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McMahon G, Best N, Coulter T, Erskine RM. Increased Neuromuscular Activity, Force Output, and Resistance Exercise Volume When Using 5-Minute Compared with 2-Minute Rest Intervals Between the Sets. J Strength Cond Res 2024:00124278-990000000-00462. [PMID: 38953795 DOI: 10.1519/jsc.0000000000004832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
ABSTRACT McMahon, G, Best, N, Coulter, T, and Erskine, RM. Increased neuromuscular activation, force output and resistance exercise volume when using 5-minute compared with 2-minute rest intervals between the sets. J Strength Cond Res XX(X): 000-000, 2024-Longer rest intervals between resistance exercise (RE) sets may promote greater muscle hypertrophy and strength gains over time by facilitating the completion of greater training volume and intensity. However, little is known about the acute neuromuscular responses to RE sets incorporating longer vs. shorter rest intervals. Using a within-subject, crossover design, 8 healthy, young subjects completed 2 separate acute bouts of 4 sets of 8 × 3-s maximal isometric contractions using either a 2-minute (REST-2) or 5-minute (REST-5) rest interval between sets. Peak torque (PT) and electromyography (EMG) were measured pre and 5 minutes postexercise. Peak torque and mean torque (MT), EMG, mean, and median frequencies were measured during each set, whereas blood lactate (BLa), heart rate (HR), and rating of perceived exertion (RPE) were measured following each set. Peak torque and MT were lower (p < 0.05) in sets 3 and 4, and sets 2-4 in REST-2 compared with REST-5, respectively. Electromyography and BL were lower and higher, respectively, in REST-2 vs. REST-5. There was no main effect of condition on HR or RPE. Pre-to-post exercise reductions in PT (-17 ± 9% vs. -4 ± 7%) and EMG (-29 ± 14% vs. -10 ± 7%) were greater (p < 0.001) in REST-2 vs. REST-5. Total exercise volume was less in REST-2 vs. REST-5 (9,748 ± 2296 N·m-1 vs. 11,212 ± 2513 N·m-1, p < 0.001). These results suggest that incorporating 5-minute between-set rest intervals into a resistance exercise session facilitates improved neuromuscular function, increased exercise volume, and less metabolic stress compared with 2-minute rest intervals. Thus, 5-minute rest intervals may be more efficacious for promoting muscle hypertrophy and strength gains in a chronic resistance training program.
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Affiliation(s)
- Gerard McMahon
- Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Belfast, Northern Ireland
| | - Nathan Best
- Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Belfast, Northern Ireland
| | - Timothy Coulter
- Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Belfast, Northern Ireland
| | - Robert M Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
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Lindinger MI, Cairns SP, Sejersted OM. Resting membrane potential and intracellular [Na +] at rest, during fatigue and during recovery in rat soleus muscle fibres in situ. J Physiol 2024; 602:3469-3487. [PMID: 38877870 DOI: 10.1113/jp285870] [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: 11/14/2023] [Accepted: 05/28/2024] [Indexed: 07/17/2024] Open
Abstract
Large trans-sarcolemmal ionic shifts occur with fatiguing exercise or stimulation of isolated muscles. However, it is unknown how resting membrane potential (EM) and intracellular sodium concentration ([Na+]i) change with repeated contractions in living mammals. We investigated (i) whether [Na+]i (peak, kinetics) can reveal changes of Na+-K+ pump activity during brief or fatiguing stimulation and (ii) how resting EM and [Na+]i change during fatigue and recovery of rat soleus muscle in situ. Muscles of anaesthetised rats were stimulated with brief (10 s) or repeated tetani (60 Hz for 200 ms, every 2 s, for 30 s or 300 s) with isometric force measured. Double-barrelled ion-sensitive microelectrodes were used to quantify resting EM and [Na+]i. Post-stimulation data were fitted using polynomials and back-extrapolated to time zero recovery. Mean pre-stimulation resting EM (layer 2-7 fibres) was -71 mV (surface fibres were more depolarised), and [Na+]i was 14 mM. With deeper fibres, 10 s stimulation (2-150 Hz) increased [Na+]i to 38-46 mM whilst simultaneously causing hyperpolarisations (7.3 mV for 2-90 Hz). Fatiguing stimulation for 30 s or 300 s led to end-stimulation resting EM of -61 to -53 mV, which recovered rapidly (T1/2, 8-22 s). Mean end-stimulation [Na+]i increased to 86-101 mM with both fatigue protocols and the [Na+]i recovery time-course (T1/2, 21-35 s) showed no difference between protocols. These combined findings suggest that brief stimulation hyperpolarises the resting EM, likely via maximum Na+-induced stimulation of the Na+-K+ pump. Repeated tetani caused massive depolarisation and elevations of [Na+]i that together lower force, although they likely interact with other factors to cause fatigue. [Na+]i recovery kinetics provided no evidence of impaired Na+-K+ pump activity with fatigue. KEY POINTS: It is uncertain how resting membrane potential, intracellular sodium concentration ([Na+]i), and sodium-potassium (Na+-K+) pump activity change during repeated muscle contractions in living mammals. For rat soleus muscle fibres in situ, brief tetanic stimulation for 10 s led to raised [Na+]i, anticipated to evoke maximal Na+-induced stimulation of the Na+-K+ pump causing an immediate hyperpolarisation of the sarcolemma. More prolonged stimulation with repeated tetanic contractions causes massive elevations of [Na+]i, which together with large depolarisations (via K+ disturbances) likely reduce force production. These effects occurred without impairment of Na+-K+ pump function. Together these findings suggest that rapid activation of the Na+-K+ pump occurs with brief stimulation to maintain excitability, whereas more prolonged stimulation causes rundown of the trans-sarcolemmal K+ gradient (hence depolarisation) and Na+ gradient, which in combination can impair contraction to contribute to fatigue in living mammals.
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Affiliation(s)
- Michael I Lindinger
- Research and Development, The Nutraceutical Alliance Inc., Guelph, Ontario, Canada
| | - Simeon P Cairns
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
- Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Ole M Sejersted
- Institute for Experimental Medical Research, University of Oslo and Oslo University Hospital, Oslo, Norway
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Winther JB, Jakobsgaard JE. The complex nature of skeletal muscle fatigue: Understanding the interaction of metabolic stress and membrane excitability. J Physiol 2024; 602:2157-2159. [PMID: 38654603 DOI: 10.1113/jp286454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
| | - Jesper Emil Jakobsgaard
- NMD Pharma A/S, Aarhus N, Denmark
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus C, Denmark
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Angelidis A, Overgaard K, Vandenboom R. Potentiation of force by extracellular potassium is not dependent on muscle length in mouse EDL muscle. Am J Physiol Cell Physiol 2024; 326:C529-C539. [PMID: 38145294 DOI: 10.1152/ajpcell.00456.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
Increases in myofiber extracellular potassium with prolonged contractile activity can potentiate twitch force. Activity-dependent potentiation, another mechanism of force increase in skeletal muscle, has a strong dependence on muscle or sarcomere length. Thus, potassium-mediated twitch potentiation could also be length-dependent. However, this has not been previously investigated. To this end, we used isolated C57BL/6 mouse extensor digitorum longus (EDL) muscles and elicited twitches at 0.9 Lo, Lo, and 1.1 Lo (Lo refers to optimal length) in normal (5 mM) and high (10 mM) potassium solutions. Potentiation magnitude was similar to previous observations and was not significantly different between lengths (0.9 Lo: 12.3 ± 4.4%, Lo: 12.2 ± 3.6%, 1.1 Lo: 11.8 ± 4.8%, values are means ± SD). Exposure to dantrolene sodium, a compound that attenuates calcium release, reduced twitch force across lengths by ∼70%. When dantrolene-affected muscles were subsequently exposed to high potassium, potentiation was similar to that observed in the absence of the former. In total, these findings provide novel information on potassium-mediated twitch potentiation.NEW & NOTEWORTHY Here, we investigated the length-dependence of twitch force potentiation by extracellular potassium in mouse extensor digitorum longus (EDL) in vitro, at 25°C. Potentiation magnitude did not display a statistically significant difference between the examined muscle lengths. These results describe, for the first time, the relationship of this form of potentiation with muscle length, thus furthering the understanding of how it is integrated in in vivo muscle function.
