scholarly journals Combination of Quantitative MRI Fat Fraction and Texture Analysis to Evaluate Spastic Muscles of Children With Cerebral Palsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Tugba Akinci D'Antonoli ◽  
Francesco Santini ◽  
Xeni Deligianni ◽  
Meritxell Garcia Alzamora ◽  
Erich Rutz ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Texture Analysis ◽  
Quantitative Mri ◽  
Control Group ◽  
Healthy Controls ◽  
Lasso Regression ◽  
Gastrocnemius Medialis ◽  
Fat Fraction ◽  
Age Range ◽  
Gastrocnemius Lateralis

Background: Cerebral palsy (CP) is the most common cause of physical disability in childhood. Muscle pathologies occur due to spasticity and contractures; therefore, diagnostic imaging to detect pathologies is often required. Imaging has been used to assess torsion or estimate muscle volume, but additional methods for characterizing muscle composition have not thoroughly been investigated. MRI fat fraction (FF) measurement can quantify muscle fat and is often a part of standard imaging in neuromuscular dystrophies. To date, FF has been used to quantify muscle fat and assess function in CP. In this study, we aimed to utilize a radiomics and FF analysis along with the combination of both methods to differentiate affected muscles from healthy ones.Materials and Methods: A total of 9 patients (age range 8–15 years) with CP and 12 healthy controls (age range 9–16 years) were prospectively enrolled (2018–2020) after ethics committee approval. Multi-echo Dixon acquisition of the calf muscles was used for FF calculation. The images of the second echo (TE = 2.87 ms) were used for feature extraction from the soleus, gastrocnemius medialis, and gastrocnemius lateralis muscles. The least absolute shrinkage and selection operator (LASSO) regression was employed for feature selection. RM, FF model (FFM), and combined model (CM) were built for each calf muscle. The receiver operating characteristic (ROC) curve and their respective area under the curve (AUC) values were used to evaluate model performance.Results: In total, the affected legs of 9 CP patients and the dominant legs of 12 healthy controls were analyzed. The performance of RM for soleus, gastrocnemius medialis, and gastrocnemius lateralis (AUC 0.92, 0.92, 0.82, respectively) was better than the FFM (AUC 0.88, 0.85, 0.69, respectively). The combination of both models always had a better performance than RM or FFM (AUC 0.95, 0.93, 0.83). FF was higher in the patient group (FFS 9.1%, FFGM 8.5%, and FFGL 10.2%) than control group (FFS 3.3%, FFGM 4.1%, FFGL 6.6%).Conclusion: The combination of MRI quantitative fat fraction analysis and texture analysis of muscles is a promising tool to evaluate muscle pathologies due to CP in a non-invasive manner.

scholarly journals Muscle deterioration due to rheumatoid arthritis: assessment by quantitative MRI and strength testing

Rheumatology ◽  
2020 ◽  
Author(s):  
Matthew Farrow ◽  
John Biglands ◽  
Steven Tanner ◽  
Elizabeth M A Hensor ◽  
Maya H Buch ◽  
...  
Keyword(s):  
Clinical Remission ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Knee Extension ◽  
Muscle Volume ◽  
Quantitative Mri ◽  
Muscle Pathology ◽  
Healthy Controls ◽  
Thigh Muscles ◽  
Fat Fraction

Abstract Objectives RA patients often present with low muscle mass and decreased strength. Quantitative MRI offers a non-invasive measurement of muscle status. This study assessed whether MRI-based measurements of T2, fat fraction, diffusion tensor imaging and muscle volume can detect differences between the thigh muscles of RA patients and healthy controls, and assessed the muscle phenotype of different disease stages. Methods Thirty-nine RA patients (13 ‘new RA’—newly diagnosed, treatment naïve, 13 ‘active RA’—persistent DAS28 >3.2 for >1 year, 13 ‘remission RA’—persistent DAS28 <2.6 for >1 year) and 13 age and gender directly matched healthy controls had an MRI scan of their dominant thigh. All participants had knee extension and flexion torque and grip strength measured. Results MRI T2 and fat fraction were higher in the three groups of RA patients compared with healthy controls in the thigh muscles. There were no clinically meaningful differences in the mean diffusivity. The muscle volume, handgrip strength, knee extension and flexion were lower in all three groups of RA patients compared with healthy controls. Conclusion Quantitative MRI and muscle strength measurements can potentially detect differences within the muscles between RA patients and healthy controls. These differences may be seen in RA patients who are yet to start treatment, those with persistent active disease, and those who were in clinical remission. This suggests that the muscles in RA patients are affected in the early stages of the disease and that signs of muscle pathology and muscle weakness are still observed in clinical remission.

