Muscle fiber type morphology and distribution in paraplegic patients with traumatic cord lesion
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Biopsies of the rectus femoris muscle of 22 paraplegic patients with complete acute spinal cord transection due to trauma were taken for enzyme-histochemical and electron-microscopic studies in successive stages starting from the occurrence of the accident (1–17 months).
Ingravescent muscular atrophy was demonstrated with a progressive decrease in the fiber diameter and changes in the fiber type distribution with predominant type II atrophy in the first stage and type I atrophy in the later stage of the cord transection. Muscular “neurogenic” changes, such as angular dark atrophic fibers, targetoid fibers, and type predominance are frequently observed. Myopathic alterations are observed in a low percentage in the later stages of the lesion. The ultrastructural findings are characterized by myofibrillar alterations and by dilatation and proliferative phenomena of the sarcoplasmic reticulum and T-system. There are ingravescent accumulation of lipid, interstitial fibrosis and microcirculatory alterations. The possible mechanism of “central” muscle atrophy is reviewed and discussed with reference to the morphological findings.
Key wordsSkeletal muscle Paraplegia Complete spinal cord lesion Histopatology Electron microscopy
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- Brooke MH, Engel WK (1969) The histographic analysis of human muscle biopsies with regard to fibre types. Part 2 (diseases of the upper and lower motoneuron). Neurology (Minneap) 19:378–393Google Scholar
- Dubowitz V, Brooke MH (1973) Muscle biopsy. A modern approach. Saunders, LondonGoogle Scholar
- Edström L (1968) Histochemical changes in upper motor lesions, Parkinsonism and disuse. Differential effect on white and red muscle fibers. Experientia (Basel) 24:916–918Google Scholar
- Edström L (1969) Selective changes in the size of red and white muscle fibers in upper motor lesions and parkinsonism. J Neurol Sci 11:537–550Google Scholar
- Edström L (1970) Selective atrophy of red muscle fibers in the quadriceps in long-standing knee-joint dysfunction. Injuries to the anterior cruciate ligament. J Neurol Sci 11:551–558Google Scholar
- Edwards R, Young A, Wiles M (1980) Needle biopsy of skeletal muscle in the diagnosis of myopathy and the clinical study of muscle function and repair. New Engl J Med 302:261–271Google Scholar
- Fenichel GM, Daroff RB, Glaser GH (1964) Hemiplegic atrophy: Histologic and etiologic considerations. Neurology (Minneap) 14:883–890Google Scholar
- Goldkamp O (1967) Electromyography and nerve conduction studies in 116 patients with hemiplegia. Arch Phys Med 48:59–63Google Scholar
- Grimby G, Broberg C, Krotkiewska L, Krotikiewska M (1976) Muscle fiber composition in patients with traumatic cord lesion. Scand J Rehabil Med 8:37–42Google Scholar
- Karpati G, Engel WK (1968) Correlative histochemical study of skeletal muscle after suprasegmental denervation, peripheral nerve section, and skeletal fixation. Neurology (Minneap) 18: 681–692Google Scholar
- McComas AJ, Sica REP, Upton AR, Aguilera N (1971) Motoneurone dysfunction in patients with hemiplegic atrophy. Nature 233:21–22Google Scholar
- Ochs S (1974) System of material transport in nerve fibers (axoplasmic transport) related to nerve function and trophic control. Ann NY Acad Sci 228:202–210Google Scholar
- Patel AN, Razzak ZA, Dastur DK (1969) Disuse atrophy of human skeletal muscles. Arch Neurol (Chic) 20:413–421Google Scholar
- Scarlato G, Valli G, Pagni G, Zavanone M (1976) L'amiotrofia spinale nelle sindromi apalliche. Acta Neurol 21:62–67Google Scholar
- Silverstein A (1955) Diagnostic localizing value of muscle atrophy in parietal lobe lesions. Neurology (Minneap) 5:30–55Google Scholar
- Siperstein MD, Raskin PR, Burns H (1973) Electron-microscopic quantification of diabetic microangiopathy. Diabetes 22:514–524Google Scholar
- Smith B (1965) Changes in the enzyme histochemistry of skeletal muscle during experimental denervation and reinnervation. J Neurol Neurosurg Psychiat 28:99–103Google Scholar
- Yusevic YS (1968) The significance of “global” electromyography for analysing the pathological mechanisms of spastic paralysis. Electromyography 8:136–157Google Scholar