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Bray NW, Pieruccini-Faria F, Witt ST, Bartha R, Doherty TJ, Nagamatsu LS, Almeida QJ, Liu-Ambrose T, Middleton LE, Bherer L, Montero-Odasso M. Combining exercise with cognitive training and vitamin D 3 to improve functional brain connectivity (FBC) in older adults with mild cognitive impairment (MCI). Results from the SYNERGIC trial. GeroScience 2023:10.1007/s11357-023-00805-6. [PMID: 37162700 PMCID: PMC10170058 DOI: 10.1007/s11357-023-00805-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
Changes in functional brain connectivity (FBC) may indicate how lifestyle modifications can prevent the progression to dementia; FBC identifies areas that are spatially separate but temporally synchronized in their activation and is altered in those with mild cognitive impairment (MCI), a prodromal state between healthy cognitive aging and dementia. Participants with MCI were randomly assigned to one of five study arms. Three times per week for 20-weeks, participants performed 30-min of (control) cognitive training, followed by 60-min of (control) physical exercise. Additionally, a vitamin D3 (10,000 IU/pill) or a placebo capsule was ingested three times per week for 20-weeks. Using the CONN toolbox, we measured FBC change (Post-Pre) across four statistical models that collapsed for and/or included some or all study arms. We conducted Pearson correlations between FBC change and changes in physical and cognitive functioning. Our sample included 120 participants (mean age: 73.89 ± 6.50). Compared to the pure control, physical exercise (model one; p-False Discovery Rate (FDR) < 0.01 & < 0.05) with cognitive training (model two; p-FDR = < 0.001), and all three interventions combined (model four; p-FDR = < 0.01) demonstrated an increase in FBC between regions of the Default-Mode Network (i.e., hippocampus and angular gyrus). After controlling for false discovery rate, there were no significant correlations between change in connectivity and change in cognitive or physical function. Physical exercise alone appears to be as efficacious as combined interventional strategies in altering FBC, but implications for behavioral outcomes remain unclear.
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Affiliation(s)
- Nick W Bray
- Cumming School of Medicine, Department of Physiology & Pharmacology, University of Calgary, Calgary, AB, T2N 1N4, Canada.
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada.
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, 550 Wellington Road, Room A3-116, London, ON, N6C-0A7, Canada.
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, 550 Wellington Road, Room A3-116, London, ON, N6C-0A7, Canada
- Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, N6A-5C1, Canada
| | - Suzanne T Witt
- BrainsCAN, Western University, London, ON, N6A-3K7, Canada
| | - Robert Bartha
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, N6A-5C1, Canada
- Robarts Research Institute, Western University, London, ON, N6A-5B7, Canada
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, N6A-5C1, Canada
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, N6A-5C1, Canada
| | - Lindsay S Nagamatsu
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, N6G-2V4, Canada
| | - Quincy J Almeida
- Faculty of Science, Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, N2L-3C5, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, V6T-1Z3, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Laura E Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L-3G1, Canada
| | - Louis Bherer
- Department of Medicine, University of Montréal, Montréal, QC, H3T-1J4, Canada
- Research Centre, Montreal Heart Institute, Montréal, QC, H1T-1C8, Canada
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, 550 Wellington Road, Room A3-116, London, ON, N6C-0A7, Canada.
- Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, N6A-5C1, Canada.
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, N6A-5C1, Canada.
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Kirk EA, Castellani CA, Doherty TJ, Rice CL, Singh SM. Local and systemic transcriptomic responses from acute exercise induced muscle damage of the human knee extensors. Physiol Genomics 2022; 54:305-315. [PMID: 35723223 DOI: 10.1152/physiolgenomics.00146.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Skeletal muscle is adaptable to a direct stimulus of exercise-induced muscle damage (EIMD). Local muscle gene networks and systemic circulatory factors respond to EIMD within days, mediating anti-inflammation and cellular proliferation. Here we show in humans that local EIMD of one muscle group is associated with a systemic response of gene networks that regulate muscle structure and cellular development in non-local homologous muscle not directly altered by EIMD. In the non-dominant knee-extensors of seven males, EIMD was induced through voluntary contractions against an electric motor that lengthened muscles. Neuromuscular assessments, vastus lateralis muscle biopsies and blood draws occurred at two days prior, and one and two days post the EIMD intervention. From the muscle and blood plasma samples, RNA-seq measured transcriptome changes of differential expression using bioinformatic analyses.Relative to the time of the EIMD intervention, local muscle that was mechanically damaged had 475 genes differentially expressed, as compared to 33 genes in the non-local homologous muscle. Gene and network analysis showed that activity of the local muscle was related to structural maintenance, repair, and energetic processes, whereas gene and network activity of the non-local muscle (that was not directly modified by the EIMD) were related to muscle cell development, stress response, and structural maintenance. Altered expression of two novel miRNAs related to the EIMD response supported that systemic factors were active. Together, these results indicate that the expression of genes and gene networks that control muscle contractile structure can be modified in response to non-local EIMD in humans.
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Affiliation(s)
- Eric A Kirk
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada.,Molecular Genetics Unit, Department of Biology, Western University, London, Ontario, Canada
| | - Christina A Castellani
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada.,Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Shiva M Singh
- Molecular Genetics Unit, Department of Biology, Western University, London, Ontario, Canada
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Allen MD, Dalton BH, Gilmore KJ, McNeil CJ, Doherty TJ, Rice CL, Power GA. Response to letter: Preventing age-related motor unit loss: Is exercise the answer? Exp Gerontol 2022; 159:111696. [PMID: 35026337 DOI: 10.1016/j.exger.2022.111696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Matti D Allen
- Department of Physical Medicine and Rehabilitation, School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON K7L 4X3, Canada; School of Kinesiology and Health Studies, Faculty of Arts and Sciences, Queen's University, Kingston, ON K7L 4X3, Canada
| | - Brian H Dalton
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Kevin J Gilmore
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E1, Canada
| | - Chris J McNeil
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Charles L Rice
- School of Kinesiology, The University of Western Ontario, London, ON, Canada; Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
| | - Geoffrey A Power
- Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
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Fanous J, Zero AM, Gilmore KJ, Doherty TJ, Rice CL. Length-dependent changes of lower limb muscle morphology in Chronic Inflammatory Demyelinating Polyneuropathy assessed with magnetic resonance imaging. Eur J Transl Myol 2021; 31. [PMID: 34802220 PMCID: PMC8758964 DOI: 10.4081/ejtm.2021.10200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/11/2021] [Indexed: 11/22/2022] Open
Abstract
The objective of the present study was to assess muscle quantity of the thigh and leg in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) compared to age and sex matched controls in exploring length-dependent changes of innervated muscles. In five people with CIDP and seven controls, magnetic resonance imaging was used to assess muscle morphology of the four parts of the quadriceps and medial hamstring muscles. Findings were compared to the triceps surae from a subset of participants. The CIDP group had less contractile tissue in the quadriceps (11.5%, P<0.05), hamstrings (15.6%, P<0.05) and triceps surae (35.9%, P<0.05) compared to controls. Additionally, CIDP had less contractile tissue (18.7%) in the triceps surae compared to the hamstrings (P<0.05). Muscle quantity in the quadriceps and hamstrings in CIDP was less than controls, but differences were greater for the distal triceps surae. These findings support a length-dependent affect of CIDP on limb musculature composition.
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Affiliation(s)
- Jacob Fanous
- School of Kinesiology, The University of Western Ontario, London, ON.
| | - Alexander M Zero
- School of Kinesiology, The University of Western Ontario, London, ON.
| | | | - Timothy J Doherty
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada ; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON.
| | - Charles L Rice
- School of Kinesiology, The University of Western Ontario, London, ON, Canada; Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON.
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Allen MD, Dalton BH, Gilmore KJ, McNeil CJ, Doherty TJ, Rice CL, Power GA. Neuroprotective effects of exercise on the aging human neuromuscular system. Exp Gerontol 2021; 152:111465. [PMID: 34224847 DOI: 10.1016/j.exger.2021.111465] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 05/31/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022]
Abstract
Human biological aging from maturity to senescence is associated with a gradual loss of muscle mass and neuromuscular function. It is not until very old age (>80 years) however, that these changes often manifest into functional impairments. A driving factor underlying the age-related loss of muscle mass and function is the reduction in the number and quality of motor units (MUs). A MU consists of a single motoneuron, located either in the spinal cord or the brain stem, and all of the muscle fibres it innervates via its peripheral axon. Throughout the adult lifespan, MUs are slowly, but progressively lost. The compensatory process of collateral reinnervation attempts to recapture orphaned muscle fibres following the death of a motoneuron. Whereas this process helps mitigate loss of muscle mass during the latter decades of adult aging, the neuromuscular system has fewer and larger MUs, which have lower quality connections between the axon terminal and innervated muscle fibres. Whether this process of MU death and degradation can be attenuated with habitual physical activity has been a challenging question of great interest. This review focuses on age-related alterations of the human neuromuscular system, with an emphasis on the MU, and presents findings on the potential protective effects of lifelong physical activity. Although there is some discrepancy across studies of masters athletes, if one considers all experimental limitations as well as the available literature in animals, there is compelling evidence of a protective effect of chronic physical training on human MUs. Our tenet is that high-levels of physical activity can mitigate the natural trajectory of loss of quantity and quality of MUs in old age.
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Affiliation(s)
- Matti D Allen
- Department of Physical Medicine and Rehabilitation, School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON K7L 4X3, Canada; School of Kinesiology and Health Studies, Faculty of Arts and Sciences, Queen's University, Kingston, ON K7L 4X3, Canada
| | - Brian H Dalton
- School of Health and Exercise Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Kevin J Gilmore
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E1, Canada
| | - Chris J McNeil
- School of Health and Exercise Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Charles L Rice
- School of Kinesiology, The University of Western Ontario, London, ON, Canada; Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
| | - Geoffrey A Power
- Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
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Bray NW, Pieruccini-Faria F, Bartha R, Doherty TJ, Nagamatsu LS, Montero-Odasso M. The effect of physical exercise on functional brain network connectivity in older adults with and without cognitive impairment. A systematic review. Mech Ageing Dev 2021; 196:111493. [PMID: 33887281 DOI: 10.1016/j.mad.2021.111493] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Neurodegeneration is a biproduct of aging that results in concomitant cognitive decline. Physical exercise is an emerging intervention to improve brain health. The underlying neural mechanisms linking exercise to neurodegeneration, however, are unclear. Functional brain network connectivity (FBNC) refers to neural regions that are anatomically separate but temporally synched in functional signalling. FBNC can be measured using functional Magnetic Resonance Imaging (fMRI) and is affected by neurodegeneration. METHODS We conducted a systematic review using PubMed and EMBASE to assess the effect of physical exercise on FBNC in older adults with and without cognitive impairment. RESULTS Our search yielded 1474 articles; after exclusion, 13 were included in the final review, 8 of which focused on cognitively healthy older adults. 10 studies demonstrated an increase in FBNC post-exercise intervention, while 11 studies showed improvements in secondary outcomes (cognitive and/or physical performance). One study showed significant correlations between FBNC and cognitive performance measures that significantly improved post-intervention. DISCUSSION We found evidence that physical exercise increases FBNC. When assessing the association between FBNC with physical and cognitive functioning, careful consideration must be given to variability in exercise parameters, neural regions of interest and networks examined, and heterogeneity in methodological approaches.
