Metabolic response to exercise in malignant hyperthermia-sensitive patients measured by 31P magnetic resonance spectroscopy

The currently favored theory of pathogenesis of malignant hyperthermia (MH) implicates an abnormality in skeletal muscle calcium ion transport. During a MH crisis a profound lactic acidosis occurs and in MH-sensitive individuals a delayed recovery of venous lactate has been previously noted postexercise. We have used ³¹P magnetic resonance spectroscopy to follow noninvasively in vivo changes in muscle of intracellular pH and high-energy phosphate metabolites during rest, exercise, and recovery of MH-sensitive subjects. Eleven biopsy-positive MH-sensitive patients have been studied and compared to 26 normal subjects. The MH-sensitive subjects as a group prematurely dropped their intracellular pH during mild aerobic exercise and they demonstrated a marked delay before the recovery of pH after maximal exercise. PCr/(PCr + P_i) ratios also dropped early during exercise but recovered normally. The observed changes in pH and PCr/(PCr + P_i) are consistent with a myopathy in MH-susceptible individuals. © 1990 Academic Press, Inc.     

Isokinetic eccentric exercise as a model to induce and reproduce pathophysiological alterations related to delayed onset muscle soreness

Physiological alterations following unaccustomed eccentric exercise in an isokinetic dynamometer of the right m. quadriceps until exhaustion were studied, in order to create a model in which the physiological responses to physiotherapy could be measured. In experiment I (exp. I), seven selected parameters were measured bilaterally in 7 healthy subjects at day 0 as a control value. Then after a standardized bout of eccentric exercise the same parameters were measured daily for the following 7 d (test values). The measured parameters were: the ratio of phosphocreatine to inorganic phosphate (PCr/P_i), the ratio of inorganic phosphate to adenosintriphosphate (Pi/ATP), the ratio of phosphocreatine to adenosintriphosphate (PCr/ATP) (all three ratios measured with ³¹P-nuclear magnetic resonance spectroscopy), dynamic muscle strength, plasma creatine kinase (CK), degree of pain and “muscle” blood flow rate (¹³³Xenon washout technique). This was repeated in experiment II (exp. II) 6–12 months later in order to study reproducbility. In experiment III (exp. III), the normal fluctuations over 8 d of the seven parameters were measured, without intervention with eccentric exercise in 6 other subjects. All subjects experienced pain, reaching a maximum 48 h after eccentric exercise in both exp. I and II. A systematic effect over time for CK (increasing 278% resp. 308%), muscle strength (decreasing more than 10%), PCr/Pi (decreasing 31% resp. 43%) and Pi/ATP (increasing 55% resp. 99%) was found in both exp. I and II (P<0.05), but not in exp. III. No significant difference was observed between exp. I and II for CK, blood-flow rate, concentric muscle strength, PCr/Pi, Pi/ATP and PCr/ATP. It is concluded that pathophysiological alterations in m. quadriceps following eccentric exercise can be induced and can be reproduced after an interval of 6 months. Thus, this model can be used to study the effects of physiotherapy.     

Evaluations of cooling exercised muscle with MR imaging and 31P MR spectroscopy

PURPOSE: To investigate the effects of cooling human skeletal muscle after strenuous exercise using 31P MR spectroscopy and MR imaging. METHODS: 14 male subjects (mean age +/- SD, 23.8 +/- 2.3 yr) were randomly assigned to the normal (N = 7) or the cooling group (N = 7). All subjects performed the ankle plantar flexion exercise (12 repetitions, 5 sets). Localized 31P-spectra were collected from the medial gastrocnemius before and after exercise (immediately, 30, 60 min, 24, 48, 96, and 168 h) to determine the ratio of inorganic phosphate to phosphocreatine (Pi/PCr) and intracellular pH. Transaxial T2-weighted MR images of the medial gastrocnemius were obtained to calculate T2 relaxation time (T2), indicative of intramuscular water level, before and after exercise (24, 48, 96, and 168 h). In addition, the muscle soreness level was assessed at the same time as 31P-spectra measurements. Fifteen-minute cold-water immersion was administered to the cooling group after exercise and initial postexercise measurements. RESULTS: The control group showed significantly increased T2 from rest at 48 h after exercise (P < 0.05), but the cooling group showed no significant change in T2 throughout this study. Both groups showed a significantly decreased intracellular pH immediately after exercise (P < 0.05). After that, the cooling group showed a significantly greater value than the value at rest or the control group at 60 min after exercise (P < 0.05). For the Pi/PCr, no significant change was observed in both groups throughout this study. The muscle soreness level significantly increased immediately and at 24-48 h after exercise in both groups (P < 0.05). CONCLUSION: The findings of this study suggest that cooling causes an increase in intracellular pH and prevents the delayed muscle edema.     

