Association Between Clinical Symptoms, Electrodiagnostic Findings, Clinical Outcome, and Prodromal Symptoms in Patients With Bell's Palsy.

OBJECTIVE: This study aimed to determine which prodromal symptoms frequently occur in patients with Bell's palsy and evaluate the association between these symptoms and clinical severity of paresis or the severity of facial nerve injury. MATERIALS AND METHODS: The study included 86 patients with Bell's palsy between August 2018 and April 2020. Severity levels of Bell's palsy and facial nerve damage were evaluated using the House-Brackmann (H-B) grading scale and electrodiagnostic study, respectively. Subsequently, a self-reported questionnaire on prodromal symptoms was administered. To assess the degree of recovery, the H-B grade was reported at 9 weeks and 6 months after the onset of paralysis. RESULTS: The most common prodromal symptoms were postauricular pain, sensory decline in the tongue, headache on the affected side, myalgia, facial sensory decline on the affected side, taste impairment, and dry eye. Taste impairment was significantly correlated with severe facial paralysis reported at 9 weeks after onset (P < .05) and was not related to the severity of paresis assessed at initial examination or 6 months after onset or on electrodiagnostic findings. CONCLUSIONS: The prodromal symptoms of Bell's palsy were not associated with the severity of facial nerve injury in an electrodiagnostic study. Taste impairment was related to clinical severity of paralysis at subacute stage, 9 weeks after onset, but it was not associated with long-term prognosis.

Central obesity is associated with lower prevalence of sarcopenia in older women, but not in men: a cross-sectional study.

BACKGROUND: Obesity is a chronic disease that causes various medical health problems, increases morbidity, and reduces the quality of life. Obesity (especially central obesity) in older adults is expected to act with the development of sarcopenia. However, the relationship between obesity, central obesity, and sarcopenia remains controversial. This study aimed to investigate the impact of obesity on sarcopenia. METHODS: In this cross-sectional study, we used data from the Korean Frailty and Aging Cohort Study; 1,827 community-dwelling older adults (883 men and 944 women) aged 70-84 years were recruited. The Asian Working Group for Sarcopenia (AWGS) criteria were used to evaluate sarcopenia. Subjects with a low appendicular skeletal muscle mass index (ASMI; men: < 7.0 kg/m2, women: < 5.4 kg/m2) and either low handgrip strength (HGS; men: < 28 kg, women: < 18 kg) or low Short Physical Performance Battery (SPPB; ≤ 9) were diagnosed with sarcopenia. Obesity was defined as a body mass index (BMI) of ≥ 25 kg/m2, while central obesity was defined as WC measurements of ≥ 90 cm in men and ≥ 85 cm in women. Logistic regression analyses were performed to evaluate the impact of obesity and central obesity on sarcopenia and the parameters of sacropenia. RESULTS: In both sexes, the obese group, defined based on the BMI, had a significantly low prevalence of low ASMI (odds ratio [OR] = 0.14, 95% confidence interval CI = 0.10-0.20 in men, OR = 0.17, 95% CI = 0.12-0.25 in women) and sarcopenia (OR = 0.28, 95% CI = 0.16-0.50 in men, OR = 0.17, 95% CI = 0.08-0.35 in women) in the multivariable logistic regression analysis. In women, the central obese group had a low prevalence of sarcopenia (OR = 0.46, 95% CI = 0.27-0.77) in the multivariable logistic regression analysis. Meanwhile, the obese group had a significantly higher prevalence of low SPPB in women (OR = 1.75, 95% CI = 1.18-2.59). CONCLUSIONS: Obesity may have a protective effect on low ASMI and sarcopenia, as defined by the AWGS criteria. Central obesity was associated with a low prevalence of sarcopenia in women only. However, obesity did not have a positive impact on functional parameters of sarcopenia including muscle strength and physical performance.

Does Unilateral Lumbosacral Radiculopathy Affect the Association between Lumbar Spinal Muscle Morphometry and Bone Mineral Density?