Fat fraction distribution in lower limb muscles of patients with CMT1A

Neurology ◽  
2020 ◽  
Vol 94 (14) ◽  
pp. e1480-e1487 ◽  
Author(s):  
Joachim Bas ◽  
Augustin C. Ogier ◽  
Arnaud Le Troter ◽  
Emilien Delmont ◽  
Benjamin Leporq ◽  
...  
Keyword(s):  
Lower Limb ◽  
Plantar Flexion ◽  
Quantitative Mri ◽  
Healthy Controls ◽  
Anterior Compartment ◽  
Fat Infiltration ◽  
Clinical Variables ◽  
Leg Muscles ◽  
Fat Fraction ◽  
Muscle Fat Infiltration

ObjectiveTo quantitatively describe the MRI fat infiltration pattern of muscle degeneration in Charcot-Marie-Tooth (CMT) type 1A (CMT1A) disease and to look for correlations with clinical variables.MethodsMRI fat fraction was assessed in lower-limb musculature of patients with CMT1A and healthy controls. More particularly, 14 muscle compartments were selected at leg and thigh levels and for proximal, distal, and medial slices. Muscle fat infiltration profile was determined quantitatively in each muscle compartment and along the entire volume of acquisition to determine a length-dependent gradient of fat infiltration. Clinical impairment was evaluated with muscle strength measurements and CMT Examination Scores (CMTESs).ResultsA total of 16 patients with CMT1A were enrolled and compared to 11 healthy controls. Patients with CMT1A showed a larger muscle fat fraction at leg and thigh levels with a proximal-to-distal gradient. At the leg level, the largest fat infiltration was quantified in the anterior and lateral compartments. CMTES was correlated with fat fraction, especially in the anterior compartment of leg muscles. Strength of plantar flexion was also correlated with fat fraction of the posterior compartments of leg muscles.ConclusionOn the basis of quantitative MRI measurements combined with a dedicated segmentation method, muscle fat infiltration quantified in patients with CMT1A disclosed a length-dependent peroneal-type pattern of fat infiltration and was correlated to main clinical variables. Quantification of fat fraction at different levels of the leg anterior compartment might be of interest in future clinical trials.

scholarly journals Arterial Structure and Function in Ambulatory Adolescents with Cerebral Palsy Are Not Different from Healthy Controls

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Audra A. Martin ◽  
Lisa M. Cotie ◽  
Brian W. Timmons ◽  
Jan Willem Gorter ◽  
Maureen J. MacDonald
Keyword(s):  
Cerebral Palsy ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Moderate Intensity ◽  
Control Group ◽  
Healthy Controls ◽  
Mobility Limitations ◽  
Increased Risk ◽  
Intensity Physical Activity ◽  
And Function

Physical inactivity in youth with cerebral palsy (CP) places them at increased risk of developing cardiovascular disease. The current study assessed indices of arterial health in adolescents with CP, classified as levels I-II of the Gross Motor Function Classification System (GMFCS) (n=11, age13.2±2.1 yr), in comparison to age- and sex-matched controls (n=11, age12.4±2.3 yr). Groups were similar in anthropometric measurements, resting blood pressures, and heart rates. There were no group differences in brachial flow-mediated dilation (11.1±7.8versus6.1±3.6), carotid intima-media thickness (0.42±0.04versus0.41±0.03 mm), and distensibility (0.008±0.002versus0.008±0.002 mmHg) or central (4.3±0.6versus4.1±0.9 m/s) and peripheral pulse wave velocity (7.1±1.7versus7.6±1.1 m/s); CP versus healthy controls, respectively. Vigorous intensity physical activity (PA) was lower in the CP group (CP:38±80 min versus controls:196±174 min); groups were similar in light and moderate intensity PA levels. Arterial health of ambulatory youth with CP is not different from a control group despite lower vigorous PA levels. Similar studies need to examine individuals with more pronounced mobility limitations (GMFCS level III–V).

