis muscle thickness (iTMT) from routine brain magnetic resonance imaging (MRI). We apply iTMT to 23,876 MRIs of healthy subjects, ages 4 through 35, and generate sex-specific iTMT normal growth charts with percentiles. We find that iTMT was associated with specific physiologic traits, including caloric intake, physical activity, sex hormone levels, and presence of malignancy. We validate iTMT across multiple demographic groups and in children with brain tumors and demonstrate feasibility for individualized longitudinal monitoring. The iTMT pipeline provides unprecedented insights into temporalis muscle growth during human development and enables the use of LMM tracking to inform clinical decision-making.
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Affiliation(s)
- Anna Zapaishchykova
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kevin X Liu
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anurag Saraf
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Zezhong Ye
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul J Catalano
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Viviana Benitez
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Yashwanth Ravipati
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Arnav Jain
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Julia Huang
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hasaan Hayat
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Michigan State University, East Lansing, MI, USA
| | - Jirapat Likitlersuang
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sridhar Vajapeyam
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
| | - Rishi B Chopra
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ariana M Familiar
- Children's Hospital of Philadelphia, Philadelphia, USA
- University of Pennsylvania, Pennsylvania, USA
| | - Ali Nabavidazeh
- Children's Hospital of Philadelphia, Philadelphia, USA
- University of Pennsylvania, Pennsylvania, USA
| | - Raymond H Mak
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Adam C Resnick
- Children's Hospital of Philadelphia, Philadelphia, USA
- University of Pennsylvania, Pennsylvania, USA
| | - Sabine Mueller
- Department of Neurology, Neurosurgery and Pediatrics, University of California, San Francisco, USA
| | - Tabitha M Cooney
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Daphne A Haas-Kogan
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tina Y Poussaint
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
| | - Hugo J W L Aerts
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology and Nuclear Medicine, CARIM & GROW, Maastricht University, Maastricht, the Netherlands
| | - Benjamin H Kann
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA.
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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11
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Tutal Gürsoy G, Görgülü Ü, Tengirşenk Z, Bektas H. The relationship between temporal muscle thickness and triglyceride glucose index in sarcopenia with mortality and third-month functional outcomes in patients after acute stroke. Medicine (Baltimore) 2023; 102:e35886. [PMID: 37933015 PMCID: PMC10627668 DOI: 10.1097/md.0000000000035886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/11/2023] [Indexed: 11/08/2023] Open
Abstract
Especially in recent years, temporal muscle thickness has been used as an important parameter for sarcopenia in neurological disorders. In addition, triglyceride glucose index was evaluated separately in studies conducted in terms of coronary diseases, diabetes, high blood pressure, body mass index and acute stroke. In this clinical study, unlike the others, both temporal muscle thickness and triglyceride glucose index were evaluated together in acute stroke patients in terms of sarcopenia. We aimed to investigate the relationship between temporal muscle thickness and triglyceride glucose index, which is atherosclerotic index, with mortality and 3rd month functional outcomes in acute stroke patients. In this retrospective study, 147 patients admitted to Ankara City Hospital with the diagnosis of acute ischemic stroke between January 2021 and September 2022 were evaluated. Fasting triglyceride glucose indexes of the patients were calculated. The temporal muscle thickness measurement of the patients was performed by the radiologist using computed tomography images. Those who scored 3 or higher on the modified Rankin Scale (mRS) at the third month were considered to have poor functional outcome. A significant cutoff point was found for estimating mortality for the temporal muscle thickness parameter [area under the curve for a receiver operating characteristic curve (AUC) = 0.636; P = .012]. The cutoff point was obtained as ≤ 5.2. Sensitivity value was 65%, specificity value was 65%, the positive predictive value (PPV) value was 42.62% and the negative predictive value (NPV) value was 82.28%. Similarly, for the triglyceride glucose index parameter, there was a significant cutoff point in estimating mortality (AUC = 0.673; P = .003). The cutoff point was obtained as ≥ 8.23. Sensitivity value was 91.18%, specificity value was 13%, PPV value was 26.96% and NPV value was 81%. Temporal muscle thickness and triglyceride glucose index parameters were found to be statistically important parameters of sarcopenia. It was concluded that the evaluation of these 2 parameters in terms of both mortality and sarcopenia in acute stroke patients is important in the evaluation of neurological and cardiac disorders.
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Affiliation(s)
| | - Ümit Görgülü
- Health Science University Faculty of Medicine, Ankara City Hospital Department of Neurology, Ankara, Turkey
| | | | - Hesna Bektas
- Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara City Hospital Department of Neurology, Ankara, Turkey
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12
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Ozaydin D, Demir AN, Oz A, Birol A, Sulu C, Sahin S, Arslan S, Tanriover N, Gazioglu N, Kadioglu P. The relationship between temporal muscle thickness and disease activity in Cushing's disease. J Endocrinol Invest 2023; 46:2411-2420. [PMID: 37704872 DOI: 10.1007/s40618-023-02195-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE This study aimed to investigate the relationship between hypercortisolism and temporal muscle thickness (TMT) in Cushing's disease (CD). METHODS A retrospective review of medical records was conducted for patients with CD who presented to our clinic between 2012 and 2022. Biochemical data and TMT measurements from sella imaging were evaluated during diagnosis and the first postoperative year. RESULTS A total of 44 patients were included in the study, with an average age of 43.9 years, of which 38 were female. The mean TMT at the time of diagnosis was 19.07 ± 1.71 mm, with no significant difference between males and females (p = 0.097), and no correlation between the TMT and age at diagnosis (p = 0.497). There was an inverse relationship between TMT and serum cortisol levels, 24-h UFC, and midnight salivary cortisol at the time of diagnosis of CD (p < 0.05, for all). One year after surgery, TMT significantly increased in all patients compared to baseline (p < 0.001). Furthermore, patients who achieved postoperative remission had significantly higher TMT values compared to those who did not achieve remission (p = 0.043). Among the patients who achieved remission, those who achieved remission through surgery had significantly higher TMT compared to those who could not reach remission with surgery and patients who started medical treatment and achieved biochemical remission (p = 0.01). Patients with severe myopathy and sarcopenia had significantly lower TMT values than the others (p < 0.001). CONCLUSION Temporal muscle thickness was found to be associated with disease activity and disease control in Cushing's disease.
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Affiliation(s)
- D Ozaydin
- Department of Neurosurgery, Health Sciences University, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - A N Demir
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - A Oz
- Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - A Birol
- Department of Internal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - C Sulu
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - S Sahin
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - S Arslan
- Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - N Tanriover
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - N Gazioglu
- Department of Neurosurgery, Istinye University, Istanbul, Turkey
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - P Kadioglu
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey.
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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13
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Furtner J. Craniofacial musculature assessment: A novel technique for predicting stroke patient outcomes. Eur J Radiol 2023; 167:111024. [PMID: 37572561 DOI: 10.1016/j.ejrad.2023.111024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/14/2023]
Affiliation(s)
- J Furtner
- Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Faculty of Medicine and Dentistry, Danube Private University, Rathausplatz 1, 3500 Krems, Austria.
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14
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Tang J, Dong Z, Sheng J, Yang P, Zhao W, Xue J, Li Q, Lv L, Lv X. Advances in the relationship between temporal muscle thickness and prognosis of patients with glioblastoma: a narrative review. Front Oncol 2023; 13:1251662. [PMID: 37771443 PMCID: PMC10525700 DOI: 10.3389/fonc.2023.1251662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
The most dangerous variety of glioma, glioblastoma, has a high incidence and fatality rate. The prognosis for patients is still bleak despite numerous improvements in treatment approaches. We urgently need to develop clinical parameters that can evaluate patients' conditions and predict their prognosis. Various parameters are available to assess the patient's preoperative performance status and degree of frailty, but most of these parameters are subjective and therefore subject to interobserver variability. Sarcopenia can be used as an objective metric to measure a patient's physical status because studies have shown that it is linked to a bad prognosis in those with cancers. For the purpose of identifying sarcopenia, temporal muscle thickness has demonstrated to be a reliable alternative for a marker of skeletal muscle content. As a result, patients with glioblastoma may use temporal muscle thickness as a potential marker to correlate with the course and fate of their disease. This narrative review highlights and defines the viability of using temporal muscle thickness as an independent predictor of survival in glioblastoma patients, and it evaluates recent research findings on the association between temporal muscle thickness and prognosis of glioblastoma patients.
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Affiliation(s)
- Jinhai Tang
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Zhenghao Dong
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Junxiu Sheng
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Ping Yang
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Wanying Zhao
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Juan Xue
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Qizheng Li
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Li Lv
- Department of Pathology, the Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiupeng Lv
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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15
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Haider L, Chung KK, Mangesius S, Furtner J, Ciccarelli O, Chard DT, Barkhof F. The relation of sarcopenia and disability in multiple sclerosis. Mult Scler Relat Disord 2023; 77:104855. [PMID: 37442077 DOI: 10.1016/j.msard.2023.104855] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND The relation of sarcopenia and disability in MS is unknown. OBJECTIVE To investigate the relation of temporal muscle thickness (TMT) and disability. METHODS A cohort of 132 people who presented with a clinically isolated syndrome (CIS) suggestive of MS at a mean age of 30.0 years, were prospectively followed clinically and with MRI over 30-years. TMT and expanded disability status scale (EDSS) were assessed at baseline, one- five- ten- fourteen- twenty- and thirty-year follow-up. RESULTS At 30-years, 27 participants remained classified as having had a CIS, 34 converted to relapsing remitting MS, 26 to secondary progressive MS, and 16 had died due to MS. Using linear mixed effect models with subject nested in time, greater annualized TMT-thinning was seen in individuals who developed MS (-0.04 mm/a, 95%CI: -0.07 to -0.01, p = 0.023). In those who converted to MS, a thinner TMT was reached at 14- (p = 0.008), 20- (p = 0.002) and 30-years (p< 0.001). TMT was negatively correlated with EDSS at 20-years (R=-0.18, p = 0.032) and 30-years (R-0.244, p = 0.005). Longitudinally, TMT at earlier timepoints was not predictive for 30-year clinical outcomes. CONCLUSION TMT thinning is accelerated in MS and correlated with disability in later disease stages, but is not predictive of future disability.
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Affiliation(s)
- Lukas Haider
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Austria
| | - Karen K Chung
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom.
