ObjectiveTo evaluate sarcopenic indices in relation to respiratory muscle strength (RMS) in elderly people.MethodsThis study included 65 volunteers over the age of 60 (30 men and 35 women). The skeletal muscle mass index (SMI) was measured using bioimpedance analysis. Limb muscle function was assessed by handgrip strength (HGS), the Short Physical Performance Battery (SPPB), and gait speed. RMS was addressed by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) using a spirometer. The relationships between RMS and other sarcopenic indices were investigated using the Pearson correlation coefficients and multiple regression analysis adjusted for age, HGS, and SPPB.ResultsBoth MIP and MEP were positively correlated with SMI (r=0.451 and r=0.388, respectively, p<0.05 in both). HGS showed a significant correlation with both MIP and MEP (r=0.560, p<0.01 and r=0.393, p<0.05, respectively). There was no significant correlation between gait speed and either MIP or MEP. The SPPB was positively correlated with MEP (r=0.436, p<0.05). In the multiple regression analysis, MIP was significantly associated with HGS and SMI (p<0.001 and p<0.05, respectively), while MEP was related only with HGS (p<0.05).ConclusionThis study suggests that respiratory muscles, especially inspiratory muscles, are significantly related to limb muscle strength and skeletal muscle mass. The clinical significance of MIP and MEP should be further investigated with prospective studies.

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Introduction:We report a case of an infant with severe white matter injury (WMI), which was serially evaluated using diffusion tensor imaging (DTI).Case presentation:A male infant showed decreased muscle tone and weak breathing. A brain magnetic resonance imaging (MRI) 10 days after birth (first study) revealed diffuse microhemorrhages and encephalomalacia. DTI revealed lack of reconstruction of corticospinal tract (CSTs), minimal reconstruction of medial lemniscus, and related thalamocortical pathways (MLs) from the brain stem to the internal capsule level on the left side. The spinothalamic tract and related thalamocortical pathways (STTs) were reconstructed from the brain stem to the internal capsule level bilaterally. The second study one year later showed the absence of reconstruction of CSTs, but reconstruction of MLs and STTS from the brain stem to above the internal capsule showed increased visualization. The third study 3 years later still showed the absence of CSTs reconstruction and MLs and STTs showed no changes from the second study. During this 3-year observation period, the patient showed minimal motor development, and was unable to walk independently, although Gross Motor Function Measure (GMFM) scores were slightly increased.Lessons:Sustained disconnection of major sensorimotor pathways after WMI confirmed by DTI was used to predict motor function outcome.