Intramuscular fat in ambulant young adults with bilateral spastic cerebral palsy

Abstract

BackgroundIt is known that individuals with bilateral spastic cerebral palsy (BSCP) have small and weak muscles. However, no studies to date have investigated intramuscular fat infiltration in this group. The objective of this study is to determine whether adults with BSCP have greater adiposity in and around their skeletal muscles than their typically developing (TD) peers as this may have significant functional and cardio-metabolic implications for this patient group.Methods10 young adults with BSCP (7 male, mean age 22.5 years, Gross Motor Function Classification System (GMFCS) levels I-III), and 10 TD young adults (6 male, mean age 22.8 years) took part in this study. 11 cm sections of the left leg of all subjects were imaged using multi-echo gradient echo chemical shift imaging (mDixon). Percentage intermuscular fat (IMAT), intramuscular fat (IntraMF) and a subcutaneous fat to muscle volume ratio (SF/M) were calculated.ResultsIntraMF was higher with BSCP for all muscles (p = 0.001-0.013) and was significantly different between GMFCS levels (p < 0.001), with GMFCS level III having the highest IntraMF content. IMAT was also higher with BSCP p < 0.001). No significant difference was observed in SF/M between groups.ConclusionYoung adults with BSCP have increased intermuscular and intramuscular fat compared to their TD peers. The relationship between these findings and potential cardio-metabolic and functional sequelae are yet to be investigated.

The impact of strength training on skeletal muscle morphology and architecture in children and adolescents with spastic cerebral palsy: A systematic review

“…Morphological and architectural adaptations of muscles in individuals with cerebral palsy (CP) compared to typically developing (TD) individuals include: (i) reduced muscle volume (Barber, Hastings-Ison, Baker, Barrett, & Lichtwark, 2011;Malaiya et al, 2007;Noble, Charles-Edwards et al, 2014), (ii) reduced (Matthiasdottir, Hahn, Yaraskavitch, & Herzog, 2014;Mohagheghi et al, 2008;Moreau, Teefey, & Damiano, 2009) or similar (Malaiya et al, 2007;Shortland, Harris, Gough, & Robinson, 2002) muscle fascicle lengths, (iii) increased intramuscular fat (Noble, Fry et al, 2014), and iv) increased Achilles tendon length (Barber, Barrett, & Lichtwark, 2012). Microscopically, sarcomeres are longer and extracellular matrix composition is different to TD muscle (Smith, Lee, Ward, Chambers, & Lieber, 2011).…”

Combination of Functional Electrical Stimulation and Noninvasive Spinal Cord Electrical Stimulation for Movement Rehabilitation of the Children with Cerebral Palsy

“…Magnetic resonance imaging of the spinal cord in the CP subjects with spastic diplegia has significantly less area of the white matter than in healthy individuals in transverse sections at C6/C7 and T10/T11 segments. In the same segments, gray matter area of CP and healthy subjects did not differ [20]. A direct correlation between the degree of imbalance of inhibitory-excitatory connections of motoneurons and the severity of the motor disorders has been reported in CP subjects [5].…”

“…Degradation of motor activity in children with CP is linked to with pathology of supraspinal as well as of spinal networks connections during ontogenesis [17,20]. One of the functional consequences of the abnormal CP development is the level of abnormal reciprocal inhibition of Ia afferents, presynaptic inhibition and nonreciprocal Ib inhibition a phenomenon largely attributable to spinal networks [10].…”

Association of Jumping Mechanography-Derived Indices of Muscle Function with Tibial Cortical Bone Geometry

“…On the one hand, although isokinetic dynamometry theoretically represents a good method for the evaluation of leg muscle function, as maximum muscle forces are generated during eccentric contractions [8,17], it is a rather impractical technique yielding a large variability in peak torque output due to methodological difficulties [8,35]. On the other hand, the use of muscle size measurements such as muscle CSA as a surrogate of maximum intrinsic muscle force is limited, because the mechanical potential of a muscle depends not only on morphology but also on muscle fibre type and muscle composition [36]. As known from biopsies, spectroscopy and MRI studies, fatty infiltration of muscles can already be noticed in young, healthy subjects, confounding the relationship between the size of a muscle and the forces that can be generated by its fibres [37,38].…”