中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (12): 2486-2493.doi: 10.4103/1673-5374.313060

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

磁共振弹性成像评估慢性脊髓损伤后的骨骼肌硬度

  

  • 出版日期:2021-12-15 发布日期:2021-05-15

Skeletal muscle stiffness as measured by magnetic resonance elastography after chronic spinal cord injury: a cross-sectional pilot study

Mina P. Ghatas1, M. Rehan Khan2, Ashraf S. Gorgey1, 3, *   

  1. 1Department of Spinal Cord Injury and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; 2Department of Radiology, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; 3Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
  • Online:2021-12-15 Published:2021-05-15
  • Contact: Ashraf S. Gorgey, MPT, PhD, FACSM, ashraf.gorgey@va.gov.

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摘要：

脊髓损伤（SCI）后骨骼肌硬度会发生改变，此种改变的评估对于脊髓损伤后的康复和药物干预的设计至关重要。研究使用磁共振弹性成像（MRE）评估慢性脊髓损伤与相匹配的健康（AB）对照的下肢肌肉硬度，并确定其与慢性脊髓损伤患者肌肉大小、痉挛、峰值扭矩的关系。研究纳入10例慢性脊髓损伤患者和8名健康对照者。利用磁共振弹性成像监测肌肉硬度。改良的Ashworth量表（MAS）用于评估肌张力。使用biodex测力计测量峰值等距和等速扭矩。与对照组相比，脊髓损伤患者的肌肉硬度值无明显降低。考虑肌间脂肪后，脊髓损伤患者肌肉僵硬度与股外侧肌（VL）的整个和绝对肌肉横截面积（CSA）呈明显正相关（r2 = 0.78，P <0.0007；r2 = 0.64，P <0.005）。肌肉僵硬度还与等轴测扭矩和等速运动峰值呈明显正相关（r2 = 0.55-0.57，P <0.05；r2 = 0.46-0.48，P <0.05）。结果表明，慢性脊髓损伤患者骨骼肌僵硬度很可能受肌内脂肪渗透和瘫痪肌肉的密度改变的影响，而肌肉硬度与痉挛之间不存在明显相关性。

https://orcid.org/0000-0002-9157-6034 (Ashraf S. Gorgey)

Abstract: Skeletal muscle stiffness is altered after spinal cord injury (SCI). Assessing muscle stiffness is essential for rehabilitation and pharmaceutical interventions design after SCI. The study used magnetic resonance elastography to assess the changes in stiffness after chronic SCI compared to matched able-bodied controls and determine its association with muscle size, spasticity, and peak torque in persons with SCI. Previous studies examined the association between muscle stiffness and spasticity, however, we are unaware of other studies that examined the effects of muscle composition on stiffness after SCI. Ten participants (one female) with chronic SCI and eight (one female) matched able-bodied controls participated in this cross-sectional study. Magnetic resonance elastography was utilized to monitor stiffness derived from shear waves propagation. Modified Ashworth scale was used to evaluate spasticity scores in a blinded fashion. Peak isometric and isokinetic torques were measured using a biodex dynamometer. Stiffness values were non-significantly lower (12.5%; P = 0.3) in the SCI group compared to able-bodied controls.  Moreover, stiffness was positively related to vastus lateralis whole muscle cross-sectional area (CSA) (r2 = 0.64, P < 0.005) and vastus lateralis absolute muscle CSA after accounting for intramuscular fat (r2 = 0.78, P < 0.0007). Stiffness was also positively correlated to both isometric (r2= 0.55–0.57, P < 0.05) and isokinetic peak (r2= 0.46–0.48, P < 0.05) torques. Our results suggest that larger clinical trial is warranted to confirm the preliminary findings that muscle stiffness is altered after SCI compared to healthy controls. Stiffness appeared to be influenced by infiltration of intramuscular fat and modestly by the spasticity of the paralyzed muscles. The preliminary data indicated that the relationship between muscle stiffness and peak torque is not altered with changing the frequency of pulses or angular velocities. All study procedures were approved by the Institutional Review Board at the Hunter Holmes McGuire VA Medical Center, USA (IRB #: 02314) on May 3, 2017.


Key words: chronic spinal cord injury, isometric and isokinetic torques, magnetic resonance elastography, muscle size, rehabilitation, shear modulus, spasticity, stiffness 

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