3D false color computed tomography for diagnosis and follow-up of permanent denervated human muscles submitted to home-based Functional Electrical Stimulation

Carraro, Ugo; Edmunds, Kyle J.; Gargiulo, Paolo

doi:10.4081/bam.2015.2.129

Cited by 16 publications

(8 citation statements)

References 64 publications

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“… 14 As further evidence of the efficacy of h-b FES for recovery of permanently denervated skeletal muscles, Figure 5 shows that once FES is discontinued (for an additional 5 years), the recovered leg muscle deteriorates again. 20 Figure 5 demonstrates that the previous muscle recovery was not due to reinnervation of the muscle fibers, but it was due to the trophic effect of the FES-induced contractions. If electrical stimulation is discontinued, the great effects seen with the treatment disappear.…”

Section: Premature Muscle Aging Due To Complete and Permanent Denervamentioning

confidence: 98%

Biology of muscle atrophy and of its recovery by FES in aging and mobility impairments: roots and by-products

Carraro

Kern

Gava³

et al. 2015

Eur J Transl Myol

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There is something in our genome that dictates life expectancy and there is nothing that can be done to avoid this; indeed, there is not yet any record of a person who has cheated death. Our physical prowess can vacillate substantially in our lifetime according to our activity levels and nutritional status and we may fight aging, but we will inevitably lose. We have presented strong evidence that the atrophy which accompanies aging is to some extent caused by loss of innervation. We compared muscle biopsies of sedentary seniors to those of life long active seniors, and show that these groups indeed have a different distribution of muscle fiber diameter and fiber type. The senior sportsmen have many more slow fiber-type groupings than the sedentary people which provides strong evidence of denervation-reinnervation events in muscle fibers. It appears that activity maintains the motoneurons and the muscle fibers. Premature or accelerated aging of muscle may occur as the result of many chronic diseases. One extreme case is provided by irreversible damage of the Conus and Cauda Equina, a spinal cord injury (SCI) sequela in which the human leg muscles may be completely and permanently disconnected from the nervous system with the almost complete disappearance of muscle fibers within 3-5 years from SCI. In cases of this extreme example of muscle degeneration, we have used 2D Muscle Color CT to gather data supporting the idea that electrical stimulation of denervated muscles can retain and even regain muscle. We show here that, if people are compliant, atrophy can be reversed. A further example of activity-related muscle adaptation is provided by the fact that mitochondrial distribution and density are significantly changed by functional electrical stimulation in horse muscle biopsies relative to those not receiving treatment. All together, the data indicate that FES is a good way to modify behaviors of muscle fibers by increasing the contraction load per day. Indeed, it should be possible to defer the muscle decline that occurs in aging people and in those who have become unable to participate in physical activities. Thus, FES should be considered for use in rehabilitation centers, nursing facilities and in critical care units when patients are completely inactive even for short periods of time.

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Section: Premature Muscle Aging Due To Complete and Permanent Denervamentioning

confidence: 98%

Biology of muscle atrophy and of its recovery by FES in aging and mobility impairments: roots and by-products

Carraro

Kern

Gava³

et al. 2015

Eur J Transl Myol

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“…This is often performed via the use of radiodensitometric absorption values, measured in Hounsfield units (HU). Here, changes in segmented cross-sectional areas have been used to illustrate changes in volume [24][25][26][27][28][29][30] , and changes in average HU values have been used to illustrate changes in muscle quality 31,32 . We have recently shown the utility of modelling entire radiodensitometric distributions from CT cross-sections of the mid-thigh, highlighting the novel nonlinear trimodal regression analysis (NTRA) method 33,34 .…”

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confidence: 99%

Assessing cardiovascular risks from a mid-thigh CT image: a tree-based machine learning approach using radiodensitometric distributions