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University of Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Austria
| | - Julia Furtner
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom
| | - Olga Ciccarelli
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, United Kingdom
| | - Declan T Chard
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, United Kingdom
| | - Frederik Barkhof
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, United Kingdom; Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, NL, USA
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16
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Klingenschmid J, Krigers A, Schön V, Pinggera D, Kerschbaumer J, Grams AE, Thomé C, Freyschlag CF. Temporal muscle thickness has no prognostic relevance in patients with high-grade glioma compared to functional scales. Front Oncol 2023; 13:1237105. [PMID: 37727210 PMCID: PMC10506078 DOI: 10.3389/fonc.2023.1237105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/09/2023] [Indexed: 09/21/2023] Open
Abstract
Background GBM research is constantly assessing potential valuable prognostic biomarkers to better understand the disease and prognosticate future outcomes. Measuring temporal muscle thickness (TMT) has appeared to be a promising new surrogate marker for skeletal muscle mass and sarcopenia, which further indicates frailty and predicts overall survival (OS). The aim of this study was to determine its usefulness as a prognostic marker in patients with high-grade glioma compared to functional status scales. Methods TMT was measured in preoperative axial T1-weighted contrast-enhanced magnetic resonance images in 277 patients who received surgical treatment of newly diagnosed WHO III and IV gliomas in our institution between 2015 and 2020. Clinical Frailty Scale (CFS) and Karnofsky Performance Scale (KPS) were assessed preoperatively and during a follow-up visit. Results Female gender has shown significant correlation with TMT, while TMT did not correlate with preoperative and follow-up functional scores, age, WHO classification, IDH mutation, MGMT promoter methylation, EGFR and ATRX expression, or 1p/19q co-deletion. No significant prognostic value of TMT could be shown in 6, 12, and 24 months OS, while changes in CFS and KPS proved to have a significant impact. Conclusion Only female gender, but no other clinical, histological, or molecular marker showed any interrelation with TMT. Functional scores outclass measuring TMT as a reliable prognostic factor for predicting OS in patients with high-grade glioma.
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Affiliation(s)
- Julia Klingenschmid
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Aleksandrs Krigers
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Victoria Schön
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniel Pinggera
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Astrid E. Grams
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
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17
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Karadag C, Kamp MA, Fischer I, Boogaarts HD, Beseoglu K, Muhammad S, Cornelius JF, Hofmann BB. Initial Temporal Muscle Thickness and Area: Poor Predictors of Neurological Outcome in Aneurysmal Subarachnoid Hemorrhage in a Central European Patient Cohort. J Clin Med 2023; 12:5210. [PMID: 37629252 PMCID: PMC10456053 DOI: 10.3390/jcm12165210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
The temporalis muscle area (TMA) has been proclaimed as a surrogate parameter for estimating skeletal muscle mass. Pilot studies in Asian populations suggested temporal muscle thickness (TMT) and TMA as prognostic factors for neurological outcomes in aneurysmal subarachnoid hemorrhage (aSAH) patients. This study aimed to validate these findings in a larger European patient cohort. We retrospectively analyzed age, sex, aneurysm location, treatment, World Federation of Neurosurgical Societies (WFNS) grade, Fisher score, and modified Rankin Score (mRS) at six months in patients with aSAH. TMT and TMA measurements were obtained from initial native CT scans. Logistic regression with the dichotomized six-month mRS as the outcome incorporating TMT, weighted average of TMT, or TMA as predictors was performed. Of the included 478 patients, 66% were female, the mean age was 56, and 48% of patients had an mRS of three to six after six months. The mean TMT at the level of the Sylvian fissure was 5.9 (±1.7) mm in males and 4.8 (±1.8) mm in females. The mean TMA was 234.5 (±107.9) mm2 in females and 380 (±134.1) mm2 in males. WFNS grade (p < 0.001), Fisher score (p < 0.001), and age (p < 0.05) correlated significantly with the mRS after six months. No correlation was found between mRS after six months and the TMT at the Sylvian fissure (p = 0.3), the weighted average of TMT (p = 0.1), or the TMA (p = 0.1). In this central European patient cohort of 478 individuals, no significant associations were found between TMT/TMA and neurological outcomes following aSAH. Further prospective studies in diverse patient populations are necessary to determine the prognostic value of TMA and TMT in aSAH patients.
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Affiliation(s)
- Cihat Karadag
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Marcel A. Kamp
- Centre for Palliative and Neuro-Palliative Care, Brandenburg Medical School Theodor Fontane, Campus Rüdersdorf, 15562 Rüdersdorf bei Berlin, Germany
| | - Igor Fischer
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Hieronymus D. Boogaarts
- Department of Neurosurgery, Medical Faculty, Radboud University Nijmegen, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Kerim Beseoglu
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Sajjad Muhammad
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Jan F. Cornelius
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Björn B. Hofmann
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
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18
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Yang SM, Wu HW, Lin YH, Lai TJ, Lin MT. Temporalis and masseter muscle thickness as predictors of post-stroke dysphagia after endovascular thrombectomy. Eur J Radiol 2023; 165:110939. [PMID: 37354770 DOI: 10.1016/j.ejrad.2023.110939] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE Post-stroke dysphagia (PSD) is a common sequela of stroke. Given the association between dysphagia and sarcopenia, we aimed to investigate the association between PSD and temporal muscle thickness (TMT) and masseter muscle thickness (MMT) following endovascular thrombectomy (EVT) in patients with large-vessel occlusion (LVO). METHODS This retrospective cohort study included hospitalized patients with LVO stroke who underwent EVT between January 1, 2018, and October 31, 2022. TMT and MMT were measured using brain computed tomography (CT) angiography. The correlation between relevant clinicodemographic factors and both TMT and MMT was examined. The relationship between each of two parameters (TMT and MMT) and PSD, which was defined as the retention of the nasogastric (NG) tube at 4 and 12 weeks, was evaluated in adjusted logistic regression models. RESULTS Among the 148 participants, the mean TMT and MMT was 5.9 ± 1.6 and 11.2 ± 2.3 mm, respectively. Lower age, male sex, higher body mass index (BMI), higher albumin levels, and a lower initial National Institute of Health Stroke Scale (NIHSS) score were associated with higher TMT and MMT (p < 0.05). In the logistic regression analysis adjusted for age, sex, BMI, serum albumin, and NIHSS score, lower TMT and MMT significantly correlated with PSD at weeks 4 and 12 (p < 0.001). CONCLUSION TMT and MMT are associated with age, sex, BMI, albumin, and the initial NIHSS score. Both TMT and MMT are independent indicators of post-EVT PSD in stroke patients and serve as reliable predictors of NG removal.
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Affiliation(s)
- Shu-Mei Yang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Hao-Wei Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Yen-Heng Lin
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-Ju Lai
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Meng-Ting Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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19
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Yang YW, Zhou YW, Xia X, Jia SL, Zhao YL, Zhou LX, Cao Y, Ge ML. Prognostic value of temporal muscle thickness, a novel radiographic marker of sarcopenia, in patients with brain tumor: A systematic review and meta-analysis. Nutrition 2023; 112:112077. [PMID: 37236042 DOI: 10.1016/j.nut.2023.112077] [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: 02/14/2023] [Revised: 04/24/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Sarcopenia has been identified as a prognostic factor among certain types of cancer. However, it is unclear whether there is prognostic value of temporalis muscle thickness (TMT), a potential surrogate for sarcopenia, in adults patients with brain tumors. Therefore, we searched the Medline, Embase, and PubMed to systematically review and meta-analyze the relationship between TMT and overall survival, progression-free survival, and complications in patients with brain tumors and the hazard ratio (HR) or odds ratios (OR), and 95% confidence interval (CI) were evaluated. The quality in prognostic studies (QUIPS) instrument was employed to evaluate study quality. Nineteen studies involving 4570 patients with brain tumors were included for qualitative and quantitative analysis. Meta-analysis revealed thinner TMT was associated with poor overall survival (HR, 1.72; 95% CI, 1.45-2.04; P < 0.01) in patients with brain tumors. Sub-analyses showed that the association existed for both primary brain tumors (HR, 2.02; 95% CI, 1.55-2.63) and brain metastases (HR, 1.39; 95% CI, 1.30-1.49). Moreover, thinner TMT also was the independent predictor of progression-free survival in patients with primary brain tumors (HR, 2.88; 95% CI, 1.85-4.46; P < 0.01). Therefore, to improve clinical decision making it is important to integrate TMT assessment into routine clinical settings in patients with brain tumors.
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Affiliation(s)
- Yan-Wu Yang
- Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi-Wu Zhou
- Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Xia
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shu-Li Jia
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yun-Li Zhao
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li-Xing Zhou
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Cao
- Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mei-Ling Ge
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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20
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Lin YH, Chung CT, Chen CH, Cheng CJ, Chu HJ, Chen KW, Yeh SJ, Tsai LK, Lee CW, Tang SC, Jeng JS. Association of temporalis muscle thickness with functional outcomes in patients undergoing endovascular thrombectomy. Eur J Radiol 2023; 163:110808. [PMID: 37080063 DOI: 10.1016/j.ejrad.2023.110808] [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: 02/20/2023] [Revised: 03/25/2023] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Temporalis muscle thickness (TMT) is a surrogate marker for sarcopenia. This study investigated the association of TMT with clinical outcomes in patients receiving endovascular thrombectomy (EVT) for stroke involving acute large vessel occlusion (LVO). MATERIAL AND METHODS We enrolled consecutive patients who had undergone EVT between September 2014 and December 2021 at three thrombectomy-capable institutes. TMT was measured through preprocedural computerized tomography angiography. The clinical variables affecting TMT were investigated. The associations between TMT and clinical functional outcomes, defined using the modified Rankin scale, were also studied. RESULTS A total of 657 patients were included (mean age: 72.0 ± 12.7 years; male: 52.1%). The mean TMT was 6.35 ± 1.84 mm. Younger age, male sex, higher body mass index, and premorbid functional independence were associated with larger TMT in both univariate and multivariate linear regression (P <.05). Ordinal logistic regression revealed that TMT was associated with better clinical outcomes at 90 days (Ptrend = 0.047); multivariate logistic regression indicated that larger TMT was an independent predictor (adjusted odds ratio: 1.14, 95% confidence interval: 1.03-1.27, P = 0.02) of favorable functional independence (modified Rankin scale score: 0-2). The effect was stronger in older patients (≥80 years) than younger patients, as revealed by interaction modeling analysis (Pinteraction = 0.06). CONCLUSION TMT is associated with age, sex, body mass index, and premorbid functional status. Larger TMT is associated with better outcomes after EVT. The effects of TMT are more pronounced in older adults, indicating that sarcopenia may have influence on stroke outcomes.
