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Quantifying Muscular Atrophy via Medical Imaging: Applications in Aging and Muscular Dystrophy

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Quantifying Muscular Atrophy via Medical Imaging: Applications in Aging and Muscular Dystrophy
Madrid, Diana Alejandra
In the United States, there are about 55 million older adults, accounting for 16% of the population. This percentage is expected to rise to 22% by 2040. Skeletal muscle function is known to decline with advancing age and muscular disease, affecting the quality of life and increasing the disability risk and morbidity of as much as 30% of community-dwelling older adults. A growing body of scientific literature suggests that, in addition to size, muscle quality may be a fundamental factor underpinning skeletal muscle function. A safe and non-invasive way of quantifying muscle size and quality is medical imaging. Given that more than 130 million magnetic resonance (MRI) and computerized tomography scans (CT) are collected each year in the US, there is significant untapped potential to assess muscle health, which is otherwise only indirectly measurable.This thesis applies quantitative imaging to achieve two objectives. First, there is not enough research to support a specific exercise recommendation to improve the muscle quality of older adults during weight loss, as quantified by CT imaging. The first objective is therefore to compare the effects of aerobic versus resistance training on CT-derived metrics of muscle health of older adults on an 18-month weight loss program. Parallel to this, myotonic dystrophy type 2 is the most common adult-onset muscular dystrophy and is characterized by a decline in muscle size and function. Despite advanced imaging technologies, quantitative MRI had previously not entered the standard of care for muscular dystrophies. This was partly because genetic testing already provides specific diagnostic information and, since few treatments were available, MRI was of limited clinical use. The treatment landscape is now changing for myotonic dystrophy and clinical trial readiness is a priority. Consequently, the second objective aims to characterize muscle health in the lower extremities of patients with myotonic dystrophy type 2 and explore the viability of quantitative imaging as a surrogate physical function endpoint for this group.
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Muscle Atrophy
Myotonic Dystrophy
Older Adults
Weight Loss
Weaver, Ashley A. (committee chair)
Puwanant, Araya (committee member)
Beavers, Kristen M. (committee member)
2022-05-24T08:36:02Z (accessioned)
2024-05-23T08:30:08Z (available)
2022 (issued)
Biomedical Engineering (discipline)
2024-05-23 (terms)
http://hdl.handle.net/10339/100737 (uri)
en (iso)
Wake Forest University

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