Is the Lipid Content of the Psoas Major Correlated with Chronic Low Back Pain and Spinopelvic Alignment? A Magnetic Resonance Spectroscopic Study

Ogon, Izaya; Takashima, Hiroyuki; Morita, Tomohiro; Oshigiri, Tsutomu; Terashima, Yoshiaki; Yoshimoto, Mitsunori; Emori, Makoto; Teramoto, Atsushi; Takebayashi, Toru; Yamashita, Toshihiko

doi:10.31616/asj.2020.0042

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…The missing differentiation of the FF of MT in IMCL versus extramyocellular lipids (EMCL), the fat content of interstitial, intramyofascial adipocytes is an important limitation of in vivo MRI. For example, a recent study on back pain using MR spectroscopy showed that EMCL content of the psoas correlated with age, but IMCL content did not [ 37 ]. Adipocytes result from differentiation of resident mesenchymal precursors such as Fibro-Adipogenic Precursor (FAP) cells and their expansion.…”

Section: Discussionmentioning

confidence: 99%

The effect of ageing on fat infiltration of thigh and paraspinal muscles in men

et al. 2022

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Background Myosteatosis, skeletal muscle fat infiltration, is associated with inflammation and fibrosis. The age-related increase of myosteatosis is an important characteristic of sarcopenia and contributes to fragility. Aims To investigate the impact of healthy aging on intermuscular adipose tissue (IMAT) and muscle fat fraction (FF) in the thigh and the paraspinal muscles in males. Methods In 54 healthy males (age 20–70), all active hobby golfers, magnetic resonance imaging was performed to determine volume of IMAT, volume of muscle tissue (MT) and of percentage of FF. Results Between ages 20–70, at the thigh, IMAT/MT volume and MT FF increased annually by 2.9% and 1.3%, respectively. At the psoas IMAT/Psoas volume did not change with age. MT FF increased by 1.5% annually. At the erector spinae IMAT/Erector volume decreased by 0.3% and MT FF increased by 2.8% annually. Discussion With increasing age, in males, thigh muscle atrophied, muscle tissue was partly replaced by adipose tissue and remaining muscle tissue also contained more fat. Similar effects were observed in the erector spinae. The psoas muscle did not atrophy, although MT FF also increased with age. Overall correlations with age were weak to moderate with higher correlations observed in the paraspinal muscles. Conclusions Age-related increases of muscle fat infiltration were observed in the thigh and in the spine. Muscle atrophy did not occur in the psoas. In cross-sectional studies, an adjustment of volumetric parameters by muscle volume is advisable when comparing age-dependent results.

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Section: Discussionmentioning

confidence: 99%

The effect of ageing on fat infiltration of thigh and paraspinal muscles in men

et al. 2022

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“…A few MRI studies have examined the association between paraspinal muscle fatty degeneration and IVDD and demonstrated an association between IVDD and multifidus muscle degeneration based on morphological measurements (using the cross-sectional area and fat infiltration) [40,41]. A correlation between the IMCL content of the multifidus muscle and T2 values of anterior AF has been demonstrated using quantitative MRI evaluation methods [32].…”

Section: Discussionmentioning

confidence: 99%

“…A previously described MRI protocol was used [26,[29][30][31][32][33]. Sagittal and transverse T2-weighted MRI were obtained using the Signa HDx 1.5T-MRI system with a spine coil from GE Healthcare in Milwaukee, Wisconsin, in USA.…”

Section: Mrsmentioning

confidence: 99%

“…These pictures were used to locate the proton MRS volume of interest (VOI) at the right L4/L5 level, near the middle of the psoas major (Figure 1). With the following settings, single-voxel point-resolved sequence spectroscopy was performed: the VOI size was 15 mm × 15 mm × 15 mm (3.4 mL), the repetition time (TR) was 2,000 ms, the echo time (TE) was 35 ms, the average number of signals was 64, and the acquisition time was 164 s. The MRS data, both with and without water suppression, were analysed, as previously described [26,[29][30][31][32][33]. The IMCL and EMCL content was measured using the spectral data obtained with LCModel software (Stephen Provencher, Inc., Oakville, ON, Canada).…”

Section: Mrsmentioning

confidence: 99%

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Quantitative magnetic resonance spectroscopy and imaging analysis of the lipid content in the psoas major and its association with intervertebral disc degeneration: a cross-sectional study

