Multicore myopathy--a case report.

Multicore myopathy is a rare congenital myopathy. The multicores consist of numerous small areas of decreased oxidative enzyme activity. The long axis of the lesion is perpendicular or parallel to the long axis of the muscle fiber. These cores are usually smaller than central cores. For this reason they are also called minicores. Although the multicores represent a nonspecific change in that they can be observed in malignant hyperthermia, muscular dystrophy, inflammatory myopathy, etc. Muscular weakness dating from early infancy is combined large proportion of the muscle fibers. In about half of the reported cases the muscular weakness has not been progressive, while in the others a slow progression has occurred. This 9-year-old boy presented with congenital nonprogressive myopathy associated with thoracic scoliosis and bilateral equinovarus deformity. The serum creatine phosphokinase and lactic dehydrogenase levels were normal. Electromyography showed "myopathic" features. The biopsy revealed a marked size variation in myofibers, ranging from 10 microns to 100 microns. A few small angular fibers and slight endomyseal fibrosis were also noted. There was type I fiber predominance. NADH-TR reaction disclosed more well-defined cores with loss of intermyofibrillary mitochondrial activity. These cores were usually located with loss of intermyofibrillary mitochondrial activity. These cores were usually located in the peripheral portions of the myofibers and the core size measured 10-30 microns in diameter. Electron microscopic examination revealed circumscribed areas of disintegrated Z band material and disorganized sarcomeric units near the sarcolemma. A decrease in the number of mitochondria and glycogen particles was noted.     

In vivo fusion of circulating fluorescent cells with dystrophin-deficient myofibers results in extensive sarcoplasmic fluorescence expression but limited dystrophin sarcolemmal expression

To investigate the therapeutic potential of bone marrow transplantation in Duchenne muscular dystrophy, green fluorescent protein-positive (GFP+) bone marrow cells were transplanted into irradiated wild-type and dystrophin-deficient mdx mice. Tibialis anterior muscles showed fivefold to sixfold more GFP+ mononucleated cells and threefold to fourfold more GFP+ myofibers in mdx than in wild-type mice. In contrast, dystrophin expression in mdx mice remained within the level of nontransplanted mdx mice, and co-expression with GFP was rare. Longitudinal sections of 5000 myofibers showed 160 GFP+ fibers, including 9 that co-expressed dystrophin. GFP was always visualized as full-length sarcoplasmic fluorescence that exceeded the span of sample length (up to 1500 microm), whereas dystrophin expression was restricted to 11 to 28% of this length. Dystrophin expression span was much shorter in GFP+ fibers (116 +/- 46 microm) than in revertant fibers (654 +/- 409 microm). These data suggest that soluble GFP diffuses far from the fusion site with a pre-existing dystrophin(-) myofiber whereas dystrophin remains mainly expressed close to the site of fusion. Because restoration of dystrophin in whole muscle fiber length is required to expect functional improvement and clinical benefits for Duchenne muscular dystrophy, future applications of cell therapies to neuromuscular disorders could be more appropriately envisaged for replacement of defective soluble sarcoplasmic proteins.     

Cycling exercise-induced myofiber transitions in skeletal muscle depend on basal fiber type distribution

The link between specific changes in myofiber type proportions and modulation of training in human skeletal muscle has yet to be unraveled. We investigated whether a defined increase in training volume induces a corresponding change of myofiber shifting in human skeletal muscle with distinct basal myofiber distribution. Twenty-one male cyclists (Age 26 ± 4 years) with different performance levels were exposed to increased cycling training volume with reduced power output for 3 months. Biopsies were taken from vastus lateralis muscle PRE-POST and the proportions of type I, IIa, IIx and IIc myofibers were determined. Total training time did not correlate to the degree of fiber type shifting of any type. In the entire sample of subjects, the proportion of type I myofibers tended to increase (P = 0.14) while IIa fibers decreased significantly (P < 0.05). Subgroups of subjects possessing higher (HPS) and lower proportions (LPS) of type I myofibers at baseline showed a distinct pattern in changing myofiber distribution. Subjects in HPS offered no change in myofiber proportions of any type. In contrast, subjects in LPS showed marked increases in type I (P = 0.06) and a significant reduction in IIa myofibers (P = 0.01). An inverse correlation between baseline proportion of type I and IIa myofibers and its change was observed. We conclude that individual myofiber composition constitutes a modulating factor for exercise-induced changes in its distribution. This might be influenced by altered demands of myofiber recruitment in relation to the intensity of muscle contraction but also by its relative abundance in contracting muscle.     