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Affiliation(s)
- Yen-Heng Lin
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Ting Chung
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hao Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chang-Jie Cheng
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Hai-Jui Chu
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Kuo-Wei Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Shin-Joe Yeh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Kai Tsai
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Wei Lee
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
| | - Sung-Chun Tang
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jiann-Shing Jeng
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
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21
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Bonm AV, Menghini A, Drolet CE, Graber JJ. Temporalis muscle thickness predicts early relapse and short survival in primary CNS lymphoma. Neurooncol Pract 2023; 10:162-168. [PMID: 36970167 PMCID: PMC10037939 DOI: 10.1093/nop/npac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Most patients with primary CNS lymphoma (PCNSL) achieve durable remission whereas a minority die in the first year. Sarcopenia is a powerful predictor of mortality in the brain and systemic cancers. Temporalis muscle thickness (TMT) is a validated radiographic measure of sarcopenia. We hypothesized that patients with thin TMT at diagnosis would have early progression and short survival. Methods Two blinded operators retrospectively measured TMT in 99 consecutive brain MRIs from untreated patients with PCNSL. Results We generated a receiver operator characteristic curve and chose a single threshold defining thin TMT in all patients as <5.65 mm, at which specificity and sensitivity for 1-year progression were 98.4% and 29.7% and for 1-year mortality were 97.4% and 43.5% respectively. Those with thin TMT were both more likely to progress (P < .001) and had higher rates of mortality (P < .001). These effects were independent of the effect of age, sex, and Eastern Cooperative Oncology Group performance status in a cox regression. Memorial Sloan Kettering Cancer Center score did not predict progression-free survival or overall survival as well as TMT. Patients with thin TMT received fewer cycles of high-dose methotrexate and were less likely to receive consolidation but neither variable could be included in the Cox regression due to violation of the proportional hazards assumption. Conclusions We conclude that PCNSL patients with thin TMT are at high risk for early relapse and short survival. Future trials should stratify patients by TMT to avoid confounding.
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Affiliation(s)
- Alipi V Bonm
- Department of Neurology, Virginia Mason Franciscan Health, Seattle, Washington, USA
| | - Anthony Menghini
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Caroline E Drolet
- Center for Neurosciences and Spine, Virginia Mason Franciscan Health, Seattle, Washington, USA
| | - Jerome J Graber
- Departments of Neurology and Neurosurgery, Alvord Brain Tumor Center, University of Washington, Seattle, Washington, USA
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22
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Peball M, Valent D, Grossauer A, Marini K, Ellmerer P, Wallnöfer J, Krismer F, Djamshidian A, Seppi K, Heim B. Temporal Muscle Thickness Correlates with Sarcopenia in Parkinson’s Disease. JOURNAL OF PARKINSON'S DISEASE 2023; 13:341-350. [PMID: 37005894 DOI: 10.3233/jpd-225108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Background: Sarcopenia is characterized by a progressive loss of muscle mass, strength, and function resulting in adverse health outcomes. Current assessment strategies are bothersome and means to simplify the diagnosis are an unmet medical need in Parkinson’s disease (PD). Objective: To evaluate temporal muscle thickness (TMT) obtained on routine cranial MRI as a surrogate marker of sarcopenia in PD patients. Methods: We correlated TMT from axial non-contrast-enhanced T1-weighted sequences of MRI close (±12 months) to an outpatient visit including sarcopenia (EWGSOP1, EWGSOP2, SARC-F), frailty (Fried’s criteria, clinical frailty scale), and disease characteristics of Parkinson’s patients (Hoehn and Yahr-scale, Movement Disorder Society-Unified Parkinson’s Disease Rating Scale, quality of life with the Parkinson’s Disease Questionnaire-8) assessments. Results: Cranial MRI was available in 32 patients with a mean age of 73.56±5.14 years, mean disease duration of 11.46±5.66 years, and median Hoehn and Yahr stage of 2.5. The mean TMT was 7.49±2.76 (7.15) mm. Mean TMT was significantly associated with sarcopenia (EWGSOP2, p = 0.018; EWGSOP1, p = 0.023) and frailty status (physical phenotype; p = 0.045). Moreover, there were significant moderate to strong correlations between TMT measurement and appendicular skeletal muscle mass index (r: 0.437, p = 0.012), as well as handgrip strength (r: 0.561, p < 0.001). Conclusion: Reduced TMT seems to be a promising surrogate marker for sarcopenia (EWGSOP2) and muscle strength in this pilot study in PD patients.
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Affiliation(s)
- Marina Peball
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Dora Valent
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Grossauer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Kathrin Marini
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Ellmerer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Jonas Wallnöfer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Beatrice Heim
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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23
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Wang JW, Chen J, McGregor AH, Williams M. A review of radiological definitions of sarcopenia in cancer. JCSM CLINICAL REPORTS 2023. [DOI: 10.1002/crt2.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Affiliation(s)
- James W. Wang
- Computational Oncology Laboratory, Institute of Global Health Innovation Imperial College London London UK
- Department of Radiotherapy, Charing Cross Hospital Imperial College Healthcare NHS Trust London UK
| | - Jiarong Chen
- Computational Oncology Laboratory, Institute of Global Health Innovation Imperial College London London UK
| | - Alison H. McGregor
- Musculoskeletal Lab, Department of Surgery and Cancer Imperial College London London UK
| | - Matthew Williams
- Computational Oncology Laboratory, Institute of Global Health Innovation Imperial College London London UK
- Department of Radiotherapy, Charing Cross Hospital Imperial College Healthcare NHS Trust London UK
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24
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Sütcüoğlu O, Erdal ZS, Akdoğan O, Çeltikçi E, Özdemir N, Özet A, Uçar M, Yazıcı O. The possible relation between temporal muscle mass and glioblastoma multiforme prognosis via sarcopenia perspective. Turk J Med Sci 2023; 53:413-419. [PMID: 36945944 PMCID: PMC10388072 DOI: 10.55730/1300-0144.5599] [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: 08/17/2022] [Accepted: 11/20/2022] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND The optimal sarcopenia measurement method in patients with a diagnosis of glioblastoma multiforme (GBM) is unknown. It has been found that temporal muscle thickness (TMT) may reflect sarcopenia and be associated with survival, but the relationship between temporal muscle area (TMA) and GBM prognosis has never been evaluated before. The primary outcome of the study was to evaluate the relationship between TMA/TMT and overall survival (OS) time in newly diagnosed GBM patients. METHODS The data of patients who presented at the university hospital between January 2009 and January 2019 with a confirmed diagnosis of glioblastoma multiforme at the time of diagnosis were analyzed retrospectively. Temporal muscle thickness and TMA were measured retrospectively from preoperative MRIs of patients diagnosed with GBM. Due to the small number of patients and the failure to determine a cut-off value with acceptable sensitivity and specificity using ROC analysis, the median values were chosen as the cut-off value. The patients were basically divided into two according to their median TMT (6.6 mm) or TMA (452 mm2 ) values, and survival analysis was performed with the Kaplan-Meier analysis. RESULTS The median TMT value was 6.6 mm, and the median TMA value was 452 mm2 . The median overall survival (OS) was calculated as 25.8 months in patients with TMT < 6.6 mm, and 15.8 months in patients with TMT ≥ 6.6 mm (p = 0.29). The median overall survival (OS) of patients with TMA < 452mm2 was 26.3 months, and the group with TMA ≥ 452mm2 was 14.6 months (p = 0.06). The median disease-free survival was 18.3 months (%95 CI: 13.2-23.4) in patients with TMT < 6.6mm, while mDFS was 10.9 (%95 CI: 8.0-13.8) months in patients with TMT ≥ 6.6mm (p = 0.21). The median disease-free survival was found to be 21.0 months (%95 CI: 15.8-26.1) in patients with TMA < 452 mm2 and 10.5 months (%95 CI: 7.8-13.2) in patients with TMA ≥ 452 mm2 (p = 0.018). DISCUSSION No association could be demonstrated between TMT or TMA and OS of GBM patients. In addition, the median DFS was found to be longer in patients with low TMA. There is an unmet need to determine the optimal method of sarcopenia in GBM patients.
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Affiliation(s)
- Osman Sütcüoğlu
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Zeynep Sezgi Erdal
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Orhun Akdoğan
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Emrah Çeltikçi
- Department of Neurosurgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nuriye Özdemir
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ahmet Özet
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Murat Uçar
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
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25
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Ten Cate C, Huijs SMH, Willemsen ACH, Pasmans RCOS, Eekers DBP, Zegers CML, Ackermans L, Beckervordersandforth J, van Raak EPM, Anten MHME, Hoeben A, Postma AA, Broen MPG. Correlation of reduced temporal muscle thickness and systemic muscle loss in newly diagnosed glioblastoma patients. J Neurooncol 2022; 160:611-618. [PMID: 36394717 PMCID: PMC9758090 DOI: 10.1007/s11060-022-04180-8] [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] [Received: 09/21/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Reduced temporal muscle thickness (TMT) has recently been postulated as a prognostic imaging marker and an objective tool to assess patients frailty in glioblastoma. Our aim is to investigate the correlation of TMT and systemic muscle loss to confirm that TMT is an adequate surrogate marker of sarcopenia in newly diagnosed glioblastoma patients. METHODS TMT was assessed on preoperative MR-images and skeletal muscle area (SMA) was assessed at the third lumbar vertebra on preoperative abdominal CT-scans. Previous published TMT sex-specific cut-off values were used to classify patients as 'patient at risk of sarcopenia' or 'patient with normal muscle status'. Correlation between TMT and SMA was assessed using Spearman's rank correlation coefficient. RESULTS Sixteen percent of the 245 included patients were identified as at risk of sarcopenia. The mean SMA of glioblastoma patients at risk of sarcopenia (124.3 cm2, SD 30.8 cm2) was significantly lower than the mean SMA of patients with normal muscle status (146.3 cm2, SD 31.1 cm2, P < .001). We found a moderate association between TMT and SMA in the patients with normal muscle status (Spearman's rho 0.521, P < .001), and a strong association in the patients at risk of sarcopenia (Spearman's rho 0.678, P < .001). CONCLUSION Our results confirm the use of TMT as a surrogate marker of total body skeletal muscle mass in glioblastoma, especially in frail patients at risk of sarcopenia. TMT can be used to identify patients with muscle loss early in the disease process, which enables the implementation of adequate intervention strategies.