Exertional heatstroke and muscle metabolism: an in vivo 31P-MRS study.

An impairment of muscle energy metabolism has been suggested as a predisposing factor for, as well as a consequence of exertional heatstroke (EHS). Thirteen young men were investigated 6 months after a well-documented EHS using 31Phosphorus Magnetic Resonance Spectroscopy (31P-MRS). The relative concentrations of ATP, phosphocreatine (PCr), inorganic phosphate (Pi), phosphomonoesters (PME), and the intracellular pH (pHi) were determined at rest, during a graded standardized exercise protocol (360 active plantar flexions) and during recovery. Also the leg tissue blood flow was determined by venous occlusion plethysmography during the MRS procedure. Sixteen age-matched healthy male volunteers served as control group. In resting muscle, there were no significant differences between the groups as regards pHi, Pi/PCr, and ATP/PCr+Pi+PME ratios. During steady state exercise conditions, effective power outputs were similar for both groups at each level of exercise: 20, 35, and 50% of maximal voluntary contraction (MVC) of the calf muscle. No significant differences were shown between the two groups in Pi/PCr, pHi, or changes of leg blood flow at each level of exercise. At 50% MVC, Pi/PCr was 0.48 +/- 0.08 vs 0.47 +/- 0.05 (P = 0.96), pHi was 6.94 +/- 0.03 vs 6.99 +/- 0.02, respectively (P = 0.13). Finally, the rate of PCr resynthesis during recovery was not significantly different between the two groups: t1/2 PCr = 0.58 +/- 0.07 vs 0.50 +/- 0.05 min, respectively (P = 0.35). Therefore, no evidence of an impairment of muscle energy metabolism was shown in the EHS group during a standardized submaximal exercise using 31P-MRS performed 6 months after an EHS.     

Phosphocreatine resynthesis during recovery in different muscles of the exercising leg by 31P‐MRS

To investigate the high‐energy phosphate metabolism by ³¹P‐nuclear magnetic resonance spectroscopy during off‐transition of exercise in different muscle groups, such as calf muscles and biceps femoris muscles, seven male long‐distance runners (LDR) and nine untrained males (UT) performed both submaximal constant and incremental exercises. The relative exercise intensity was set at 60% of the maximal work rate (60%Wmax) during both knee flexion and plantar flexion submaximal constant load exercises. The relative areas under the inorganic phosphate (P_i) and phosphocreatine (PCr) peaks were determined. During the 5‐min recovery following the 60%Wmax, the time constant for the PCr off‐kinetics was significantly faster in the plantar flexion (LDR: 17.3 ± 3.6 s, UT: 26.7 ± 6.7 s) than in the knee flexion (LDR: 29.7 ± 4.7 s, UT: 42.7 ± 2.8 s, P < 0.05). In addition, a significantly faster PCr off‐kinetics was observed in LDR than in UT for both exercises. The ratio of P_i to PCr (P_i/PCr) during exercise was significantly lower during the plantar flexion than during the knee flexion (P < 0.01). These findings indicated that the calf muscles had relatively higher potential for oxidative capacity than that of biceps femoris muscles with an association of training status.     

Assessment of magnetic resonance techniques to measure muscle damage 24 h after eccentric exercise

The study examined which of a number of different magnetic resonance (MR) methods were sensitive to detecting muscle damage induced by eccentric exercise. Seventeen healthy, physically active participants, with muscle damage confirmed by non‐MR methods were tested 24 h after performing eccentric exercise. Techniques investigated whether damage could be detected within the quadriceps muscle as a whole, and individually within the rectus femoris, vastus lateralis (VL), vastus medialis (VM), and vastus intermedius (VI). Relative to baseline values, significant changes were seen in leg and muscle cross‐sectional areas and volumes and the resting inorganic phosphate concentration. Significant time effects over all muscles were also seen in the transverse relaxation time (T2) and apparent diffusion coefficient (ADC) values, with individually significant changes seen in the VL, VM, and VI for T2 and in the VI for ADC. A significant correlation was found between muscle volume and the average T2 change (r = 0.59) but not between T2 and ADC or Pi alterations. There were no significant time effects over all muscles for magnetization transfer contrast images, for baseline pH, phosphocreatine (PCr), phosphodiester, or ATP metabolite concentrations or the time constant describing the rate of PCr recovery following exercise.     