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Affiliation(s)
- Angelos Angelidis
- Department of Kinesiology, Centre for Bone and Muscle Health, Brock University, St. Catharines, Ontario, Canada
| | - Kristian Overgaard
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Rene Vandenboom
- Department of Kinesiology, Centre for Bone and Muscle Health, Brock University, St. Catharines, Ontario, Canada
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Cairns SP, Renaud JM. The potassium-glycogen interaction on force and excitability in mouse skeletal muscle: implications for fatigue. J Physiol 2023; 601:5669-5687. [PMID: 37934587 DOI: 10.1113/jp285129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023] Open
Abstract
A reduced muscle glycogen content and potassium (K+ ) disturbances across muscle membranes occur concomitantly during repeated intense exercise and together may contribute to skeletal muscle fatigue. Therefore, we examined whether raised extracellular K+ concentration ([K+ ]o ) (4 to 11 mM) interacts with lowered glycogen to reduce force production. Isometric contractions were evoked in isolated mouse soleus muscles (37°C) using direct supramaximal field stimulation. (1) Glycogen declined markedly in non-fatigued muscle with >2 h exposure in glucose-free physiological saline compared with control solutions (11 mM glucose), i.e. to <45% control. (2) Severe glycogen depletion was associated with increased 5'-AMP-activated protein kinase activity, indicative of metabolic stress. (3) The decline of peak tetanic force at 11 mM [K+ ]o was exacerbated from 67% initial at normal glycogen to 22% initial at lowered glycogen. This was due to a higher percentage of inexcitable fibres (71% vs. 43%), yet without greater sarcolemmal depolarisation or smaller amplitude action potentials. (4) Returning glucose while at 11 mM [K+ ]o increased both glycogen and force. (5) Exposure to 4 mM [K+ ]o glucose-free solutions (15 min) did not increase fatiguability during repeated tetani; however, after recovery there was a greater force decline at 11 mM [K+ ]o at lower than normal glycogen. (6) An important exponential relationship was established between relative peak tetanic force at 11 mM [K+ ]o and muscle glycogen content. These findings provide direct evidence of a synergistic interaction between raised [K+ ]o and lowered muscle glycogen as the latter shifts the peak tetanic force-resting EM relationship towards more negative resting EM due to lowered sarcolemmal excitability, which hence may contribute to muscle fatigue. KEY POINTS: Diminished muscle glycogen levels and raised extracellular potassium concentrations ([K+ ]o ) occur simultaneously during intense exercise and together may contribute to muscle fatigue. Prolonged exposure of isolated non-fatigued soleus muscles of mice to glucose-free physiological saline solutions markedly lowered muscle glycogen levels, as does fatigue then recovery in glucose-free solutions. For both approaches, the subsequent decline of maximal force at 11 mM [K+ ]o , which mimics interstitial [K+ ] levels during intense exercise, was exacerbated at lowered compared with normal glycogen. This was mainly due to many more muscle fibres becoming inexcitable. We established an important relationship that provides evidence of a synergistic interaction between raised [K+ ]o and lowered glycogen content to reduce force production. This paper indicates that partially lowered muscle glycogen (and/or metabolic stress) together with elevated interstitial [K+ ] interactively lowers muscle force, and hence may diminish performance especially during repeated high-intensity exercise.
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Affiliation(s)
- Simeon P Cairns
- SPRINZ, School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand
- Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand
| | - Jean-Marc Renaud
- Department of Cellular and Molecular Medicine, Neuromuscular Research Center, University of Ottawa, Ottawa, Ontario, Canada
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Renaud JM, Ørtenblad N, McKenna MJ, Overgaard K. Exercise and fatigue: integrating the role of K +, Na + and Cl - in the regulation of sarcolemmal excitability of skeletal muscle. Eur J Appl Physiol 2023; 123:2345-2378. [PMID: 37584745 PMCID: PMC10615939 DOI: 10.1007/s00421-023-05270-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/29/2023] [Indexed: 08/17/2023]
Abstract
Perturbations in K+ have long been considered a key factor in skeletal muscle fatigue. However, the exercise-induced changes in K+ intra-to-extracellular gradient is by itself insufficiently large to be a major cause for the force decrease during fatigue unless combined to other ion gradient changes such as for Na+. Whilst several studies described K+-induced force depression at high extracellular [K+] ([K+]e), others reported that small increases in [K+]e induced potentiation during submaximal activation frequencies, a finding that has mostly been ignored. There is evidence for decreased Cl- ClC-1 channel activity at muscle activity onset, which may limit K+-induced force depression, and large increases in ClC-1 channel activity during metabolic stress that may enhance K+ induced force depression. The ATP-sensitive K+ channel (KATP channel) is also activated during metabolic stress to lower sarcolemmal excitability. Taking into account all these findings, we propose a revised concept in which K+ has two physiological roles: (1) K+-induced potentiation and (2) K+-induced force depression. During low-moderate intensity muscle contractions, the K+-induced force depression associated with increased [K+]e is prevented by concomitant decreased ClC-1 channel activity, allowing K+-induced potentiation of sub-maximal tetanic contractions to dominate, thereby optimizing muscle performance. When ATP demand exceeds supply, creating metabolic stress, both KATP and ClC-1 channels are activated. KATP channels contribute to force reductions by lowering sarcolemmal generation of action potentials, whilst ClC-1 channel enhances the force-depressing effects of K+, thereby triggering fatigue. The ultimate function of these changes is to preserve the remaining ATP to prevent damaging ATP depletion.