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Affiliation(s)
- Nick W Bray
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, Canada; Gait and Brain Lab, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada.
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada; Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Robert Bartha
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Robarts Research Institute, Western University, London, ON, Canada.
| | - Timothy J Doherty
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, Canada; Neuromuscular Function Lab, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada; Department of Clinical Neurological Sciences, Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Lindsay S Nagamatsu
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, Canada; Exercise, Mobility and Brain Health Lab, Western University, London, ON, Canada; Brain and Mind Institute, Western University, London, ON, Canada.
| | - Manuel Montero-Odasso
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, Canada; Gait and Brain Lab, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada; Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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Schranz AL, Dekaban GA, Fischer L, Blackney K, Barreira C, Doherty TJ, Fraser DD, Brown A, Holmes J, Menon RS, Bartha R. Brain Metabolite Levels in Sedentary Women and Non-contact Athletes Differ From Contact Athletes. Front Hum Neurosci 2020; 14:593498. [PMID: 33324185 PMCID: PMC7726472 DOI: 10.3389/fnhum.2020.593498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/28/2020] [Indexed: 01/31/2023] Open
Abstract
White matter tracts are known to be susceptible to injury following concussion. The objective of this study was to determine whether contact play in sport could alter white matter metabolite levels in female varsity athletes independent of changes induced by long-term exercise. Metabolite levels were measured by single voxel proton magnetic resonance spectroscopy (MRS) in the prefrontal white matter at the beginning (In-Season) and end (Off-Season) of season in contact (N = 54, rugby players) and non-contact (N = 23, swimmers and rowers) varsity athletes. Sedentary women (N = 23) were scanned once, at a time equivalent to the Off-Season time point. Metabolite levels in non-contact athletes did not change over a season of play, or differ from age matched sedentary women except that non-contact athletes had a slightly lower myo-inositol level. The contact athletes had lower levels of myo-inositol and glutamate, and higher levels of glutamine compared to both sedentary women and non-contact athletes. Lower levels of myo-inositol in non-contact athletes compared to sedentary women indicates long-term exercise may alter glial cell profiles in these athletes. The metabolite differences observed between contact and non-contact athletes suggest that non-contact athletes should not be used as controls in studies of concussion in high-impact sports because repetitive impacts from physical contact can alter white matter metabolite level profiles. It is imperative to use athletes engaged in the same contact sport as controls to ensure a matched metabolite profile at baseline.
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Affiliation(s)
- Amy L Schranz
- Department of Medical Biophysics, Robarts Research Institute, Centre for Functional and Metabolic Mapping, Western University, London, ON, Canada
| | - Gregory A Dekaban
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, ON, Canada.,Department of Microbiology and Immunology, Western University, London, ON, Canada
| | - Lisa Fischer
- Fowler Kennedy Sport Medicine Clinic, Department of Family Medicine, Western University, London, ON, Canada
| | - Kevin Blackney
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, ON, Canada.,Department of Microbiology and Immunology, Western University, London, ON, Canada
| | - Christy Barreira
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, ON, Canada
| | - Timothy J Doherty
- Physical Medicine and Rehabilitation, Western University, London, ON, Canada
| | - Douglas D Fraser
- Paediatrics Critical Care Medicine, London Health Sciences Centre, London, ON, Canada
| | - Arthur Brown
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, ON, Canada.,Department of Anatomy and Cell Biology, Western University, London, ON, Canada
| | - Jeff Holmes
- School of Occupational Therapy, Western University, London, ON, Canada
| | - Ravi S Menon
- Department of Medical Biophysics, Robarts Research Institute, Centre for Functional and Metabolic Mapping, Western University, London, ON, Canada
| | - Robert Bartha
- Department of Medical Biophysics, Robarts Research Institute, Centre for Functional and Metabolic Mapping, Western University, London, ON, Canada
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Gilmore KJ, Kirk EA, Doherty TJ, Kimpinski K, Rice CL. Abnormal motor unit firing rates in chronic inflammatory demyelinating polyneuropathy. J Neurol Sci 2020; 414:116859. [DOI: 10.1016/j.jns.2020.116859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 12/14/2022]
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Gilmore KJ, Fanous J, Doherty TJ, Kimpinski K, Rice CL. Nerve dysfunction leads to muscle morphological abnormalities in chronic inflammatory demyelinating polyneuropathy assessed by MRI. Clin Anat 2019; 33:77-84. [DOI: 10.1002/ca.23473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/05/2019] [Accepted: 09/15/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Kevin J. Gilmore
- School of Kinesiology, Faculty of Health Science London Ontario Canada
| | - Jacob Fanous
- School of Kinesiology, Faculty of Health Science London Ontario Canada
| | - Timothy J. Doherty
- Department of Clinical Neurological Sciences Schulich School of Medicine and Dentistry, The University of Western Ontario London Ontario Canada
- Department of Physical Medicine and Rehabilitation Schulich School of Medicine and Dentistry, The University of Western Ontario London Ontario Canada
| | - Kurt Kimpinski
- School of Kinesiology, Faculty of Health Science London Ontario Canada
- Department of Clinical Neurological Sciences Schulich School of Medicine and Dentistry, The University of Western Ontario London Ontario Canada
| | - Charles L. Rice
- School of Kinesiology, Faculty of Health Science London Ontario Canada
- Department of Anatomy and Cell Biology Schulich School of Medicine and Dentistry, The University of Western Ontario London Ontario Canada
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Tsang P, MacDermid JC, Eventov M, Miller TA, Doherty TJ, Ross DC, Doherty CD. Test-retest reliability of near-fibre jiggle in the ulnar intrinsic hand muscles. J Electromyogr Kinesiol 2019; 49:102349. [PMID: 31476613 DOI: 10.1016/j.jelekin.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 08/03/2019] [Accepted: 08/10/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Near-fibre (NF) jiggle is one method of measuring the shape variability of motor unit potentials (MUPs) from successive firings during voluntary contractions. MUP shape variability has been associated with neuromuscular stability and health. The purpose of this study was to analyze the test-retest reliability of NF jiggle in the ulnar nerve innervated intrinsic hand muscles of healthy subjects. METHODS Twenty healthy adult were tested (Mean age = 23.2 ± 1.9; 8 females). Measurements of NF jiggle were assessed with a standard concentric needle during mild-moderate contractions from the first dorsal interosseous (FDI), the abductor digiti minimi (ADM), and the forth dorsal interosseous (4DI) muscles. Test-retest reliability were evaluated using intraclass-correlation coefficient (ICC). RESULTS NF jiggle showed good test-retest reliability in the FDI, ADM and 4DI muscles with ICC values of 0.86, 0.85, and 0.87, respectively. The SEM for the FDI, ADM, and 4DI were 1.9%, 2.1%, and 2.5%. Finally, the MDC of the FDI, ADM and 4DI were 4.4%, 5.0%, and 7.1%. CONCLUSION To date, this is the first investigation to explore NF jiggle in the intrinsic hand muscles. NF Jiggle demonstrates good test-retest reliability coefficients and with low measurement error.
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Affiliation(s)
- Philemon Tsang
- Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.
| | - Joy C MacDermid
- Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada; Hand and Upper Limb Centre Clinical Research Lab, St. Joseph's Health Centre, Canada; Department of Surgery, Division of Plastic Surgery, Roth-McFarlane Hand & Upper Limb Centre, Schulich School of Medicine and Dentistry, Western University, Canada
| | - Michelle Eventov
- Department of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Thomas A Miller
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, Canada
| | - Timothy J Doherty
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, Canada; Lawson Health Research Institute, Canada
| | - Douglas C Ross
- Department of Surgery, Division of Plastic Surgery, Roth-McFarlane Hand & Upper Limb Centre, Schulich School of Medicine and Dentistry, Western University, Canada
| | - Christopher D Doherty
- Department of Surgery, Division of Plastic Surgery, Roth-McFarlane Hand & Upper Limb Centre, Schulich School of Medicine and Dentistry, Western University, Canada
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11
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Kirk EA, Gilmore KJ, Stashuk DW, Doherty TJ, Rice CL. Human motor unit characteristics of the superior trapezius muscle with age-related comparisons. J Neurophysiol 2019; 122:823-832. [PMID: 31242057 DOI: 10.1152/jn.00138.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Current understanding of human motor unit (MU) control and aging is mostly derived from hand and limb muscles that have spinal motor neuron innervations. The aim here was to characterize and test whether a muscle with a shared innervation supply from brainstem and spinal MU populations would demonstrate similar age-related adaptations as those reported for other muscles. In humans, the superior trapezius (ST) muscle acts to elevate and stabilize the scapula and has primary efferent supply from the spinal accessory nerve (cranial nerve XI) located in the brainstem. We compared electrophysiological properties obtained from intramuscular and surface recordings between 10 young (22-33 yr) and 10 old (77-88 yr) men at a range of voluntary isometric contraction intensities (from 15 to 100% of maximal efforts). The old group was 41% weaker with 43% lower MU discharge frequencies compared with the young (47.2 ± 9.6 Hz young and 26.7 ± 5.8 Hz old, P < 0.05) during maximal efforts. There was no difference in MU number estimation between age groups (228 ± 105 young and 209 ± 89 old, P = 0.33). Furthermore, there were no differences in needle detected near fiber (NF) stability parameters of jitter or jiggle. The old group had lower amplitude and smaller area of the stimulated compound muscle action potential and smaller NF MU potential area with higher NF counts. Thus, despite age-related ST weakness and lower MU discharge rates, there was minimal evidence of MU loss or compensatory reinnervation.NEW & NOTEWORTHY The human superior trapezius (ST) has shared spinal and brainstem motor neuron innervation providing a unique model to explore the impact of aging on motor unit (MU) properties. Although the ST showed higher MU discharge rates compared with most spinally innervated muscles, voluntary strength and mean MU rates were lower in old compared with young at all contraction intensities. There was no age-related difference in MU number estimates with minimal electrophysiological evidence of collateral reinnervation.
