The objective of this study was to assess the cross-sectional areas (CSA) of lumbar paraspinal muscles and their fatty degeneration in adults with degenerative lumbar spondylolisthesis (DLS) diagnosed with chronic radiculopathy, compare them with those of the same age- and sex-related groups with radiculopathy, and evaluate their correlations and the changes observed on magnetic resonance imaging (MRI). This retrospective study included 62 female patients aged 65–85 years, who were diagnosed with lumbar polyradiculopathy. The patients were divided into two groups: 30 patients with spondylolisthesis and 32 patients without spondylolisthesis. We calculated the CSA and fatty degeneration of the erector spinae (ES) and multifidus (MF) on axial T2-weighted magnetic resonance (MR) images from the inferior end plate of the L4 vertebral body levels. The functional CSA (FCSA): CSA ratio, skeletal muscle index (SMI), and MF CSA: ES CSA ratio were calculated and compared between the two groups using an independent t-test. We performed logistic regression analysis using spondylolisthesis as the dependent variable and SMI, FCSA, rFCSA, fat infiltration rate as independent variables. The result showed more fat infiltration of MF in patients with DLS (56.33 vs. 44.66%; p = 0.001). The mean FCSA (783.33 vs. 666.22 mm2; p = 0.028) of ES muscle was a statistically larger in the patients with DLS. The ES FCSA / total CSA was an independent predictor of lumbar spondylolisthesis (odd ratio =1.092, p = 0.016), while the MF FCSA / total CSA was an independent protective factor (odd ratio =0.898, p = 0.002)
Despite advances in microsurgical technology and an improved understanding of nerve regeneration, obtaining satisfactory results after facial nerve injury remains a difficult clinical problem. Among existing peripheral nerve regeneration studies, relatively few have focused on the facial nerve, particularly how experimental studies of the facial nerve using animal models play an essential role in understanding functional outcomes and how such studies can lead to improved axon regeneration after nerve injury. The purpose of this article is to review current perspectives on strategies for applying potential therapeutic methods for facial nerve regeneration. To this end, we searched Embase, PubMed, and the Cochrane library using keywords, and after applying exclusion criteria, obtained a total of 31 qualifying experimental studies. We then summarize the fundamental experimental studies on facial nerve regeneration, highlighting recent bioengineering studies employing various strategies for supporting facial nerve regeneration, including nerve conduits with stem cells, neurotrophic factors, and/or other therapeutics. Our summary of the methods and results of these previous reports reveal a common feature among studies, showing that various neurotrophic factors arising from injured nerves contribute to a microenvironment that plays an important role in functional recovery. In most cases, histological examinations showed that this microenvironmental influence increased axonal diameter as well as myelination thickness. Such an analysis of available research on facial nerve injury and regeneration represents the first step toward future therapeutic strategies.
Vitamin B12 (B12) is involved as a cofactor in the synthesis of myelin. A lack of B12 impairs peripheral nerve production, which can contribute to sarcopenia. In this cross-sectional study, we aimed to investigate the relationship between B12 insufficiency and sarcopenia in community-dwelling older Korean adults. A total of 2325 (1112 men; 1213 women) adults aged 70–84 years were recruited. The tools used for sarcopenia were based on the Asian Working Group for Sarcopenia (AWGS) guidelines. Individuals with low appendicular skeletal muscle mass index (ASMI) (<7.0 kg/m2 for men; <5.4 kg/m2 for women) and low hand grip strength (HGS) (<28 kg for men; <18 kg for women) were defined as the sarcopenia group. Among this group, those who showed low physical performance (≤9 points on the Short Physical Performance Battery (SPPB)) were defined as the severe sarcopenia group. B12 concentrations were classified into insufficient (<350 pg/mL) and sufficient (≥350 pg/mL). Univariate and multivariate logistic regression analyses were used to evaluate the relationship between sarcopenia and B12 levels. Low ASMI showed a high incidence in the B12-insufficient group. However, HGS, SPPB, and the severity of sarcopenia showed no correlation with B12. Further, insufficient B12 may affect muscle quantity rather than muscle strength or physical performance.
The asymmetry in lower extremity strength is known to be related to the functional mobility in older adults living in the community. However, little is known about the association between lower extremity lean mass asymmetry and functional mobility in this patient group. Hence, this study aimed to determine whether asymmetry in lower extremity muscle mass has a significant relationship with functional mobility in older adults living in the community. This cross-sectional study analyzed the pre-existing data from the Korean Frailty and Aging Cohort Study. A total of 435 older people (aged 70–84 years) were divided into the following groups according to their Limb Asymmetry Index (LAsI): low, intermediate, and high asymmetric groups. LAsI is calculated using lower extremity lean mass, and comparisons between groups were conducted. The participants were also further divided into better and worse mobility groups based on their physical performance test results (Timed Up and Go and Short Physical Performance Battery), and comparisons between groups were conducted. Comparisons between fallers and non-fallers were also conducted. In addition, this study investigated the factors that had a significant effect on gait speed and fall experience within the past year among older adults living in the community. The LAsI was significantly associated with gait speed in older adults living in the community. Older adults in the highest tertile of the LAsI had a slower gait speed than those in the lowest tertile of the LAsI. However, no significant difference was observed in the LAsI between the better mobility group and worse mobility group. Moreover, the LAsI was not a significant predictor of falls. Asymmetry in lower extremity lean mass was significantly associated with gait speed in older adults living in the community.
Previous studies have reported that low levels of physical activity result in sarcopenic obesity (SO). However, the effects of specific intensities of physical activity on SO and the optimal amount of physical activity for lowering the prevalence of SO have not been well studied. This study aimed to identify the effects of physical activity levels and intensity on SO and the optimal amount of physical activity related to a lower prevalence of SO. This cross-sectional study used data from the nationwide Korean Frailty and Aging Cohort Study (KFACS), which included 2071 older adults (1030 men, 1041 women). SO was defined according to the criteria of the European Society for Clinical Nutrition Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO). Multivariate logistic regression analysis was performed to investigate the association between the physical activity level and SO. The high activity group had a significantly lower prevalence of SO than the non-high activity (low and moderate activity) group. On the other hand, moderate-intensity physical activity was associated with a lower prevalence of SO. A total physical activity energy expenditure of > 3032 kcal/week (433 kcal/day) for men and 2730 kcal/week (390 kcal/day) for women was associated with a reduced prevalence of SO. The high physical activity and total physical energy expenditure described above may be beneficial for reducing the prevalence of SO.
The longitudinal effect of B12 insufficiency on sarcopenia has not yet been investigated in older adults. We aimed to study the impact of B12 levels on alterations in muscle mass, function and strength over two years. Non-sarcopenic older adults (n = 926) aged 70–84 were included. Using the Korean Frailty and Aging Cohort Study, this two-year longitudinal study used data across South Korea. The tools used for assessing muscle criteria were based on the Asian Working Group for Sarcopenia guidelines. Participants were divided into the insufficiency (initial serum B12 concentration < 350 pg/mL) and sufficiency groups (≥350 pg/mL). Logistic regression analyses were performed to evaluate the effect of initial B12 concentration on sarcopenia parameters over a two-year period. In women, multivariate analysis showed that the B12 insufficiency group had a significantly higher incidence of low SPPB scores (odds ratio [OR] = 3.28, 95% confidence interval [CI] = 1.59–6.76) and sarcopenia (OR = 3.72, 95% CI = 1.10–12.62). However, the B12 insufficiency group did not have a greater incidence of sarcopenia or other parameters in men. Our findings suggest B12 insufficiency negatively impacts physical performance and increases the incidence of sarcopenia only in women.