Skeletal muscle atrophy and increased intramuscular fat after incomplete spinal cord injury

Gorgey, Ashraf S.; Dudley, Gary A.

doi:10.1038/sj.sc.3101968

Cited by 341 publications

(348 citation statements)

References 28 publications

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“…This phenomenon of elevated muscle lipid has been reported in a number of clinical populations including individuals with stroke 15 as well as both complete 9 and incomplete SCI. 10 Elder and co-workers demonstrated that persons with complete SCI display an almost fourfold increase in intramuscular fat relative to controls, and that these values correlate with plasma glucose levels during an oral glucose tolerance test (r 2 ¼ 0.52 and 0.71, Po0.001). In another study, a threefold elevation in intramuscular fat was observed in persons with chronic motor incomplete SCI.…”

Section: Discussionmentioning

confidence: 98%

“…In another study, a threefold elevation in intramuscular fat was observed in persons with chronic motor incomplete SCI. 10 Previous studies in SCI patients, however, did not distinguish between IMCL and EMCL, but instead used MRI to estimate total intramuscular lipid content. An advantage of the present study is that using localized H-spectroscopy we were able to individually quantify both IMCL and EMCL.…”

Section: Discussionmentioning

confidence: 99%

“…Given the higher reported incidence of insulin resistance in persons with incomplete SCI 7 and a purported relatively inactive lifestyle, 8 we hypothesized that individuals with incomplete SCI would demonstrate an elevated IMCL content in skeletal muscle. Although studies have demonstrated elevated lipid depots in the lower extremity muscles of persons with complete and incomplete SCI using magnetic resonance imaging (MRI), 9,10 we are not aware of any study that has specifically investigated alterations in the IMCL content in persons with motor incomplete SCI.…”

Section: Introductionmentioning

confidence: 99%

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Non-invasive assessment of lower extremity muscle composition after incomplete spinal cord injury

et al. 2008

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Study Design: Cross-sectional study. Objective: (1) To quantify intramyocellular lipid (IMCL) content of the soleus muscle. (2) To assess the T 2 relaxation rates in the lower extremity skeletal muscles in persons with incomplete spinal cord injury (SCI). Setting: Academic Institution, Florida. Methods: Eight subjects (42 ± 10 years old; 70 ± 12 kg; 176 ± 10 cm) with chronic (17 ± 9 months post injury) motor SCI (C4-T12; ASIA C or D) and eight matched healthy controls were tested. Localized unsuppressed proton spectroscopy (H-MRS) was performed to estimate total lipid content and individual lipid components; IMCL and extramyocellular lipid (EMCL) from the soleus muscle. T 2 -weighted imaging of lower extremity muscles yielded muscle T 2 rates. Results: The IMCL content of the soleus muscle was 3.3 times higher in the patient group as compared to controls (P ¼ 0.002; 0.0401 (0.0234-0.0849) versus 0.0123 (0.0090-0.0175)). Similarly, EMCL measures were 4.5 times higher as compared to the controls (P ¼ 0.002). Significant differences were observed in the T 2 relaxation times of the soleus and gastrocnemius muscles (Po0.05). Conclusion:The increased levels of IMCL might interfere with the glucose uptake in skeletal muscle; potentially predisposing persons with incomplete SCI to the development of peripheral insulin resistance. Marked elevations in the T 2 relaxation times of the locomotor muscles are reflective of an altered muscle composition.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-invasive assessment of lower extremity muscle composition after incomplete spinal cord injury