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Affiliation(s)
- Eric A Kirk
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Kevin J Gilmore
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Daniel W Stashuk
- Department of Systems Design Engineering, University of Waterloo, Ontario, Canada
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, The University of Western Ontario, London, Ontario, Canada.,Department of Physical Medicine and Rehabilitation, The University of Western Ontario, London, Ontario, Canada
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada.,Department of Anatomy and Cell Biology, The University of Western Ontario, London, Ontario, Canada
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Gilmore KJ, Doherty TJ, Kimpinski K, Rice CL. Reductions in muscle quality and quantity in chronic inflammatory demyelinating polyneuropathy patients assessed by magnetic resonance imaging. Muscle Nerve 2018; 58:396-401. [DOI: 10.1002/mus.26159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 05/01/2018] [Accepted: 05/05/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Kevin J. Gilmore
- School of Kinesiology; The University of Western Ontario; London Ontario Canada
| | - Timothy J. Doherty
- Department of Clinical Neurological Sciences; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
- Department of Physical Medicine and Rehabilitation; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
| | - Kurt Kimpinski
- School of Kinesiology; The University of Western Ontario; London Ontario Canada
| | - Charles L. Rice
- School of Kinesiology; The University of Western Ontario; London Ontario Canada
- Department of Anatomy and Cell Biology; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
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13
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Bray NW, Doherty TJ, Montero-Odasso M. The Effect of High Dose Vitamin D3 on Physical Performance in Frail Older Adults. A Feasibility Study. J Frailty Aging 2018; 7:155-161. [PMID: 30095145 DOI: 10.14283/jfa.2018.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Vitamin D deficiency is ubiquitous in frailty but the effectiveness of vitamin D supplementation to improve outcomes in frail individuals is unclear. It has been postulated that higher than the current recommended doses (800 IU/day) may be needed to achieve a neuromuscular effect in frail individuals. OBJECTIVES 1) determine if 4000 IU per day of vitamin D3 is safe for frail older adults; and 2) establish the efficacy of this dose to improve physical performance outcomes in this population. DESIGN Open-label, feasibility study. SETTING Community retirement centre. PARTICIPANTS 40 older adults with frail or pre-frail characteristics. INTERVENTION 4000 IU of vitamin D3 and 1200 mcg of calcium carbonate daily for four months. MEASUREMENTS Physical performance (grip strength, gait speed and short physical performance battery score), cognitive health and vitamin D and iPTH serum levels before and after the intervention. RESULTS Frail individuals improved short physical performance battery score (1.19, p = 0.005), fast gait speed (4.65, p = 0.066) and vitamin D levels (7.81, p = 0.011). Only frail females made a significant improvement in grip strength (1.92, p = 0.003). Stratifying the sample by baseline vitamin D levels revealed that participants with vitamin D insufficiency (≤ 75 nmol/L) significantly improved short physical performance battery score (1.06, p = 0.04), fast gait speed (6.28, p = 0.004) and vitamin D levels (25.73, p = <0.0001). Pre-frail individuals, as well as those with sufficient vitamin D levels (> 75 nmol/L) made no significant improvement in any outcome. CONCLUSIONS Vitamin D supplementation using 4000 IU/daily is safe and has a modest beneficial effect on physical performance for frail individuals and those with insufficient vitamin D levels. Participants with vitamin D insufficiency (≤ 75 nmol/L) showed greater benefits. Our feasibility study provides results to help calculate effect size for a future RCT.
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Affiliation(s)
- N W Bray
- Dr. Manuel Montero-Odasso, Gait and Brain Lab, Parkwood Institute, 550 Wellington Road, Room A3-116, London, ON, Canada, N6C 0A7,E-mail: , Fax: (519) 685 0493
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Schranz AL, Manning KY, Dekaban GA, Fischer L, Jevremovic T, Blackney K, Barreira C, Doherty TJ, Fraser DD, Brown A, Holmes J, Menon RS, Bartha R. Reduced brain glutamine in female varsity rugby athletes after concussion and in non-concussed athletes after a season of play. Hum Brain Mapp 2017; 39:1489-1499. [PMID: 29271016 DOI: 10.1002/hbm.23919] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/07/2017] [Accepted: 12/04/2017] [Indexed: 11/07/2022] Open
Abstract
The purpose of this study was to use non-invasive proton magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) to monitor changes in prefrontal white matter metabolite levels and tissue microstructure in female rugby players with and without concussion (ages 18-23, n = 64). Evaluations including clinical tests and 3 T MRI were performed at the beginning of a season (in-season) and followed up at the end of the season (off-season). Concussed athletes were additionally evaluated 24-72 hr (n = 14), three months (n = 11), and six months (n = 8) post-concussion. Reduced glutamine at 24-72 hr and three months post-concussion, and reduced glutamine/creatine at three months post-concussion were observed. In non-concussed athletes (n = 46) both glutamine and glutamine/creatine were lower in the off-season compared to in-season. Within the MRS voxel, an increase in fractional anisotropy (FA) and decrease in radial diffusivity (RD) were also observed in the non-concussed athletes, and correlated with changes in glutamine and glutamine/creatine. Decreases in glutamine and glutamine/creatine suggest reduced oxidative metabolism. Changes in FA and RD may indicate neuroinflammation or re-myelination. The observed changes did not correlate with clinical test scores suggesting these imaging metrics may be more sensitive to brain injury and could aid in assessing recovery of brain injury from concussion.
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Affiliation(s)
- Amy L Schranz
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, 1151 Richmond Street North, London, Ontario, N6A 5B7, Canada.,Department of Medical Biophysics, The University of Western Ontario, Schulich School of Medicine and Dentistry, 1151 Richmond Street North, Medical Sciences Building, London, Ontario, N6A 5C1, Canada
| | - Kathryn Y Manning
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, 1151 Richmond Street North, London, Ontario, N6A 5B7, Canada.,Department of Medical Biophysics, The University of Western Ontario, Schulich School of Medicine and Dentistry, 1151 Richmond Street North, Medical Sciences Building, London, Ontario, N6A 5C1, Canada
| | - Gregory A Dekaban
- Molecular Medicine Research Laboratories, Robarts Research Institute, The University of Western Ontario, 1151 Richmond Street North, London, Ontario, N6A 5B7, Canada.,Department of Microbiology and Immunology, The University of Western Ontario, Schulich School of Medicine and Dentistry, 1151 Richmond Street North, Dental Sciences Building, London, Ontario, N6A 3K7, Canada
| | - Lisa Fischer
- Department of Family Medicine and Fowler Kennedy Sport Medicine Clinic, The University of Western Ontario, 3M Centre, 1151 Richmond Street North, London, Ontario, N6A 3K7, Canada
| | - Tatiana Jevremovic
- Department of Family Medicine and Fowler Kennedy Sport Medicine Clinic, The University of Western Ontario, 3M Centre, 1151 Richmond Street North, London, Ontario, N6A 3K7, Canada
| | - Kevin Blackney
- Molecular Medicine Research Laboratories, Robarts Research Institute, The University of Western Ontario, 1151 Richmond Street North, London, Ontario, N6A 5B7, Canada.,Department of Microbiology and Immunology, The University of Western Ontario, Schulich School of Medicine and Dentistry, 1151 Richmond Street North, Dental Sciences Building, London, Ontario, N6A 3K7, Canada
| | - Christy Barreira
- Molecular Medicine Research Laboratories, Robarts Research Institute, The University of Western Ontario, 1151 Richmond Street North, London, Ontario, N6A 5B7, Canada
| | - Timothy J Doherty
- Department of Physical Medicine and Rehabilitation, The University of Western Ontario, Schulich School of Medicine and Dentistry, Parkwood Institute, 550 Wellington Road, Hobbins Building, London, Ontario, N6C 0A7, Canada
| | - Douglas D Fraser
- Paediatrics Critical Care Medicine, London Health Sciences Centre, Children's Hospital, 800 Commissioners Road East, London, Ontario, N6A 5W9, Canada
| | - Arthur Brown
- Molecular Medicine Research Laboratories, Robarts Research Institute, The University of Western Ontario, 1151 Richmond Street North, London, Ontario, N6A 5B7, Canada.,Department of Anatomy and Cell Biology, The University of Western Ontario, 1151 Richmond Street North, Medical Sciences Building, London, Ontario, N6A 3K7, Canada
| | - Jeff Holmes
- School of Occupational Therapy, The University of Western Ontario, 1201 Western Road, Elborn College, London, Ontario, N6A 1H1, Canada
| | - Ravi S Menon
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, 1151 Richmond Street North, London, Ontario, N6A 5B7, Canada.,Department of Medical Biophysics, The University of Western Ontario, Schulich School of Medicine and Dentistry, 1151 Richmond Street North, Medical Sciences Building, London, Ontario, N6A 5C1, Canada
| | - Robert Bartha
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, 1151 Richmond Street North, London, Ontario, N6A 5B7, Canada.,Department of Medical Biophysics, The University of Western Ontario, Schulich School of Medicine and Dentistry, 1151 Richmond Street North, Medical Sciences Building, London, Ontario, N6A 5C1, Canada
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Manning KY, Schranz A, Bartha R, Dekaban GA, Barreira C, Brown A, Fischer L, Asem K, Doherty TJ, Fraser DD, Holmes J, Menon RS. Multiparametric MRI changes persist beyond recovery in concussed adolescent hockey players. Neurology 2017; 89:2157-2166. [PMID: 29070666 PMCID: PMC5696642 DOI: 10.1212/wnl.0000000000004669] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/06/2017] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To determine whether multiparametric MRI data can provide insight into the acute and long-lasting neuronal sequelae after a concussion in adolescent athletes. METHODS Players were recruited from Bantam hockey leagues in which body checking is first introduced (male, age 11-14 years). Clinical measures, diffusion metrics, resting-state network and region-to-region functional connectivity patterns, and magnetic resonance spectroscopy absolute metabolite concentrations were analyzed from an independent, age-matched control group of hockey players (n = 26) and longitudinally in concussed athletes within 24 to 72 hours (n = 17) and 3 months (n = 14) after a diagnosed concussion. RESULTS There were diffusion abnormalities within multiple white matter tracts, functional hyperconnectivity, and decreases in choline 3 months after concussion. Tract-specific spatial statistics revealed a large region along the superior longitudinal fasciculus with the largest decreases in diffusivity measures, which significantly correlated with clinical deficits. This region also spatially intersected with probabilistic tracts connecting cortical regions where we found acute functional connectivity changes. Hyperconnectivity patterns at 3 months after concussion were present only in players with relatively less severe clinical outcomes, higher choline concentrations, and diffusivity indicative of relatively less axonal disruption. CONCLUSIONS Changes persisted well after players' clinical scores had returned to normal and they had been cleared to return to play. Ongoing white matter maturation may make adolescent athletes particularly vulnerable to brain injury, and they may require extended recovery periods. The consequences of early brain injury for ongoing brain development and risk of more serious conditions such as second impact syndrome or neural degenerative processes need to be elucidated.