Effects of eccentric exercise in rehabilitation of phasic and tonic muscles after leg immobilization in rats

Eccentric exercise is an essential resource for skeletal muscle rehabilitation following muscle disuse however, abnormalities linked to the tissue recuperation require further research. Our aim was analyze the adaptation ability of rehabilitated muscular tissue in rats during different periods of eccentric training after 10 days of limb immobilization. Twenty-seven Wistar rats were divided into six groups: immobilized 10 days, immobilized and eccentric trained for 10 days, immobilized and eccentric trained for 21 days, and three age-matched control groups. After sacrifice, soleus and plantaris muscles were frozen, cut and stained for general histology using hematoxylin and eosin and Gomori trichrome methods and immunohistochemical methods for fiber typing (mATPase, NADH2-TR), for capillaries (CD31) and intermediate filaments (desmin, vimentin) and high resolution microscopy of resin embedded material. Immobilization resulted in more intense morphological alterations in soleus muscles such as formation of target fibers, nuclear centralization, a reduction in the number of type I fibers, diameter of type I, IIA, IIAD fibers, and capillaries. After 10 days of eccentric training, increases in the nuclear centralization and the number of lobulated fibers were observed. This period was insufficient to reestablish the capillary/fiber (C/F) ratio and distribution of fiber types as that observed in the control group. However, 21 days of rehabilitation allowed the reversal of all morphological and quantitative abnormalities. For the plantaris muscles, 10-days of training restored their basic characteristics. Despite the fact that immobilization affected soleus and plantaris muscles, 10 days of eccentric training was insufficient to restore the morphological characteristics of soleus muscles, which was not the case observed in plantaris muscle.     

Distribution of myofiber types in the hip and thigh musculature of sheep

The composition of muscles by myofiber type is associated with their locomotory or postural functions. In the present study the composition of the hip and thigh musculature of sheep by myofiber types and the differences in their distribution were examined. Myofibers were classified into type I, IIA, and IIB myofibers by differences in myosin ATPase and NADH tetrazolium reductase (NADH-TR) activity. The vastus intermedius muscle consisted only of type I myofibers, which exhibit weak alkali-stable myosin ATPase and strong NADH-TR activity. The gluteus accessorius and profundus muscles had more than 50% type I myofibers. The other muscles had less than 50% type I myofibers as a whole. Type I myofibers were concentrated in the deep portions of the gluteus and quadriceps femoris muscles, which extend the hip and stifle joints, and of the pectineus muscle. They were scattered evenly in the caudally situated locomotory muscles in the thigh. Type IIA myofibers, characterized by strong alkali-stable myosin ATPase and NADH-TR activity, showed little difference in distribution in the hip and thigh muscles. Type IIB myofibers, characterized by strong alkali-stable myosin ATPase and weak NADH-TR activity, were distributed more in the cranial, caudolateral, and caudomedial portions than in the middle portions of the thigh. The distribution of type IIB myofibers is suited to powerful flexion and extension of the thigh and leg. In the hip and thigh musculature, it appears that type I myofibers are effectively distributed to maintain a standing posture without diminishing the propulsive force of the hindlimb.     

关于骨胳肌的损害及其修复

对20例死于克山病的尸体骨胳肌进行检查,其中6例的腓肠肌有着特殊的损害和修复。具体表现为,由解离的肌纤维构成的灶性坏死,表现为幼稚的结缔组织细胞在肌纤维表面展开其积极活动,表现为在肌纤维内部由结缔组织所进行的置换,以及表现为在受损的相邻肌纤维之间,由结缔组织所促成的粘连。特别是肌膜溶解,在电镜下有了切实证明,使肌纤维内修复的机制得到应有的解释。     

Degenerative and regenerative features of myofibers differ among skeletal muscles in a murine model of muscular dystrophy

