Regulation of mild cognitive impairment associated with liver disease by humoral factors derived from the gastrointestinal tract and MRI research progress: a literature review.

Patients with liver disease are prone to various cognitive impairments. It is undeniable that cognitive impairment is often regulated by both the nervous system and the immune system. In this review our research focused on the regulation of mild cognitive impairment associated with liver disease by humoral factors derived from the gastrointestinal tract, and revealed that its mechanisms may be involved with hyperammonemia, neuroinflammation, brain energy and neurotransmitter metabolic disorders, and liver-derived factors. In addition, we share the emerging research progress in magnetic resonance imaging techniques of the brain during mild cognitive impairment associated with liver disease, in order to provide ideas for the prevention and treatment of mild cognitive impairment in liver disease.

Evaluation of Psoas Major and Quadratus Lumborum Recruitment Using Diffusion-Weighted Imaging Before and After 5 Trunk Exercises.

Study Design Controlled laboratory study, with a pretest-posttest design. Background Diffusion-weighted imaging is a noninvasive magnetic resonance imaging technique that can be used to assess the recruitment of the psoas major (PM) and quadratus lumborum (QL). The recruitment of these muscles during trunk exercises has not been evaluated. Objective To evaluate the diffusion of water movement in several trunk muscles using diffusion-weighted imaging before and after specific trunk exercises and thereby to understand the level of recruitment of each muscle during each exercise. Methods Nine healthy male participants performed the right side bridge, knee raise, and 3 front bridges, including the hand-knee, elbow-knee, and elbow-toe bridges. Diffusion-weighted imaging was performed before and after each exercise. After scanning, the apparent diffusion coefficient (ADC) map was constructed, and ADC values of the rectus abdominis, lateral abdominal muscles, QL, PM, and back muscles were calculated. Results The right PM following the elbow-toe bridge demonstrated the largest increase in ADC values, a change significantly greater than that demonstrated by the hand-knee bridge (P<.001) and side bridge (P = .002) exercises. The ADC change in the right QL following the side bridge exercise was significantly larger than that of other exercises (P<.008). Conclusion Of the 5 exercises investigated, the elbow-toe bridge and side bridge exercises elicit the greatest recruitment of the PM and QL, respectively. J Orthop Sports Phys Ther 2017;47(2):108-114. Epub 5 Nov 2016. doi:10.2519/jospt.2017.6730.

Advancements in Imaging Technology: Do They (or Will They) Equate to Advancements in Our Knowledge of Recovery in Whiplash?

Synopsis It is generally accepted that up to 50% of those with a whiplash injury following a motor vehicle collision will fail to fully recover. Twenty-five percent of these patients will demonstrate a markedly complex clinical picture that includes severe pain-related disability, sensory and motor disturbances, and psychological distress. A number of psychosocial factors have shown prognostic value for recovery following whiplash from a motor vehicle collision. To date, no management approach (eg, physical therapies, education, psychological interventions, or interdisciplinary strategies) for acute whiplash has positively influenced recovery rates. For many of the probable pathoanatomical lesions (eg, fracture, ligamentous rupture, disc injury), there remains a lack of available clinical tests for identifying their presence. Fractures, particularly at the craniovertebral and cervicothoracic junctions, may be radiographically occult. While high-resolution computed tomography scans can detect fractures, there remains a lack of prevalence data for fractures in this population. Conventional magnetic resonance imaging has not consistently revealed lesions in patients with acute or chronic whiplash, a "failure" that may be due to limitations in the resolution of available devices and the use of standard sequences. The technological evolution of imaging techniques and sequences eventually might provide greater resolution to reveal currently elusive anatomical lesions (or, perhaps more importantly, temporal changes in physiological responses to assumed lesions) in those patients at risk of poor recovery. Preliminary findings from 2 prospective cohort studies in 2 different countries suggest that this is so, as evidenced by changes to the structure of skeletal muscles in those who do not fully recover. In this clinical commentary, we will briefly introduce the available imaging decision rules and the current knowledge underlying the pathomechanics and pathophysiology of whiplash. We will then acknowledge known prognostic factors underlying functional recovery. Last, we will highlight emerging evidence regarding the pathobiology of muscle degeneration/regeneration, as well as advancements in neuroimaging and musculoskeletal imaging techniques (eg, functional magnetic resonance imaging, magnetization transfer imaging, spectroscopy, diffusion-weighted imaging) that may be used as noninvasive and objective complements to known prognostic factors associated with whiplash recovery, in particular, poor functional recovery. J Orthop Sports Phys Ther 2016;46(10):861-872. doi:10.2519/jospt.2016.6735.

Intrinsic foot muscle volume in experienced runners with and without chronic plantar fasciitis.

OBJECTIVES: Plantar fasciitis, a common injury in runners, has been speculated to be associated with weakness of the intrinsic foot muscles. A recent study reported that atrophy of the intrinsic forefoot muscles might contribute to plantar fasciitis by destabilizing the medial longitudinal arch. However, intrinsic foot muscle volume difference between individuals with plantar fasciitis and healthy counterparts remains unknown. This study examined the relationship of intrinsic foot muscle volume and incidence of plantar fasciitis. DESIGN: Case-control study. METHODS: 20 experienced (≥5 years) runners were recruited. Ten of them had bilateral chronic (≥2 years) plantar fasciitis while the others were healthy characteristics-matched runners. Intrinsic muscle volumes of the participants' right foot were scanned with a 1.5T magnetic resonance system and segmented using established methods. Body-mass normalized intrinsic foot muscle volumes were compared between runners with and without chronic plantar fasciitis. RESULTS: There was significant greater rearfoot intrinsic muscle volume in healthy runners than runners with chronic plantar fasciitis (Cohen's d=1.13; p=0.023). A similar trend was also observed in the total intrinsic foot muscle volume but it did not reach a statistical significance (Cohen's d=0.92; p=0.056). Forefoot volume was similar between runners with and without plantar fasciitis. CONCLUSIONS: These results suggest that atrophy of intrinsic foot muscles may be associated with symptoms of plantar fasciitis in runners. These findings may provide useful information in rehabilitation strategies of chronic plantar fasciitis.