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Affiliation(s)
- Kathryn Y Manning
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Amy Schranz
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Robert Bartha
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Gregory A Dekaban
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Christy Barreira
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Arthur Brown
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Lisa Fischer
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Kevin Asem
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Timothy J Doherty
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Douglas D Fraser
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Jeff Holmes
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada
| | - Ravi S Menon
- From the Department of Medical Biophysics (K.Y.M., A.S., R.B., R.S.M.), Department of Microbiology and Immunology (G.A.D., C.B.), Department of Anatomy and Cell Biology (A.B), Department of Physical Medicine and Rehabilitation (T.J.D.), and School of Occupational Therapy (J.H.), University of Western Ontario; Centre for Functional and Metabolic Mapping (K.Y.M., R.B., R.S.M.) and Molecular Medicine (G.A.D., C.B., A.B.), Robarts Research Institute; Primary Care Sport Medicine (L.F., K.A.), Family Medicine, Fowler Kennedy Sport Medicine; and Paediatrics Critical Care Medicine (D.D.F.), London Health Sciences Centre, London, Ontario, Canada.
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Gilmore KJ, Kirk EA, Doherty TJ, Rice CL. Effect of very old age on anconeus motor unit loss and compensatory remodelling. Muscle Nerve 2017; 57:659-663. [DOI: 10.1002/mus.25982] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 09/18/2017] [Accepted: 10/03/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Kevin J. Gilmore
- School of Kinesiology, Canadian Centre for Activity and Aging, Faculty of Health SciencesThe University of Western Ontario, 1490 Richmond Street London Ontario CanadaN6G 2M3
| | - Eric A. Kirk
- School of Kinesiology, Canadian Centre for Activity and Aging, Faculty of Health SciencesThe University of Western Ontario, 1490 Richmond Street London Ontario CanadaN6G 2M3
| | - Timothy J. Doherty
- Department of Clinical Neurological SciencesThe University of Western OntarioLondon Ontario Canada
- Department of Physical Medicine and RehabilitationThe University of Western OntarioLondon Ontario Canada
| | - Charles L. Rice
- School of Kinesiology, Canadian Centre for Activity and Aging, Faculty of Health SciencesThe University of Western Ontario, 1490 Richmond Street London Ontario CanadaN6G 2M3
- Department of Anatomy and Cell Biology, Schulich School of Medicine and DentistryThe University of Western OntarioLondon Ontario Canada
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Allen MD, Doherty TJ, Rice CL, Kimpinski K. Reply to Drs. Sacco et al. J Appl Physiol (1985) 2017. [PMID: 28637834 DOI: 10.1152/japplphysiol.00330.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Matti D Allen
- School of Medicine, Queen's University, Kingston, Ontario, Canada.,School of Kinesiology and Health Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.,School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Timothy J Doherty
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; and
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Kurt Kimpinski
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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18
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McKinnon NB, Connelly DM, Rice CL, Hunter SW, Doherty TJ. Neuromuscular contributions to the age-related reduction in muscle power: Mechanisms and potential role of high velocity power training. Ageing Res Rev 2017; 35:147-154. [PMID: 27697547 DOI: 10.1016/j.arr.2016.09.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/15/2016] [Accepted: 09/26/2016] [Indexed: 01/21/2023]
Abstract
Although much of the literature on neuromuscular changes with aging has focused on loss of muscle mass and isometric strength, deficits in muscle power are more pronounced with aging and may be a more sensitive measure of neuromuscular degeneration. This review aims to identify the adaptations to the neuromuscular system with aging, with specific emphasis on changes that result in decreased muscle power. We discuss how these changes in neuromuscular performance can affect mobility, and ultimately contribute to an increased risk for falls in older adults. Finally, we evaluate the literature regarding high-velocity muscle power training (PT), and its potential advantages over conventional strength training for improving functional performance and mitigating fall risk in older adults.
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Abstract
Invited Letter to the Editor. This article is a commentary on the recently published manuscript "Use it or lose it: tonic activity of slow motoneurons promotes their survival and preferentially increases slow fiber-type groupings in muscles of old lifelong recreational sportsmen". Mosole S, Carraro U, Kern H, Loefler S, Zampieri S. Use it or lose it: tonic activity of slow motoneurons promotes their survival and preferentially increases slow fiber-type groupings in muscles of old lifelong recreational sportsmen. Eur J Transl Myol 2016;26:5972. doi: 10.4081/ejtm.2016.5972. We offer some unique perspectives on masters athletes and the role of physical activity in maintaining the number and function of motor units into old age.
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Affiliation(s)
- Geoffrey A Power
- Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Brian H Dalton
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Kevin J Gilmore
- Canadian Centre for Activity and Aging, School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Matti D Allen
- Schools of Medicine and Kinesiology and Health Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Timothy J Doherty
- Departments of Physical Medicine and Rehabilitation and Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Charles L Rice
- Canadian Centre for Activity and Aging, School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada.,Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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Gilmore KJ, Allen MD, Doherty TJ, Kimpinski K, Rice CL. Electrophysiological and neuromuscular stability of persons with chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2017; 56:413-420. [DOI: 10.1002/mus.25516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/07/2016] [Accepted: 12/09/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Kevin J. Gilmore
- School of Kinesiology; The University of Western Ontario; London ON Canada
| | - Matti D. Allen
- School of Medicine Queen's University Kingston ON Canada
| | - Timothy J. Doherty
- Department of Clinical Neurological Sciences; Schulich School of Medicine and Dentistry, The University of Western Ontario; London ON Canada
- Department of Physical Medicine and Rehabilitation; Schulich School of Medicine and Dentistry, The University of Western Ontario; London ON Canada
| | - Kurt Kimpinski
- School of Kinesiology; The University of Western Ontario; London ON Canada
- Department of Clinical Neurological Sciences; Schulich School of Medicine and Dentistry, The University of Western Ontario; London ON Canada
| | - Charles L. Rice
- School of Kinesiology; The University of Western Ontario; London ON Canada
- Department of Anatomy and Cell Biology; Schulich School of Medicine and Dentistry, The University of Western Ontario; London ON Canada
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Affiliation(s)
- Kevin J Gilmore
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Tobias Morat
- German Sport University Cologne, Institute of Movement and Sport Gerontology, Cologne, Germany
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, The University of Western Ontario, London, Ontario, Canada.,Department of Physical Medicine and Rehabilitation, The University of Western Ontario, London, Ontario, Canada
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada.,Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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22
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Gilmore KJ, Morat T, Doherty TJ, Rice CL. Motor unit number estimation and neuromuscular fidelity in 3 stages of sarcopenia. Muscle Nerve 2017; 55:676-684. [DOI: 10.1002/mus.25394] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 08/23/2016] [Accepted: 08/29/2016] [Indexed: 01/01/2023]
Affiliation(s)
- Kevin J. Gilmore
- School of Kinesiology; Faculty of Health Sciences, The University of Western Ontario; London Ontario Canada
| | - Tobias Morat
- German Sport University Cologne, Institute of Movement and Sport Gerontology; Cologne Germany
| | - Timothy J. Doherty
- Department of Clinical Neurological Sciences; The University of Western Ontario; London Ontario Canada
- Department of Physical Medicine and Rehabilitation; The University of Western Ontario; London Ontario Canada
| | - Charles L. Rice
- School of Kinesiology; Faculty of Health Sciences, The University of Western Ontario; London Ontario Canada
- Department of Anatomy and Cell Biology; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario N6G 1H1 Canada
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23
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Macaluso S, Ross DC, Doherty TJ, Doherty CD, Miller TA. Spinal accessory nerve injury: A potentially missed cause of a painful, droopy shoulder. J Back Musculoskelet Rehabil 2016; 29:899-904. [PMID: 26966820 DOI: 10.3233/bmr-160674] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Spinal accessory nerve (SAN) injury can be an overlooked cause of scapular winging and shoulder dysfunction. The most common etiology is iatrogenic injury following surgical procedures at the posterior triangle of the neck. We present three cases of isolated injury to the SAN following trauma. OBJECTIVE To improve detection of SAN injuries through highlighting the clinical presentation, diagnosis and treatment via three cases in which the injuries were initially missed. METHODS Clinical case series and narrative review. RESULTS Three (3) patients were evaluated by history, physical exam and electrodiagnostic study (EMG). Clinical symptoms included, a painful, droopy shoulder and difficulties with overhead activities. Clinical signs included the observation of scapular winging, and focal atrophy of the trapezius and in some cases the sternocleidomastoid (SCM). Novel clinical signs such as the active elevation lag sign and triangle sign were also helpful clinically to highlight the SAN as the site of pathology. EMG revealed denervation and reduced motor unit recruitment in the trapezius and SCM. CONCLUSIONS Early detection of SAN injuries can be improved through appropriate clinical suspicion, a detailed history and careful physical exam. EMG testing can help guide prognosis, direct conservative and surgical treatment, and reduce patient morbidity.
