Abstract
Sarcopenia is a muscle disease listed within the ICD-10 classification. Several operational definitions have been created for sarcopenia screening; however, an international consensus is lacking. The Centers for Disease Control and Prevention have recently recognized that sarcopenia detection requires improved diagnosis and screening measures. Mounting evidence hints towards changes in the corticospinal communication system where corticomuscular coherence (CMC) reflects an effective mechanism of corticospinal interaction. CMC can be assessed during locomotion by means of simultaneously measuring Electroencephalography (EEG) and Electromyography (EMG). The aim of this study was to perform sarcopenia screening in community-dwelling older adults and explore the possibility of using CMC assessed during gait to discriminate between sarcopenic and non-sarcopenic older adults. Receiver Operating Characteristic (ROC) curves showed high sensitivity, precision and accuracy of CMC assessed from EEG Cz sensor and EMG sensors located over Musculus Vastus Medialis [Cz-VM; AUC (95.0%CI): 0.98 (0.92–1.04), sensitivity: 1.00, 1-specificity: 0.89, p < 0.001] and with Musculus Biceps Femoris [Cz-BF; AUC (95.0%CI): 0.86 (0.68–1.03), sensitivity: 1.00, 1-specificity: 0.70, p < 0.001]. These muscles showed significant differences with large magnitude of effect between sarcopenic and non-sarcopenic older adults [Hedge’s g (95.0%CI): 2.2 (1.3–3.1), p = 0.005 and Hedge’s g (95.0%CI): 1.5 (0.7–2.2), p = 0.010; respectively]. The novelty of this exploratory investigation is the hint toward a novel possible determinant of age-related sarcopenia, derived from corticospinal control of locomotion and shown by the observed large differences in CMC when sarcopenic and non-sarcopenic older adults are compared. This, in turn, might represent in future a potential treatment target to counteract sarcopenia as well as a parameter to monitor the progression of the disease and/or the potential recovery following other treatment interventions.
Highlights
Sarcopenia is an age-related progressive decline in skeletal muscle mass and function [1], which was only very recently officially recognized as a muscle disorder by the World Health Organization (WHO) with a specific code (M62.84) from the 10th revision of the International Classification of Diseases (ICD-10) [2]
Receiver Operating Characteristic (ROC) curve analysis of the logarithmically transformed sum of coherence above significant confidence limits, between EEG Cz sensors and eight lower limbs muscle, yielded to significant accuracy above 85% of chance in differentiating between sarcopenic and non-sarcopenic older adults, with high sensitivity and precision, when EEG Cz sensor is coupled with Vastus Medialis [Cz-VM; AUC (95.0%confidence intervals (CI)): 0.98 (0.92–1.04), sensitivity: 1.00, 1-specificity: 0.89, p < 0.001] or with Biceps Femoris [Cz-BF; AUC (95.0%CI): 0.86 (0.68–1.03), sensitivity: 1.00, 1-specificity: 0.70, p < 0.001]
Corticomuscular coherence represents an effective mechanism of corticospinal interaction and central drive to skeletal muscle[19,20,21,22,23] and it can be assessed during locomotor tasks such as walking[28,29,35], where it has been observed to differently modulate in older compared to younger adults[24,25,26,48,50]
Summary
Sarcopenia is an age-related progressive decline in skeletal muscle mass and function [1], which was only very recently officially recognized as a muscle disorder by the World Health Organization (WHO) with a specific code (M62.84) from the 10th revision of the International Classification of Diseases (ICD-10) [2]. Recent studies demonstrated that muscle atrophy is a relatively small contributor to the loss of muscle strength, since the latter is lost at a substantially faster rate than muscle atrophy and gaining muscle mass does not necessarily prevent the aging-related loss of muscle strength [14]. For this reason, the new term dynapenia (from Greek: dyna- = power/strength and -penia = loss) has been suggested to replace the traditionally used term sarcopenia (from Greek: sarco- = meat/muscle and -penia = loss) [1,14,15,16]. A not well-functioning neuromuscular system in sarcopenia might be due to an impaired corticospinal interaction [18], which, in turn, may contribute to the muscle microenvironment leading to the loss of muscle mass, strength and functionality
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