Ricciardi

Edmunds

Recenti

et al. 2020

Sci Rep

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The nonlinear trimodal regression analysis (NTRA) method based on radiodensitometric CT distributions was recently developed and assessed for the quantification of lower extremity function and nutritional parameters in aging subjects. However, the use of the NTRA method for building predictive models of cardiovascular health was not explored; in this regard, the present study reports the use of NTRA parameters for classifying elderly subjects with coronary heart disease (CHD), cardiovascular disease (CVD), and chronic heart failure (CHF) using multivariate logistic regression and three tree-based machine learning (ML) algorithms. Results from each model were assembled as a typology of four classification metrics: total classification score, classification by tissue type, tissuebased feature importance, and classification by age. The predictive utility of this method was modelled using CHF incidence data. ML models employing the random forests algorithm yielded the highest classification performance for all analyses, and overall classification scores for all three conditions were excellent: CHD (AUCROC: 0.936); CVD (AUCROC: 0.914); CHF (AUCROC: 0.994). Longitudinal assessment for modelling the prediction of CHF incidence was likewise robust (AUCROC: 0.993). The present work introduces a substantial step forward in the construction of non-invasive, standardizable tools for associating adipose, loose connective, and lean tissue changes with cardiovascular health outcomes in elderly individuals.The progressive degeneration of skeletal muscle is consistently identified as an independent risk factor for significant morbidity, disability, and mortality in aging individuals 1-7 . Defined as sarcopenia, recent literature has interrogated its mediating and moderating roles in a wide range of adverse health outcomes, including its role in the etiology of cardiovascular pathophysiology. Catabolic inflammatory cytokine production and characteristic adiposity from the progression of sarcopenia have been linked with the onset of diabetes 8 , hypertension 9 , and dyslipidemia 10 -all of which are well-established risk factors for coronary heart disease (CHD) 11 and all-type cardiovascular disease (CVD) [12][13][14][15] . Chronic heart failure (CHF) patients frequently develop cardiac cachexia, a similar muscle wasting condition whose advanced stage has been implicated as an accelerated analogue of sarcopenic muscle degeneration 16 . Indeed, the progression of sarcopenia in older CHF patients may be considerably entangled with embedded cachexic effects 16,17 . While literature cites the associations and potential causal mechanisms between cardiovascular pathophysiology and downstream changes in skeletal muscle form and function 18 , validating standardized predictive models for these conditions remains debated. Furthermore, incorporating more nuanced quantitative methods for the non-invasive prediction of these events remains a priority in literature. Identifying such a methodology would further establish the generalizability of ...

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“…False Color Computed Tomography is popular in cardiology [115], but QMC-CT is still a novelty for quantitative analyses of total volume and quality of anatomically defined skeletal muscles. QMC-CT is a highly sensitive quantitative imaging analysis recently developed by the group of Prof. Paolo Gargiulo to monitor skeletal muscle and perform follow-up examinations of muscle affected by wasting conditions [116][117][118][119][120]. Through the successful EU Program: RISE [Use of electrical stimulation to restore standing in paraplegics with longterm denervated degenerated muscles (QLG5-CT-2001-02191), and INTERREG III and IV: European Regional Development Fund, project Mobilität im Alter, MOBIL, N_00033)], we have demonstrated, mainly through the use of QMC-CT, that h-bFES therapy improves the muscle quality of mobility impaired persons [9] and of healthy seniors [114].…”

Section: Quantitative Computed Tomography and Image Analysis For Advamentioning

confidence: 99%

Modulation of trophism and fiber type gene expression in denervated muscle activated by different patterns of electrical stimulation. Role of muscle fiber regeneration revisited in 2017

Marcante¹,

Baba²,

Carraro³

et al. 2017

Biol Eng Med

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After sixty and more years of basic research on electrostimulation-induced muscle plasticity, in the last fifteen years a few studies have employed long impulse biphasic electrical stimulation as a treatment for human long-term denervated muscle. Tissue trophism and muscle power are improved to a level sufficient to restore some functions by home based Functional Electrical Stimulation (h-bFES). These treatments usually start late after denervation due to clinical constraints. The changes induced by 1) denervation, 2) spontaneous or induced aneural myogenesis, and 3) long-term electrical stimulation starting either early or late after denervation, in both animal models and in clinic, are here reported once again to attract attention of patients, physiatrists and physiotherapists on achievable results and on limitations of h-bFES for denervated degenerating muscles (DDM). The trophic and functional recovery from severe atrophy/degeneration of long-term denervated muscle by h-bFES of DDM is a fact standing on a sound foundation. Furthermore, a new muscle quantitative color computed tomography (MQC-CT) adds, to functional evidence and to muscle biopsy analyses, the results based on tridimensional analysis of a full skeletal muscle. The differentiation of muscle fibers regenerating in the absence of the nerve is remarkable in animal experiments. If myogenesis in patients could be modulated during the months needed to recover denervated muscle tetanic contractility, it should be possible to substantially abbreviate the time needed to achieve functional recovery of long term denervated human muscle by h-bFES of DDM using the commercial muscle stimulator and the large electrodes now available.

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3D false color computed tomography for diagnosis and follow-up of permanent denervated human muscles submitted to home-based Functional Electrical Stimulation

Cited by 16 publications

References 64 publications

Biology of muscle atrophy and of its recovery by FES in aging and mobility impairments: roots and by-products

Biology of muscle atrophy and of its recovery by FES in aging and mobility impairments: roots and by-products

Assessing cardiovascular risks from a mid-thigh CT image: a tree-based machine learning approach using radiodensitometric distributions

Modulation of trophism and fiber type gene expression in denervated muscle activated by different patterns of electrical stimulation. Role of muscle fiber regeneration revisited in 2017

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