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Affiliation(s)
- Steven Macaluso
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Douglas C Ross
- Department of Surgery, Division of Plastic Surgery, Roth-McFarlane Hand & Upper Limb Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Timothy J Doherty
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Christopher D Doherty
- Department of Surgery, Division of Plastic Surgery, Roth-McFarlane Hand & Upper Limb Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Thomas A Miller
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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24
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Allen MD, Doherty TJ, Rice CL, Kimpinski K. Reply to Senefeld and Hunter: Physiology in Medicine: Neuromuscular consequences of diabetic neuropathy. The authors' reply. J Appl Physiol (1985) 2016; 121:361. [PMID: 27451279 DOI: 10.1152/japplphysiol.00423.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Matti D Allen
- School of Medicine, Queen's University, Kingston, Ontario, Canada; School of Kinesiology and Health Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada;
| | - Timothy J Doherty
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; and
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada; Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Kurt Kimpinski
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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25
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Power GA, Allen MD, Gilmore KJ, Stashuk DW, Doherty TJ, Hepple RT, Taivassalo T, Rice CL. Motor unit number and transmission stability in octogenarian world class athletes: Can age-related deficits be outrun? J Appl Physiol (1985) 2016; 121:1013-1020. [PMID: 27013605 DOI: 10.1152/japplphysiol.00149.2016] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 03/18/2016] [Indexed: 11/22/2022] Open
Abstract
Our group has shown a greater number of functioning motor units (MU) in a cohort of highly active older (∼65 yr) masters runners relative to age-matched controls. Because of the precipitous loss in the number of functioning MUs in the eighth and ninth decades of life it is unknown whether older world class octogenarian masters athletes (MA) would also have greater numbers of functioning MUs compared with age-matched controls. We measured MU numbers and neuromuscular transmission stability in the tibialis anterior of world champion MAs (∼80 yr) and compared the values with healthy age-matched controls (∼80 yr). Decomposition-enhanced spike-triggered averaging was used to collect surface and intramuscular electromyography signals during dorsiflexion at ∼25% of maximum voluntary isometric contraction. Near fiber (NF) MU potential analysis was used to assess neuromuscular transmission stability. For the MAs compared with age-matched controls, the amount of excitable muscle mass (compound muscle action potential) was 14% greater (P < 0.05), there was a trend (P = 0.07) toward a 27% smaller surface-detected MU potential representative of less collateral reinnervation, and 28% more functioning MUs (P < 0.05). Additionally, the MAs had greater MU neuromuscular stability than the controls, as indicated by lower NF jitter and jiggle values (P < 0.05). These results demonstrate that high-performing octogenarians better maintain neuromuscular stability of the MU and mitigate the loss of MUs associated with aging well into the later decades of life during which time the loss of muscle mass and strength becomes functionally relevant. Future studies may identify the concomitant roles genetics and exercise play in neuroprotection.
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Affiliation(s)
- Geoffrey A Power
- Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph Ontario, Canada;
| | - Matti D Allen
- School of Medicine and School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Kevin J Gilmore
- Faculty of Health Sciences, School of Kinesiology, Canadian Centre for Activity and Aging, The University of Western Ontario, Ontario, Canada
| | - Daniel W Stashuk
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Timothy J Doherty
- Faculty of Health Sciences, School of Kinesiology, Canadian Centre for Activity and Aging, The University of Western Ontario, Ontario, Canada.,Department of Physical Medicine and Rehabilitation, The University of Western Ontario, London, Ontario, Canada
| | - Russell T Hepple
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada.,Meakins Christie Laboratories, McGill University, Montreal, Quebec, Canada; and
| | - Tanja Taivassalo
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Charles L Rice
- Faculty of Health Sciences, School of Kinesiology, Canadian Centre for Activity and Aging, The University of Western Ontario, Ontario, Canada.,Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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26
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Allen MD, Doherty TJ, Rice CL, Kimpinski K. Physiology in Medicine: neuromuscular consequences of diabetic neuropathy. J Appl Physiol (1985) 2016; 121:1-6. [PMID: 26989220 DOI: 10.1152/japplphysiol.00733.2015] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 03/17/2016] [Indexed: 02/07/2023] Open
Abstract
Diabetic polyneuropathy (DPN) refers to peripheral nerve dysfunction as a complication of diabetes mellitus. This condition is relatively common and is likely a result of vascular and/or metabolic disturbances related to diabetes. In the early or less severe stages of DPN it typically results in sensory impairments but can eventually lead to major dysfunction of the neuromuscular system. Some of these impairments may include muscle atrophy and weakness, slowing of muscle contraction, and loss of power and endurance. Combined with sensory deficits these changes in the motor system can contribute to decreased functional capacity, impaired mobility, altered gait, and increased fall risk. There is no pharmacological disease-modifying therapy available for DPN and the mainstay of treatment is linked to treating the diabetes itself and revolves around strict glycemic control. Exercise therapy (including aerobic, strength, or balance training-based exercise) appears to be a promising preventative and treatment strategy for patients with DPN and those at risk. The goal of this Physiology in Medicine article is to highlight important and overlooked dysfunction of the neuromuscular system as a result of DPN with an emphasis on the physiologic basis for that dysfunction. Additionally, we sought to provide information that clinicians can use when following patients with diabetes or DPN including support for the inclusion of exercise-based therapy as an effective, accessible, and inexpensive form of treatment.
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Affiliation(s)
- Matti D Allen
- School of Medicine, Queen's University, Kingston, Ontario, Canada; School of Kinesiology and Health Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada;
| | - Timothy J Doherty
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; and
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada; Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Kurt Kimpinski
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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27
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Montero-Odasso MM, Barnes B, Speechley M, Muir Hunter SW, Doherty TJ, Duque G, Gopaul K, Sposato LA, Casas-Herrero A, Borrie MJ, Camicioli R, Wells JL. Disentangling Cognitive-Frailty: Results From the Gait and Brain Study. J Gerontol A Biol Sci Med Sci 2016; 71:1476-1482. [PMID: 26984391 DOI: 10.1093/gerona/glw044] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 02/20/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive-frailty, defined as the presence of both frailty and cognitive impairment, is proposed as a distinctive entity that predicts dementia. However, it remains controversial whether frailty alone, cognitive-frailty, or the combination of cognitive impairment and slow gait pose different risks of incident dementia. METHODS Two hundred and fifty-two older adults free of dementia at baseline (mean age 76.6±8.6 years) were followed up to 5 years with bi-annual visits including medical, cognitive, and gait assessments. Incident all-cause of dementia and cognitive decline were the main outcomes. Frailty was defined using validated phenotypic criteria. Cognition was assessed using the Montreal Cognitive Assessment while gait was assessed using an electronic walkway. Cox Proportional Hazards models were used to estimate the risk of cognitive decline and dementia for frailty, cognitive-frailty, and gait and cognition models. RESULTS Fifty-three participants experienced cognitive decline and 27 progressed to dementia (incident rate: 73/1,000 person-years). Frailty participants had a higher prevalence of cognitive impairment compared with those without frailty (77% vs. 54%, p = .02) but not significant risk to incident dementia. Cognitive-frailty increased incident rate (80/1,000 person-years) but not risk for progression to dementia. The combination of slow gait and cognitive impairment posed the highest risk for progression to dementia (hazard ratio: 35.9, 95% confidence interval: 4.0-319.2; p = 0.001, incident rate: 130/1,000 person-years). None of the models explored significantly predicted cognitive decline. CONCLUSIONS Combining a simple motor test, such as gait velocity, with a reliable cognitive test like the Montreal Cognitive Assessment is superior than the cognitive-frailty construct to detect individuals at risk for dementia. Cognitive-frailty may embody two different manifestations, slow gait and low cognition, of a common underlying mechanism.
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Affiliation(s)
- Manuel M Montero-Odasso
- Gait and Brain Lab, Parkwood Institute and Lawson Health Research Institute, London, Canada. .,Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada.,Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
| | - Brittany Barnes
- Gait and Brain Lab, Parkwood Institute and Lawson Health Research Institute, London, Canada
| | - Mark Speechley
- Gait and Brain Lab, Parkwood Institute and Lawson Health Research Institute, London, Canada.,Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada.,Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
| | - Susan W Muir Hunter
- Gait and Brain Lab, Parkwood Institute and Lawson Health Research Institute, London, Canada.,Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Timothy J Doherty
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Sciences, University of Melbourne, Melbourne, Australia
| | - Karen Gopaul
- Gait and Brain Lab, Parkwood Institute and Lawson Health Research Institute, London, Canada
| | - Luciano A Sposato
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada
| | - Alvaro Casas-Herrero
- Division of Geriatric Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Michael J Borrie
- Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Jennie L Wells
- Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
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28
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Moore CW, Allen MD, Kimpinski K, Doherty TJ, Rice CL. Reduced skeletal muscle quantity and quality in patients with diabetic polyneuropathy assessed by magnetic resonance imaging. Muscle Nerve 2016. [DOI: 10.1002/mus.24779] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Colin W. Moore
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario; London Ontario N6G 1H1 Canada
| | - Matti D. Allen
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario; London Ontario N6G 1H1 Canada
- School of Medicine, Queen's University; Kingston Ontario Canada
| | - Kurt Kimpinski
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario; London Ontario N6G 1H1 Canada
- Department of Clinical Neurological Sciences; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
| | - Timothy J. Doherty
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario; London Ontario N6G 1H1 Canada
- Department of Clinical Neurological Sciences; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
- Department of Physical Medicine and Rehabilitation; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
| | - Charles L. Rice
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario; London Ontario N6G 1H1 Canada
- Department of Anatomy and Cell Biology; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
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29
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McKinnon NB, Montero-Odasso M, Doherty TJ. Motor unit loss is accompanied by decreased peak muscle power in the lower limb of older adults. Exp Gerontol 2015; 70:111-8. [PMID: 26190479 DOI: 10.1016/j.exger.2015.07.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 12/14/2022]
Abstract
This study investigated the relationship between motor unit (MU) properties and the isometric strength and power of two lower limb muscles in healthy young and older adults. Twelve older adults (6 men, mean age, 77 ± 5 years) and twelve young adults (6 men, mean age, 24 ± 3 years) were studied. MU properties of the tibialis anterior (TA) and vastus medialis (VM) muscles were determined electrophysiologically using decomposition-enhanced spike-triggered averaging (DE-STA). Motor unit number estimates (MUNEs) of the TA were significantly reduced (p<0.05) in older adults (102 ± 76) compared to young adults (234 ± 109), primarily as a result of significantly larger surface-detected motor unit potentials (S-MUPs) in older adults (63 ± 29 μV) compared to young adults (27 ± 14 μV). Although VM S-MUP values were larger in older adults (60 ± 31 μV) compared to young (48 ± 42 μV), the difference was not significant. Maximal isometric strength was significantly larger in both the TA and knee extensors of young adults (TA: 0.56 Nm/kg, KE: 2.2 Nm/kg) compared to old (TA: 0.4 Nm/kg, KE: 1.3 Nm/kg). Similar reductions in peak muscle power were observed between young (TA: 33 W, KE: 35 7 W) and old adults (TA: 26 W, KE: 224 W). The greatest deficit between young and old subjects in peak power output occurred at 20% MVC for the TA and 40% MVC for the knee extensors. Results from this study indicate that there are changes in MU properties with age, and that this effect may be greater in the more distal TA muscle. Further, this study demonstrates that muscle power may be a sensitive marker of changes in neuromuscular function with aging.
