SUMMARY Motor units comprise a pre-synaptic motor neuron and multiple post-synaptic muscle fibers. Many movement disorders disrupt motor unit contractile dynamics and the structure of sarcomeres, skeletal muscle’s contractile units. Despite the motor unit’s centrality to neuromuscular physiology, no extant technology can image sarcomere twitch dynamics in live humans. We created a wearable microscope equipped with a microendoscope for minimally invasive observation of sarcomere lengths and contractile dynamics in any major skeletal muscle. By electrically stimulating twitches via the microendoscope and visualizing the sarcomere displacements, we monitored single motor unit contractions in soleus and vastus lateralis muscles of healthy individuals. Control experiments verified that these evoked twitches involved neuromuscular transmission and faithfully reported muscle force generation. In post-stroke patients with spasticity of the biceps brachii, we found involuntary microscopic contractions and sarcomere length abnormalities. The wearable microscope facilitates exploration of many basic and disease-related neuromuscular phenomena never visualized before in live humans.
Introduction Second-harmonic generation microendoscopy is a minimally invasive technique to image sarcomeres and measure their lengths in humans, but motion artifact and low signal have limited the use of this novel technique. Methods We discovered that an excitation wavelength of 960 nm maximized image signal; this enabled an image acquisition rate of 3 frames/s, which decreased motion artifact. We then used microendoscopy to measure sarcomere lengths in the human extensor carpi radialis brevis with the wrist at 45° extension and 45° flexion in 7 subjects. We also measured the variability in sarcomere lengths within single fibers. Results Average sarcomere lengths in 45° extension were 2.93±0.29 μm (±SD) and increased to 3.58±0.19 μm in 45° flexion. Within single fibers the standard deviation of sarcomere lengths in series was 0.20 μm. Conclusions Microendoscopy can be used to measure sarcomere lengths at different body postures. Lengths of sarcomeres in series within a fiber vary substantially.
Engaging, hands-on design experiences are key for formal and informal Science, Technology, Engineering, and Mathematics (STEM) education. Robotic and video game design challenges have been particularly effective in stimulating student interest, but equivalent experiences for the life sciences are not as developed. Here we present the concept of a "biotic game design project" to motivate student learning at the interface of life sciences and device engineering (as part of a cornerstone bioengineering devices course). We provide all course material and also present efforts in adapting the project's complexity to serve other time frames, age groups, learning focuses, and budgets. Students self-reported that they found the biotic game project fun and motivating, resulting in increased effort. Hence this type of design project could generate excitement and educational impact similar to robotics and video games.
Sarcomeres are the basic contractile units of muscle, and their lengths influence muscle force-generating capacity. Despite their importance, in vivo sarcomere lengths remain unknown for many human muscles. Second harmonic generation (SHG) microendoscopy is a minimally invasive technique for imaging sarcomeres in vivo and measuring their lengths. In this study, we used SHG microendoscopy to visualize sarcomeres of the human vastus lateralis, a large knee extensor muscle important for mobility, to examine how sarcomere lengths change with knee flexion and thus affect the muscle’s force-generating capacity. We acquired in vivo sarcomere images of several muscle fibers of the resting vastus lateralis in six healthy individuals. Mean sarcomere lengths increased (p = 0.031) from 2.84±0.16 μm at 50° of knee flexion to 3.17±0.13 μm at 110° of knee flexion. The standard deviation of sarcomere lengths among different fibers within a muscle was 0.21±0.09 μm. Our results suggest that the sarcomeres of the resting vastus lateralis at 50° of knee flexion are near optimal length. At a knee flexion angle of 110° the resting sarcomeres of vastus lateralis are longer than optimal length. These results show a smaller sarcomere length change and greater conservation of force-generating capacity with knee flexion than estimated in previous studies.
Amyotrophic lateral sclerosis (ALS) is a fatal disease involving motor neuron degeneration. Effective diagnosis of ALS and quantitative monitoring of its progression are crucial to the success of clinical trials. Second harmonic generation (SHG) microendoscopy is an emerging technology for imaging single motor unit contractions. to assess the potential value of microendoscopy for diagnosing and tracking ALS, we monitored motor unit dynamics in a B6.SOD1G93A mouse model of ALS for several weeks. prior to overt symptoms, muscle twitch rise and relaxation time constants both increased, consistent with a loss of fast-fatigable motor units. These effects became more pronounced with disease progression, consistent with the death of fast fatigue-resistant motor units and superior survival of slow motor units. From these measurements we constructed a physiological metric that reflects the changing distributions of measured motor unit time constants and effectively diagnoses mice before symptomatic onset and tracks disease state. these results indicate that SHG microendoscopy provides a means for developing a quantitative, physiologic characterization of ALS progression.ALS is a paralytic, fatal neurodegenerative disease characterized by a progressive loss of motor neurons 1 . The first approved drug to treat ALS, riluzole, which only prolongs survival by a few months 2 , was approved over 20 years ago. Since then, over 50 clinical trials 3 have resulted in only 1 new recently approved drug 4 , edaravone, whose effect on survival has yet to be studied. Development of effective treatments has suffered from a lack of methods for early diagnosis and sensitive monitoring of the disease 5 . Patients enter clinical trials at late disease stages that may be too advanced to gain therapeutic benefit, and subtle improvements might be undetectable. Sensitive diagnostics are needed to reduce diagnostic delay so that earlier-stage patients can be identified and participate in clinical trials.To assess if a therapy is effective, it is also important to have biomarkers of disease progression. Currently, the Revised ALS Functional Rating Score (ALSFRS-R) -a numerical score from 0-48 based on assessments of bulbar, limb, and respiratory function 6 -is the predominant clinical method for measuring disease progression. This score is subjective and a sum of multiple metrics, some of which are highly correlated, making changes in the ALSFRS-R score hard to relate to changes in disease state 7 . As new candidate treatments enter clinical trials, the field needs quantitative diagnostics that reflect the neurophysiologic changes in ALS, provide accurate assessments of disease progression, and inform treatment development and usage.To meet this challenge, we examined whether second harmonic generation (SHG) microendoscopy might detect the physiological changes that occur in ALS. SHG microendoscopy is a minimally invasive approach to imaging the twitch contractions of individual motor units in live patients 8 . Myosin filaments within muscle sar-
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