Interrelation between Sarcopenia and the Number of Motor Neurons in Patients with Parkinsonian Syndromes

Gerontology. 2020;66(4):409-415. doi: 10.1159/000505590. Epub 2020 Feb 21.

Abstract

Introduction: Pathogenesis in a subgroup of sarcopenic patients seems to be based on a reduced number of motor neurons. This study aimed at investigating the overlap between sarcopenia and neurodegeneration, as reflected by a low number of motor neurons in patients with Parkinsonian syndromes (PS).

Methods: The motor unit number index (MUNIX) of the hypothenar muscle was used to assess the number and size (MUSIX) of motor units (MUs) in patients with idiopathic Parkinson disease (iPD, n = 53), patients with atypical Parkinsonian syndrome (aPS, n = 21), and a control group (n = 30). Mean age of participants was 70.3 years and 54.1% were female. Skeletal muscle mass by bioelectrical impedance analysis, hand-grip strength and gait speed were measured. Based on these assessments, sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People.

Results: Sarcopenia criteria were met by 10 patients with PS (13.5%). The study group had significantly lower MUNIX values than the control group (109 [SD ±39.1] vs. 129 [SD ±45.1]; p = 0.020) even after adjustment for age and sex. Three of the 5 sarcopenic iPD patients (75%) had pathological low MUNIX values (<80).

Discussion/conclusion: Sarcopenia is a frequent comorbidity in PS. The pathologically low MUNIX values found in 75% of our sarcopenic iPD patients provides further support for the existence of a neurodegenerative overlap syndrome with a reduced number of MUs potentially leading to sarcopenia. This finding warrants further evaluation.

Keywords: Frailty; MUNIX; Neurodegenerative overlap syndrome; Parkinsonian syndromes; Sarcopenia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Germany
  • Hand Strength
  • Humans
  • Male
  • Motor Neurons / pathology*
  • Muscle, Skeletal
  • Nerve Degeneration / physiopathology
  • Parkinson Disease / physiopathology
  • Parkinsonian Disorders / complications
  • Parkinsonian Disorders / physiopathology*
  • Sarcopenia / complications
  • Sarcopenia / physiopathology*
  • Walking Speed