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Affiliation(s)
- Neal B McKinnon
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Hospital, Lawson Health Research Institute, Canada; Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Timothy J Doherty
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
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30
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Power GA, Dalton BH, Doherty TJ, Rice CL. If you don't use it you'll likely lose it. Clin Physiol Funct Imaging 2015; 36:497-498. [PMID: 25944085 DOI: 10.1111/cpf.12248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 02/23/2015] [Indexed: 11/27/2022]
Abstract
This article is a commentary on the recently published manuscript by Drey et al. (2014). The age-related loss of motor units (MU) is an immutable process and understanding the possible role of physical activity in maintaining functional MUs is an important topic. Dysfunctional remodelling of a MU is associated with denervation of the muscle and ultimate death of the spinal motoneurone. Conversely, in cross-sectional studies, high levels of physical activity in humans report a maintenance in the number of functional MUs in older master runners. However, it seems that only those MUs directly associated with the elevated long-term physical activity appear to benefit from any exercise-induced neuroprotective effect.
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Affiliation(s)
- Geoffrey A Power
- Human Performance Laboratory, University of Calgary, Calgary, AB, Canada.
| | - Brian H Dalton
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | - Timothy J Doherty
- Departments of Physical Medicine and Rehabilitation and Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Charles L Rice
- Faculty of Health Sciences, Canadian Centre for Activity and Aging, School of Kinesiology, The University of Western Ontario, London, ON, Canada.,Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
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31
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Moore CW, Allen MD, Kimpinsky K, Doherty TJ, Rice CL. Intermuscular Differences in Leg Muscle Protein Quality in Human Diabetic Neuropathy. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478801.67913.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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32
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Cameron S, Ball I, Cepinskas G, Choong K, Doherty TJ, Ellis CG, Martin CM, Mele TS, Sharpe M, Shoemaker JK, Fraser DD. Early mobilization in the critical care unit: A review of adult and pediatric literature. J Crit Care 2015; 30:664-72. [PMID: 25987293 DOI: 10.1016/j.jcrc.2015.03.032] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/19/2015] [Accepted: 03/28/2015] [Indexed: 11/19/2022]
Abstract
Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes. Pediatric ICU data are limited, but recent studies also suggest that early mobilization is achievable without increasing patient risk. In this review, we provide a current and comprehensive appraisal of ICU mobilization techniques in both adult and pediatric critically ill patients. Contraindications and perceived barriers to early mobilization, including cost and health care provider views, are identified. Methods of overcoming barriers to early mobilization and enhancing sustainability of mobilization programs are discussed. Optimization of patient outcomes will require further studies on mobilization timing and intensity, particularly within specific ICU populations.
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Affiliation(s)
- Saoirse Cameron
- Functional Recovery in Critically Ill Children: The "Wee-Cover" Longitudinal Cohort Study; Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study
| | - Ian Ball
- Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Medicine, Western University, London, ON, Canada
| | - Gediminas Cepinskas
- Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Medical Biophysics, Western University, London, ON, Canada
| | - Karen Choong
- Functional Recovery in Critically Ill Children: The "Wee-Cover" Longitudinal Cohort Study; Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Timothy J Doherty
- Functional Recovery in Critically Ill Children: The "Wee-Cover" Longitudinal Cohort Study; Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Physical Medicine and Rehabilitation, Western University, London, ON, Canada
| | - Christopher G Ellis
- Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Medicine, Western University, London, ON, Canada; Medical Biophysics, Western University, London, ON, Canada
| | - Claudio M Martin
- Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Medicine, Western University, London, ON, Canada
| | - Tina S Mele
- Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Surgery, Western University, London, ON, Canada
| | - Michael Sharpe
- Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Anesthesia and Perioperative Medicine, Western University, London, ON, Canada
| | - J Kevin Shoemaker
- Functional Recovery in Critically Ill Children: The "Wee-Cover" Longitudinal Cohort Study; Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Kinesiology, Western University, London, ON, Canada
| | - Douglas D Fraser
- Functional Recovery in Critically Ill Children: The "Wee-Cover" Longitudinal Cohort Study; Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Pediatrics, Western University, London, ON, Canada.
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33
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Hourigan ML, McKinnon NB, Johnson M, Rice CL, Stashuk DW, Doherty TJ. Increased motor unit potential shape variability across consecutive motor unit discharges in the tibialis anterior and vastus medialis muscles of healthy older subjects. Clin Neurophysiol 2015; 126:2381-9. [PMID: 25727901 DOI: 10.1016/j.clinph.2015.02.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 01/31/2015] [Accepted: 02/02/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To study the potential utility of using near fiber (NF) jiggle as an assessment of neuromuscular transmission stability in healthy older subjects using decomposition-based quantitative electromyography (DQEMG). METHODS The tibialis anterior (TA) and vastus medialis (VM) muscles were tested in 9 older men (77 ± 5 years) and 9 young male control subjects (23 ± 0.3 years). Simultaneous surface and needle-detected electromyographic (EMG) signals were collected during voluntary contractions, and then analyzed using DQEMG. Motor unit potential (MUP) and NF MUP parameters were analyzed. RESULTS NF jiggle was significantly increased for both the TA and VM in the old age group relative to the younger controls (P<0.05). NF jiggle was significantly higher in the TA compared to VM (P<0.05). For TA, NF jiggle was negatively correlated with MUNE, and positively correlated with S-MUP amplitude, NF count, MUP duration, MUP peak-to-peak voltage, and MUP area (P<0.05). For VM, NF jiggle was positively correlated with NF count and MUP area (P<0.05), and no significant correlations were found between NF jiggle and S-MUP amplitude, MUP duration, or MUP peak-to-peak voltage (MUNE was not calculated for VM, so no correlation could be made). CONCLUSIONS Healthy aging is associated with neuromuscular transmission instability (increased NF jiggle) and MU remodeling, which can be measured using DQEMG. SIGNIFICANCE NF jiggle derived from DQEMG can be a useful method of identifying neuromuscular dysfunction at various stages of MU remodeling and aging.
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Affiliation(s)
- Maddison L Hourigan
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Neal B McKinnon
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Marjorie Johnson
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Charles L Rice
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Daniel W Stashuk
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Timothy J Doherty
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
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Allen MD, Kimpinski K, Doherty TJ, Rice CL. Decreased muscle endurance associated with diabetic neuropathy may be attributed partially to neuromuscular transmission failure. J Appl Physiol (1985) 2015; 118:1014-22. [PMID: 25663671 DOI: 10.1152/japplphysiol.00441.2014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 02/03/2015] [Indexed: 01/25/2023] Open
Abstract
Diabetic polyneuropathy (DPN) can cause muscle atrophy, weakness, contractile slowing, and neuromuscular transmission instability. Our objective was to assess the response of the impaired neuromuscular system of DPN in humans when stressed with a sustained maximal voluntary contraction (MVC). Baseline MVC and evoked dorsiflexor contractile properties were assessed in DPN patients (n = 10) and controls (n = 10). Surface electromyography was used to record tibialis anterior evoked maximal compound muscle action potentials (CMAPs) and neuromuscular activity during MVCs. Participants performed a sustained isometric dorsiflexion MVC for which task termination was determined by the inability to sustain ≥60% MVC torque. The fatigue protocol was immediately followed by a maximal twitch, with additional maximal twitches and MVCs assessed at 30 s and 2 min postfatigue. DPN patients fatigued ∼21% more quickly than controls (P < 0.05) and featured less relative electromyographic activity during the first one-third of the fatigue protocol compared with controls (P < 0.05). Immediately following fatigue, maximal twitch torque was reduced similarly (∼20%) in both groups, and concurrently CMAPs were reduced (∼12%) in DPN patients, whereas they were unaffected in controls (P > 0.05). Twitch torque and CMAP amplitude recovered to baseline 30 s postfatigue. Additionally, at 30 s postfatigue, both groups had similar (∼10%) reductions in MVC torque relative to baseline, and MVC strength recovered by 2 min postfatigue. We conclude DPN patients possess less endurance than controls, and neuromuscular transmission failure may contribute to this greater fatigability.
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Affiliation(s)
- Matti D Allen
- School of Medicine, Queen's University, Kingston, Ontario, Canada; School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada; School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada;
| | - Kurt Kimpinski
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Timothy J Doherty
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada; and
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada; Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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Gooch CL, Doherty TJ, Ming Chan K, Bromberg MB, Lewis RA, Stashuk DW, Berger MJ, Andary MT, Daube JR. Reply to reflection on MUNE. Muscle Nerve 2015; 51:624. [PMID: 25620429 DOI: 10.1002/mus.24585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 01/20/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Clifton L Gooch
- Department of Neurology, University of South Florida, Tampa, Florida, U.S.A
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Ives CT, Findlater K, Shoesmith CL, Doherty TJ. Preliminary evaluation of the sensitivity to change of DE-STA motor unit number estimation in the upper trapezius muscle in amyotrophic lateral sclerosis. Clin Neurophysiol 2014; 126:1427-34. [PMID: 25453610 DOI: 10.1016/j.clinph.2014.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 09/13/2014] [Accepted: 10/06/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the sensitivity to change of decomposition-enhanced spike-triggered averaging (DE-STA) motor unit number estimation (MUNE) in the upper trapezius (UT) to that of various clinical outcome measures in subjects with amyotrophic lateral sclerosis (ALS). METHODS Ten patients with clinically probable or definite ALS were assessed at baseline, 2, 4 and 6months with the following outcome measures: manual muscle testing in five upper extremity muscle groups, scapular elevation and elbow flexion peak force measured with hand-held dynamometry, MUNE, forced vital capacity and the Revised ALS Functional Rating Scale (ALSFRS-R). RESULTS ALSFRS-R was the only outcome measure for which there was a significant difference between baseline and 6months (p=0.034). ALSFRS-R had the largest standardized response mean (SRM), and was thus the most sensitive to change. MUNE demonstrated a decline over 6months and a moderate SRM (-0.63). CONCLUSIONS This study has demonstrated a moderate degree of sensitivity to change for DE-STA MUNE as applied to the UT in subjects with ALS. SIGNIFICANCE In this preliminary study, DE-STA MUNE detected motor unit loss over 6months, with a moderate degree of sensitivity, in the upper trapezius of subjects with ALS.
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Affiliation(s)
- Colleen T Ives
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Karen Findlater
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Christen L Shoesmith
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Western University, London, Ontario, Canada.
