Human genome comparison of paretic and nonparetic vastus lateralis muscle in patients with hemiparetic stroke

McKenzie, Michael J.; Yu, Su-Yeon; Macko, Richard F.; McLenithan, John C.; Hafer‐Macko, Charlene E.

doi:10.1682/jrrd.2007.02.0036

Cited by 13 publications

(11 citation statements)

References 59 publications

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“…Although little is known about skeletal muscle phenotypic abnormalities after stroke, the decrease in PCr suggests changes in muscle physiology and composition. Hemiparetic-side skeletal muscle changes after stroke can include gross muscular atrophy, increased intramuscular fat, and a shift toward fast myosin heavy chain phenotypes, with reduced muscle oxidative capacities [ 16 ]. Abnormal expression of several major gene categories or clusters may present in hemiplegic leg muscles, including genes that regulate muscle metabolism, contractile proteins, mitogenesis and growth factors, inflammation, metabolism, and signal transduction pathways [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Investigating Muscle Function After Stroke Rehabilitation with 31P-MRS: A Preliminary Study

2018

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BackgroundNew evidence reveals significant metabolic changes in skeletal muscle after stroke. However, it is unknown if 31P magnetic resonance spectroscopy (31P-MRS) can evaluate these metabolic changes. Our objective here was to investigate: (a) if muscle energy metabolism changes in the affected side; (b) if muscle energy metabolism changes after rehabilitation; and (c) if energy metabolism measured by 31P-MRS can reflect changes in the Modified Modified Ashworth Scale (MMAS) and Fugl-Meyer assessment-lower extremity (FMA-LE) scores after rehabilitation.Material/MethodsWe enrolled 13 patients with stroke symptoms and hemiplegia. Lower-limb motor status on the affected side was evaluated by FMA-LE and MMAS. The 31P-MRS measures included phosphocreatine (PCr), inorganic phosphate (Pi), PCr/Pi, and pH. We statistically compared these measures in the affected and unaffected lower leg muscles before rehabilitation and after rehabilitation on the affected side. Spearman correlational analyses was performed to determine correlations between change in energy metabolism and change in FMA-LE score and MMAS score after rehabilitation.ResultsPCr and PCr/Pi were significantly lower in the affected muscle compared to the unaffected muscle; however, there were no significant differences in Pi or pH. After rehabilitation, PCr, Pi, PCr/Pi, and pH did not significantly change. However, FMA-LE and MMAS score improved significantly after rehabilitation. Changes in energy metabolism measured by 31P-MRS had no correlation with FMA-LE change after rehabilitation. However, changes in PCr and PCr/Pi were correlated with change in MMAS score after rehabilitation.Conclusions31P-MRS can evaluate changes in muscle energy metabolism in patients with stroke. PCr measured by 31P-MRS can reflect changes in MMAS after rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Investigating Muscle Function After Stroke Rehabilitation with 31P-MRS: A Preliminary Study

2018

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“…In post-stroke patients, the ratio of the intramuscular fat in a given skeletal muscle in the paretic limb was higher than that in the non-paretic limb [6]. Additionally, the tumor necrosis factor-α gene expression in the paretic limb increased and systemic inflammation was observed [9,42,43]. Because increased insulin resistance and decreased insulin-like growth factor-1 activity can induce diabetes and protein breakdown in skeletal muscle [6,8,18,40,44], improvement of muscle quality is needed.…”

Section: Relationship Of Muscle Ei With Mt and Motor Paralysismentioning

confidence: 99%

Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Maeda

Imada²,

Ishida

et al. 2019

Eur Neurol

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Introduction: Quadriceps muscle atrophy and quality loss, defined as an increased ratio of intramuscular fat and/or connective tissue, are often observed especially in the paretic limb of post-stroke patients. This study was performed to examine the relationship of quadriceps muscle thickness (MT) with muscle echo intensity (EI) and the severity of motor paralysis after stroke. Methods: Thirty-six hemiparetic subacute post-stroke patients were enrolled. We examined the MT (index of muscle quantity) and the EI (index of muscle quality) at the anterior mid-thigh in both limbs. We also assessed the Brunnstrom stage (BR stage), subcutaneous adipose tissue thickness, time since stroke, age, body weight, sex, number of medications, and nutritional and inflammation status. Results: The MT in the paretic limb was explained by the BR stage (β = –0.26, p < 0.01), body weight (β = 0.68, p < 0.01), and serum albumin (β = 0.34, p < 0.01), with an adjusted R² of 0.81. The MT in the non-paretic limb was explained by the muscle EI (β = –0.55, p < 0.01) and age (β = –0.40, p < 0.01), with an adjusted R² of 0.69. The muscle EI was explained by the MT in the paretic limb (β = –0.34, p < 0.01) and non-paretic limb (β = –0.69, p < 0.01). Conclusions: Our results suggest that motor paralysis, aging, and malnutrition contribute to quadriceps atrophy in post-stroke patients. Moreover, a potential countermeasure to diminish muscle quality loss is maintenance of muscle quantity.

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“…The effects of IL-6 during the different stages of acute stroke and genetic variation may assist in selective therapeutic targeting of this cytokine [62, 63]. Interestingly, increased cytokine activity has also been demonstrated in the muscles of the paretic limb after-stroke, and this may further hinder recovery [64]. This enhanced inflammatory state in elderly stroke patients may explain the increased risk of morbidity and mortality in this age group [65].…”

Section: Cytokine Activation In Acute Stroke and Senescencementioning

confidence: 99%

Neuroinflammation and Cerebrovascular Disease in Old Age: A Translational Medicine Perspective

Napoli¹,

Shah

2011

Journal of Aging Research

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The incidence of cerebrovascular disease is highest in the elderly population. However, the pathophysiological mechanisms of brain response to cerebral ischemia in old age are currently poorly understood. Ischemic changes in the commonly used young animal stroke models do not reflect the molecular changes associated with the aged brain. Neuroinflammation and oxidative stress are important pathogenic processes occurring during the acute phase of cerebral ischemia. Free radical generation is also implicated in the aging process, and the combination of these effects in elderly stroke patients could explain the higher risk of morbidity and mortality. A better understanding of stroke pathophysiology in the elderly patient would assist in the development of new therapeutic strategies for this vulnerable age group. With the increasing use of reperfusion therapies, inflammatory pathways and oxidative stress remain attractive therapeutic targets for the development of adjuvant neuroprotective agents. This paper will discuss these molecular aspects of acute stroke and senescence from a bench-to-bedside research perspective.

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Human genome comparison of paretic and nonparetic vastus lateralis muscle in patients with hemiparetic stroke

Cited by 13 publications

References 59 publications

Investigating Muscle Function After Stroke Rehabilitation with 31P-MRS: A Preliminary Study

Investigating Muscle Function After Stroke Rehabilitation with 31P-MRS: A Preliminary Study

Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Neuroinflammation and Cerebrovascular Disease in Old Age: A Translational Medicine Perspective

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