Corticospinal Control of Human Locomotion as a New Determinant of Age-Related Sarcopenia: An Exploratory Study

Abstract

Sarcopenia is a muscle disease listed within the ICD-10 classification. Several operational definitions have been created for sarcopenia screening; however, an international consensus is lacking. The Centers for Disease Control and Prevention have recently recognized that sarcopenia detection requires improved diagnosis and screening measures. Mounting evidence hints towards changes in the corticospinal communication system where corticomuscular coherence (CMC) reflects an effective mechanism of corticospinal interaction. CMC can be assessed during locomotion by means of simultaneously measuring Electroencephalography (EEG) and Electromyography (EMG). The aim of this study was to perform sarcopenia screening in community-dwelling older adults and explore the possibility of using CMC assessed during gait to discriminate between sarcopenic and non-sarcopenic older adults. Receiver Operating Characteristic (ROC) curves showed high sensitivity, precision and accuracy of CMC assessed from EEG Cz sensor and EMG sensors located over Musculus Vastus Medialis [Cz-VM; AUC (95.0%CI): 0.98 (0.92-1.04), sensitivity: 1.00, 1-specificity: 0.89, p < 0.001] and with Musculus Biceps Femoris [Cz-BF; AUC (95.0%CI): 0.86 (0.68-1.03), sensitivity: 1.00, 1-specificity: 0.70, p < 0.001]. These muscles showed significant differences with large magnitude of effect between sarcopenic and non-sarcopenic older adults [Hedge's g (95.0%CI): 2.2 (1.3-3.1), p = 0.005 and Hedge's g (95.0%CI): 1.5 (0.7-2.2), p = 0.010; respectively]. The novelty of this exploratory investigation is the hint toward a novel possible determinant of age-related sarcopenia, derived from corticospinal control of locomotion and shown by the observed large differences in CMC when sarcopenic and non-sarcopenic older adults are compared. This, in turn, might represent in future a potential treatment target to counteract sarcopenia as well as a parameter to monitor the progression of the disease and/or the potential recovery following other treatment interventions.

Prevalence of probable sarcopenia in community-dwelling older Swiss people – a cross-sectional study

“…It is characterized by quantitative and qualitative alterations in muscles that may emerge from middle age onwards [3] and cumulatively occur in people with chronic diseases and an inactive lifestyle [4]. The prevalence of sarcopenia in Europe was between 11 and 20% in healthy men and women aged ≥60 years in 2016 [5,6] and an accumulated 17% in a recently studied Swiss sample in the Italian speaking part of Switzerland where seven different Sarcopenia definitions were applied [7]. The prevalence significantly increases with age and is expected to rise within the next 30 years, particularly in the highest age groups [5].…”

Gait disorders in CKD patients: muscle wasting or cognitive impairment? A cross-sectional pilot study to investigate gait signatures in Stage 1–5 CKD patients

“…This rapid loss of muscle strength is explained by mitochondrial damage and protein degradation [ 52 – 54 ] typical for CKD patients. However, changes in grip strength are largely reflective of decreased integrity of the nervous system [ 55 ] and sarcopenia is also linked to changes in the central nervous system [ 56 , 57 ]. This would hint to the possibility of gait disorders in CKD caused by peripheral and central factors.…”

Sarcopenia in Patients With Parkinson's Disease: A Systematic Review and Meta-Analysis

“…Some studies on corticospinal activity have been performed in PD patients and healthy controls during gait. One study found corticospinal control of human locomotion as a new determinant of age-related sarcopenia through comparison of corticomuscular coherence (CMC) between sarcopenic and non-sarcopenic older adults during gait, which may hint at a novel possible mechanism derived from corticospinal control of locomotion in age-related sarcopenia ( 36 ). Another study found that older healthy controls and PD participants had significantly decreased CMC and electromyography (EMG) power at low beta frequencies (13–21 Hz) compared with young healthy controls, whereas there was no difference between the older healthy and PD groups ( 37 ).…”