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Gooch CL, Doherty TJ, Chan KM, Bromberg MB, Lewis RA, Stashuk DW, Berger MJ, Andary MT, Daube JR. Motor unit number estimation: A technology and literature review. Muscle Nerve 2014; 50:884-93. [PMID: 25186553 DOI: 10.1002/mus.24442] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Clifton L. Gooch
- Department of Neurology; University of South Florida; Tampa Florida USA
| | - Timothy J. Doherty
- Department of Physical Medicine and Rehabilitation; University of Western Ontario; London Ontario Canada
- Department of Clinical Neurological Sciences; University of Western Ontario; London Ontario Canada
- Schulich School of Medicine and Dentistry; University of Western Ontario; London Ontario Canada
| | - K. Ming Chan
- Division of Physical Medicine and Rehabilitation/Centre for Neuroscience; University of Alberta; Edmonton Alberta Canada
| | - Mark B. Bromberg
- Department of Neurology; University of Utah; Salt Lake City Utah USA
| | - Richard A. Lewis
- Department of Neurology; Cedars-Sinai; Los Angeles California USA
| | - Dan W. Stashuk
- Systems Design Engineering; University of Waterloo; Waterloo Ontario Canada
| | - Michael J. Berger
- School of Kinesiology; University of Western Ontario; London Ontario Canada
- Schulich School of Medicine and Dentistry; University of Western Ontario; London Ontario Canada
| | - Michael T. Andary
- College of Osteopathic Medicine; Michigan State University; East Lansing Michigan USA
| | - Jasper R. Daube
- Department of Neurology; Mayo Clinic; Rochester Minnesota USA
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Ives CT, Doherty TJ. Influence of needle electrode depth on DE-STA motor unit number estimation. Muscle Nerve 2014; 50:587-92. [PMID: 24639081 DOI: 10.1002/mus.24208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 01/21/2014] [Accepted: 02/10/2014] [Indexed: 12/14/2022]
Abstract
INTRODUCTION To assess a potential source of technique-associated error, we evaluated the influence of needle electrode depth on decomposition-enhanced spike-triggered averaging (DE-STA) motor unit number estimation (MUNE) and quantitative motor unit analysis in the upper trapezius (UT). METHODS The DE-STA MUNE protocol was performed at superficial, intermediate, and deep needle electrode depths in 18 control subjects. RESULTS Mean surface-detected motor unit potential amplitudes were significantly smaller for intermediate versus superficial (P<0.05), deep versus superficial (P<0.001), and deep versus intermediate (P<0.05). MUNE was significantly larger for deep versus superficial (P<0.001), with statistical trends toward larger MUNE values at greater depths for the remaining comparisons. No significant differences were found among needle electrode depths for quantitative motor unit potential parameters. CONCLUSIONS These results demonstrate the important influence of needle electrode depth on DE-STA MUNE in the UT. Suggestions are made for improved standardization of the protocol.
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Affiliation(s)
- Colleen T Ives
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
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Allen MD, Stashuk DW, Kimpinski K, Doherty TJ, Hourigan ML, Rice CL. Increased neuromuscular transmission instability and motor unit remodelling with diabetic neuropathy as assessed using novel near fibre motor unit potential parameters. Clin Neurophysiol 2014; 126:794-802. [PMID: 25240249 DOI: 10.1016/j.clinph.2014.07.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/19/2014] [Accepted: 07/08/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess the degree of neuromuscular transmission variability and motor unit (MU) remodelling in patients with diabetic polyneuropathy (DPN) using decomposition-based quantitative electromyography (DQEMG) and near fibre (NF) motor unit potential (MUP) parameters. METHODS The tibialis anterior (TA) muscle was tested in 12 patients with DPN (65 ± 15 years) and 12 controls (63 ± 15 years). DQEMG was used to analyze electromyographic (EMG) signals collected during voluntary contractions. MUP and NF MUP parameters were analyzed. NF MUPs were obtained by high-pass filtering MUP template waveforms, which isolates contributions of fibres that are close to the needle detection surface. NF MUP parameters provided assessment of motor unit size (NF area), fibre density (NF fibre count) and contribution dispersion (NF dispersion) and neuromuscular transmission instability (NF jiggle). RESULTS DPN patients had larger (+45% NF area), more complex (+30% NF fibre count), and less stable (+30% NF jiggle) NF MUPs (p<0.05). No significant relationships were found between NF MUP stability and denervation, or strength; however NF MUP complexity was positively related to TA denervation in the DPN group (r=0.63; p<0.05). NF MUP complexity and instability were positively related in DPN patients (r=0.46; p<0.05). CONCLUSIONS DPN is associated with neuromuscular transmission instability and MU remodelling that can be assessed using DQEMG. SIGNIFICANCE DQEMG-derived NF MUP parameters may be useful in identifying patients in early stages of neuromuscular dysfunction related to DPN.
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Affiliation(s)
- Matti D Allen
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.
| | | | - Kurt Kimpinski
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Timothy J Doherty
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Maddison L Hourigan
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada; Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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Stevens DES, Harwood B, Power GA, Doherty TJ, Rice CL. Anconeus motor unit number estimates using decomposition-based quantitative electromyography. Muscle Nerve 2014; 50:52-9. [PMID: 24123180 DOI: 10.1002/mus.24092] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 10/02/2013] [Accepted: 10/04/2013] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Motor unit number estimates (MUNEs) provide important information in health, aging, and disease, and can be determined using decomposition-enhanced spike-triggered averaging (DE-STA). Discrimination of surface-detected motor unit potentials (S-MUPs) has been limited to contractile forces of ∽30% maximum voluntary contraction (MVC), which is insufficient to recruit a representative sample of the entire MU pool in most muscles. Unique features of the anconeus may permit MUNEs at high muscle activation levels. METHODS In 10 men (25 ± 3 years), anconeus MUNEs were performed using DE-STA at 10%, 30%, and 50% root-mean-square of MVC (RMS(MVC)). RESULTS The mean compound muscle action potential of the anconeus was ∽6 mV, and average S-MUP amplitudes were ∽100 μV, 145 μV, and 235 μV at 10%, 30%, and 50% RMS(MVC), resulting in low average MUNEs of 58, 38, and 25, respectively. CONCLUSIONS Elbow extensor force-EMG relationships suggest full recruitment of the anconeus MU pool at 50% RMS(MVC), thus providing a representative sample for MUNE.
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Affiliation(s)
- Daniel E S Stevens
- Canadian Centre for Activity and Aging, School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
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Allen MD, Major B, Kimpinski K, Doherty TJ, Rice CL. Skeletal muscle morphology and contractile function in relation to muscle denervation in diabetic neuropathy. J Appl Physiol (1985) 2013; 116:545-52. [PMID: 24356519 DOI: 10.1152/japplphysiol.01139.2013] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The objective of the study was to assess the effects of diabetic polyneuropathy (DPN) on muscle contractile properties in humans, and how these changes are related to alterations in muscle morphology and denervation. Patients with DPN (n = 12) were compared with age- and sex-matched controls (n = 12). Evoked and voluntary contractile properties, including stimulated twitch responses and maximal voluntary contractions, of the dorsiflexor muscles were assessed using an isometric ankle dynamometer. Motor unit number estimates (MUNE) of the tibialis anterior (TA) were performed via quantitative electromyography and decomposition-enhanced spike-triggered averaging. Peak tibialis anterior (TA) cross-sectional area (CSA; cm(2)), and relative proportion of contractile to noncontractile tissue (%) was determined from magnetic resonance images. Patients with DPN demonstrated decreased strength (-35%) and slower (-45%) dorsiflexion contractile properties for both evoked and voluntary contractions (P < 0.05). These findings were not accounted for by differences in voluntary activation (P > 0.05) or antagonist coactivation (P > 0.05). Additionally, patients with DPN were weaker when strength was normalized to TA total CSA (-30%; P < 0.05) or contractile tissue CSA (-26%; P < 0.05). In the DPN patient group, TA MUNEs were negatively related to both % noncontractile tissue (P < 0.05; r = 0.72) and twitch half-relaxation time (P < 0.05; r = 0.60), whereas no relationships were found between these variables in controls (P > 0.05). We conclude that patients with DPN demonstrated reduced strength and muscle quality as well as contractile slowing. This process may contribute to muscle power loss and functional impairments reported in patients with DPN, beyond the loss of strength commonly observed.
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Affiliation(s)
- Matti D Allen
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
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Ives CT, Doherty TJ. Intra-rater reliability of motor unit number estimation and quantitative motor unit analysis in subjects with amyotrophic lateral sclerosis. Clin Neurophysiol 2013; 125:170-8. [PMID: 23867065 DOI: 10.1016/j.clinph.2013.04.345] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Revised: 04/26/2013] [Accepted: 04/27/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess the intra-rater reliability of decomposition-enhanced spike-triggered averaging (DE-STA) motor unit number estimation (MUNE) and quantitative motor unit potential analysis in the upper trapezius (UT) and biceps brachii (BB) of subjects with amyotrophic lateral sclerosis (ALS) and to compare the results from the UT to control data. METHODS Patients diagnosed with clinically probable or definite ALS completed the experimental protocol twice with the same evaluator for the UT (n=10) and BB (n=9). RESULTS Intra-rater reliability for the UT was good for the maximum compound muscle action potential (CMAP) (ICC=0.88), mean surface-detected motor unit potential (S-MUP) (ICC=0.87) and MUNE (ICC=0.88), and for the BB was moderate for maximum CMAP (ICC=0.61), and excellent for mean S-MUP (ICC=0.94) and MUNE (ICC=0.93). A significant difference between tests was found for UT MUNE. Comparing subjects with ALS to control subjects, UT maximum CMAP (p<0.01) and MUNE (p<0.001) values were significantly lower, and mean S-MUP values significantly greater (p<0.05) in subjects with ALS. CONCLUSIONS This study has demonstrated the ability of the DE-STA MUNE technique to collect highly reliable data from two separate muscle groups and to detect the underlying pathophysiology of the disease. SIGNIFICANCE This was the first study to examine the reliability of this technique in subjects with ALS, and demonstrates its potential for future use as an outcome measure in ALS clinical trials and studies of ALS disease severity and natural history.
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Affiliation(s)
- Colleen T Ives
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Western University, London, Ontario, Canada.