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Affiliation(s)
- Cecil Ten Cate
- Master of Science in Medicine and Clinical Research, Maastricht University, Maastricht, The Netherlands
| | - Sandra M H Huijs
- Department of Neurology Zuyderland Medical Center, Heerlen, The Netherlands
| | - Anna C H Willemsen
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Daniëlle B P Eekers
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Catharina M L Zegers
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Linda Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan Beckervordersandforth
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elisabeth P M van Raak
- Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Monique H M E Anten
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Ann Hoeben
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Alida A Postma
- Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Martinus P G Broen
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
- Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
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26
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Predictive Value of Temporal Muscle Thickness for Sarcopenia after Acute Stroke in Older Patients. Nutrients 2022; 14:nu14235048. [PMID: 36501078 PMCID: PMC9739439 DOI: 10.3390/nu14235048] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
The assessment of sarcopenia is part of the nutritional assessment index and is essential in stroke management. This study aimed to identify and validate cutoff values of temporal muscle thickness (TMT) measured using computed tomography to identify sarcopenia after acute stroke. The participants were patients with stroke aged ≥65 years who were admitted to rehabilitation units. The recruited patients were randomly divided into the calculation and validation cohort. In the calculation cohort, TMT cutoff values for identifying sarcopenia were calculated using receiver operating characteristic analysis. The obtained values were validated in the validation cohort using sensitivity and specificity. The calculation cohort included 230 patients (125 men, mean age, 77.2 ± 7.2 years), whereas the validation cohort included 235 patients (125 men, mean age, 76.4 ± 6.95 years). The TMT cutoff values for identifying sarcopenia and low skeletal muscle index were the same: 3.83 mm for men and 2.78 mm for women. The TMT cutoff value for identifying sarcopenia showed a sensitivity and specificity of 0.642 and 0.750, respectively, for men, and 0.660 and 0.567, respectively, for women. We identified a valid cutoff value of temporal muscle thickness for identifying sarcopenia after acute stroke. TMT is easy to measure and may be useful for the early detection of sarcopenia.
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27
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Temporal muscle thickness as an independent prognostic marker in glioblastoma patients—a systematic review and meta-analysis. Neurosurg Rev 2022; 45:3619-3628. [DOI: 10.1007/s10143-022-01892-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/03/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022]
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28
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Diagnostic Utility of Temporal Muscle Thickness as a Monitoring Tool for Muscle Wasting in Neurocritical Care. Nutrients 2022; 14:nu14214498. [PMID: 36364761 PMCID: PMC9654352 DOI: 10.3390/nu14214498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/22/2022] [Accepted: 10/23/2022] [Indexed: 11/16/2022] Open
Abstract
Temporalis muscle (TM) atrophy has emerged as a potential biomarker for muscle wasting. However, its diagnostic utility as a monitoring tool in intensive care remains uncertain. Hence, the objective of this study was to evaluate the diagnostic value of sequential ultrasound- and computed tomography (CT)-based measurements of TM thickness (TMT). With a prospective observational design, we included 40 patients without preexisting sarcopenia admitted to a neurointensive care unit. TMT measurements, performed upon admission and serially every 3−4 days, were correlated with rectus femoris muscle thickness (RFT) ultrasound measurements. Interrater reliability was assessed by Bland Altmann plots and intraclass correlation coefficient (ICC). Analysis of variance was performed in subgroups to evaluate differences in the standard error of measurement (SEM). RFT decline was paralleled by ultrasound- as well as CT-based TMT measurements (TMT to RFT: r = 0.746, p < 0.001; CT-based TMT to ultrasound-based RFT: r = 0.609, p < 0.001). ICC was 0.80 [95% CI 0.74, 0.84] for ultrasound-based assessment and 0.90 [95% CI 0.88, 0.92] for CT-based TMT measurements. Analysis of variance for BMI, Heckmatt score, fluid balance, and agitation showed no evidence of measurement errors in these subgroups. This study demonstrates the clinical feasibility and utility of ultrasound- and CT-based TMT measurements for the assessment of muscle wasting.
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29
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Cho A, Hennenberg J, Untersteiner H, Hirschmann D, Gatterbauer B, Zöchbauer-Müller S, Hochmair MJ, Preusser M, Rössler K, Dorfer C, Frischer JM, Furtner J. Influence of temporal muscle thickness on the outcome of radiosurgically treated patients with brain metastases from non-small cell lung cancer. J Neurosurg 2022; 137:999-1005. [PMID: 35120324 DOI: 10.3171/2021.12.jns212193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/06/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the impact of temporal muscle thickness (TMT), a surrogate marker for sarcopenia, in radiosurgically treated patients with brain metastases (BMs) from non-small cell lung cancer (NSCLC). METHODS For 566 patients with BMs from NSCLC in the period between June 2012 and December 2019, TMT values were retrospectively measured on the planning brain magnetic resonance imaging (MRI) studies that had been obtained before their first Gamma Knife radiosurgery treatment (GKRS1). Predefined sex-specific TMT cutoff values were used to stratify the study cohort into patients at risk for sarcopenia and patients with normal muscle status. Cox regression models adjusted for other prognostic parameters were used to evaluate sarcopenia as an independent prognostic factor. RESULTS In sarcopenia patients with a TMT below the sex-specific cutoff values, the risk of death was significantly increased (HR 1.908, 95% CI 1.550-2.349, p < 0.001). In addition, sarcopenia was revealed as an independent prognostic factor even after adjusting for age groups, sex, number of BMs, presence of extracranial metastases, NSCLC subtypes, Karnofsky Performance Status groups, recursive partitioning analysis classes, and concomitant immunotherapy or targeted therapy (HR 1.680, 95% CI 1.347-2.095, p < 0.001). However, patients at risk for sarcopenia showed no significant differences in the estimated mean time until local BM progression after GKRS1, compared to patients with normal muscle status (p = 0.639). CONCLUSIONS TMT obtained from planning MRI studies is an independent prognostic marker in radiosurgically treated patients with BMs from NSCLC and may aid patient stratification in future clinical trials.
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Affiliation(s)
| | - Juliane Hennenberg
- 2Biomedical Imaging and Image-guided Therapy, Medical University of Vienna
| | | | | | | | | | - Maximilian J Hochmair
- 4Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Matthias Preusser
- 3Department of Internal Medicine I, Division of Oncology, Medical University of Vienna; and
| | | | | | | | - Julia Furtner
- 2Biomedical Imaging and Image-guided Therapy, Medical University of Vienna
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30
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Association between Temporal Muscle Thickness and Overall Survival in Non-Small Cell Lung Cancer Patients with Brain Metastasis. Curr Oncol 2022; 29:6463-6471. [PMID: 36135077 PMCID: PMC9497949 DOI: 10.3390/curroncol29090508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 12/01/2022] Open
Abstract
Temporal muscle thickness (TMT) has recently been suggested as a novel biomarker of sarcopenia in head and neck malignancies. However, few studies have evaluated TMT as a prognostic marker in patients with brain metastasis. This study investigated the association of TMT with overall survival (OS) in non-small cell lung cancer (NSCLC) patients with brain metastasis. The records of all NSCLC patients with brain metastasis between 2009 and 2018 at St. Vincent’s Hospital were reviewed retrospectively. A total of 221 patients met our eligibility criteria. In the group with TMT thicker than the median, OS was longer than the group with TMT thinner than the median (240 days versus 139 days, p = 0.014). In multivariate analysis, the thicker TMT group had longer survival (HR 0.73 CI 0.56−0.96, p = 0.024). Male (HR 1.58 CI 1.19−2.09, p = 0.002) and older age (≥65 years) (HR 2.05 CI 1.53−2.74, p < 0.001) also showed statistical significance. We also performed subgroup analysis in older patients (≥65 years). In this subgroup of 107 patients, the thicker TMT group also showed longer OS than the thinner TMT group (209 days versus 82 days, p = 0.009). Our findings suggest that TMT can be a useful biomarker for OS in NSCLC patients with brain metastasis.
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31
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Li YX, Hou J, Liu WY. Long-term prognostic significance of sarcopenia in acute ischemic stroke. Medicine (Baltimore) 2022; 101:e30031. [PMID: 36042682 PMCID: PMC9410603 DOI: 10.1097/md.0000000000030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Because sarcopenia is widely distributed in patients with acute ischemic stroke (AIS) and has not attracted enough attention, this study aims to explore the relationship between sarcopenia defined by temporal muscle thickness (TMT) and physical function and prognosis of patients with AIS. A total of 265 hospitalized nonsurgical AIS patients from 2015 to 2018, with an age range of 28 ~ 92, were analyzed retrospectively. The median value of TMT was used as the risk classification index of sarcopenia. The main results were the relationship between sarcopenia and Essen Stroke Risk Score, National Institutes of Health Stroke Scale, modified Rankin Score, water swallow test, venous thromboembolism assessment of medical inpatients, activities of daily living assessed by Barthel Index, and the relationship between TMT and final survival outcome. The mean TMT of men in the study cohort was higher than that of women. The measured values of TMT among different researchers had good consistency (intraclass correlation coefficient, 0.980; P < .001). After adjusting for confounding variables, logistic regression showed that sarcopenia was associated with Essen Stroke Risk Score (odds ratio, 1.89; P < .05) and Barthel Index (odds ratio, 1.67; P < .05). Kaplan-Meier analysis showed that the survival time of low TMT group was significantly lower than that of high TMT group (36 vs 49 months; P < .001). Multivariate Cox regression showed that there was causal correlation between sarcopenia and patient death (hazard ratio, 3.54; 95% confidence interval, 1.46-8.58; P < .01). As a potential comprehensive index, thickness of temporal muscle can be included in baseline evaluation to show the physical status, stroke recurrence, and survival prognosis of AIS patients.