Effects of age on muscle energy metabolism and oxygenation in the forearm muscles

PURPOSE: The effects of aging on muscle metabolism and oxygenation have not yet been elucidated. We evaluated the effects of aging on energy metabolism and oxygenation in sedentary healthy subjects by simultaneously measuring 31P-magnetic resonance spectroscopy (MRS) and near-infrared spectroscopy (NIRS). METHODS: Nine young (28.1 +/- 5.0 yr) and nine older (61.4 +/- 4.6 yr) healthy subjects were studied. The 31P-MR spectrum was obtained every 15 s during and after hand gripping exercise. Intracellular pH (pHi) and PCr/(PCr+Pi) [PCr: phosphocreatine, Pi: inorganic phosphate] were calculated as an index of energy metabolism. The time constant of the PCr/(PCr+Pi) recovery (tau PCr) was calculated. With NIRS, we evaluated the recovery rates of oxygenated (RHbO2) and deoxygenated hemoglobin (RHb) during the initial 10 s of recovery. RESULTS: The PCr/(PCr+Pi) and pHi at rest and at completion of the exercise and tau PCr did not differ between young and older subjects. However, RHbO2 and RHb were significantly slower in older subjects than in young subjects. CONCLUSIONS: The results suggest that muscle energy metabolism in the forearm muscle was not affected by aging. The slower RHbO2 and RHb in older subjects suggested impaired O2 supply, which was probably due to impaired peripheral circulation caused by the process of aging.     

Impact of single and multiple sets of resistance exercise in type 1 diabetes

To examine glycemic and glucoregulatory responses to resistance exercise (RE) sessions of different volume in type 1 diabetes (T1DM). Eight T1DM (seven males: one female; age: 38 ± 6 years, HbA_1C: 8.7 ± 1.0%/71 ± 11 mmol/mol) attended the research facility fasted and on four separate occasions, having taken their usual basal insulin, but omitted morning rapid‐acting insulin. Participants completed a 1SET (14 min), 2SET (28 min), 3SET (42 min) RE session (eight exercises × 10 repetitions) at 67 ± 3% one‐repetition‐maximum followed by 60‐min recovery, or a resting trial (CON). Venous blood samples were taken before and after exercise. Data (mean ± SEM) were analyzed using repeated‐measures analysis of variance (P ≤ 0.05). RE did not induce hypoglycemia (BG < 4 mmol/L). During recovery, blood glucose (BG) concentrations remained above pre‐exercise after 1SET (15–60 min, P < 0.05) and 2SET (0–60 min, P < 0.05) but comparable (P > 0.05) with pre‐exercise after 3SET. BG_{IAUC(area‐under‐curve)} (mmol/L/60 min) was greater after 1SET and 2SET vs CON (1SET 103.6 ± 36.9 and 2SET 128.7 ± 26.1 vs CON ?24.3 ± 15.2, P < 0.05), but similar between 3SET and CON (3SET 40.7 ± 59.3, P > 0.05). Under all trials, plasma creatine kinase levels at 24 h post‐exercise were similar (P > 0.05) to pre‐exercise. RE does not induce acute hypoglycemia or damage muscle. BG progressively rose after one and two sets of RE. However, inclusion of a third set attenuated exercise‐induced hyperglycemia and returned BG to that of a non‐exercise trial.     

Assessment of 31P relaxation times in the human calf muscle: A comparison between 3 T and 7 T in vivo