et al. 2008

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“…In paralyzed muscle, characteristic changes include a marked decrease in cross-sectional area of both slow-and fast-twitch muscle fibers 6 and reduction in slow myosin heavy chain proportion, and concomitantly, a marked shift to fast myosin heavy chain isoforms; 7 and increased intramuscular fat accumulation. 4,5 No studies have compared GLUT4 content in those with and without SCI. However, in rodents, denervation reduces GLUT4 and contraction-stimulated glucose transport, and more potently reduces insulinstimulated glucose uptake than severe (streptozotocin-induced) diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 It has been suggested that the extent of neurological impairment after SCI is an important determinant of these impairments; participants with complete tetraplegia (TETRA) had higher levels of serum glucose and plasma insulin during a 2-h oral glucose tolerance test (OGTT) and higher incidence of IGT or diabetes than participants with either incomplete TETRA or complete or incomplete paraplegia (PARA). 3 The suggestion that greater neurological deficit is associated with poorer glucose tolerance may be explained by the consequences of denervation such as skeletal muscle atrophy 4,5 and altered fiber-type proportions, 6,7 with the volume of muscle affected related to level and completeness of the neurological lesion. Skeletal muscle is the major site for insulin-mediated glucose disposal and glucose transport is rate limiting for glucose utilization under most conditions.…”

Section: Introductionmentioning

confidence: 99%

Glucose tolerance and physical activity level in people with spinal cord injury

et al. 2010

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Study design: Cross-sectional, observational study. Objectives: To evaluate the associations of physical activity and neurological lesion level with glucose tolerance in people with spinal cord injury (SCI). Setting: New South Wales, Australia. Methods: Twenty-five people (5 women, 20 men) with SCI (46 months post-injury) aged between 18 and 65 years were recruited. Exclusion criteria included known coronary heart disease, stroke or diabetes. Participants underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose concentrations were classified according to the World Health Organization categories of glycemia. Participants also completed the Physical Activity Scale for Individuals with Physical Disabilities and mean MET-hours day À1 was calculated. Associations with the 2-h plasma glucose concentration were calculated through multiple and stepwise regressions. Results: Participants presented with complete or incomplete tetraplegia (n ¼ 11 TETRA) or complete or incomplete paraplegia (n ¼ 14 PARA) with neurological lesion levels ranging from C3/4 to T12. Mean 2-h plasma glucose was 7.13 ± 2.32 mmol l À1 . Nine participants had disordered glycemia (n ¼ 6 TETRA; n ¼ 3 PARA) and the remaining participants had normal glucose tolerance. Those participants with normal glucose tolerance participated in more moderate-vigorous and strength exercise and undertook more non-exercise-related mobility than those with disordered glycemia. Physical activity and age, but not lesion level were independent determinants of 2-h plasma glucose concentration (r ¼ 0.683, P ¼ 0.001), explaining 47% of the variance. Conclusion: Physical activity level is independently associated with glucose tolerance in people with SCI. Non-exercise activity may also be important for maintaining normal glycemia.

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Spinal Cord Injury Associated Disease of the Skeleton, an Unresolved Problem with Need for Multimodal Interventions

Echevarria‐Cruz,

McMillan,

Reid

et al. 2024

Advanced Biology

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Spinal cord injury is associated with skeletal unloading, sedentary behavior, decreases in skeletal muscle mass, and exercise intolerance, which results in rapid and severe bone loss. To date, monotherapy with physical interventions such as weight‐bearing in standing frames, computer‐controlled electrically stimulated cycling and ambulation exercise, and low‐intensity vibration are unsuccessful in maintaining bone density after SCI. Strategies to maintain bone density with commonly used osteoporosis medications also fail to provide a significant clinical benefit, potentially due to a unique pathology of bone deterioration in SCI. In this review, the available data is discussed on evaluating and monitoring bone loss, fracture, and physical and pharmacological therapeutic approaches to SCI‐associated disease of the skeleton. The treatment of SCI‐associated disease of the skeleton, the implications for clinical management, and areas of need are considered for future investigation.

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Skeletal muscle atrophy and increased intramuscular fat after incomplete spinal cord injury

Cited by 341 publications

References 28 publications

Non-invasive assessment of lower extremity muscle composition after incomplete spinal cord injury

Non-invasive assessment of lower extremity muscle composition after incomplete spinal cord injury

Glucose tolerance and physical activity level in people with spinal cord injury

Spinal Cord Injury Associated Disease of the Skeleton, an Unresolved Problem with Need for Multimodal Interventions

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