scholarly journals P1439DO PATIENTS ON DIALYSIS AGE FASTER THAN HEALTHY ADULTS BASED ON TELOMERE LENGTH; A BIOLOGICAL MARKER OF AGEING AND MORTALITY?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Vasantha Muthuppalaniappan ◽  
Kieran McCafferty ◽  
Muhammad Yaqoob
Keyword(s):  
Telomere Length ◽  
Control Group ◽  
Healthy Controls ◽  
Control Cohort ◽  
Dialysis Patients ◽  
Healthy Cohort ◽  
And Gender ◽  
Age Range ◽  
And Control

Abstract Background and Aims Telomere length (TL) is an emerging novel biomarker of ageing and survival. Telomere shortening to a critical limit is associated with replicative senescence and cell death; a process accelerated by oxidative stress and chronic inflammation. This process is often observed among patients with end stage kidney disease (ESKD). This predisposes them to increased morbidity and mortality in comparison to their normal counterparts when matched for age and gender. The exact reason for premature ageing in this cohort remains poorly understood and there is a need for further investigations into biomarkers of ageing to help understand the process. The aim of the study was to investigate if patients with ESKD in comparison to healthy controls had an increased biological age based on telomere length measurements. Method This was a single centre prospective, observational, cohort study among eligible dialysis patients and healthy controls. The healthy control group consisted of potential living donors. Patients were recruited as per the study protocol. Recruited patients on HD had their blood sampled prior to their mid-week dialysis session while potential live donors and PD patients had their blood sampled at outpatient clinics. Whole blood was immediately isolated for peripheral blood mononuclear cells (PBMC). Genomic DNA was extracted from PBMC to measure relative telomere length (rTL) by quantitative real-time polymerase chain reaction according to the modified Cawthon protocol. Baseline demographic data and 1-year mortality were obtained from electronic patient records. Results A total of 336 patients (125 patients on HD, 114 patients on PD and 100 healthy controls) had their baseline rTL measured between the period of December 2015 to July 2018. Inter assay CV for rTL assay was 4.86%. Mean age of the dialysis cohort was 54.3 with an age range between 23-83 years. Mean age of control cohort was 44.5 with an age range between 20-75years. There were 87 and 56 females in the dialysis and control cohort respectively. Age was significantly associated with TL in a multivariate regression model in both the dialysis (p<0.001) and control group (p<0.001). There was no significant difference in mean TL between gender in the healthy cohort in our study p=0.778. However, mean TL was higher in females than in males among dialysis patients, p=0.007. Mean TL of control and dialysis group was 2.23 ± 0.33 and 2.11 ± 0.34 respectively. The difference in TL between the groups was significant, p=0.006. However, a multivariate analysis of TL adjusted for age and gender was not significant, p=0.875. This was due to the control cohort consisting of younger recruits in comparison to the dialysis cohort. TL was not significantly different between HD and PD patients. There were 10 deaths in 365 days with no loss of follow up throughout the study period. All the deaths were in the dialysis cohort. There was no significant association found between TL and mortality outcomes but the direction of effect i.e shorter TL was associated with increased risk of death. Conclusion This study failed to show any difference between TL between dialysis patients and controls to demonstrate that patients on dialysis age faster. This does not preclude current evidence suggesting that dialysis patients do have an accelerated ageing in comparison to healthy cohort but merely that our study has shown that TL may not be the ideal biomarker of ageing to demonstrate this difference. In fact, increasing animal studies have found that the rate of change in TL over a period of time is a better representation of ageing. The study also identified no association between TL and 1-year mortality as there were only 10 deaths within the 1 year of follow up. This may be largely due to a short duration of follow up and it may be interesting to evaluate TL and 5-year mortality data in this cohort in future.