Phosphorus (³¹P) T₁ and T₂ relaxation times in the resting human calf muscle were assessed by interleaved, surface coil localized inversion recovery and frequency‐selective spin‐echo at 3 and 7 T. The obtained T₁ (mean ± SD) decreased significantly (P < 0.05) from 3 to 7 T for phosphomonoesters (PME) (8.1 ± 1.7 s to 3.1 ± 0.9 s), phosphodiesters (PDE) (8.6 ± 1.2 s to 6.0 ± 1.1 s), phosphocreatine (PCr) (6.7 ± 0.4 s to 4.0 ± 0.2 s), γ‐NTP (nucleotide triphosphate) (5.5 ± 0.4 s to 3.3 ± 0.2 s), α‐NTP (3.4 ± 0.3 s to 1.8 ± 0.1 s), and β‐NTP (3.9 ± 0.4 s to 1.8 ± 0.1 s), but not for inorganic phosphate (Pi) (6.9 ± 0.6 s to 6.3 ± 1.0 s). The decrease in T₂ was significant for Pi (153 ± 9 ms to 109 ± 17 ms), PDE (414 ± 128 ms to 314 ± 35 ms), PCr (354 ± 16 ms to 217 ± 14 ms), and γ‐NTP (61.9 ± 8.6 ms to 29.0 ± 3.3 ms). This decrease in T₁ with increasing field strength of up to 62% can be explained by the increasing influence of chemical shift anisotropy on relaxation mechanisms and may allow shorter measurements at higher field strengths or up to 62% additional signal‐to‐noise ratio (SNR) per unit time. The fully relaxed SNR increased by +96%, while the linewidth increased from 6.5 ± 1.2 Hz to 11.2 ± 1.9 Hz or +72%. At 7 T ³¹P‐MRS in the human calf muscle offers more than twice as much SNR per unit time in reduced measurement time compared to 3 T. This will facilitate in vivo ³¹P‐MRS of the human muscle at 7 T. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Muscle high-energy metabolites and metabolic capacity in patients with heart failure

OKITA, K., K. YONEZAWA, H. NISHIJIMA, A. HANADA, T. NAGAI, T. MURAKAMI, and A. KITABATAKE. Muscle high-energy metabolites and metabolic capacity in patients with heart failure. Med Sci. Sports. Exerc., Vol. 33, No. 3, 2001, pp. 442-448. Background: Various abnormalities in skeletal muscle have been demonstrated by biopsy in patients with chronic heart failure (CHF). In mammalian muscles, high-energy metabolite composition at rest (HEMC) provides data on important metabolic characteristics; however, the significance of HEMC has not been clarified in patients with CHF. Therefore, we investigated HEMC in normal subjects and patients with CHF and examined its relation to muscle metabolic capacity and exercise tolerance. Methods: High-energy metabolites (phosphocreatine (PCr), inorganic phosphate (Pi), and ATP) in resting calf muscle were measured by 31P-magnetic resonance spectroscopy (31P-MRS), and ratios of Pi to PCr, Pi to ATP, and PCr to ATP were calculated in 34 patients with CHF and 13 age- and size-matched normal subjects. Muscle metabolism was evaluated during local exercise of unilateral plantar flexion by 31P-MRS. Metabolic capacity was estimated by the rate of PCr breakdown in relation to the workload. Systemic exercise capacity was evaluated by a bicycle ergometer. Results: The ratio of PCr to ATP was significantly increased in patients with CHF compared with controls (3.06 +/- 0.43 vs 2.72 +/- 0.36, P < 0.05) and was significantly correlated with metabolic capacity (r = -0.37, P < 0.01) and with peak oxygen uptake (r = -0.45, P < 0.01). There was a significant correlation between metabolic capacity and peak oxygen uptake (r = 0.53, P < 0.001). Conclusion: HEMC was altered in patients with CHF, and this change was related to metabolic capacity and exercise capacity. These findings provide new insight into the mechanism of impaired muscle metabolism in CHF.     

Measurement of human skeletal muscle oxidative capacity by 31P-MR spectroscopy: a cross-validation with in vitro measurements

Purpose:

To cross‐validate skeletal muscle oxidative capacity measured by ³¹P‐MR spectroscopy with in vitro measurements of oxidative capacity in mitochondria isolated from muscle biopsies of the same muscle group in 18 healthy adults.

Materials and Methods:

Oxidative capacity in vivo was determined from PCr recovery kinetics following a 30‐s maximal isometric knee extension. State 3 respiration was measured in isolated mitochondria using high‐resolution respirometry. A second cohort of 10 individuals underwent two ³¹P‐MRS testing sessions to assess the test–retest reproducibility of the method.

Results:

Overall, the in vivo and in vitro methods were well‐correlated (r = 0.66–0.72) and showed good agreement by Bland Altman plots. Excellent reproducibility was observed for the PCr recovery rate constant (CV = 4.6%; ICC = 0.85) and calculated oxidative capacity (CV = 3.4%; ICC = 0.83).

Conclusion:

These results indicate that ³¹P‐MRS corresponds well with gold‐standard in vitro measurements and is highly reproducible. J. Magn. Reson. Imaging 2011;. © 2011 Wiley Periodicals, Inc.     

