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BACKGROUNDPeripheral arterial disease (PAD) is associated with reduced muscle mass and quality, but the effects of leg ischemia caused by PAD on muscle quality remain poorly understood. The purpose of this study was to evaluate leg muscle mass and muscle quality in patients with intermittent claudication due to PAD using bioelectrical impedance analysis (BIA).METHODSOne hundred forty-one patients with intermittent claudication due to PAD who visited Tokyo Medical University Hospital from April 2019 to April 2020 were retrospectively analyzed. Leg ischemia was assessed using ankle-brachial pressure index (ABI). The skeletal muscle mass (SMM) assessed leg muscle mass, while the phase angle (PhA) assessed leg muscle quality using BIA.RESULTSA total of 282 legs in 141 patients were included in the analysis. Leg PhA and SMM showed a decreasing trend according to the severity of leg ischemia (borderline/no ischemia: 2.80 ± 0.50 kg/m², 4.38 ± 0.94°; mild ischemia: 2.83 ± 0.49 kg/m², 4.33 ± 1.03°; moderate/severe ischemia: 2.50 ± 0.40 kg/m², 3.89 ± 0. 88°; P < 0.001 and P = 0.020, respectively). The ABI was moderately correlated with leg SMM (B = 0.347, β = 0.134, P < 0.001) and leg PhA (B = 0.577, β = 0.111, P = 0.013) after adjustment for all significant covariates. Leg PhA was moderately correlated with leg SMM (r = 0.318, P < 0.001).CONCLUSIONSLeg ischemia, especially when moderate or severe, has an adverse effect on both muscle mass and quality in the lower extremities and is associated with skeletal muscle myopathy.

01 Aug 2024·Experimental Neurology

[123I]CLINDE SPECT as a neuroinflammation imaging approach in a rat model of stroke

Article

Author: Enmi, Jun-Ichiro ; Tsuji, Masahiro ; Zeniya, Tsutomu ; Moriguchi, Tetsuaki ; Koshino, Kazuhiro ; Ohshima, Makiko ; Kawashima, Hidekazu ; Iida, Hidehiro

Poststroke neuroinflammation exacerbates disease progression. [¹¹C]PK11195-positron emission tomography (PET) imaging has been used to visualize neuroinflammation; however, its short half-life of 20 min limits its clinical use. [¹²³I]CLINDE has a longer half-life (13h); therefore, [¹²³I]CLINDE-single-photon emission computed tomography (SPECT) imaging is potentially more practical than [¹¹C]PK11195-PET imaging in clinical settings. The objectives of this study were to 1) validate neuroinflammation imaging using [¹²³I]CLINDE and 2) investigate the mechanisms underlying stroke in association with neuroinflammation using multimodal techniques, including magnetic resonance imaging (MRI), gas-PET, and histological analysis, in a rat model of ischemic stroke, that is, permanent middle cerebral artery occlusion (pMCAo). At 6 days post-pMCAo, [¹²³I]CLINDE-SPECT considerably corresponded to the immunohistochemical images stained with the CD68 antibody (a marker for microglia/microphages), comparable to the level observed in [¹¹C]PK11195-PET images. In addition, the [¹²³I]CLINDE-SPECT images corresponded well with autoradiography images. Rats with severe infarcts, as defined by MRI, exhibited marked neuroinflammation in the peri-infarct area and less neuroinflammation in the ischemic core, accompanied by a substantial reduction in the cerebral metabolic rate of oxygen (CMRO₂) in ¹⁵O-gas-PET. Rats with moderate-to-mild infarcts exhibited neuroinflammation in the ischemic core, where CMRO₂ levels were mildly reduced. This study demonstrates that [¹²³I]CLINDE-SPECT imaging is suitable for neuroinflammation imaging and that the distribution of neuroinflammation varies depending on the severity of infarction.

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