Ultrasound guided compressibility of the lower leg anterior tibial muscle compartment: a feasibility study.

OBJECTIVES: Some young individuals participating in sports activities may encounter lower leg muscle pain and tightness, potentially indicating chronic exertional compartment syndrome (CECS). While muscle pressure measurement is typically recommended for diagnosis, it is invasive and associated with low sensitivity and specificity. Thus, there is a need for novel diagnostic approaches. METHODS: This feasibility study aims to assess whether an ultrasound-guided technique can effectively measure the compressibility of the anterior tibial muscle compartment, focusing on optimal leg positioning and identifying reliable external and internal anatomical landmarks. The compressibility of the anterior tibial muscle compartment was evaluated using ultrasound images obtained at 10 mmHg and 80 mmHg external pressure, with the drop in compartment thickness used to calculate the compressibility ratio. Measurements were conducted in various leg positions and utilizing different external and internal landmarks. RESULTS: Studies in healthy volunteers showed that knee and heel support positioning, measuring at the leg's widest circumference, and using the interosseous membrane as an internal landmark yielded the lowest measurement variability with an intra class correlation of .977 (.764-1.000; 95%-confidence interval). CONCLUSION: These findings suggest that ultrasound-guided techniques can feasibly determine the compressibility ratio of the anterior tibial muscle compartment, providing valuable insights for standardized protocols in future studies on suspected cases of chronic exertional compartment syndrome.

Single-cell activity tracking reveals that orbitofrontal neurons acquire and maintain a long-term memory to guide behavioral adaptation.

Learning to predict rewards based on environmental cues is essential for survival. The orbitofrontal cortex (OFC) contributes to such learning by conveying reward-related information to brain areas such as the ventral tegmental area (VTA). Despite this, how cue-reward memory representations form in individual OFC neurons and are modified based on new information is unknown. To address this, using in vivo two-photon calcium imaging in mice, we tracked the response evolution of thousands of OFC output neurons, including those projecting to VTA, through multiple days and stages of cue-reward learning. Collectively, we show that OFC contains several functional clusters of neurons distinctly encoding cue-reward memory representations, with only select responses routed downstream to VTA. Unexpectedly, these representations were stably maintained by the same neurons even after extinction of the cue-reward pairing, and supported behavioral learning and memory. Thus, OFC neuronal activity represents a long-term cue-reward associative memory to support behavioral adaptation.