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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Autores principales:	Matthew Wilcox, Liane Dos Santos Canas, Rikin Hargunani, Tom Tidswell, Hazel Brown, Marc Modat, James Benjamin Phillips, Sebastien Ourselin, Tom Quick
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9a7fcb7d4a6844e1a676b8dfd00fdde0
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spelling	oai:doaj.org-article:9a7fcb7d4a6844e1a676b8dfd00fdde02021-11-21T12:22:59ZVolumetric MRI is a promising outcome measure of muscle reinnervation10.1038/s41598-021-01342-y2045-2322https://doaj.org/article/9a7fcb7d4a6844e1a676b8dfd00fdde02021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01342-yhttps://doaj.org/toc/2045-2322Abstract 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.Matthew WilcoxLiane Dos Santos CanasRikin HargunaniTom TidswellHazel BrownMarc ModatJames Benjamin PhillipsSebastien OurselinTom QuickNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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
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.
format	article
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
title	Volumetric MRI is a promising outcome measure of muscle reinnervation
title_short	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_sort	volumetric mri is a promising outcome measure of muscle reinnervation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9a7fcb7d4a6844e1a676b8dfd00fdde0
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Volumetric MRI is a promising outcome measure of muscle reinnervation

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