Skeletal muscle myofibers constantly undergo degeneration and regeneration. Histopathological features of 6 skeletal muscles (cranial tibial [CT], gastrocnemius, quadriceps femoris, triceps brachii [TB], lumbar longissimus muscles, and costal part of the diaphragm [CPD]) were compared using C57BL/10ScSn-Dmd ^mdx (mdx) mice, a model for muscular dystrophy versus control, C57BL/10 mice. Body weight and skeletal muscle mass were lower in mdx mice than the control at 4 weeks of age; these results were similar at 6–30 weeks. Additionally, muscular lesions were observed in all examined skeletal muscles in mdx mice after 4 weeks, but none were noted in the controls. Immunohistochemical staining revealed numerous paired box 7-positive satellite cells surrounding the embryonic myosin heavy chain-positive regenerating myofibers, while the number of the former and staining intensity of the latter decreased as myofiber regeneration progressed. Persistent muscular lesions were observed in skeletal muscles of mdx mice between 4 and 14 weeks of age, and normal myofibers decreased with age. Number of muscular lesions was lowest in CPD at all ages examined, while the ratio of normal myofibers was lowest in TB at 6 weeks. In CT, TB, and CPD, Iba1-positive macrophages, the main inflammatory cells in skeletal muscle lesions, showed a significant positive correlation with the appearance of regenerating myofibers. Additionally, B220-positive B-cells showed positive and negative correlation with regenerating and regenerated myofibers, respectively. Our data suggest that degenerative and regenerative features of myofibers differ among skeletal muscles and that inflammatory cells are strongly associated with regenerative features of myofibers in mdx mice.     

Morphometric evaluation of muscle fiber types in different skeletal muscles of rats

The purpose of the present work was to study some morphological differences of similar muscle fiber types--classified by ATPase reactions in different muscles of rats. Morphological parameters were used as stereological techniques at light and electron microscopic level. There was a great variation in the diameter of each muscle fiber type of different muscles. The smallest diameter of type 1 myofibers of the soleus was greater than the diameter of type 1 myofibers of other muscles. The diameter of type 1 myofibers of the soleus and of the lateral part of the gastrocnemius was almost twice the diameter of type 1 myofibers of sternocleidomastoid. The lateral and medial parts of gastrocnemius had the largest 2A and 2B muscle fibers. As a whole, among the studied muscles, myofibers of postural muscles of the posterior parts of the posterior limbs had the greatest diameter. Stereological analysis at electron microscopic level revealed that there were differences in the volume density of mitochondria in the different muscles. The quantity of mitochondria was greater in the diaphragm than in the gastrocnemius, soleus and sternocleidomastoid muscles. Our results suggested that the diameter of muscle fibers is more related to the resistance the muscle is submitted than to the continuous necessity of contraction. However, the quantity of mitochondria of oxidative fibers of the diaphragm would be related to continuous necessity of contraction and high oxidative necessity of this muscle.     

HISTOMETRICAL and HISTOLOGICAL CHANGES OF THE SKELETAL MUSCLE IN NEUROMUSCULAR DISORDERS – AN AUTOPSY STUDY

Systemic hlstometrical and histological examinations of major skeletal muscles were performed by using autopsy cases with simple atrophy, neurogenic muscular atrophy, Duchenne type progressive muscular dystrophy, myositis of myasthenia gravis, and autopsy control cases. In hlstometrical studies, the shortest diameters of muscle fibers were measured and arranged in histograms. Volume ratio of stroma to muscle was measured by point-counting method.
Histometrical studies revealed the following results: (1) averages of muscle fiber diameters in controls showed the largest value In the muscles of the upper and lower extremities, and the smallest value in the lingual muscle; (2) in simple atrophy, neurogenic muscular atrophy, progressive muscular dystrophy and myositis, a decrease in muscle fiber diameters was more prominent in the muscles of the lower extremities than those of the upper extremities; (3) patterns of histograms of muscle fiber diameters were classified into six types, and in simple atrophy, almost one-half of muscles examined belonged to type 3 histogram, which had the mode situated at a relatively small diameter and a not so high kurtosls; (4) volume ratios of stroma to muscle Increased most in both muscular dystrophy and long-standing neurogenic muscular atrophy, moderately in myositis, and mildly in simple atrophy; and (5) hlstometrical changes In myasthenia gravis were minimal.     

Altered expression of ARPP protein in skeletal muscles of patients with muscular dystrophy, congenital myopathy and spinal muscular atrophy.