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Affiliation(s)
- Yu-Xuan Li
- Image center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Juan Hou
- Image center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Wen-Ya Liu
- Image center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- *Correspondence: Wen-Ya Liu, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China (e-mail: )
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Tay W, Quek R, Kaur B, Lim J, Henry CJ. Use of Facial Morphology to Determine Nutritional Status in Older Adults: Opportunities and Challenges. JMIR Public Health Surveill 2022; 8:e33478. [PMID: 35849429 PMCID: PMC9345026 DOI: 10.2196/33478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
Undiagnosed malnutrition is a significant problem in high-income countries, which can reduce the quality of life of many individuals, particularly of older adults. Moreover, it can also inflate the costs of existing health care systems because of the many metabolic complications that it can cause. The current methods for assessing malnutrition can be cumbersome. A trained practitioner must be present to conduct an assessment, or patients must travel to facilities with specialized equipment to obtain their measurements. Therefore, digital health care is a possible way of closing this gap as it is rapidly gaining traction as a scalable means of improving efficiency in the health care system. It allows for the remote monitoring of nutritional status without requiring the physical presence of practitioners or the use of advanced medical equipment. As such, there is an increasing interest in expanding the range of digital applications to facilitate remote monitoring and management of health issues. In this study, we discuss the feasibility of a novel digital remote method for diagnosing malnutrition using facial morphometrics. Many malnutrition screening assessments include subjective assessments of the head and the face. Facial appearance is often used by clinicians as the first point of qualitative indication of health status. Hence, there may be merit in quantifying these subtle but observable changes using facial morphometrics. Modern advancements in artificial intelligence, data science, sensors, and computing technologies allow facial features to be accurately digitized, which could potentially allow these previously intuitive assessments to be quantified. This study aims to stimulate further discussion and discourse on how this emerging technology can be used to provide real-time access to nutritional status. The use of facial morphometrics extends the use of currently available technology and may provide a scalable, easily deployable solution for nutritional status to be monitored in real time. This will enable clinicians and dietitians to keep track of patients remotely and provide the necessary intervention measures as required, as well as providing health care institutions and policy makers with essential information that can be used to inform and enable targeted public health approaches within affected populations.
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Affiliation(s)
- Wesley Tay
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Rina Quek
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Bhupinder Kaur
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Joseph Lim
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Vinciguerra C, Toriello A, Nardone V, Romano D, Tartaglione S, Abate F, Landolfi A, Barone P. Temporal muscle thickness and survival in patients with amyotrophic lateral sclerosis. Neurol Res 2022; 44:1006-1010. [PMID: 35786412 DOI: 10.1080/01616412.2022.2096004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Temporal muscle thickness (TMT) is a new potential MRI biomarker, which has shown prognostic relevance in neuro-oncology. We aim at investigating the potential prognostic value of TMT in patients with Amyotrophic Lateral Sclerosis (ALS). We retrospectively evaluated 30 ALS patients, whose clinical, Magnetic Resonance Imaging (MRI) and Electrodiagnostic testing (EDX) data were available, in comparison to age-matched 30 healthy subjects. TMT calculated on T1-weighted MR images was significantly lower in ALS patients than in healthy subjects (p < 0.001), correlating with the ALS Functional Rating Scale (FRS) (p:0.018) and compound motor action potential (CMAP) (p:0.012) in the patients group. Multivariate analysis of overall survival (OS) showed that the only parameters that remained significant were TMT (p:0.002, OR 0.45, 95%vCI: 0.28-0.75) and ALS FRS-R (p:0.023, OR: 0.80, 95%CI: 0.67-0.92). TMT seems to be a promising surrogate biomarker of survival and functional status in ALS. Our data deserve further investigations in multicenter and prospective trials.
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Affiliation(s)
- Claudia Vinciguerra
- Neurology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Antonella Toriello
- Neurology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Valerio Nardone
- Department of Precision Medicine, University of Campania L.Vanvitelli, Napoli, Italy
| | - Daniele Romano
- Department of Neuroradiology, "San Giovanni di Dio e Ruggi d'Aragona" Hospital, Salerno, Italy
| | - Salvatore Tartaglione
- Department of Neuroradiology, "San Giovanni di Dio e Ruggi d'Aragona" Hospital, Salerno, Italy
| | - Filomena Abate
- Neurology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Annamaria Landolfi
- Neurology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Paolo Barone
- Neurology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
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Broen MPG, Beckers R, Willemsen ACH, Huijs SMH, Pasmans RCOS, Eekers DBP, Ackermans L, Beckervordersandforth J, van Raak EPM, Verduin M, Anten MHME, Hoeben A, Postma AA. Temporal muscle thickness as an independent prognostic imaging marker in newly diagnosed glioblastoma patients: a validation study. Neurooncol Adv 2022; 4:vdac038. [PMID: 35475275 PMCID: PMC9034111 DOI: 10.1093/noajnl/vdac038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Previous studies have recognized temporal muscle thickness (TMT) as a prognostic marker in glioblastoma, but clinical implementation is hampered due to studies’ heterogeneity and lack of established cutoff values. The aim of this study was to assess the validity of recent proposed sex-specific TMT cutoff values in a real-world population of genotyped primary glioblastoma patients. Methods We measured TMT in preoperative MR images of 328 patients. Sex-specific TMT cutoff values were used to divide patients into “at risk of sarcopenia” or “normal muscle status”. Kaplan-Meier analyses and stepwise multivariate Cox-Regression analyses were used to assess the association with overall survival (OS) and progression-free survival (PFS). The association with occurrence of complications and discontinuation of glioblastoma treatment was investigated using odds ratios (OR). Results Patients at risk of sarcopenia had a significantly higher risk of progression and death than patients with normal muscle status, which remained significant in the multivariate analyses (OS HR = 1.437; 95%CI: 1.046–1.973; P = .025 and PFS HR = 1.453; 95%CI: 1.037–2.036; P = .030). Patients at risk of sarcopenia also had a significantly higher risk of early discontinuation of treatment (OR = 2.45; 95%CI: 1.011–5.952; P = .042) and a significantly lower chance of receiving second-line treatment (OR = 0.23; 95%CI: 0.09–0.60; P = .001). There was no association with the occurrence of complications. Conclusions Our study confirms external validity of the use of proposed sex-specific TMT cutoff values as an independent prognostic marker in newly diagnosed glioblastoma patients. This simple, noninvasive marker could improve patient counseling and aid in treatment decision processes or trial stratification.
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Affiliation(s)
- Martinus P G Broen
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands
- GROW- School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
| | - Rueben Beckers
- Department of Neurology, Zuyderland Medical Center, Heerlen, Netherlands
| | - Anna C H Willemsen
- GROW- School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Netherlands
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Sandra M H Huijs
- Department of Neurology, Zuyderland Medical Center, Heerlen, Netherlands
| | | | - Daniëlle B P Eekers
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Linda Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Jan Beckervordersandforth
- GROW- School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
- Department of Pathology, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Maikel Verduin
- GROW- School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Monique H M E Anten
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands
- GROW- School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
| | - Ann Hoeben
- GROW- School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Alida A Postma
- Department of Radiology, Maastricht University Medical Center, Maastricht, Netherlands
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Cellular Senescence and Aging in Myotonic Dystrophy. Int J Mol Sci 2022; 23:ijms23042339. [PMID: 35216455 PMCID: PMC8877951 DOI: 10.3390/ijms23042339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/06/2022] [Accepted: 02/12/2022] [Indexed: 01/10/2023] Open
Abstract
Myotonic dystrophy (DM) is a dominantly inherited multisystemic disorder affecting various organs, such as skeletal muscle, heart, the nervous system, and the eye. Myotonic dystrophy type 1 (DM1) and type 2 (DM2) are caused by expanded CTG and CCTG repeats, respectively. In both forms, the mutant transcripts containing expanded repeats aggregate as nuclear foci and sequester several RNA-binding proteins, resulting in alternative splicing dysregulation. Although certain alternative splicing events are linked to the clinical DM phenotypes, the molecular mechanisms underlying multiple DM symptoms remain unclear. Interestingly, multi-systemic DM manifestations, including muscle weakness, cognitive impairment, cataract, and frontal baldness, resemble premature aging. Furthermore, cellular senescence, a critical contributor to aging, is suggested to play a key role in DM cellular pathophysiology. In particular, several senescence inducers including telomere shortening, mitochondrial dysfunction, and oxidative stress and senescence biomarkers such as cell cycle inhibitors, senescence-associated secretory phenotype, chromatin reorganization, and microRNA have been implicated in DM pathogenesis. In this review, we focus on the clinical similarities between DM and aging, and summarize the involvement of cellular senescence in DM and the potential application of anti-aging DM therapies.
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Katsuki M, Kakizawa Y, Nishikawa A, Yamamoto Y, Uchiyama T, Agata M, Wada N, Kawamura S, Koh A. Temporal Muscle and Stroke—A Narrative Review on Current Meaning and Clinical Applications of Temporal Muscle Thickness, Area, and Volume. Nutrients 2022; 14:nu14030687. [PMID: 35277046 PMCID: PMC8840759 DOI: 10.3390/nu14030687] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Evaluating muscle mass and function among stroke patients is important. However, evaluating muscle volume and function is not easy due to the disturbances of consciousness and paresis. Temporal muscle thickness (TMT) has been introduced as a novel surrogate marker for muscle mass, function, and nutritional status. We herein performed a narrative literature review on temporal muscle and stroke to understand the current meaning of TMT in clinical stroke practice. Methods: The search was performed in PubMed, last updated in October 2021. Reports on temporal muscle morphomics and stroke-related diseases or clinical entities were collected. Results: Four studies reported on TMT and subarachnoid hemorrhage, two studies on intracerebral hemorrhage, two studies on ischemic stroke, two studies on standard TMT values, and two studies on nutritional status. TMT was reported as a prognostic factor for several diseases, a surrogate marker for skeletal muscle mass, and an indicator of nutritional status. Computed tomography, magnetic resonance imaging, and ultrasonography were used to measure TMT. Conclusions: TMT is gradually being used as a prognostic factor for stroke or a surrogate marker for skeletal muscle mass and nutritional status. The establishment of standard methods to measure TMT and large prospective studies to further investigate the relationship between TMT and diseases are needed.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan; (S.K.); (A.K.)
| | - Yukinari Kakizawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
- Correspondence:
| | - Akihiro Nishikawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Yasunaga Yamamoto
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Toshiya Uchiyama
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Masahiro Agata
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Naomichi Wada
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan; (S.K.); (A.K.)
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan; (S.K.); (A.K.)
