Muscle physiology in spasticity and muscle stiffness

IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY
Preeti Raghavan
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Abstract

This paper examines the physiological changes in spastic muscles contributing to spasticity and muscle stiffness, focusing on the underlying mechanisms and their clinical implications. Spasticity, which is prevalent in neurological conditions such as multiple sclerosis, cerebral palsy, spinal cord injury, stroke, and traumatic brain injury, is characterized by disordered sensorimotor control and often results in increased muscle stiffness and resistance to movement. Recent developments in the understanding of spasticity suggest the importance of architectural changes in muscles that may contribute to increased passive resistance, potentiate reflex mechanisms, and progression to fibrosis, with hyaluronan (HA), a glycosaminoglycan, playing a pivotal in modulating the properties of the muscle extracellular matrix (ECM). The hyaluronan hypothesis of muscle stiffness postulates that the accumulation and biophysical alteration of HA in the ECM of muscle increases its viscosity, resulting in increased passive mechanical resistance. This is turn mayincrease muscle sensitivity to stretch, potentiating spasticity, and lead to cellular differentiation of myofibroblasts to fibroblasts ultimately leading to fibrosis and contracture. A deeper understanding of HA's role in ECM dynamics offers promising avenues for novel treatments aimed at mitigating stiffness and preventing long-term disability in patients with spasticity.

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痉挛和肌肉僵硬的肌肉生理学
本文探讨痉挛肌肉的生理变化对痉挛和肌肉僵硬的影响,重点讨论其潜在机制及其临床意义。痉挛在多发性硬化症、脑瘫、脊髓损伤、中风和创伤性脑损伤等神经系统疾病中很常见,其特征是感觉运动控制紊乱,经常导致肌肉僵硬和运动阻力增加。最近对痉挛的理解表明,肌肉结构变化的重要性,可能有助于增加被动阻力,增强反射机制,并进展为纤维化,透明质酸(HA),一种糖胺聚糖,在调节肌肉细胞外基质(ECM)的特性中起关键作用。肌肉僵硬的透明质酸假说认为,HA在肌肉外基质中的积累和生物物理改变增加了其粘度,导致被动机械阻力增加。这可能会增加肌肉对拉伸的敏感性,增强痉挛,并导致肌成纤维细胞分化为成纤维细胞,最终导致纤维化和挛缩。更深入地了解HA在ECM动力学中的作用,为缓解痉挛患者僵硬和预防长期残疾的新疗法提供了有希望的途径。
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来源期刊
Toxicon
Toxicon 医学-毒理学
CiteScore
4.80
自引率
10.70%
发文量
358
审稿时长
68 days
期刊介绍: Toxicon has an open access mirror Toxicon: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. An introductory offer Toxicon: X - full waiver of the Open Access fee. Toxicon''s "aims and scope" are to publish: -articles containing the results of original research on problems related to toxins derived from animals, plants and microorganisms -papers on novel findings related to the chemical, pharmacological, toxicological, and immunological properties of natural toxins -molecular biological studies of toxins and other genes from poisonous and venomous organisms that advance understanding of the role or function of toxins -clinical observations on poisoning and envenoming where a new therapeutic principle has been proposed or a decidedly superior clinical result has been obtained. -material on the use of toxins as tools in studying biological processes and material on subjects related to venom and antivenom problems. -articles on the translational application of toxins, for example as drugs and insecticides -epidemiological studies on envenoming or poisoning, so long as they highlight a previously unrecognised medical problem or provide insight into the prevention or medical treatment of envenoming or poisoning. Retrospective surveys of hospital records, especially those lacking species identification, will not be considered for publication. Properly designed prospective community-based surveys are strongly encouraged. -articles describing well-known activities of venoms, such as antibacterial, anticancer, and analgesic activities of arachnid venoms, without any attempt to define the mechanism of action or purify the active component, will not be considered for publication in Toxicon. -review articles on problems related to toxinology. To encourage the exchange of ideas, sections of the journal may be devoted to Short Communications, Letters to the Editor and activities of the affiliated societies.
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