OBJECTIVES: Ankyrin-repeated protein with PEST and a proline-rich region (ARPP) is a recently identified protein with 4 ankyrin-repeated motifs in its central portion. Type 1 myofibers of skeletal muscle express high levels of ARPP. Recently, we have found that ARPP expression was induced in mouse denervated skeletal muscle. This led us to hypothesize that ARPP expression might be induced in skeletal muscle under some pathological conditions. METHODS: In this study, we performed immunohistochemical analysis of ARPP expression in biopsy specimens of muscle tissue from 15 patients with muscular dystrophies (MDs), 13 with congenital myopathies and 11 with spinal muscular atrophies (SMAs). RESULTS: The ARPP expression levels of all the specimens from MD patients appeared to be lower than control muscle levels. In contrast, the specimens from the 13 patients with congenital myopathies were all ARPP positive. We also found increased numbers of ARPP-positive myofibers in patients with congenital myopathies, and these myofibers co-expressed the slow myosin heavy chain. Indeed, it has been reported that type 1 myofibers are predominant in patients with congenital myopathies, suggesting that increased numbers of ARPP-positive myofibers in such patients may be associated with increased numbers of type 1 fibers. In patients with SMAs, we found that ARPP-positive myofibers tended to be distributed in groups. As grouped myofibers have been reported to result from the process of denervation, innervation and subsequent denervation of re-innervated myofibers, the grouped ARPP-positive myofibers in SMA patients may result from denervation of the motor units. CONCLUSIONS: These findings suggest that evaluation of ARPP may be helpful for the histological diagnosis of muscle diseases.     

Myosin heavy chain profile of equine Gluteus medius muscle following prolonged draught-exercise training and detraining

Fourteen 4-year old Andalusian mares were used to examine the plasticity of myosin heavy chain (MHC) composition in horse skeletal muscle with heavy draught-exercise training and detraining. Seven horses underwent a training programme based on carriage exercises for 8 months. Afterwards, they were kept in paddocks for 3 months. The remaining seven animals were used as control horses. Three gluteus medius muscle biopsies were removed at depths of 20, 40 and 60 mm from each horse before (month 0), during the training (months 3 and 8) and after detraining (month 11). Myosin heavy chain composition was analysed by electrophoresis and immunohistochemically with anti-MHC monoclonal antibodies. Fibre areas, oxidative capacity and capillaries were studied histochemically. After 8 months of training, MHC-IIX and IIX fibres decreased whereas MHC-I and type I and I + IIA fibres increased. Neither MHC-IIA nor the percentage of IIA fibres changed when the data were considered as a whole, but the proportion of MHC-IIA increased in the superficial region of the muscle after 8 months of training. Mean areas of type II fibres were not affected by training and detraining, but the cross-sectional of type I fibres increased after 3 month of training and not further increases were recorded afterward. The percentage of high-oxidative capacity fibres and the number of capillaries per mm² increased with training. Most of these muscular adaptations reverted after detraining. These results indicate that long term draught-exercise training induces a reversible transition of MHC composition in equine muscle in the order IIX IIA I. The physiological implication of these changes is an impact on the velocity of shortening and fatigue resistance of muscle fibres.     

Distribution, density, and structure of muscle spindles in the vastus intermedius and the peroneus longus muscles of sheep

Muscle spindles are not always distributed more in postural muscles with many slow-twitch-oxidative (SO) myofibers than in locomotory muscles with few SO myofibers. The purpose of present study was to examine the distribution, density, and structure of muscle spindles in the vastus intermedius muscle: an antigravity muscle and the peroneus longus muscle: a locomotory muscle in the sheep. Muscle spindles were reconstructed from serial sections at 300 microns intervals throughout the muscles. Myofiber types were classified into SO, fast-twitch-oxidative-glycolytic, and fast-twitch-glycolytic myofibers by differences in histochemical reactivity. No significant difference in the density of muscle spindles (DMS) existed between the vastus intermedius (DMS: 5.3) and peroneus longus (DMS: 5.7) muscles. The muscle spindles were distributed more in the distal portion than in the proximal portion of the vastus intermedius muscle. The muscle spindles were distributed in the proximal and middle portion but hardly in the distal portion of the peroneus longus muscle. Muscle spindles were classified into simple, tandem, and compound muscle spindles. Most of the muscle spindles were the simple type. The differences in size of the muscle spindle and numbers of the intrafusal myofibers were not significant between the two muscles. The results show that the density and structure of the muscle spindles do not differ between the postural and locomotory muscles in the sheep.     