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Sarcopenia: Diagnosis and Management, State of the Art and Contribution of Ultrasound. J Clin Med 2021; 10:jcm10235552. [PMID: 34884255 PMCID: PMC8658070 DOI: 10.3390/jcm10235552] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 12/15/2022] Open
Abstract
Age-related muscle loss is a phenomenon that has been extensively studied in recent decades. Sarcopenia is a multisystem disease, which predisposes to muscle weakness and frailty. At around 50 years of age, an individual begins to lose muscle strength, although this becomes more evident after 70. Sarcopenia is a condition typically found in older adults but can also affect younger people. Sarcopenia is a preventable and treatable condition. In past years, methods and tools to recognize the condition early have been researched. For the development of therapeutic interventions, agreement on diagnosis is fundamental. In recent years, a possible role of ultrasonography in the diagnosis of sarcopenia has been evaluated, compared with the best-known techniques.
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Chung SJ, Kim YJ, Yoo HS, Jung JH, Baik K, Lee HS, Lee YH, Hong JM, Sohn YH, Lee PH. Temporalis Muscle Thickness as an Indicator of Sarcopenia Is Associated With Long-term Motor Outcomes in Parkinson's Disease. J Gerontol A Biol Sci Med Sci 2021; 76:2242-2248. [PMID: 33754634 DOI: 10.1093/gerona/glab082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To investigate the relationship between temporalis muscle thickness (TMT) at baseline as a surrogate marker for sarcopenia and long-term motor outcomes in patients with Parkinson's disease (PD). METHODS We enrolled 249 patients with drug-naïve early-stage PD (119 males and 130 females, follow-up > 3 years). Baseline TMT of each patient was measured on the axial plane of T1-weighted images. The association between baseline TMT and long-term motor outcomes in PD was assessed using Cox regression models for levodopa-induced dyskinesia, wearing-off, and freezing of gait and a linear mixed model for the longitudinal increases in levodopa-equivalent dose per body weight over time. Statistical analyses were performed separately for sex if an interaction effect between TMT and sex was assumed. RESULTS TMT differed substantially between the sexes, and male PD patients had higher TMT (6.69 ± 1.39 mm) than female PD patients (5.64 ± 1.34 mm, p < .001). Cox regression models demonstrated that baseline TMT was not associated with the risk of developing levodopa-induced dyskinesia, wearing-off, or freezing of gait during the follow-up period. The linear mixed model was applied separately for sex and demonstrated that higher TMT at baseline was associated with slower increases in levodopa-equivalent dose per body weight in male PD patients, but not in female PD patients. CONCLUSIONS This study demonstrated that baseline TMT could be an indicator of the longitudinal requirement for dopaminergic medications in male patients with PD, suggesting that sarcopenia may have a detrimental effect on disease progression in PD in a sex-specific manner.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
| | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
| | - KyoungWon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
| | - Ji-Man Hong
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
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Furtner J, Weller M, Weber M, Gorlia T, Nabors B, Reardon DA, Tonn JC, Stupp R, Preusser M. Temporal muscle thickness as a prognostic marker in newly diagnosed glioblastoma patients: translational imaging analysis of the CENTRIC EORTC 26071-22072 and CORE trials. Clin Cancer Res 2021; 28:129-136. [PMID: 34667022 DOI: 10.1158/1078-0432.ccr-21-1987] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/20/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the prognostic relevance of temporal muscle thickness (TMT) as a surrogate parameter of skeletal muscle status in patients with newly diagnosed glioblastoma. METHODS We assessed TMT in cranial magnetic resonance images (MRI) of 755 patients enrolled in the CENTRIC EORTC 26071-22072 study (n=508) and CORE study (n=247). We used predefined sex-specific TMT cutoff values to categorize "patients at risk of sarcopenia" and "patients with normal muscle status" at baseline. Furthermore, we categorized patients according to the extent of TMT loss over time. Associations with progression-free survival (PFS) and overall survival (OS) were evaluated using the Cox model adjusted for other exploratory variables. RESULTS Patients at risk of sarcopenia (CENTRIC; n=158/508, 31.1%; CORE; n=87/247, 35.2%) at baseline had significantly higher risk of progression and death than patients with normal muscle status in both study cohorts (CENTRIC: PFS=HR 0.16, 95% CI: 0.12, 0.21, p<0.001; OS=HR 0.341, 95% CI: 0.27, 0.44, p < 0.001; CORE: PFS=HR 0.29, 95% CI: 0.21, 0.39, p<0.001; OS=HR 0.365, 95% CI: 0.27, 0.49, p<0.001). Similar results were obtained in multivariate Cox models adjusted for other important prognostic parameters. The extent of TMT loss over time showed a significant inverse correlation with median OS times in patients at risk for sarcopenia (CENTRIC: p<0.001, CORE: p=0.005), but not in patients with normal baseline muscle mass (CENTRIC: p=0.538, CORE: p=0.28). CONCLUSION TMT identifies ambulatory patients with newly diagnosed glioblastoma at risk for progressive sarcopenia and adverse outcomes. Early intervention may prevent skeletal muscle loss and improve patient outcome.
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Affiliation(s)
- Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna
| | - Michael Weller
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, University Hospital and University of Zurich
| | - Michael Weber
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna
| | - Thierry Gorlia
- Data Center, European Organisation for Research and Treatment of Cancer
| | - Burt Nabors
- Department of Neurology, University of Alabama at Birmingham
| | | | | | - Roger Stupp
- Malnati Brain Tumor Institute and Lurie Cancer Center, Northwestern University, Feinberg School of Medicine
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Leone R, Sferruzza G, Calimeri T, Steffanoni S, Conte GM, De Cobelli F, Falini A, Ferreri AJM, Anzalone N. Quantitative muscle mass biomarkers are independent prognosis factors in primary central nervous system lymphoma: The role of L3-skeletal muscle index and temporal muscle thickness. Eur J Radiol 2021; 143:109945. [PMID: 34492625 DOI: 10.1016/j.ejrad.2021.109945] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/03/2021] [Accepted: 08/29/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To investigate the role of quantitative muscle biomarkers assessed with skeletal muscle index at the third lumbar vertebra (L3-SMI) and temporal muscle thickness (TMT) in predicting progression-free and overall survival in patients with primary central nervous system lymphoma (PCNSL) undergoing first-line high-dose methotrexate-based chemotherapy. METHODS L3-SMI and TMT were calculated on abdominal CT and brain high-resolution 3D-T1-weighted MR images, respectively, using predefined validated methods. Standardized sex-specific cut-off values were used to divide patients in different risk categories. Kaplan-Meier plots were calculated, and survival analysis was performed using log-rank tests, univariate, and multivariable Cox-regression models, calculating hazard ratios (HR) and 95% confidence intervals (CI), also adjusting for potential confounders (age, sex, and performance status). RESULTS Forty-three patients were included in this study. Median follow-up was 23 months (interquartile range 12-40); at median follow-up, rates of progression-free and overall survival for the cohort were 46% and 57%, respectively. Thirteen (30%) and 11 (26%) patients showed L3-SMI or TMT values below the predefined cut-offs. In Cox-regression multivariable analysis patients with low L3-SMI or TMT showed significantly worse progression-free (HR 4.40, 95% CI 1.66-11.61, p = 0.003; HR 4.40, 95% CI 1.68-11.49, p = 0.003, respectively) and overall survival (HR 3.16, 95% CI 1.09-9.11, p = 0.034; HR 4.93, 95% CI 1.78-13.65, p = 0.002, respectively) compared to patients with high L3-SMI or TMT. CONCLUSIONS Quantitative muscle mass evaluation assessed by both L3-SMI and TMT is a promising tool to identify PCNSL patients at high risk of negative outcome. Confirmatory studies on larger independent series are warranted.
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Affiliation(s)
- R Leone
- Department of Neuroradiology, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
| | - G Sferruzza
- Department of Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan and Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
| | - T Calimeri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - S Steffanoni
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - G M Conte
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - F De Cobelli
- Department of Radiology, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, via Olgettina 60, 20132 Milan, Italy
| | - A Falini
- Department of Neuroradiology, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
| | - A J M Ferreri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - N Anzalone
- Department of Neuroradiology, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy.
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Katsuki M, Narita N, Ozaki D, Sato Y, Jia W, Nishizawa T, Kochi R, Sato K, Kawamura K, Ishida N, Watanabe O, Cai S, Shimabukuro S, Yasuda I, Kinjo K, Yokota K. Deep Learning-Based Functional Independence Measure Score Prediction After Stroke in Kaifukuki (Convalescent) Rehabilitation Ward Annexed to Acute Care Hospital. Cureus 2021; 13:e16588. [PMID: 34466308 PMCID: PMC8396410 DOI: 10.7759/cureus.16588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 01/11/2023] Open
Abstract
Introduction Prediction models of functional independent measure (FIM) score after kaifukuki (convalescent) rehabilitation ward (KRW) are needed to decide the treatment strategies and save medical resources. Statistical models were reported, but their accuracies were not satisfactory. We made such prediction models using the deep learning (DL) framework, Prediction One (Sony Network Communications Inc., Tokyo, Japan). Methods Of the 559 consecutive stroke patients, 122 patients were transferred to our KRW. We divided our 122 patients’ data randomly into halves of training and validation datasets. Prediction One made three prediction models from the training dataset using (1) variables at the acute care ward admission, (2) those at the KRW admission, and (3) those combined (1) and (2). The models’ determination coefficients (R2), correlation coefficients (rs), and residuals were calculated using the validation dataset. Results Of the 122 patients, the median age was 71, length of stay (LOS) in acute care ward 23 (17-30) days, LOS in KRW 53 days, total FIM scores at the admission of KRW 85, those at discharge 108. The mean FIM gain and FIM efficiency were 19 and 0.417. All patients were discharged home. Model (1), (2), and (3)’s R2 were 0.794, 0.970, and 0.972. Their mean residuals between the predicted and actual total FIM scores were -1.56±24.6, -4.49±17.1, and -2.69±15.7. Conclusion Our FIM gain and efficiency were better than national averages of FIM gain 17.1 and FIM efficiency 0.187. We made DL-based total FIM score prediction models, and their accuracies were superior to those of previous statistically calculated ones. The DL-based FIM score prediction models would save medical costs and perform efficient stroke and rehabilitation medicine.
