Decrease of Muscle Mass in Young Patients With Neuromuscular Disease: Assessment of Sarcopenia

Area of Science:

• Neurology
• Pediatric Medicine
• Radiology
• Orthopedics

Background:

• Sarcopenia, or muscle loss, can occur in children with neurologic diseases beyond degenerative causes.
• The link between neurologic conditions, scoliosis, and gait is known, but sarcopenia's role as a mediator is unclear.
• This study investigates sarcopenia in pediatric and young adult patients with neurologic conditions.

Purpose of the Study:

• To quantify sarcopenia in young patients with neurologic diseases using computed tomography (CT).
• To analyze the association between sarcopenia and the presence of scoliosis.
• To determine the correlation between sarcopenia and ambulatory function.

Main Methods:

• Retrospective analysis of pediatric and young adult patients (≤25 years) who underwent whole-spine or lower-extremity CT.
• Calculation of psoas muscle z-score (PMz) and psoas muscle index (PMI) from L3 psoas muscle areas.
• Statistical analysis including t-tests, Fisher's exact test, and logistic regression.

Main Results:

• Patients with neurologic diseases exhibited significantly lower PMz and PMI compared to non-neurologic controls.
• Severe scoliosis in neurologic patients correlated with lower PMz and PMI.
• Non-ambulatory patients showed lower BMI and PMz; severe scoliosis in this subgroup was linked to reduced PMz and PMI.

Conclusions:

• Sarcopenia is prevalent in young patients with neurologic diseases.
• Psoas muscle volume is associated with ambulatory function in this population.
• Severe scoliosis is linked to more pronounced sarcopenia, particularly in non-ambulatory patients.