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University of Padua – cir MYO Interdepartmental Research Center of Myology
2009 Autumn PaduaMuscleDays
Terme Euganee, Padova, Italy – October 16-18, 2009
Terme Euganee Conference Hall, Hotel Augustus, Viale Stazione 150 - 35136 Montegrotto Terme, Padova, Italy Phone +39 049 793 200 - Fax +39 049 793518 –
http://www.hotelaugustus.com/english/pages/hotel_augustus.php - E-mail: info@hotelaugustus.com
Editorial Forging an EU Task Force for Translational Myology
In name of the Interdepartmental Research Center of Myology of the University of Padua we invite you to the 2009Autumn PaduaMuscleDays, that will be held October 16-18, 2009 in Terme Euganee, Padua (Italy). The aim of the Meeting is to forge an EU Task Force for Translational Myology and present to our Panel of International Experts the four-year cirMYO interdisciplinary research program. Helmut Kern, Thordur Helgason, Vittorio Bianchi and Corrado Angelini helped in organizing the Meeting that offer to many medical and non- medical students, scientists and professionals updates in key myology topics: Muscle Therapeutic Electrical Stimulation (mTES) – Exercise&Nutrition – Myopathies&Monitoring.
mTES of denervated muscles. One of the effects of Spinal Cord Injury (SCI), secondary to neurons dis-function (lack of voluntary contraction and spasticity) or a-function (lack of spontaneous and electrical stimulation induced muscle contractions) is the rapid loss of contractile force and mass of muscles. Disuse/disfunction and atrophy of leg muscles became particularly severe when the injury irreversibly destroys the lower motor neurons. The striking alterations of functional and structural properties of muscle fibers caused by the permanent lack of innervation in SCI patients could be prevented or reverted by muscle Therapeutical Electrical Stimulation (mTES), using custom-designed electrodes and stimulators developed in Vienna, Austria. Our observations showed that: i) human skeletal muscle fibers survive longer (in years) than generally accepted; ii) human muscles that have undergone atrophy as a result of persistent lower motor neuron lesion due to SCI may obtain considerable restitution of excitability, force and mass by home-based muscle therapeutical electrical stimulation (mTES); iii) starting mTES within the first year post-lesion results in a better recovery of muscle function. Friday October 16, 2009 during the Tutorial organized by H. Kern participants will have demonstration of the training methodologies for “mTES of denervated muscles” on patients suffering SCI or peripheral nerve lesions. Results of animal research and the clinical value of “Muscle tissue composition and macrostructural changes by 3D-Color Tomography for denervated/reinnervating muscles” and “Functional Echo Myography of denervated/reinnervating muscle” will be then presented and discussed. Beside the key references, see for additional readings articles printed in Basic and Applied Myology / European Journal of Translational Myology 19 (4), 2009. You may retrive them for free in BAM On-Line at: http://www.bio.unipd.it/bam/bam.html
Myopathies. The morning sessions of Saturday October 17, 2009 will address diagnostic, pathogenetic, therapeutic and rehabilitation aspects of innervation-dependent or innervation- independent myopathies. Wolfgang Grisold, Vienna, Austria will lecture on “Paraneoplastic myopathies and muscle cachexia”. The Lecture on “Nutritional influences on the hormonal responses to exercise and training” by Antony C. Hackney, Chapel Hill, USA opens the session on Authophagic and metabolic myopathies.
Myopathies Monitoring and Modelling. Validated follow-up procedures of disease progression and recovery are basics for validation of treatment strategies. The Lecture of Thordur Helgason, University of Reykjavik (Iceland), will open the afternoon sessions of Saturday October 17, 2009, providing information on Muscle Three-dimensional Tissue Segmentation & Composition analysis. The following presenters will share with the audience their experiences on others approaches applied to monitoring of innervation-dependent and innervation-independent myopathies.
Workshop of the EU Task Force: Assist and Mimic Muscle Reinnervation An introduction by Stanley Salmons and the Lecture “Time course and dose-dependence of
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transcriptional changes in electrically stimulated skeletal muscle” by Jonathan C. Jarvis, Liverpool, UK will open the sessions of Sunday October 18, 2009, which are dedicated to the Workshop of the EU Task Force: Assist and Mimic Muscle Reinnervation. During morning partners will present their contribution, while during afternoon the Research Project will be finalized.
In conclusion it is worth to stress that there are too many old controversial issues that need new approaches. Combining sound invasive “time zero” and “end-point” analyses (tissue biopsy and three dimensional macro-morphometry by Tomography) with non-invasive repeatable Ultra Sound analyses some of the open questions will find a final answer: i) Extent of muscle denervation and spontaneous reinnervation; ii) Rate of progression of atrophy to degeneration in denervated muscles; iii) Influence (positive/negative) of electrical stimulation on reinnervation; iv) Translation of the knowledge an interdisciplinary group of European Scientists and Clinicians gathered with the EU Project Rise to a wider population of elderly and diseased persons.
Ugo Carraro Helmut Kern Winfried Mayr
ugo.carraro@unipd.it helmut.kern@wienkav.at winfried.mayr@meduniwien.ac.at
Key References
Boncompagni S, Kern H, Rossini K, Hofer C, Mayr W, Carraro U, Protasi F. Structural differentiation of skeletal muscle fibers in the absence of innervation in humans. Proc Natl Acad Sci U S A. 2007; 104: 19339-19344. Epub 2007 Nov 27.
Carraro U, Rossini K, Mayr W, Kern H. Muscle fiber regeneration in human permanent lower motoneuron denervation: relevance to safety and effectiveness of FES-training, which induces muscle recovery in SCI subjects. Artif Organs 2005; 29: 187-191.
Gargiulo P, Vatnsdal B, Ingvarsson P, Knútsdóttir S, Gudmundsdóttir V, Yngvason S, Kern H, Carraro U, Helgason T. Computational methods to analyze tissue composition and structural changes in denervated muscle undergoing therapeutic electrical stimulation. Basic Appl Myol 2009; 19: 157-161.
Kern H, Boncompagni S, Rossini K, Mayr W, Fanò G, Zanin ME, Podhorska-Okolow M, Protasi F, Carraro U. Long-term denervation in humans causes degeneration of both contractile and excitation-contraction coupling apparatus that can be reversed by functional electrical stimulation (FES). A role for myofiber regeneration? J Neuropath Exp Neurol 2004; 63: 919- 931.
Squecco R, Carraro U, Kern H, Pond A, Adami N, Biral D, Vindigni V, Boncompagni S, Pietrangelo T, Bosco G, Fanò G, Marini M, Abruzzo PM, Germinario E, Danieli-Betto D, Protasi F, Francini F, Zampieri S. Despite lost contractility, a sub-population of rat muscle fibers maintains an assessable excitation-contraction coupling mechanism after long-standing denervation. J Neuropath Exp Neurol, 2009, in press.
Stramare R, Martino L, Masiero S, Kern H, Carraro U. Functional EchoMyography of denervated muscle. Preliminary results. Basic Appl Myol 2009; 19: 206.