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Affiliation(s)
- Masahito Katsuki
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN.,Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Norio Narita
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | - Dan Ozaki
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | | | - Wenting Jia
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | | | | | - Kanako Sato
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | | | - Naoya Ishida
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | - Ohmi Watanabe
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | - Siqi Cai
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | | | - Iori Yasuda
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | - Kengo Kinjo
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
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Huq S, Khalafallah AM, Ruiz-Cardozo MA, Botros D, Oliveira LAP, Dux H, White T, Jimenez AE, Gujar SK, Sair HI, Pillai JJ, Mukherjee D. A novel radiographic marker of sarcopenia with prognostic value in glioblastoma. Clin Neurol Neurosurg 2021; 207:106782. [PMID: 34186275 DOI: 10.1016/j.clineuro.2021.106782] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Sarcopenia is an important prognostic consideration in surgical oncology that has received relatively little attention in brain tumor patients. Temporal muscle thickness (TMT) has recently been proposed as a novel radiographic marker of sarcopenia that can be efficiently obtained within existing workflows. We investigated the prognostic value of TMT in primary and progressive glioblastoma. METHODS TMT measurements were performed on magnetic resonance images of 384 patients undergoing 541 surgeries for glioblastoma. Relationships between TMT and clinical characteristics were examined on bivariate analysis. Optimal TMT cutpoints were established using maximally selected rank statistics. Predictive value of TMT upon postoperative survival (PS) was assessed using Cox proportional hazards regression adjusted for age, sex, Karnofsky performance status (KPS), Stupp protocol completion, extent of resection, and tumor molecular markers. RESULTS Average TMT for the primary and progressive glioblastoma cohorts was 9.55 mm and 9.40 mm, respectively. TMT was associated with age (r = -0.14, p = 0.0008), BMI (r = 0.29, p < 0.0001), albumin (r = 0.11, p = 0.0239), and KPS (r = 0.11, p = 0.0101). Optimal TMT cutpoints for the primary and progressive cohorts were ≤ 7.15 mm and ≤ 7.10 mm, respectively. High TMT was associated with increased Stupp protocol completion (p = 0.001). On Cox proportional hazards regression, high TMT predicted increased PS in progressive [HR 0.47 (95% confidence interval (CI)) 0.25-0.90), p = 0.023] but not primary [HR 0.99 (95% CI 0.64-1.51), p = 0.949] glioblastoma. CONCLUSIONS TMT correlates with important prognostic variables in glioblastoma and predicts PS in patients with progressive, but not primary, disease. TMT may represent a pragmatic neurosurgical biomarker in glioblastoma that could inform treatment planning and perioperative optimization.
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Affiliation(s)
- Sakibul Huq
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Adham M Khalafallah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Miguel A Ruiz-Cardozo
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - David Botros
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Leonardo A P Oliveira
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Hayden Dux
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Taija White
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Adrian E Jimenez
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Sachin K Gujar
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Neuroradiology, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Neuroradiology, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Jay J Pillai
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA; The Russell H. Morgan Department of Radiology and Radiological Science, Division of Neuroradiology, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Debraj Mukherjee
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA.
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Katsuki M, Kawamura S, Koh A. Easily Created Prediction Model Using Automated Artificial Intelligence Framework (Prediction One, Sony Network Communications Inc., Tokyo, Japan) for Subarachnoid Hemorrhage Outcomes Treated by Coiling and Delayed Cerebral Ischemia. Cureus 2021; 13:e15695. [PMID: 34277282 PMCID: PMC8281789 DOI: 10.7759/cureus.15695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 01/28/2023] Open
Abstract
Introduction Reliable prediction models of subarachnoid hemorrhage (SAH) outcomes and delayed cerebral ischemia (DCI) are needed to decide the treatment strategy. Automated artificial intelligence (AutoAI) is attractive, but there are few reports on AutoAI-based models for SAH functional outcomes and DCI. We herein made models using an AutoAI framework, Prediction One (Sony Network Communications Inc., Tokyo, Japan), and compared it to other previous statistical prediction scores. Methods We used an open dataset of 298 SAH patients, who were with non-severe neurological grade and treated by coiling. Modified Rankin Scale 0-3 at six months was defined as a favorable functional outcome and DCI occurrence as another outcome. We randomly divided them into a 248-patient training dataset and a 50-patient test dataset. Prediction One made the model using training dataset with 5-fold cross-validation. We evaluated the model using the test dataset and compared the area under the curves (AUCs) of the created models. Those of the modified SAFIRE score and the Fisher computed tomography (CT) scale to predict the outcomes. Results The AUCs of the AutoAI-based models for functional outcome in the training and test dataset were 0.994 and 0.801, and those for the DCI occurrence were 0.969 and 0.650. AUCs for functional outcome calculated using modified SAFIRE score were 0.844 and 0.892. Those for the DCI occurrence calculated using the Fisher CT scale were 0.577 and 0.544. Conclusions We easily and quickly made AutoAI-based prediction models. The models' AUCs were not inferior to the previous prediction models despite the easiness.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Iwaki City Medical Center, Iwaki, JPN
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
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Sakai K, Katayama M, Nakajima J, Inoue S, Koizumi K, Okada S, Suga S, Nomura T, Matsuura N. Temporal muscle thickness is associated with the severity of dysphagia in patients with acute stroke. Arch Gerontol Geriatr 2021; 96:104439. [PMID: 34090127 DOI: 10.1016/j.archger.2021.104439] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Post-stroke dysphagia is a common and expensive complication of acute stroke. The relationship between dysphagia and skeletal muscle loss (sarcopenia) has been recently highlighted. This study aimed to determine the relationship between temporal muscle thickness (TMT) measured by head magnetic resonance imaging (MRI) and dysphagia in patients with acute stroke. METHODS Seventy participants (43 men and 27 women; mean age, 75.6 ± 12.7 years) were included in this study. TMT was measured by T2-magnetic resonance images within seven days of hospitalization. The severity of dysphagia was assessed using the Functional Oral Intake Scale (FOIS). Participants were classified into three categories according to the severity of dysphagia (severe: FOIS score, 1-3; mild: FOIS score, 4-6; normal: FOIS score, 7). Linear regression analysis was used to determine the independent explanators of dysphagia severity. RESULTS Twenty participants (28.6%) had severe dysphagia, 31 participants (44.3%) had mild dysphagia, and 19 participants (27.1%) had normal swallowing function at discharge. The results of the linear regression analysis showed that TMT was a significant explanator of dysphagia severity following stroke, along with age and National Institute of Health Stroke Scale (NIHSS) score (P < 0.05, effect size: f2 = 0.72). CONCLUSIONS TMT was an independent risk factor for dysphagia in patients with acute stroke. Skeletal muscle loss may be secondarily involved in dysphagia with acute stroke, and measurement of TMT with head MRI is a useful method to assess skeletal muscle loss.
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Affiliation(s)
- Katsuhiko Sakai
- Department of Oral Medicine and Hospital Dentistry, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba 272-8513, Japan.
| | - Masateru Katayama
- Division of Neurosurgery, Tokyo Dental College, Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa city, Chiba 272-8513, Japan
| | - Junko Nakajima
- Department of Oral Medicine and Hospital Dentistry, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba 272-8513, Japan
| | - Satoshi Inoue
- Division of Neurosurgery, Tokyo Dental College, Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa city, Chiba 272-8513, Japan
| | - Kenzo Koizumi
- Division of Neurology, Tokyo Dental College, Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa city, Chiba 272-8513, Japan
| | - Satoshi Okada
- Division of Neurology, Tokyo Dental College, Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa city, Chiba 272-8513, Japan
| | - Sadao Suga
- Division of Neurosurgery, Tokyo Dental College, Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa city, Chiba 272-8513, Japan
| | - Takeshi Nomura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba 272-8513, Japan
| | - Nobuyuki Matsuura
- Department of Oral Medicine and Hospital Dentistry, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba 272-8513, Japan
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Katsuki M, Yasuda I, Narita N, Ozaki D, Sato Y, Kato Y, Jia W, Nishizawa T, Kochi R, Sato K, Kawamura K, Ishida N, Watanabe O, Cai S, Shimabukuro S, Yokota K. Chronic subdural hematoma in patients over 65 years old: Results of using a postoperative cognitive evaluation to determine whether to permit return to driving. Surg Neurol Int 2021; 12:212. [PMID: 34084639 PMCID: PMC8168661 DOI: 10.25259/sni_186_2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/08/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Chronic subdural hematoma (CSDH) is usually associated with good recovery with burr hole irrigation and postoperative drainage under local anesthesia. In Japan, traffic accidents by the elderly drivers over 65 years old are severely increasing, and there is no consensus on whether or not to return to driving after CSDH treatment. We perform a postoperative cognitive assessment. We retrospectively investigated the return-to-driving rate and associated factors. Methods: Of the 45 patients over 65 y.o. and who had usually driven, 30 patients wished to drive again. We performed tests composed of Mini-Mental State Examination (MMSE), line cancellation and line bisection task, Kohs block design test, trail making test (TMT)-A and B, Kana-hiroi test, Rey-Osterrieth complex figure test, and behavioral assessment of the dysexecutive syndrome, in order. When all tests’ scores were better than the cutoff values, we let patients drive again. When some of the scores were worse than the cutoff values, we reevaluated the patients at the outpatient every month. If the patients’ scores could not improve at the outpatient, we recommended them to stop driving. Results: Nineteen of 30 patients could return to driving. Worse MMSE, Kohs block design test, TMT-A, TMT-B scores, higher age, dementia, or consciousness disturbance as chief complaints were associated with driving disability. Conclusion: CSDH is known as treatable dementia. However, we should perform an objective cognitive assessment before discharge because only 63% of the patients over 65 y.o. who wished to drive could return to driving.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Iori Yasuda
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Norio Narita
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Dan Ozaki
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Yoshimichi Sato
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Yuya Kato
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Wenting Jia
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Taketo Nishizawa
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Ryuzaburo Kochi
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Kanako Sato
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Kokoro Kawamura
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Naoya Ishida
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Ohmi Watanabe
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Siqi Cai