Complex three-dimensional patterns of myosin isoform expression: differences between and within specific extraocular muscles

Because complex structural differences in adult extraocular muscles may have physiological and pathophysiological significance, the three-dimensional pattern of myosin heavy chain (MHC) isoform expression within the orbital and global layers of the muscle bellies compared with the distal tendon ends was quantitatively assessed. Three of the six extraocular muscles of adult rabbits were examined for immunohistologic expression of all fast, fast IIA/X, slow, neonatal and developmental MHC isoforms. The percentages of myofibers positive for each of these 5 myosin isoforms were determined in the orbital and global layers. There were relatively similar patterns of fast and slow MHC expression in the orbital and global layers of each of the three muscles examined. There were high levels of developmental MHC in the orbital layers, but significantly fewer developmental MHC positive myofibers in the global layer. The most variable expression was found with the neonatal MHC. There were significant differences between the longitudinal expression of the various isoforms in the middle of each muscle compared with the tendon end. In the orbital layer of all three muscles examined, the large numbers of fibers positive for fast MHC in the middle of the muscle dramatically decreased at the tendon end, with a concomitant increase in expression of slow myosin. There was a greater number of developmental MHC-positive myofibers at the tendon end than in the middle of the muscle in all three muscles examined. In the global layer, the IIA/X-positive myofibers comprised only half of the total number of fast-positive myofibers whereas in the orbital layer they comprised all or almost all of the fast positive myofibers. The configuration of the extraocular muscles is more complex than might be indicated by previous studies. The lateral rectus muscle had the most individual pattern of MHC expression when compared with the inferior rectus and inferior oblique muscles. Together with dramatic cross-sectional MHC fiber type differences between the orbital and global layers of the muscles, there are pronounced longitudinal differences in the proportions of myofibers expressing these five MHC isoforms in the middle region of the muscles and those in the distal tendon ends. This longitudinal progression appears to occur both within single myofibers, as well as within the series of myofibers that comprise the length of the muscle. We also confirm that the number of myofibers is reduced at the tendonous end while the cross-sectional area of each of the remaining myofibers is proportionally increased with regard to those in the muscle belly. Future studies may yet require two additional schemes for anatomic classification of the named extraocular muscles. One will be based on immunohistochemical features of their constituent myofibers as a supplement to classifications based on their electron microscopic appearance, innervation patterns or relative position with regard to the globe and orbit. Another will be based on the proportional length and longitudinal position of individual myofibers within an individual extraocular muscle.     

Fiber Type Composition of the Sternomastoid and Diaphragm Muscles of Dystrophin‐Deficient mdx Mice

The muscle fiber phenotype is mainly determined by motoneuron innervation and changes in neuromuscular interaction alter the muscle fiber type. In dystrophin‐deficient mdx mice, changes in the molecular assembly of the neuromuscular junction and in nerve terminal sprouting occur in the sternomastoid (STN) muscle during early stages of the disease. In this study, we were interested to see whether early changes in neuromuscular assembly are correlated with alterations in fiber type in dystrophic STN at 2 months of age. A predominance of hybrid fast myofibers (about 52% type IIDB) was observed in control (C57Bl/10) STN. In mdx muscle, the lack of dystrophin did not change this profile (about 54% hybrid type IIDB). Pure fast type IID fibers predominated in normal and dystrophic diaphragm (DIA; about 39% in control and 30% in mdx muscle) and a population of slow Type I fibers was also present (about 10% in control and 13% in mdx muscle). In conclusion, early changes in neuromuscular assembly do not affect the fiber type composition of dystrophic STN. In contrast to the pure fast fibers of the more affected DIA, the hybrid phenotype of the STN may permit dynamic adaptations during progression of the disease. Anat Rec 293:1722–1728, 2010. © 2010 Wiley‐Liss, Inc.     