A prospective gait analysis study in patients with diplegic cerebral palsy 20 years after selective dorsal rhizotomy

2008 ◽  
Vol 1 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Nelleke G. Langerak ◽  
Robert P. Lamberts ◽  
A. Graham Fieggen ◽  
Jonathan C. Peter ◽  
Lize van der Merwe ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Sagittal Plane ◽  
Video Camera ◽  
Step Length ◽  
Control Group ◽  
Healthy Controls ◽  
Selective Dorsal Rhizotomy ◽  
Locomotor Function ◽  
Dorsal Rhizotomy ◽  
Digital Video Camera

Object Selective dorsal rhizotomy (SDR) has been widely performed for the reduction of spasticity in patients with cerebral palsy during the past 2 decades. The objective of this study was to determine whether the surgery has yielded long-term functional benefits for these patients. Methods The authors present results from a prospective 20-year follow-up study of locomotor function in 13 patients who underwent an SDR in 1985. For comparison, we also present gait data for 48 age-matched healthy controls (12 at each of 4 time points). Patients were studied preoperatively and then at 1, 3, 10, and 20 years after surgery. Study participants were recorded in the sagittal plane while walking using a digital video camera, and 6 standard gait parameters were measured. Results In this group of patients 20 years after surgery, knee range of motion (ROM) was on average 12° greater than preoperative values (p < 0.001). Hip ROM before surgery was no different from that in the healthy control group. This parameter increased markedly immediately after surgery (p < 0.001) but had returned to normal after 20 years. The knee and hip midrange values—a measure of the degree of “collapse” due to muscle weakness after surgery—had returned to preoperative levels after 20 years, although they were respectively 11 and 8° greater than those in healthy controls. Both temporal-distance parameters (dimensionless cadence and dimensionless step length) were significantly greater at 20 years than preoperative values (cadence, p = 0.003; step length, p = 0.02), leading to improved walking speed. Conclusions Twenty years after undergoing SDR, our patients showed improved locomotor function compared with their preoperative status.

A Common Thrombomodulin Amino Acid Dimorphism Is Associated with Myocardial Infarction

1997 ◽  
Vol 77 (02) ◽  
pp. 248-251 ◽  
Author(s):  
Lena Norlund ◽  
Johan Holm ◽  
Bengt Zöller ◽  
Ann-Kristin Öhlin
Keyword(s):  
Myocardial Infarction ◽  
Amino Acid ◽  
Plasma Concentration ◽  
Acute Coronary Syndromes ◽  
Protein C ◽  
Integral Membrane Protein ◽  
Control Group ◽  
Healthy Controls ◽  
Coronary Syndromes ◽  
Premature Myocardial Infarction

SummaryEndothelial dysfunction and haemostatic imbalance are believed to be important aetiological factors in the development of acute coronary syndromes. Thrombomodulin (TM) is an integral membrane protein crucial for normal endothelial function and activation of the protein C anticoagulant pathway. We have investigated the importance of a common C/T dimorphism in the TM gene (nucleotide 1418) for development of premature myocardial infarction (MI). The C/T dimorphism predicts an Ala455 to Val replacement in the sixth EGF-like domain of TM. The dimorphism was investigated in 97 MI survivors and 159 healthy controls. The C allele was significantly more frequent among patients than controls (p = 0.035). The allele frequency for the C allele was 0.82 in the patients and 0.72 in the control group. The plasma concentration of TM was investigated among healthy controls but was not related to the C/T dimorphism. In conclusion, the association of the C allele with premature MI, suggests that the TM gene and the C/T dimorphism may be aetiological factors involved in the pathogenesis of MI. Possibly, the Ala455 to Val replacement may affect the function of the TM molecule and the activation of the protein C anticoagulant pathway.