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Shinya Shimabukuro
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Kenichi Yokota
- Department of Rehabilitation, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
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Katsuki M, Kakizawa Y, Nishikawa A, Yamamoto Y, Uchiyama T. Postsurgical functional outcome prediction model using deep learning framework (Prediction One, Sony Network Communications Inc.) for hypertensive intracerebral hemorrhage. Surg Neurol Int 2021; 12:203. [PMID: 34084630 PMCID: PMC8168705 DOI: 10.25259/sni_222_2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Reliable prediction models of intracerebral hemorrhage (ICH) outcomes are needed for decision-making of the treatment. Statistically making such prediction models needs a large number of samples and time-consuming statistical analysis. Deep learning (DL), one of the artificial intelligence, is attractive, but there were no reports on DL-based functional outcome prediction models for ICH outcomes after surgery. We herein made a functional outcome prediction model using DLframework, Prediction One (Sony Network Communications Inc., Tokyo, Japan), and compared it to original ICH score, ICH Grading Scale, and FUNC score. METHODS We used 140 consecutive hypertensive ICH patients' data in our hospital between 2012 and 2019. All patients were surgically treated. Modified Rankin Scale 0-3 at 6 months was defined as a favorable outcome. We randomly divided them into 100 patients training dataset and 40 patients validation dataset. Prediction One made the prediction model using the training dataset with 5-fold cross-validation. We calculated area under the curves (AUCs) regarding the outcome using the DL-based model, ICH score, ICH Grading Scale, and FUNC score. The AUCs were compared. RESULTS The model made by Prediction One using 64 variables had AUC of 0.997 in the training dataset and that of 0.884 in the validation dataset. These AUCs were superior to those derived from ICH score, ICH Grading Scale, and FUNC score. CONCLUSION We easily and quickly made prediction models using Prediction One, even with a small single-center dataset. The accuracy of the DL-based model was superior to those of previous statistically calculated models.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Yukinari Kakizawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Akihiro Nishikawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Yasunaga Yamamoto
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Toshiya Uchiyama
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
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Katsuki M, Kakizawa Y, Nishikawa A, Yamamoto Y, Uchiyama T. Temporal muscle thickness and area are an independent prognostic factors in patients aged 75 or younger with aneurysmal subarachnoid hemorrhage treated by clipping. Surg Neurol Int 2021; 12:151. [PMID: 33948321 PMCID: PMC8088495 DOI: 10.25259/sni_814_2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Skeletal muscle mass is an important factor for various diseases' outcomes. As for its indicators, temporal muscle thickness (TMT) and temporal muscle area (TMA) on the head computed tomography are useful, and TMT and TMA were reported as potential prognostic factors for aneurysmal subarachnoid hemorrhage (SAH). We examined the clinical characteristics, including TMT and TMA, of SAH patients aged 75 or younger. METHODS We retrospectively investigated 127 SAH patients with all World Federation of Neurosurgical Societies (WFNS) grades and treated by clipping between 2009 and 2019. Clinical outcome was measured with the modified Rankin Scale (mRS) at 6 months, with favorable outcome defined as mRS 0-2. The associations between the clinical variables and the outcomes were analyzed. RESULTS The mean age was 60.6 (32-74) years, and 65% were women. The mean ± standard deviation of WFNS grade was 2.8 ± 1.4. TMT and TMA were larger in the favorable outcome group than the poor one. Multivariate analysis revealed that age, smoking, WFNS grade, and TMT or TMA were associated with favorable outcome. Receiver operating characteristic analysis found that the threshold of TMT was 4.9 mm in female and 6.7 mm in male, and that of TMA was 193 mm2 in female and 333 mm2 in male. CONCLUSION The odds ratios for TMT and TMA related to clinical outcome were lower than for smoking and WFNS grade; however, on multivariate analysis they remained independent prognostic factors in SAH patients aged 75 or younger treated by clipping. Further studies are needed to confirm these findings.
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Affiliation(s)
| | - Yukinari Kakizawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
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Nakanishi N, Okura K, Okamura M, Nawata K, Shinohara A, Tanaka K, Katayama S. Measuring and Monitoring Skeletal Muscle Mass after Stroke: A Review of Current Methods and Clinical Applications. J Stroke Cerebrovasc Dis 2021; 30:105736. [PMID: 33756264 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105736] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/16/2021] [Accepted: 02/28/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Muscle mass at admission is important to survive stroke, and stroke-induced sarcopenia is a serious problem because of its poor prognosis. Muscle mass measurement and monitoring are essential for appropriate rehabilitation and nutrition management. However, few reviews are available about the muscle mass measurement and monitoring after stroke. MATERIAL AND METHODS Several methods are used to assess skeletal muscle mass in stroke, such as computed tomography (CT), ultrasound, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, biomarkers, and anthropometrics. We summarized the current methods and clinical applications in stroke. RESULTS In stroke, a head CT is used to estimate muscle mass by measuring the temporal muscle. However, it can be conducted retrospectively due to radiation exposure. After stroke, limb muscle atrophy and diaphragm dysfunction are observed using ultrasound. However, ultrasound requires an understanding of the methods and skill. A bioelectrical impedance analysis can be used to assess muscle mass in patients after a stroke unless they have dynamic fluid changes. Dual-energy X-ray absorptiometry is used for follow-up after hospital discharge. Urinary titin N-fragment and serum C-terminal agrin fragment reflect muscle atrophy after stroke. Anthropometrics may be useful with limited resources. CONCLUSIONS We summarized the features of each measurement and proved the recent evidence to properly measure and monitor skeletal muscle mass after stroke.
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Affiliation(s)
- Nobuto Nakanishi
- Emergency and Critical Care Medicine, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
| | - Kazuki Okura
- Department of Rehabilitation, Akita University Hospital, 44-2 Hasunuma, Aza, Hiroomote, Akita 010-8543, Japan
| | - Masatsugu Okamura
- Department of Rehabilitation, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan
| | - Keishi Nawata
- Department of Rehabilitation, University Hospital of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, Fukuoka 807-8556, Japan
| | - Ayato Shinohara
- Department of Rehabilitation, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Kohei Tanaka
- Department of Rehabilitation Medicine, Osaka Police Hospital, 10-31 Kitayama, Tennouji, Osaka 543-0035, Japan
| | - Sho Katayama
- Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 shikata, Kitaku, Okayama 700-8558, Japan
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Katsuki M, Narita N, Sasaki K, Sato Y, Suzuki Y, Mashiyama S, Tominaga T. Standard values for temporal muscle thickness in the Japanese population who undergo brain check-up by magnetic resonance imaging. Surg Neurol Int 2021; 12:67. [PMID: 33767871 PMCID: PMC7982108 DOI: 10.25259/sni_3_2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Skeletal muscle mass is an important factor for various diseases' outcomes. The psoas muscle cross-sectional area on the abdominal computed tomography (CT), gait speed, and handgrip strength is used to measure it. However, it is difficult to measure the neurological patients' muscle mass or function because (1) we do not perform abdominal CT. (2) Such patients have impaired consciousness, gait disturbance, paresis, and need of rest. Temporal muscle thickness (TMT) on magnetic resonance imaging (MRI) is now attractive for skeletal muscle volume indicator, but the reference values are not established. We herein investigated the standard value of the Japanese TMT using the brain check-up database by MRI. METHODS We retrospectively investigated 360 Japanese individuals from two institutions between 2017 and 2019. We measured TMT on the T1-weighted images in the previously reported way. The associations between TMT and other variables were analyzed. RESULTS TMT of 214 women and 146 men, ranging from 35 to 84 years old, was investigated. TMT ranged from 3.69 to 16.90 mm. Mean TMT values were significantly higher in men compared to women except for the over 70-year-old cohort. TMT was correlated to weight and body mass index in both sexes. CONCLUSION This is the first retrospective study on the standard TMT values from the Japanese brain check-up database. Our results were just reference values, but these would be useful for further investigation in other neurosurgical and neurological diseases regarding muscle volume or sarcopenia.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Norio Narita
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Keisuke Sasaki
- Department of Neurosurgery, Iwaki City Medical Center, Iwaki, Fukushima, Japan
| | - Yoshimichi Sato
- Department of Neurosurgery, Iwaki City Medical Center, Iwaki, Fukushima, Japan
| | - Yasuhiro Suzuki
- Department of Neurosurgery, Iwaki City Medical Center, Iwaki, Fukushima, Japan
| | - Shoji Mashiyama
- Department of Neurosurgery, Iwaki City Medical Center, Iwaki, Fukushima, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Evaluation of the Temporal Muscle Thickness as an Independent Prognostic Biomarker in Patients with Primary Central Nervous System Lymphoma. Cancers (Basel) 2021; 13:cancers13030566. [PMID: 33540564 PMCID: PMC7867149 DOI: 10.3390/cancers13030566] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 01/05/2023] Open
Abstract
Simple Summary Primary central nervous system lymphoma (PCNSL) is a rare brain tumor with an exceedingly poor outcome. Although some of the established prognostic parameters in PCNSL patients, such as age, blood-related parameters, or the involvement of deep brain structures, are objectively evaluable, the information about the patient’s physical condition is still based on the subjective perception of the attending physician. The thickness of the temporal muscle has previously shown to be a biomarker of skeletal muscle quantity and quality, and thus be a potential parameter reflecting sarcopenia, which is a main feature of cancer-related cachexia and a well-known prognostic marker in various disease entities. In the current study we show that temporal muscle thickness is an independent and objectively assessable parameter for outcome prognostication in PCNSL patients and may facilitate the selection and stratification of patients for treatment options or clinical trials in the future. Abstract In this study, we assessed the prognostic relevance of temporal muscle thickness (TMT), likely reflecting patient’s frailty, in patients with primary central nervous system lymphoma (PCNSL). In 128 newly diagnosed PCNSL patients TMT was analyzed on cranial magnetic resonance images. Predefined sex-specific TMT cutoff values were used to categorize the patient cohort. Survival analyses, using a log-rank test as well as Cox models adjusted for further prognostic parameters, were performed. The risk of death was significantly increased for PCNSL patients with reduced muscle thickness (hazard ratio of 3.189, 95% CI: 2–097–4.848, p < 0.001). Importantly, the results confirmed that TMT could be used as an independent prognostic marker upon multivariate Cox modeling (hazard ratio of 2.504, 95% CI: 1.608–3.911, p < 0.001) adjusting for sex, age at time of diagnosis, deep brain involvement of the PCNSL lesions, Eastern Cooperative Oncology Group (ECOG) performance status, and methotrexate-based chemotherapy. A TMT value below the sex-related cutoff value at the time of diagnosis is an independent adverse marker in patients with PCNSL. Thus, our results suggest the systematic inclusion of TMT in further translational and clinical studies designed to help validate its role as a prognostic biomarker.
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