Ogon

Takashima

Morita

et al. 2023

Explor Musculoskeletal Dis

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Aim: It is shown that the diminished function of the psoas major is mainly associated with increased lipid content; nonetheless, whether the fat content of the psoas major is associated with intervertebral disc degeneration (IVDD) is still under study. It is hypothesized that IVDD is correlated with the lipid content of the psoas major and that IVDD can be comprehensively investigated using quantitative magnetic resonance imaging (MRI). Consequently, this study aimed to analyse the association between the psoas major extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) content and disc degeneration quantified using MRI T2 mapping in patients with chronic low back pain (CLBP). Methods: In this study, 20 men and 23 women (mean age, 63.1 years ± 2.6 years) underwent magnetic resonance spectroscopy (MRS). The psoas major IMCL and EMCL content of patients was analysed. T2 values of the anterior annulus fibrosus (AF), nucleus pulposus (NP), and posterior AF were evaluated using MRI T2 mapping. Multiple linear regression analysis was used to determine the possible correlations of the psoas major EMCL and IMCL content with the T2 values of the anterior AF, NP, and posterior AF. Results: The EMCL content and T2 values of the anterior AF were significantly and negatively correlated [standardised partial regression coefficient (β) = −0.60, P < 0.01]. There were no significant correlations between the EMCL content and T2 values of the NP (β = −0.16, P = 0.30) or posterior AF (β = −0.14, P = 0.49) or between the IMCL content and T2 values of the anterior AF (β = −0.04, P = 0.82), NP (β = 0.05, P = 0.73), or posterior AF (β = −0.11, P = 0.58). Conclusions: The EMCL content and T2 values of the anterior AF were correlated. Conversely, the IMCL content and T2 values were not correlated.

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“…LBP can be caused by various problems in any part of the interconnected network of spinal muscles, bones, discs, nerves, or tendons of the lumbar spine. Some mechanisms of LBP have been elucidated in previous studies 2, [6][7][8][9][10][11][12][13][14][15][16][17][18][19] . Despite this, the pathophysiology of LBP is poorly understood and there is inadequate correlation between investigative findings and clinical symptoms.…”

Section: Introductionmentioning

confidence: 98%

Association Between Multifidus Intramyocellular Lipids and Pain-Related Disorders, Lumbar Spine Dysfunction, Gait Disturbance in Patients with Chronic Low Back Pain: A Cross-Sectional Study Using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire

Ogon¹,

Takashima²,

Morita³

et al. 2023

J Rehab Therapy

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Background and aims: Fat degeneration in the multifidus muscle (Mm) was more common than in other trunk muscles. We hypothesised that the lipid contents of the Mm and patient-reported quality of life (QOL) are related. However, there are no papers examining the association between fatty degeneration of the Mm and patient-reported QOL using magnetic resonance spectroscopy (MRS). This cross-sectional study aimed to investigate the association between patient-reported QOL, evaluated with the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and the intramyocellular lipid (IMCL) and extramyocellular lipid (EMCL) contents of the Mm and psoas major (PM) by MRS in patients with chronic low back pain (CLBP). Materials and Methods: Forty-eight patients (mean age, 64.2 ± 13.2 years; age range, 41–79 years) with nonspecific CLBP underwent MRS for the quantification of IMCL and EMCL of the right Mm and PM in a volume of interest at L4/L5. All subjects underwent MRS and completed the JOABPEQ in the same day. We performed multiple linear regression analysis of the IMCL and EMCL contents of the Mm and PM with the five domains of the JOABPEQ adjusted for age, sex, and body mass index. Results: The IMCL content of the Mm was correlated with pain-related disorders (standardised partial regression coefficient (β)=−0.59, p<0.01), lumbar spine dysfunction (β=−0.64, p<0.01), and social life dysfunction (β=−0.31, p<0.01) which showed moderate negative correlation, but not with psychological disorders. The EMCL content of the Mm was not correlated with the five domains of the JOABPEQ. The IMCL and EMCL contents of the PM was not correlated with the five domains of the JOABPEQ. Conclusions: IMCL content of the Mm was significantly correlated with the pain-related disorders, lumbar spine dysfunction, gait disturbance, and social life dysfunction domain scores of the JOABPEQ. Future studies using magnetic resonance spectroscopy of the Mm in patients with CLBP may help optimize exercise strategies using IMCL as an index to enhance patient-reported quality of life.

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Is the Lipid Content of the Psoas Major Correlated with Chronic Low Back Pain and Spinopelvic Alignment? A Magnetic Resonance Spectroscopic Study

Cited by 4 publications

References 28 publications

The effect of ageing on fat infiltration of thigh and paraspinal muscles in men

The effect of ageing on fat infiltration of thigh and paraspinal muscles in men

Quantitative magnetic resonance spectroscopy and imaging analysis of the lipid content in the psoas major and its association with intervertebral disc degeneration: a cross-sectional study

Association Between Multifidus Intramyocellular Lipids and Pain-Related Disorders, Lumbar Spine Dysfunction, Gait Disturbance in Patients with Chronic Low Back Pain: A Cross-Sectional Study Using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire

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