Skeletal muscle fibre type transformation following spinal cord injury.

Following spinal cord injury (SCI), upper motor neuron paralysed muscles lose the normal type I (slow) and II (fast) fibre mosaic pattern and become predominantly composed of type II (fast glycolytic) fibres). The majority of the research demonstrating this fibre type shift was based on pH sensitive myofibrillar ATPase staining techniques on muscle from longstanding paraplegics and quadriplegics. The purpose of this study was to describe muscle fibre type changes over a wide time spectrum post SCI using immunofluorescent techniques which may be more sensitive to change. A total of 19 vastus lateralis muscle biopsy specimens were obtained from 12 SCI subjects representing time points of 0.5-219 months post SCI. Fast and slow myosin heavy chain isoform distribution was determined on single muscle fibres for each of the biopsy specimens. Early post SCI (< 1 month) myosin heavy chain (MCH) isoform composition remained relatively stable. A transitional period was seen between 1 and 20 months post SCI wherein there was a progressive drop in the proportion of slow MHC isoform fibres and a rise in the proportion that co-expressed both the fast and slow MHC isoform. By approximately 70 months post SCI a new steady state had been reached characterized by almost exclusively fast MHC isoform expression. This research has demonstrated that post SCI muscle type II transformation occurs in stages and commences earlier than previously appreciated. Interventions aimed at preventing or minimizing the transformation would need to be instituted within weeks post SCI.