The use of nuclear magnetic resonance to evaluate muscle injury.

Magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) are new and powerful tools to study tissue biochemistry, and to provide precise anatomical visualization of soft tissue structures. This review focuses on the use of these techniques to study exercise-induced muscle injury. MRS measurements show an increase in the ratio of inorganic phosphate to phosphocreatine (Pi/PCr) 1-7 d after eccentric exercise. This increase in Pi/PCr could be due to either increases in extracellular Pi or small increases in resting muscle metabolism. Increased Pi/PCr is also seen during training programs and may indicate persistent muscle injury. Increased resting Pi/PCr with injury was not associated with altered metabolism during exercise. Elevations in resting Pi/PCr have been used to show increased susceptibility of dystrophic muscle to exercise-induced injury. Progressive clinical deterioration in dystrophic dogs is marked by impaired muscle metabolism, and the presence of low oxidative muscle fibers not seen in normal dogs. MRI shows increased proton T2 relaxation times following eccentric exercise that last up to 80 d after injury, and can reflect muscle edema as well as longer lasting changes in the characteristics of cell water. MRI demonstrate precise localization of the injured area, with large differences in both location and degree of injury in different subjects following the same exercise protocol. Thus, MRS can provide information on the metabolic response to injury, while MRI provides information regarding the site and extent of the injury. These tools have promise in helping to understand exercise-induced muscle injury.     

The effect of passive stretching on delayed onset muscle soreness, and other detrimental effects following eccentric exercise

The aim of this study was to measure if passive stretching would influence delayed onset muscle soreness (DOMS), dynamic muscle strength, plasma creatine kinase concentration (CK) and the ratio of phosphocreatine to inorganic phosphate (PCr/Pi) following eccentric exercise. Seven healthy untrained women, 28–46 years old, performed eccentric exercise with the right m. quadriceps in an isokinetic dynamometer (Biodex, angle velocity: 60°. s⁻¹) until exhaustion, in two different experiments, with an interval of 13-23 months. In both experiments the PCr/P_i ratio, dynamic muscle strength, CK and muscle pain were measured before the eccentric exercise (day 0) and the following 7 d. In the second experiment daily passive stretching (3 times of 30 s duration, with a pause of 30 s in between) of m. quadriceps was included in the protocol. The stretching was performed before and immediately after the eccentric exercise at day 0, and before measurements of the dependent variables daily for the following 7 d. The eccentric exercise alone led to significant decreases in PCr/P_i ratio ( P <0.001) and muscle strength ( P <0.001), and an increase in CK concentration ( P <0.01). All subjects reported pain in the right m. quadriceps with a peak 48 h after exercise. There was no difference in the reported variables between experiments one and two. It is concluded that passive stretching did not have any significant influence on increased plasma- CK, muscle pain, muscle strength and the PCr/P_i ratio, indicating that passive stretching after eccentric exercise cannot prevent secondary pathological alterations.     

Influence of aerobic cycle exercise training on patellar tendon cross‐sectional area in older women

Nine to 12 weeks of resistance exercise training in young individuals induces quadriceps muscle (～6%) and region‐specific patellar tendon (4–6%) hypertrophy. However, 12 weeks of resistance exercise training (～1 h total exercise time) in older individuals (60–78 years) induces quadriceps muscle hypertrophy (9%) without impacting patellar tendon size. The current study examined if a different loading paradigm using cycle exercise would promote patellar tendon hypertrophy or alter the internal tendon properties, measured with magnetic resonance imaging signal intensity, in older individuals. Nine women (70 ± 2 years) completed 12 weeks of aerobic upright cycle exercise training (～28 h total exercise time). Aerobic exercise training increased (P < 0.05) quadriceps muscle size (11 ± 2%) and VO_2max (30 ± 9%). Mean patellar tendon cross‐sectional area (CSA) (2 ± 1%) and signal intensity (?1 ± 2%) were unchanged (P > 0.05) over the 12 weeks of training. Region‐specific CSA was unchanged (P > 0.05) at the proximal (?1 ± 3%) and mid regions (2 ± 2%) of the tendon but tended (P = 0.069) to increase at the distal region (5 ± 3%). Region‐specific signal intensity differed along the tendon but was unchanged (P > 0.05) with training. Although more studies are needed, exercise‐induced patellar tendon hypertrophy, compared with skeletal muscle, appears to be attenuated in older individuals, while the loading pattern associated with aerobic exercise seems to have more impact than resistance exercise in promoting patellar tendon hypertrophy.     