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Affiliation(s)
- Jean-Marc Renaud
- Faculty of Medicine, Department of Cellular and Molecular Medicine, University of Ottawa, 451 Smyth Rd., Ottawa, ON, K1H 8M5, Canada.
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Michael J McKenna
- Institute for Health and Sport, Victoria University, Melbourne, VIC, 8001, Australia
- College of Physical Education, Southwest University, Chongqing, China
- College of Sport Science, Zhuhai College of Science and Technology, Zhuhai, China
| | - Kristian Overgaard
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
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Bolaños P, Calderón JC. Excitation-contraction coupling in mammalian skeletal muscle: Blending old and last-decade research. Front Physiol 2022; 13:989796. [PMID: 36117698 PMCID: PMC9478590 DOI: 10.3389/fphys.2022.989796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
The excitation–contraction coupling (ECC) in skeletal muscle refers to the Ca2+-mediated link between the membrane excitation and the mechanical contraction. The initiation and propagation of an action potential through the membranous system of the sarcolemma and the tubular network lead to the activation of the Ca2+-release units (CRU): tightly coupled dihydropyridine and ryanodine (RyR) receptors. The RyR gating allows a rapid, massive, and highly regulated release of Ca2+ from the sarcoplasmic reticulum (SR). The release from triadic places generates a sarcomeric gradient of Ca2+ concentrations ([Ca2+]) depending on the distance of a subcellular region from the CRU. Upon release, the diffusing Ca2+ has multiple fates: binds to troponin C thus activating the contractile machinery, binds to classical sarcoplasmic Ca2+ buffers such as parvalbumin, adenosine triphosphate and, experimentally, fluorescent dyes, enters the mitochondria and the SR, or is recycled through the Na+/Ca2+ exchanger and store-operated Ca2+ entry (SOCE) mechanisms. To commemorate the 7th decade after being coined, we comprehensively and critically reviewed “old”, historical landmarks and well-established concepts, and blended them with recent advances to have a complete, quantitative-focused landscape of the ECC. We discuss the: 1) elucidation of the CRU structures at near-atomic resolution and its implications for functional coupling; 2) reliable quantification of peak sarcoplasmic [Ca2+] using fast, low affinity Ca2+ dyes and the relative contributions of the Ca2+-binding mechanisms to the whole concert of Ca2+ fluxes inside the fibre; 3) articulation of this novel quantitative information with the unveiled structural details of the molecular machinery involved in mitochondrial Ca2+ handing to understand how and how much Ca2+ enters the mitochondria; 4) presence of the SOCE machinery and its different modes of activation, which awaits understanding of its magnitude and relevance in situ; 5) pharmacology of the ECC, and 6) emerging topics such as the use and potential applications of super-resolution and induced pluripotent stem cells (iPSC) in ECC. Blending the old with the new works better!