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Allen MD, Choi IH, Kimpinski K, Doherty TJ, Rice CL. Motor unit loss and weakness in association with diabetic neuropathy in humans. Muscle Nerve 2013; 48:298-300. [DOI: 10.1002/mus.23792] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2013] [Indexed: 01/15/2023]
Affiliation(s)
- Matti D. Allen
- School of Kinesiology, Faculty of Health Sciences; The University of Western Ontario; London Ontario Canada N6G 1H1
| | - In Ho Choi
- School of Kinesiology, Faculty of Health Sciences; The University of Western Ontario; London Ontario Canada N6G 1H1
| | - Kurt Kimpinski
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry; The University of Western Ontario; London Ontario Canada
| | - Timothy J. Doherty
- School of Kinesiology, Faculty of Health Sciences; The University of Western Ontario; London Ontario Canada N6G 1H1
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry; The University of Western Ontario; London Ontario Canada
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry; The University of Western Ontario; London Ontario Canada
| | - Charles L. Rice
- School of Kinesiology, Faculty of Health Sciences; The University of Western Ontario; London Ontario Canada N6G 1H1
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry; The University of Western Ontario; London Ontario Canada
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Affiliation(s)
| | - Geoff A Power
- School of KinesiologyUniversity of Western OntarioLondonONCanada
| | - Maire Eve Filion
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
| | | | - Charles L Rice
- School of KinesiologyUniversity of Western OntarioLondonONCanada
| | - Tanja Taivassalo
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
- Neuromuscular Research GroupMontreal Neurological InstituteMcGill UniversityMontrealQCCanada
| | - Russell T Hepple
- Neuromuscular Research GroupMontreal Neurological InstituteMcGill UniversityMontrealQCCanada
- McGill University Health CenterMcGill UniversityMontrealQCCanada
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Power GA, Dalton BH, Behm DG, Doherty TJ, Vandervoort AA, Rice CL. Motor unit survival in lifelong runners is muscle dependent. Med Sci Sports Exerc 2012; 44:1235-42. [PMID: 22246219 DOI: 10.1249/mss.0b013e318249953c] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
UNLABELLED A contributing factor to the loss of muscle mass and strength with adult aging is the reduction in the number of functioning motor units (MUs). Recently, we reported that lifelong competitive runners (master runners = ~66 yr) had greater numbers of MUs in a leg muscle (tibialis anterior) than age-matched recreationally active controls. This suggested that long-term exposure to high levels of physical activity may limit the loss of MU numbers with adult aging. However, it is unknown if this finding is the result of long-term activation of the specifically exercised motoneuron pool (i.e., tibialis anterior) or an overall systemic neuroprotective effect of high levels of physical activity. PURPOSE The purpose was to estimate the number of functioning MUs (MUNEs) in the biceps brachii (an upper body muscle not directly loaded by running) of nine young (27 ± 5 yr) and nine old (70 ± 5 yr) men and nine lifelong competitive master runners (67 ± 4 yr). METHODS Decomposition-enhanced spike-triggered averaging was used to measure surface and intramuscular EMG signals during elbow flexion at 10% of maximum voluntary isometric contraction. RESULTS Derived MUNEs were lower in the biceps brachii of runners (185 ± 69 MUs) and old men (133 ± 69 MUs) than the young (354 ± 113 MUs), but the old and master runners were similar. CONCLUSIONS Although there were no significant differences in MUNE between both older groups in the biceps brachii muscle, with the number of subjects tested here, we cannot eliminate the possibility of some whole-body neuroprotective effect. However, when compared with the remote biceps muscle, a greater influence on age-related spinal motoneuron survival was found in a chronically activated MN pool specific to the exercised muscle.
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Affiliation(s)
- Geoffrey A Power
- Canadian Centre for Activity and Aging, School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
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Abstract
The purposes of this study were to determine 1) whether sex differences in quadriceps torque and isotonic power persist when controlling for muscle volume (i. e., torque/muscle volume and power/muscle volume) in participants with knee osteoarthritis (OA) and 2) the factors responsible for potential sex differences. Isometric torque, isotonic power (the product of torque and velocity, measured at 10, 20, 30, 40 and 50% maximal voluntary contraction; MVC) and maximal unloaded velocity were assessed in men (n=16, mean age=62.1 ± 7.2) and women (n=17, mean age=60.4 ± 4.3) with knee OA. Torque and power were normalized to muscle volume. The interpolated twitch technique was used to measure voluntary activation (VA) and evoked twitch and torque-frequency characteristics were measured to obtain information about muscle fibre distribution. Torque and power at all loads were significantly lower in women (p<0.05). Sex differences in power were reduced by 50% when controlling for muscle volume but were still significant at 10-40% MVC (p<0.05). No differences in VA, torque-frequency properties or time-to-peak tension of the evoked twitch were observed (p>0.05). These results suggest that only minor sex differences in torque and power persist when controlling for muscle volume. As VA and contractile property differences were not observed, other factors seem to be responsible.
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Affiliation(s)
- M J Berger
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada.
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Berger MJ, Kean CO, Goela A, Doherty TJ. Disease severity and knee extensor force in knee osteoarthritis: data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2012; 64:729-34. [PMID: 22238225 DOI: 10.1002/acr.21608] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine whether the method of disease severity measurement influences the magnitude of knee extensor force deficits in knee osteoarthritis (OA). METHODS Data from the Osteoarthritis Initiative (n = 659) were analyzed. Knee extensor force was assessed with isometric contractions. Clinical severity was measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patients were stratified into tertiles of severity (i.e., moderate, mild, and severe OA) based on the lowest, middle, and highest WOMAC scores, respectively. Kellgren/Lawrence (K/L) grading was used to assess radiographic severity of the tibiofemoral compartment and patients were again stratified into mild (K/L grade <2), moderate (K/L grade 2), and severe (K/L grade >2) knee OA. RESULTS When stratifying with the WOMAC, force was significantly lower in the severe group compared to the mild (~18% lower; P < 0.001) and moderate groups (~9% lower; P = 0.03), and in the moderate group compared to the mild group (∼10% lower; P = 0.03). When stratifying with K/L grade, small nonsignificant differences were observed in the severe (~7% lower; P = 0.19) and moderate groups (~8% lower; P = 0.08) compared to the mild group. Large intragroup variability was observed when comparing WOMAC scores across radiographic severity (coefficients of variation were 79.3%, 74.6%, and 61.6% for K/L grade <2, K/L grade 2, and K/L grade >2, respectively). CONCLUSION The method of disease severity stratification influences the magnitude of knee extensor force deficits because no difference in force between disease subgroups was observed when stratifying with K/L grade. Furthermore, there was large variability in the WOMAC score within each radiographic subgroup, highlighting the limitations in using radiographic measures to reflect symptom severity.
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Affiliation(s)
- Michael J Berger
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
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Berger MJ, McKenzie CA, Chess DG, Goela A, Doherty TJ. Quadriceps neuromuscular function and self-reported functional ability in knee osteoarthritis. J Appl Physiol (1985) 2012; 113:255-62. [PMID: 22604883 DOI: 10.1152/japplphysiol.00947.2011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purposes of this study were to determine 1) the relationships of self-reported function scores in patients with knee osteoarthritis (OA) to both maximal isometric torque and to isotonic power at a variety of loads, and 2) the degree to which muscle volume (MV) or voluntary activation (VA) are associated with torque and power measures in this population. Isometric maximal voluntary contraction (MVC) torque and isotonic power [performed at loads corresponding to 10, 20, 30, 40, and 50% MVC, and a minimal load ("Zero Load")] were measured in 40 participants with knee OA. Functional ability was measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC) function subscale. MV was determined with magnetic resonance imaging, and VA was measured with the interpolated twitch technique. In general, power measured at lower loads (Zero Load and 10-30% MVC, r(2) = 0.21-0.28, P < 0.05) predicted a greater proportion of the variance in function than MVC torque (r(2) = 0.18, P < 0.05), with power measured at Zero Load showing the strongest association (r(2) = 0. 28, P < 0.05). MV was the strongest predictor of MVC torque and power measures in multiple regression models (r(2) = 0.42-0.72). VA explained only 6% of the variance in MVC torque and was not significantly associated with power at any load (P > 0.05). Quadriceps MVC torque and power are associated with self-reported function in knee OA, but muscle power at lower loads is more predictive of function than MVC torque. The variance in MVC torque and power between participants is due predominantly to differences in MV and has little to do with deficits in VA.
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Affiliation(s)
- M J Berger
- Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
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Derry KL, Venance SL, Doherty TJ. Decomposition-based quantitative electromyography in the evaluation of muscular dystrophy severity. Muscle Nerve 2012; 45:507-13. [PMID: 22431083 DOI: 10.1002/mus.22341] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Electromyography is useful in the diagnosis of myopathies, but its utility in determining disease severity requires further investigation. In this study we aimed to determine whether decomposition-based quantitative electromyography (DQEMG) could indicate the severity of involvement in a cohort of patients with muscular dystrophies (MDs). METHODS Fifteen patients with facioscapulohumeral (FSHD), limb-girdle (LGMD), and Becker (BMD) muscular dystrophy, and 7 healthy controls, participated in this investigation. Knee extensor isometric strength differentiated the "more severe" and "less severe" MD groups. The vastus lateralis (VL), biceps brachii (BB), and tibialis anterior (TA) muscle groups were investigated using DQEMG. RESULTS All muscles from the MD group showed changes in mean MUP (motor unit potential) AAR (area-to-amplitude ratio), and turns, compared with controls (P < 0.05). More severely affected muscles (VL and BB) also had shortened mean MUP durations compared with controls (P < 0.01). CONCLUSIONS DQEMG was capable of indicating the severity of MD involvement, as changes in MUP morphology reflected the progressive nature of the disease.
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Affiliation(s)
- Kendra L Derry
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, 339 Windermere Road, London, Ontario N6A 5A5, Canada
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Abstract
BACKGROUND Maximal isometric quadriceps strength deficits have been widely reported in studies of knee osteoarthritis (OA), however little is known about the effect of osteoarthritis knee pain on submaximal quadriceps neuromuscular function. The purpose of this study was to measure vastus medialis motor unit (MU) properties in participants with knee OA, during submaximal isometric contractions. METHODS Vastus medialis motor unit potential (MUP) parameters were assessed in 8 patients with knee OA and 8 healthy, sex and age-matched controls during submaximal isometric contractions (20% of maximum isometric torque). Unpaired t-tests were used to compare groups for demographic and muscle parameters. RESULTS Maximum knee extension torque was ~22% lower in the OA group, a difference that was not statistically significantly (p = 0.11). During submaximal contractions, size related parameters of the needle MUPs (e.g. negative peak duration and amplitude-to-area ratio) were greater in the OA group (p < 0.05), with a rightward shift in the frequency distribution of surface MUP negative peak amplitude. MUP firing rates were significantly lower in the OA group (p < 0.05). CONCLUSIONS Changes in MU recruitment and rate coding strategies in OA may reflect a chronic reinnervation process or a compensatory strategy in the presence of chronic knee pain associated with OA.
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Affiliation(s)
- Michael J Berger
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada.
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