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Association between muscle strength, histopathology, and magnetic resonance imaging in sporadic inclusion body myositis

Dahlbom, Kathe ; Geijer, Mats LU ; Oldfors, Anders and Lindberg, Christopher (2019) In Acta Neurologica Scandinavica 139(2). p.177-182
Abstract

Objectives: Inclusion body myositis is characterized by inflammatory and degenerative changes, but the temporal relation of these events is unknown. Materials and Methods: In nineteen patients with inclusion body myositis, muscle strength was correlated with inflammatory and degenerative findings on magnetic resonance imaging (MRI) and in muscle biopsies in three different muscles (tibialis anterior, vastus lateralis, and biceps brachii). Muscle strength, measured with a handheld dynamometer, was described as percentage of muscle strength in age- and sex-matched normal individuals. The muscles were categorized as the strongest, the intermediate, and the weakest muscle in each individual. T1-weighted sequences on MRI were used to... (More)

Objectives: Inclusion body myositis is characterized by inflammatory and degenerative changes, but the temporal relation of these events is unknown. Materials and Methods: In nineteen patients with inclusion body myositis, muscle strength was correlated with inflammatory and degenerative findings on magnetic resonance imaging (MRI) and in muscle biopsies in three different muscles (tibialis anterior, vastus lateralis, and biceps brachii). Muscle strength, measured with a handheld dynamometer, was described as percentage of muscle strength in age- and sex-matched normal individuals. The muscles were categorized as the strongest, the intermediate, and the weakest muscle in each individual. T1-weighted sequences on MRI were used to evaluate the degree of fatty infiltration and muscle atrophy and STIR sequences to evaluate edematous changes. Results: The vastus lateralis, which in general was the weakest muscle, was significantly more atrophic compared to the other two muscles and also demonstrated most edema. The biceps brachii had in most cases an intermediate degree of weakness and atrophy but the most pronounced inflammatory cell infiltration on biopsy. Cytochrome c oxidase-negative muscle fibers were significantly more prevalent in the vastus lateralis and biceps brachii muscles than in the tibialis anterior and thus correlated with muscular atrophy, indicating that this is a secondary change. Inflammatory changes as assessed by MRI and muscle biopsy were seen in all muscles irrespective of atrophy and thus appear to be prevalent at all stages of the disease. Conclusions: Our study could not provide an answer to the question which comes first, the inflammation or the degenerative changes.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
inclusion body myositis, magnetic resonance imaging, morphology, muscle biopsy, muscle function
in
Acta Neurologica Scandinavica
volume
139
issue
2
pages
177 - 182
publisher
Wiley-Blackwell
external identifiers
  • pmid:30347435
  • scopus:85056182073
ISSN
0001-6314
DOI
10.1111/ane.13040
language
English
LU publication?
yes
id
8dc87e61-8a9e-407a-ad49-411e5285bfaa
date added to LUP
2018-11-23 09:42:06
date last changed
2020-02-26 07:08:05
@article{8dc87e61-8a9e-407a-ad49-411e5285bfaa,
  abstract     = {<p>Objectives: Inclusion body myositis is characterized by inflammatory and degenerative changes, but the temporal relation of these events is unknown. Materials and Methods: In nineteen patients with inclusion body myositis, muscle strength was correlated with inflammatory and degenerative findings on magnetic resonance imaging (MRI) and in muscle biopsies in three different muscles (tibialis anterior, vastus lateralis, and biceps brachii). Muscle strength, measured with a handheld dynamometer, was described as percentage of muscle strength in age- and sex-matched normal individuals. The muscles were categorized as the strongest, the intermediate, and the weakest muscle in each individual. T1-weighted sequences on MRI were used to evaluate the degree of fatty infiltration and muscle atrophy and STIR sequences to evaluate edematous changes. Results: The vastus lateralis, which in general was the weakest muscle, was significantly more atrophic compared to the other two muscles and also demonstrated most edema. The biceps brachii had in most cases an intermediate degree of weakness and atrophy but the most pronounced inflammatory cell infiltration on biopsy. Cytochrome c oxidase-negative muscle fibers were significantly more prevalent in the vastus lateralis and biceps brachii muscles than in the tibialis anterior and thus correlated with muscular atrophy, indicating that this is a secondary change. Inflammatory changes as assessed by MRI and muscle biopsy were seen in all muscles irrespective of atrophy and thus appear to be prevalent at all stages of the disease. Conclusions: Our study could not provide an answer to the question which comes first, the inflammation or the degenerative changes.</p>},
  author       = {Dahlbom, Kathe and Geijer, Mats and Oldfors, Anders and Lindberg, Christopher},
  issn         = {0001-6314},
  language     = {eng},
  number       = {2},
  pages        = {177--182},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Neurologica Scandinavica},
  title        = {Association between muscle strength, histopathology, and magnetic resonance imaging in sporadic inclusion body myositis},
  url          = {http://dx.doi.org/10.1111/ane.13040},
  doi          = {10.1111/ane.13040},
  volume       = {139},
  year         = {2019},
}