Temporal and anatomical variations of brain water apparent diffusion coefficient in perinatal cerebral hypoxic-ischemic injury: Relationships to cerebral energy metabolism

Cerebral apparent diffusion coefficients {ADCs) were determined in nine newborn piglets before and for 48 h after transient hypoxia-ischemia. Phosphorus MRS revealed severely reduced cerebral energy metabolism during the insult and an apparently complete recovery 2 h after resuscitation commenced. At this time, mean ADC over the imaging slice (ADC_global) was 0.88 (0.04) × 10^{? 9} m² · s^{? 1} (mean (SD}), which was close to the baseline value of 0.92 (0.4) × 10^{? 9} m² · s^{? 1}. In seven of the animals, a “secondary” failure of energy metabolism then evolved, accompanied by a decline in ADC_global to 0.64 (0.17) × 10^{? 9} m² · s^{? 1} at 46 h postresuscitation (P < 0.001 versus baseline). For these seven animals, ADC_global correlated linearly with the concentration ratio [phosphocreatine (PCr)][inorganic phosphate (Pi)] (0.94 r < 0.99; P > 0.001). A nonlinear relationship was demonstrated between ADC_global, and the concentration ratio [nucleotide triphosphate (NTP)]/ [Pi + PCr + 3 NTP]. The ADC reduction commenced in the parasagittal cortex before spreading in a characteristic pattern throughout the brain. ADC seems to be closely related to cerebral energy status and shows considerable potential for the assessment of hypoxic-ischemic injury in the newborn brain.     

Peak oxygen consumption and skeletal muscle bioenergetics in African-American and Caucasian men

OBJECTIVE: To compare peak oxygen consumption (VO2peak) and skeletal muscle oxidative metabolism between nine African-American and nine Caucasian men. METHODS: Subjects performed arm ergometry to exhaustion. On a separate occasion 31phosphorous-nuclear magnetic resonance spectroscopy (31P-NMRS) was used to determine the concentrations of phosphorous (Pi), phosphocreatine (PCr), and the intracellular pH of the flexor carpi radialis before and during 4 min of steady-state, wrist flexion exercise performed at 28% (15 W) of each subject's peak voluntary contraction. RESULTS: The Pi/PCr ratio was used as an indirect measure of skeletal muscle oxidative metabolism. VO2peak was lower in the African-Americans compared with the Caucasians (means +/- SD, 19.4 +/- 3.4 vs 23.3 +/- 4.0 mL x kg(-1) x min(-1)) (P < 0.05). No significant between group difference was noted in the Pi/PCr ratio at rest (0.10 +/- 0.02 both groups). However, resting pH was lower in the African-Americans (6.99 +/- 0.04 vs 7.03 +/- 0.05) (P < 0.05). Exercise caused an increase in the Pi/PCr ratio in the African-Americans (1.06 +/- 0.11), which was higher than the increase observed in the Caucasians (0.50 +/- 0.14) (P < 0.05). pH levels decreased to a lower level during exercise in the African-Americans (6.89 +/- 0.04) than in the Caucasians (6.98 +/- 0.05) (P < 0.05). CONCLUSIONS: This select group of African-American men achieved a lower VO2peak than the Caucasian men. Variations in skeletal muscle oxidative metabolic components may explain this difference.     

Characterization of the regional distribution of skeletal muscle adipose tissue in type 2 diabetes using chemical shift-based water/fat separation

Purpose:

To show the feasibility of assessing the spatial distribution of skeletal muscle adipose tissue using chemical shift‐based water/fat separation and to characterize differences in calf intermuscular adipose tissue (IMAT) compartmentalization in patients with type 2 diabetes mellitus (T2DM) compared to healthy age‐matched controls.

Materials and Methods:

A chemical shift‐based water/fat separation approach using a multiecho 3D spoiled gradient echo sequence was applied in a study of 64 patients, including 35 healthy controls and 29 subjects with T2DM. Masks were defined based on manual segmentations to compute fat volume within different compartments, including regions of subcutaneous adipose tissue (SAT) and six muscular regions. IMAT was divided into two compartments representing fat within the muscular regions (intraMF) and fat between the muscular regions (interMF). Two‐sample Student's t‐tests were used to compare fat volumes between the two groups.

