Volumetric MRI is a promising outcome measure of muscle reinnervation
Abstract The development of outcome measures that can track the recovery of reinnervated muscle would benefit the clinical investigation of new therapies which hope to enhance peripheral nerve repair. The primary objective of this study was to assess the validity of volumetric Magnetic Resonance Ima...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-01342-y |
| _version_ | 1818425014429417472 |
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| author | Matthew Wilcox Liane Dos Santos Canas Rikin Hargunani Tom Tidswell Hazel Brown Marc Modat James Benjamin Phillips Sebastien Ourselin Tom Quick |
| author_facet | Matthew Wilcox Liane Dos Santos Canas Rikin Hargunani Tom Tidswell Hazel Brown Marc Modat James Benjamin Phillips Sebastien Ourselin Tom Quick |
| author_sort | Matthew Wilcox |
| collection | DOAJ |
| description | Abstract The development of outcome measures that can track the recovery of reinnervated muscle would benefit the clinical investigation of new therapies which hope to enhance peripheral nerve repair. The primary objective of this study was to assess the validity of volumetric Magnetic Resonance Imaging (MRI) as an outcome measure of muscle reinnervation by testing its reproducibility, responsiveness and relationship with clinical indices of muscular function. Over a 3-year period 25 patients who underwent nerve transfer to reinnervate elbow flexor muscles were assessed using intramuscular electromyography (EMG) and MRI (median post-operative assessment time of 258 days, ranging from 86 days pre-operatively to 1698 days post- operatively). Muscle power (Medical Research Council (MRC) grade) and Stanmore Percentage of Normal Elbow Assessment (SPONEA) assessment was also recorded for all patients. Sub-analysis of peak volitional force (PVF), muscular fatigue and co-contraction was performed in those patients with MRC > 3. The responsiveness of each parameter was compared using Pearson or Spearman correlation. A Hierarchical Gaussian Process (HGP) was implemented to determine the ability of volumetric MRI measurements to predict the recovery of muscular function. Reinnervated muscle volume per unit Body Mass Index (BMI) demonstrated good responsiveness (R2 = 0.73, p < 0.001). Using the temporal and muscle volume per unit BMI data, a HGP model was able to predict MRC grade and SPONEA with a mean absolute error (MAE) of 0.73 and 1.7 respectively. Muscle volume per unit BMI demonstrated moderate to good positive correlations with patient reported impairments of reinnervated muscle; co- contraction (R2 = 0.63, p = 0.02) and muscle fatigue (R2 = 0.64, p = 0.04). In summary, volumetric MRI analysis of reinnervated muscle is highly reproducible, responsive to post-operative time and demonstrates correlation with clinical indices of muscle function. This encourages the view that volumetric MRI is a promising outcome measure for muscle reinnervation which will drive advancements in motor recovery therapy. |
| first_indexed | 2024-12-14T14:07:12Z |
| format | Article |
| id | doaj.art-9a7fcb7d4a6844e1a676b8dfd00fdde0 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T14:07:12Z |
| publishDate | 2021-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-9a7fcb7d4a6844e1a676b8dfd00fdde02022-12-21T22:58:29ZengNature PortfolioScientific Reports2045-23222021-11-0111111210.1038/s41598-021-01342-yVolumetric MRI is a promising outcome measure of muscle reinnervationMatthew Wilcox0Liane Dos Santos Canas1Rikin Hargunani2Tom Tidswell3Hazel Brown4Marc Modat5James Benjamin Phillips6Sebastien Ourselin7Tom Quick8Peripheral Nerve Injury Research Unit, Royal National Orthopaedic HospitalBiomedical Engineering and Imaging Sciences, King’s College LondonDepartment of Radiology, Royal National Orthopaedic HospitalDepartment of Clinical Neurophysiology, Royal Free HospitalPeripheral Nerve Injury Research Unit, Royal National Orthopaedic HospitalBiomedical Engineering and Imaging Sciences, King’s College LondonUCL Centre for Nerve Engineering, University College LondonBiomedical Engineering and Imaging Sciences, King’s College LondonPeripheral Nerve Injury Research Unit, Royal National Orthopaedic HospitalAbstract The development of outcome measures that can track the recovery of reinnervated muscle would benefit the clinical investigation of new therapies which hope to enhance peripheral nerve repair. The primary objective of this study was to assess the validity of volumetric Magnetic Resonance Imaging (MRI) as an outcome measure of muscle reinnervation by testing its reproducibility, responsiveness and relationship with clinical indices of muscular function. Over a 3-year period 25 patients who underwent nerve transfer to reinnervate elbow flexor muscles were assessed using intramuscular electromyography (EMG) and MRI (median post-operative assessment time of 258 days, ranging from 86 days pre-operatively to 1698 days post- operatively). Muscle power (Medical Research Council (MRC) grade) and Stanmore Percentage of Normal Elbow Assessment (SPONEA) assessment was also recorded for all patients. Sub-analysis of peak volitional force (PVF), muscular fatigue and co-contraction was performed in those patients with MRC > 3. The responsiveness of each parameter was compared using Pearson or Spearman correlation. A Hierarchical Gaussian Process (HGP) was implemented to determine the ability of volumetric MRI measurements to predict the recovery of muscular function. Reinnervated muscle volume per unit Body Mass Index (BMI) demonstrated good responsiveness (R2 = 0.73, p < 0.001). Using the temporal and muscle volume per unit BMI data, a HGP model was able to predict MRC grade and SPONEA with a mean absolute error (MAE) of 0.73 and 1.7 respectively. Muscle volume per unit BMI demonstrated moderate to good positive correlations with patient reported impairments of reinnervated muscle; co- contraction (R2 = 0.63, p = 0.02) and muscle fatigue (R2 = 0.64, p = 0.04). In summary, volumetric MRI analysis of reinnervated muscle is highly reproducible, responsive to post-operative time and demonstrates correlation with clinical indices of muscle function. This encourages the view that volumetric MRI is a promising outcome measure for muscle reinnervation which will drive advancements in motor recovery therapy.https://doi.org/10.1038/s41598-021-01342-y |
| spellingShingle | Matthew Wilcox Liane Dos Santos Canas Rikin Hargunani Tom Tidswell Hazel Brown Marc Modat James Benjamin Phillips Sebastien Ourselin Tom Quick Volumetric MRI is a promising outcome measure of muscle reinnervation Scientific Reports |
| title | Volumetric MRI is a promising outcome measure of muscle reinnervation |
| title_full | Volumetric MRI is a promising outcome measure of muscle reinnervation |
| title_fullStr | Volumetric MRI is a promising outcome measure of muscle reinnervation |
| title_full_unstemmed | Volumetric MRI is a promising outcome measure of muscle reinnervation |
| title_short | Volumetric MRI is a promising outcome measure of muscle reinnervation |
| title_sort | volumetric mri is a promising outcome measure of muscle reinnervation |
| url | https://doi.org/10.1038/s41598-021-01342-y |
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