STUDY DESIGN: Unrandomized trial. OBJECTIVES: To investigate the structural and functional relationships and the progression of muscle atrophy up to 20 years of spastic paraplegia. SETTING: Clinical follow-up in Vienna, Austria; muscle biopsies analyzed by light microscopy in Padova and by electron microscopy (EM) in Chieti, Italy. METHODS: Force was measured as knee extension torque; trophism by computer tomography scan; tissue composition and fiber morphology by histopathology and EM. RESULTS: In the long-term group of patients (17.0+/-2.6 years), force and size of thigh muscles were only slightly different from those of mid-term subjects (2.2+/-0.5 years). Histology and ultrastructure confirm that the difference in average size of muscle fibers between long-term and mid-term paralyzed leg muscles is actually very small. In addition, muscle fibers maintain the striated appearance characteristic of normal skeletal fibers even after 14-20 years of paralysis. Ultrastructural alterations of the activating and metabolic machineries, and the presence of fibers with lower motor neuron denervation features, may explain the low-force output and the reduced endurance of paretic muscles. CONCLUSION: The stable muscle atrophy that characterizes long-lasting spastic paraplegia suggests that there are no upper-time limits to begin a training program based on functional electrical stimulation.
STUDY DESIGN: Unrandomized trial. OBJECTIVES: To investigate the structural and functional relationships and the progression of muscle atrophy up to 20 years of spastic paraplegia. SETTING: Clinical follow-up in Vienna, Austria; muscle biopsies analyzed by light microscopy in Padova and by electron microscopy (EM) in Chieti, Italy. METHODS: Force was measured as knee extension torque; trophism by computer tomography scan; tissue composition and fiber morphology by histopathology and EM. RESULTS: In the long-term group of patients (17.0+/-2.6 years), force and size of thigh muscles were only slightly different from those of mid-term subjects (2.2+/-0.5 years). Histology and ultrastructure confirm that the difference in average size of muscle fibers between long-term and mid-term paralyzed leg muscles is actually very small. In addition, muscle fibers maintain the striated appearance characteristic of normal skeletal fibers even after 14-20 years of paralysis. Ultrastructural alterations of the activating and metabolic machineries, and the presence of fibers with lower motor neuron denervation features, may explain the low-force output and the reduced endurance of paretic muscles. CONCLUSION: The stable muscle atrophy that characterizes long-lasting spastic paraplegia suggests that there are no upper-time limits to begin a training program based on functional electrical stimulation.
Authors: Ashraf S Gorgey; Oksana Witt; Laura O'Brien; Christopher Cardozo; Qun Chen; Edward J Lesnefsky; Zachary A Graham Journal: Eur J Appl Physiol Date: 2018-12-11 Impact factor: 3.078
Authors: Shauna Dudley-Javoroski; Tara McMullen; Michelle R Borgwardt; Lauren M Peranich; Richard K Shields Journal: Ultrasound Med Biol Date: 2010-10 Impact factor: 2.998
Authors: Stephanie C Jefferson; Nicole J Tester; Melanie Rose; Adele E Blum; Brian G Howland; Donald C Bolser; Dena R Howland Journal: Exp Neurol Date: 2010-01-04 Impact factor: 5.330