Study the Relationship Between Estrogen Hormone and Calcium in Normal Females Before and After Menopause in Baghdad / Iraq

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Sameerah Mustafa ◽  
Asal Tawfeeq ◽  
Hadeel Hasan
Keyword(s):  
Oral Contraceptive ◽  
Healthy Controls ◽  
Serum Samples ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Menopausal Women ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Age Range

This study involved the collection of (90) samples of women serum which included (30) serum samples collected from women before menopause (reproductive women) in the age range of (22-43) years and were considered as (group A- control). While, (group B) included (30) serum samples collected from women using oral contraceptive pills between the ages of (22-43) years old. Whereas, another (30) serum samples were collected from women after menopause between the ages of (43-54) years and were considered as (group C). All of the collected serum samples were subjected to a number of serological and chemical tests for the measurement of (E2, HDL, LDL and Ca). Then, the obtained data were statistical analyzed and results showed a significant decrease (p˂ 0.05) in (E2 ,Ca and HDL) levels in menopausal women compared to that of the normal healthy controls. While, there were non-significant decrease (p> 0.05) in (E2, Ca and HDL) levels in women taking oral contraceptive when compared to the normal healthy controls. On the other hand, a significant increase (p˂ 0.05) was recorded in LDL level in menopausal women compared to that of the normal healthy controls whereas, no-significant increase (p˃ 0.05) in the LDL level in women taking oral contraceptives when compared to the control women.

scholarly journals Dopamine adjusts the circadian gene expression of Per2 and Per3 in human dermal fibroblasts from ADHD patients

2021 ◽  
Author(s):  
Frank Faltraco ◽  
Denise Palm ◽  
Adriana Uzoni ◽  
Lena Borchert ◽  
Frederick Simon ◽  
...  
Keyword(s):  
Gene Expression ◽  
Dermal Fibroblast ◽  
Sleep Onset ◽  
Dermal Fibroblasts ◽  
Control Group ◽  
Adhd Group ◽  
Healthy Controls ◽  
Circadian Gene ◽  
Significant Difference ◽  
Circadian Preference

AbstractA link between dopamine levels, circadian gene expression, and attention deficit hyperactivity disorder (ADHD) has already been demonstrated. The aim of this study was to investigate the extent of these relationships by measuring circadian gene expression in primary human-derived dermal fibroblast cultures (HDF) after dopamine exposure. We analyzed circadian preference, behavioral circadian and sleep parameters as well as the circadian gene expression in a cohort of healthy controls and participants with ADHD. Circadian preference was evaluated with German Morningness-Eveningness-Questionnaire (D-MEQ) and rhythms of sleep/wake behavior were assessed via actigraphy. After ex vivo exposure to different dopamine concentrations in human dermal fibroblast (HDF) cultures, the rhythmicity of circadian gene expression (Clock, Bmal1, Per1-3, Cry1) was analyzed via qRT-PCR. We found no statistical significant effect in the actigraphy of both groups (healthy controls, ADHD group) for mid-sleep on weekend days, mid-sleep on weekdays, social jetlag, wake after sleep onset, and total number of wake bouts. D-MEQ scores indicated that healthy controls had no evening preference, whereas subjects with ADHD displayed both definitive and moderate evening preferences. Dopamine has no effect on Per3 expression in healthy controls, but produces a significant difference in the ADHD group at ZT24 and ZT28. In the ADHD group, incubation with dopamine, either 1 µM or 10 µM, resulted in an adjustment of Per3 expression to control levels. A similar effect also was found in the expression of Per2. Statistical significant differences in the expression of Per2 (ZT4) in the control group compared to the ADHD group were found, following incubation with dopamine. The present study illustrates that dopamine impacts on circadian function. The results lead to the suggestion that dopamine may improve the sleep quality as well as ADHD symptoms by adjustment of the circadian gene expression, especially for Per2 and Per3.

scholarly journals Efficacy of axial TheraTogs on gait pattern in children with dyskinetic cerebral palsy: a randomized controlled trial

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy
Keyword(s):  
Cerebral Palsy ◽  
Physical Therapy ◽  
Muscle Tone ◽  
Controlled Trial ◽  
Gait Pattern ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Gait Parameters ◽  
Experimental Group

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).

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