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Affiliation(s)
- Pura Bolaños
- Laboratory of Cellular Physiology, Centre of Biophysics and Biochemistry, Venezuelan Institute for Scientific Research (IVIC), Caracas, Venezuela
| | - Juan C. Calderón
- Physiology and Biochemistry Research Group-PHYSIS, Faculty of Medicine, University of Antioquia, Medellín, Colombia
- *Correspondence: Juan C. Calderón,
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DiFranco M, Cannon S. Voltage-Dependent Ca 2+ Release Is Impaired in Hypokalemic Periodic Paralysis Caused by Ca V1.1-R528H but not by Na V1.4-R669H. Am J Physiol Cell Physiol 2022; 323:C478-C485. [PMID: 35759432 PMCID: PMC9359662 DOI: 10.1152/ajpcell.00209.2022] [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]
Abstract
Hypokalemic periodic paralysis (HypoPP) is a channelopathy of skeletal muscle caused by missense mutations in the voltage sensor domains (usually at an arginine of the S4 segment) of the CaV1.1 calcium channel or of the NaV1.4 sodium channel. The primary clinical manifestation is recurrent attacks of weakness, resulting from impaired excitability of anomalously depolarized fibers containing leaky mutant channels. While the ictal loss of fiber excitability is sufficient to explain the acute episodes of weakness, a deleterious change in voltage sensor function for CaV1.1 mutant channels may also compromise excitation-contraction coupling (EC-coupling). We used the low-affinity Ca2+ indicator OGN-5 to assess voltage-dependent Ca2+-release as a measure of EC-coupling for our knock-in mutant mouse models of HypoPP. The peak in fibers isolated from CaV1.1-R528H mice was about two-thirds of the amplitude observed in WT mice; whereas in HypoPP fibers from NaV1.4-R669H mice the was indistinguishable from WT. No difference in the voltage dependence of from WT was observed for fibers from either HypoPP mouse model. Because late-onset permanent muscle weakness is more severe for CaV1.1-associated HypoPP than for NaV1.4, we propose the reduced Ca2+-release for CaV1.1-R528H mutant channels may increase the susceptibility to fixed myopathic weakness. In contrast the episodes of transient weakness are similar for CaV1.1- and NaV1.4-associated HypoPP, consistent with the notion that acute attacks of weakness are primarily caused by leaky channels and are not a consequence of reduced Ca2+-release.
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Affiliation(s)
- Marino DiFranco
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA United States
| | - Steve Cannon
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA United States.,Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
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Cairns SP, Leader JP, Higgins A, Renaud JM. The peak force - resting membrane potential relationships of mouse fast- and slow-twitch muscle. Am J Physiol Cell Physiol 2022; 322:C1151-C1165. [PMID: 35385328 DOI: 10.1152/ajpcell.00401.2021] [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]
Abstract
We endeavored to understand the factors determining the peak force‑resting membrane potential (EM) relationships of isolated slow-twitch soleus and fast-twitch extensor digitorum longus (EDL) muscles from mice (25oC), especially in relation to fatigue. Inter-relationships between intracellular K+‑activity (aK+i), extracellular K+‑concentration ([K+]o), resting EM, action potentials and force were studied. The large resting EM variation was mainly due to the variability of aK+i. Action potential overshoot‑resting EM relationships determined at 4 and 8-10mM[K+]o following short (<5min) and prolonged (>50min) depolarization periods revealed a constant overshoot from ‑90 to ‑70mV providing a safety margin. Overshoot decline with depolarization beyond ‑70mV was less following short than prolonged depolarization. Inexcitable fibers occurred only with prolonged depolarization. The overshoot decline during action potential trains (2‑s) exceeded that during short depolarizations. Concomitant lower extracellular [Na+] and raised [K+]o depressed the overshoot in an additive manner and peak force in a synergistic manner. Raised [K+]o-induced force loss was exacerbated with transverse wire versus parallel plate stimulation in soleus, implicating action potential propagation failure in the surface membrane. Increasing stimulus pulse parameters restored tetanic force at 9‑10mM[K+]o in soleus, but not EDL, indicative of action potential failure within trains. The peak tetanic force‑resting EM relationships (determined using resting EM from deeper rather than surface fibers) were dynamic and show pronounced force depression over ‑69 to ‑60mV in both muscle-types, implicating that such depolarization contributes to fatigue. The K+-Na+-interaction shifted this relationship towards less depolarized potentials suggesting that the combined ionic effect is physiologically important during fatigue.
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Affiliation(s)
- Simeon P Cairns
- SPRINZ, School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.,Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.,Department of Physiology, School of Medicine, University of Auckland, Auckland, New Zealand
| | - John P Leader
- Department of Physiology, University of Otago, Dunedin, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Amanda Higgins
- Department of Cellular and Molecular Medicine, Neuromuscular Research Center, University of Ottawa, Ottawa, Canada
| | - Jean-Marc Renaud
- Department of Cellular and Molecular Medicine, Neuromuscular Research Center, University of Ottawa, Ottawa, Canada
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