An investigation of the skeletal muscle metabolic and functional window: a multimodal non-invasive approach using 1H Magnetic Resonance Spectroscopy (1H-MRS), Magnetization Transfer (MT) and Blood Oxygen Level Dependent (BOLD) signal

Abstract

Skeletal muscle performs essential functions, including movement and posture. Musculoskeletal disorders can disrupt these functions, leading to temporary or permanent impairment. As most muscle abnormalities will cause morphological and physiological changes in skeletal muscle, identifying diseased or injured skeletal muscle relies on having a frame of reference, i.e. a correct characterization of what is considered healthy or 'normal' skeletal muscle.

Non-invasive Magnetic Resonance Imaging (MRI) techniques such as 1H Magnetic Resonance Spectroscopy (1H-MRS) to assess the biochemical environment, Magnetization Transfer (MT) to study water dynamics and Blood Oxygen Level Dependent (BOLD) signal to study blood flow and relative (de)oxy-Hb concentration have yet to be extensively explored in skeletal muscle. Therefore, to improve the knowledge of the biochemical environment of skeletal muscle, a series of experiments were performed using these techniques in calf muscles.

1H-MRS investigations showed high repeatability of metabolite quantification within and across scanning sessions despite its challenges due to the high structural organization of skeletal muscle. Furthermore, differences in the metabolic profile between endurance vs. power-oriented participants at rest were found, suggesting 1H-MRS could be used as a non-invasive technique to assess muscle fiber composition.

A multimodal MT, and BOLD study were performed on exercised skeletal muscle to complement the metabolic understanding of skeletal muscle. It was shown that high-quality data could be obtained in simultaneous studies of BOLD/EMG. In addition, during a multimodal MT and BOLD acquisition, MT signal showed a decrease after exercise and was linearly correlated to the BOLD signal activation. The ability of MT to distinguish between highly/lowly activated muscle groups during exercise opens the opportunity to non-invasively investigate muscle group recruitment with a higher spatial resolution compared to EMG, and lower scanning times compared to BOLD.

Overall, the main purpose of this thesis was to investigate, characterize and provide unique metrics to study the functional and metabolic profile of healthy skeletal muscle at rest and during exercise.