Age-related degenerative changes lead to a gradual decrease in bone mineral density (BMD) and muscle mass. We aimed to assess the effects of decreased BMD and lumbar denervation on lumbar spinal muscle morphometry and the relationship between BMD and lumbar spinal muscular morphometry, respectively. Eighty-one patients, aged 50-85 years, diagnosed with unilateral lumbosacral radiculopathy based on electrodiagnostic studies between January 2016 and April 2021 were enrolled. BMD T scores in the lumbar spine and hip were measured using dual-energy X-ray absorptiometry. The cross-sectional area (CSA) of the psoas, multifidus, and erector spinae located in the middle of the lumbar spine, between the L3 and L4 and between the L4 and L5 levels, respectively, was measured using axial MRI. Functional CSA (FCSA) was defined as the CSA of lean muscle mass. Pearson correlation analyses were performed to evaluate the association between BMD T scores and the CSA, FCSA, and the ratio of the FCSA to the CSA (functional ratio) for each side. The CSA of lumbar spinal muscles showed no significant correlation with lumbar BMD. The FCSA and functional ratio of lumbar spinal muscles were significantly correlated with lumbar BMD. There was no correlation between femur BMD and lumbar spinal muscle morphometry.

Impact of Vitamin B12 Insufficiency on Sarcopenia in Community-Dwelling Older Korean Adults.

Vitamin B12 (B12) is involved as a cofactor in the synthesis of myelin. A lack of B12 impairs peripheral nerve production, which can contribute to sarcopenia. In this cross-sectional study, we aimed to investigate the relationship between B12 insufficiency and sarcopenia in community-dwelling older Korean adults. A total of 2325 (1112 men; 1213 women) adults aged 70-84 years were recruited. The tools used for sarcopenia were based on the Asian Working Group for Sarcopenia (AWGS) guidelines. Individuals with low appendicular skeletal muscle mass index (ASMI) (<7.0 kg/m2 for men; <5.4 kg/m2 for women) and low hand grip strength (HGS) (<28 kg for men; <18 kg for women) were defined as the sarcopenia group. Among this group, those who showed low physical performance (≤9 points on the Short Physical Performance Battery (SPPB)) were defined as the severe sarcopenia group. B12 concentrations were classified into insufficient (<350 pg/mL) and sufficient (≥350 pg/mL). Univariate and multivariate logistic regression analyses were used to evaluate the relationship between sarcopenia and B12 levels. Low ASMI showed a high incidence in the B12-insufficient group. However, HGS, SPPB, and the severity of sarcopenia showed no correlation with B12. Further, insufficient B12 may affect muscle quantity rather than muscle strength or physical performance.

Asymmetric atrophy of cervical multifidus muscles in patients with chronic unilateral cervical radiculopathy.

The purpose of this study was to assess whether the asymmetry of cervical multifidus muscles occurred in radiculopathy patients, and if it did, whether it was related to the chronicity of unilateral cervical radiculopathy by assessing the cross-sectional area (CSA) of multifidus muscles using magnetic resonance imaging (MRI).This study used a retrospective design and was conducted from January 2013 to August 2016. Seventy-seven patients (age 18-65) who had unilateral neck pain, symptom duration of 3 months to 1 year, and who were diagnosed with unilateral 6th cervical radiculopathy by electrodiagnostic testing, were included in study. The CSA of cervical multifidus muscles was measured at the midpoint between the lower margin of the upper vertebra and upper margin of the lower vertebra on axial MRI. Relative CSA (rCSA), which is the ratio of the CSA of muscles to that of the lower margin of C5 vertebra was also obtained.At the C4-5 and C6-7 levels, CSA and rCSA of cervical multifidus muscles showed no statistically difference between the affected and unaffected sides. At the C5-6 level, multifidus muscles were significantly smaller in the affected side (at the C5-6 level, P value of CSA.007 and P value of rCSA.102).The atrophy of multifidus muscles ipsilateral to cervical radiculopathy was observed in patients who had chronic unilateral cervical radiculopathy.