Myofiber degeneration in autosomal dominant Emery-Dreifuss muscular dystrophy (AD-EDMD) (LGMD1B)

Autosomal dominant Emery-Dreifuss muscular dystrophy is caused by mutations in the LMNA gene that code for the nuclear membrane protein lamin A/C. We investigated skeletal muscle fibers from several muscles for cytoplasmic degenerative changes in three patients with genetically confirmed Emery-Dreifuss muscular dystrophy. Methods included quantitative light and electron microscopy and PCR-based mutational analysis. Results: The degenerative pathway was characterized by the gradual replacement of individual myofibers by connective tissue. Early stages of degeneration typically involved only a segment of the cross-sectional area of a myofiber. Intermediate stages consisted of myofiber shrinkage due to "shedding" of peripheral cytoplasmic portions into the endomysial space, and fragmentation of the myofibers by interposed collagen fibrils. Empty basement membrane sheaths surrounded by abundant deposits of extracellular matrix marked the end stage of the degenerative process. The nuclear number-to-cytoplasmic area in myofibers of one patient increased with increasing cross-sectional area, suggesting that satellite cell fusion with myofibers may have compensated for myofiber shrinkage. The pattern of degeneration described herein differs from muscular dystrophies with plasma membrane defects (dystrophinopathy, dysferlinopathy) and explains the frequently found absence of highly elevated serum creatine kinase levels in autosomal dominant Emery-Dreifuss muscular dystrophy.     

Prediction of the In Vivo Force–Velocity Relationship of Slow Human Skeletal Muscle from Measurements in Myofibers

Direct measurement of the in vivo contractile properties of an individual muscle cannot be made in humans. The objective of this study was to predict the force–velocity (F–V) properties of slow human skeletal muscle for the in vivo temperature of 37 °C from F–V measurements in type I myofibers. Specifically, to quantitatively link myofiber measurements, which must be conducted at relatively low temperatures, to in vivo properties, the temperature-dependence of contractile properties must be modeled. We estimated the kinetic parameters of a crossbridge model within 15–30 °C from F–V measurements recorded in the myofibers of one subject, extrapolated their values at 37 °C, and then predicted the in vivo shortening and lengthening F–V curves. The prediction for maximal shortening velocity was 2.2 ± 0.2 fiber lengths per second and that for saturation force during lengthening was 2.3 ± 0.2 times isometric force. These estimates agree with previously reported in vivo measurements but are substantially different than those used in muscle models for many musculoskeletal simulations. The results from this study indicate that during low levels of muscle activation when slow motor units are primarily recruited, musculoskeletal models should consider having F–V properties that reflect the contractile properties of type I myofibers.     

Central core disease--a case report.

Central core disease is a rare congenital myopathy characterized by the formation of "cores" that consist of abnormal arrangement of myofibrils inside the myofibers. We report a 5-year-old Korean girl who showed a fairly typical clinical course of non-progressive muscle weakness. Electrodiagnostic studies showed low-amplitude polyphasic electromyograph and normal nerve conduction velocity. Gastrocnemius muscle biopsy showed central cores in over 80% of the fibers on H&E section. Histochemistry revealed deficient or absent mitochondrial enzyme in the cores and type I predominance. Ultrastructurally both structured and non-structured cores were found separately or simultaneously in one fiber. This case is the first report in the Korean literature.     

Experimental Periodontitis in the Potentialization of the Effects of Immobilism in the Skeletal Striated Muscle

This study aims to evaluate if ligature-induced periodontitis can potentiates the deleterious effects of immobilization in the skeletal striated muscle, contributing to the development of muscle atrophy due to disuse. Forty Wistar rats were divided into four groups: (1) Control Group (CG), (2) Periodontal Disease (PDG), (3) Immobilized (IG), and (4) Immobilized with Periodontal Disease (IPDG). Periodontal disease was induced for 30 days, with ligature method, and the immobilization was performed with cast bandage for 15 days. Prior to euthanasia, nociceptive threshold and muscular grasping force were evaluated. Afterwards, the soleus muscle was dissected and processed for sarcomere counting and morphological/morphometric analysis. For data analysis, was used the one-way ANOVA and post-test Tukey (p < 0.05). The IG and IPDG presented lower muscle weight, lower muscular grip strength, and less number of sarcomeres compared to CG. The PDG showed reduction of muscle strength and nociceptive threshold after 15 days of periodontal disease and increased connective tissue compared to CG. The IPDG presented lower muscle length and nociceptive threshold. The IG presented reduction in cross-sectional area and smaller diameter, increase in the number of nuclei and a nucleus/fiber ratio, decrease in the number of capillaries and capillary/fiber ratio, with increase in connective tissue. The IPDG had increased nucleus/fiber ratio, decreased capillaries, and increased connective tissue when compared to the IG. The IPDG presented greater muscle tissue degeneration and increased inflammatory cells compared to the other groups. Ligature-induced periodontitis potentiated the deleterious effects of immobilization of the skeletal striated muscle.