Results:

The subjects with T2DM had a lower volume of SAT compared to the healthy controls (P = 4 × 10^?5). There was no statistically significant difference in the IMAT volume between the two groups. However, the intraMF volume normalized by the IMAT volume was higher in the diabetics compared to the controls (P = 0.006).

Conclusion:

Chemical shift‐based water/fat separation enables the quantification of fat volume within localized muscle regions, showing that the IMAT regional distribution is significantly different in T2DM compared to normal controls. J. Magn. Reson. Imaging 2012;35:899–907. © 2011 Wiley Periodicals, Inc.

     

Reduction in plasma leucine after sprint exercise is greater in males than in females

There is a pronounced gender difference in the accumulation of plasma ammonia after sprint exercise. Ammonia is a key intermediate in amino acid metabolism, which implies that gender‐related differences in plasma and muscle amino acid concentrations after sprint exercise exist. To study this, three bouts of 30‐s sprint exercise were performed by healthy females (n=8) and males (n=6). Blood leucine and muscle leucine were collected over the exercise period. Basal arterial plasma and skeletal muscle leucine were 40% higher in males than females (P<0.010 and P<0.020). Plasma, but not muscle, leucine decreased by sprint exercise and more so in males than females (g × t: P=0.025). Increase in ammonia was higher in males than females in both plasma and muscle (g × t: P<0.001 and P=0.003). An opposite pattern was shown for plasma glutamine, where an increase was found in females (P<0.001), but not in males. In conclusion, the lower plasma ammonia after sprint exercise in females seems to be explained by a lower accumulation of ammonia in skeletal muscle and by a buffering of ammonia in the form of glutamine in females. The greater reduction in plasma leucine in males seems to be related to their greater increase in muscle ammonia after sprint exercise.     

One session of partial‐body cryotherapy (−110 °C) improves muscle damage recovery

To evaluate the effects of a single session of partial‐body cryotherapy (PBC) on muscle recovery, 26 young men performed a muscle‐damaging protocol that consisted of five sets of 20 drop jumps with 2‐min rest intervals between sets. After the exercise, the PBC group (n = 13) was exposed to 3 min of PBC at ?110 °C, and the control group (n = 13) was exposed to 3 min at 21 °C. Anterior thigh muscle thickness, isometric peak torque, and muscle soreness of knee extensors were measured pre, post, 24, 48, 72, and 96 h following exercise. Peak torque did not return to baseline in control group (P < 0.05), whereas the PBC group recovered peak torques 96 h post exercise (P > 0.05). Peak torque was also higher after PBC at 72 and 96 h compared with control group (P < 0.05). Muscle thickness increased after 24 h in the control group (P < 0.05) and was significantly higher compared with the PBC group at 24 and 96 h (P < 0.05). Muscle soreness returned to baseline for the PBC group at 72 h compared with 96 h for controls. These results indicate that PBC after strenuous exercise may enhance recovery from muscle damage.     

Significance of the "Delayed hyperintense portal vein sign" in the hepatobiliary phase MRI obtained with Gd-EOB-DTPA

Purpose:

To identify MRI biomarkers that could be used to follow disease progression and therapeutic efficacy in one individual muscle in patients with myotonic dystrophy type 1 (DM1).

Materials and Methods:

Lower limb MRI and maximal ankle dorsiflexor strength assessment, using a hand‐held dynamometer, were performed in 19 DM1 patients and 6 control subjects. The volume of residual muscle tissue of Tibialis Anterior (TA) muscle was chosen as an index for muscle atrophy, and the T2‐relaxation‐time of the residual muscle tissue was measured to evaluate edema‐like lesions. The fat‐to‐water ratio was assessed using three‐point Dixon images to quantify fat infiltration in the entire muscle.

Results:

The intra‐observer variability of MRI indices (～5.2% for the residual muscle tissue volume and 2.5% for the fat‐to‐water ratio) was lower than that of the dorsiflexor torque measurement (～11.5%). A high correlation (r = 0.91) was found between maximal ankle dorsiflexor strength and residual TA muscle tissue volume in DM1 patients. Increases in the fat‐to‐water ratio and T2‐relaxation‐time were associated with a decrease in maximal ankle dorsiflexor strength.

Conclusion:

MRI appears as a noninvasive method which can be used to follow disease progression and therapeutic efficacy. J. Magn. Reson. Imaging 2012;35:678‐685. © 2011 Wiley Periodicals, Inc.