Skip to main content

Neuromyopathy: Histological and Molecular Findings

  • Chapter
  • First Online:
Post-Intensive Care Syndrome

Part of the book series: Lessons from the ICU ((LEICU))

  • 1872 Accesses

Abstract

After reading the chapter, the reader should be able to…

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 89.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Osler SW. The principles and practice of medicine, designed for the use of practitioners and students of medicine. 1st ed. Edinburgh, London: Young J. Putland; 1892.

    Google Scholar 

  2. Latronico N, Fenzi F, Recupero D, Guarneri B, Tomelleri G, Tonin P, et al. Critical illness myopathy and neuropathy. Lancet. 1996;347(9015):1579–82.

    Article  CAS  PubMed  Google Scholar 

  3. Bolton CF, Gilbert JJ, Hahn AF, Sibbald WJ. Polyneuropathy in critically ill patients. J Neurol Neurosurg Psychiatry. 1984;47(11):1223–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Koch S, Spuler S, Deja M, Bierbrauer J, Dimroth A, Behse F, et al. Critical illness myopathy is frequent: accompanying neuropathy protracts ICU discharge. J Neurol Neurosurg Psychiatry. 2011;82(3):287–93.

    Article  PubMed  Google Scholar 

  5. Shepherd S, Batra A, Lerner DP. Review of critical illness myopathy and neuropathy. Neurohospitalist. 2017;7(1):41–8.

    Article  PubMed  Google Scholar 

  6. Hermans G, Van Mechelen H, Clerckx B, Vanhullebusch T, Mesotten D, Wilmer A, et al. Acute outcomes and 1-year mortality of intensive care unit-acquired weakness. A cohort study and propensity-matched analysis. Am J Respir Crit Care Med. 2014;190(4):410–20.

    Article  PubMed  Google Scholar 

  7. Puthucheary ZA, Rawal J, McPhail M, Connolly B, Ratnayake G, Chan P, et al. Acute skeletal muscle wasting in critical illness. JAMA. 2013;310(15):1591–600.

    Article  CAS  PubMed  Google Scholar 

  8. Wollersheim T, Woehlecke J, Krebs M, Hamati J, Lodka D, Luther-Schroeder A, et al. Dynamics of myosin degradation in intensive care unit-acquired weakness during severe critical illness. Intensive Care Med. 2014;40(4):528–38.

    Article  CAS  PubMed  Google Scholar 

  9. Bierbrauer J, Koch S, Olbricht C, Hamati J, Lodka D, Schneider J, et al. Early type II fiber atrophy in intensive care unit patients with nonexcitable muscle membrane. Crit Care Med. 2012;40(2):647–50.

    Article  PubMed  Google Scholar 

  10. Derde S, Hermans G, Derese I, Guiza F, Hedstrom Y, Wouters PJ, et al. Muscle atrophy and preferential loss of myosin in prolonged critically ill patients. Crit Care Med. 2012;40(1):79–89.

    Article  PubMed  Google Scholar 

  11. Klaude M, Mori M, Tjader I, Gustafsson T, Wernerman J, Rooyackers O. Protein metabolism and gene expression in skeletal muscle of critically ill patients with sepsis. Clin Sci (Lond). 2012;122(3):133–42.

    Article  CAS  Google Scholar 

  12. Cohen S, Nathan JA, Goldberg AL. Muscle wasting in disease: molecular mechanisms and promising therapies. Nat Rev Drug Discov. 2015;14(1):58–74.

    Article  CAS  PubMed  Google Scholar 

  13. Mitch WE, Goldberg AL. Mechanisms of muscle wasting. The role of the ubiquitin-proteasome pathway. N Engl J Med. 1996;335(25):1897–905.

    Article  CAS  PubMed  Google Scholar 

  14. Constantin D, McCullough J, Mahajan RP, Greenhaff PL. Novel events in the molecular regulation of muscle mass in critically ill patients. J Physiol. 2011;589(Pt 15):3883–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Hooijman PE, Beishuizen A, Witt CC, de Waard MC, Girbes AR, Spoelstra-de Man AM, et al. Diaphragm muscle fiber weakness and ubiquitin-proteasome activation in critically ill patients. Am J Respir Crit Care Med. 2015;191(10):1126–38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Tiao G, Hobler S, Wang JJ, Meyer TA, Luchette FA, Fischer JE, et al. Sepsis is associated with increased mRNAs of the ubiquitin-proteasome proteolytic pathway in human skeletal muscle. J Clin Invest. 1997;99(2):163–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Klaude M, Fredriksson K, Tjader I, Hammarqvist F, Ahlman B, Rooyackers O, et al. Proteasome proteolytic activity in skeletal muscle is increased in patients with sepsis. Clin Sci (Lond). 2007;112(9):499–506.

    Article  CAS  Google Scholar 

  18. Helliwell TR, Wilkinson A, Griffiths RD, McClelland P, Palmer TE, Bone JM. Muscle fibre atrophy in critically ill patients is associated with the loss of myosin filaments and the presence of lysosomal enzymes and ubiquitin. Neuropathol Appl Neurobiol. 1998;24(6):507–17.

    Article  CAS  PubMed  Google Scholar 

  19. Langhans C, Weber-Carstens S, Schmidt F, Hamati J, Kny M, Zhu X, et al. Inflammation-induced acute phase response in skeletal muscle and critical illness myopathy. PLoS One. 2014;9(3):e92048.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  20. Cai D, Frantz JD, Tawa NE Jr, Melendez PA, Oh BC, Lidov HG, et al. IKKbeta/NF-kappaB activation causes severe muscle wasting in mice. Cell. 2004;119(2):285–98.

    Article  CAS  PubMed  Google Scholar 

  21. Vanhorebeek I, Gunst J, Derde S, Derese I, Boussemaere M, Guiza F, et al. Insufficient activation of autophagy allows cellular damage to accumulate in critically ill patients. J Clin Endocrinol Metab. 2011;96(4):E633–45.

    Article  CAS  PubMed  Google Scholar 

  22. Hermans G, Casaer MP, Clerckx B, Guiza F, Vanhullebusch T, Derde S, et al. Effect of tolerating macronutrient deficit on the development of intensive-care unit acquired weakness: a subanalysis of the EPaNIC trial. Lancet Respir Med. 2013;1(8):621–9.

    Article  PubMed  Google Scholar 

  23. Stibler H, Edstrom L, Ahlbeck K, Remahl S, Ansved T. Electrophoretic determination of the myosin/actin ratio in the diagnosis of critical illness myopathy. Intensive Care Med. 2003;29(9):1515–27.

    Article  PubMed  Google Scholar 

  24. Helliwell TR, Coakley JH, Wagenmakers AJ, Griffiths RD, Campbell IT, Green CJ, et al. Necrotizing myopathy in critically-ill patients. J Pathol. 1991;164(4):307–14.

    Article  CAS  PubMed  Google Scholar 

  25. Coakley JH, Nagendran K, Honavar M, Hinds CJ. Preliminary observations on the neuromuscular abnormalities in patients with organ failure and sepsis. Intensive Care Med. 1993;19(6):323–8.

    Article  CAS  PubMed  Google Scholar 

  26. Sander HW, Golden M, Danon MJ. Quadriplegic areflexic ICU illness: selective thick filament loss and normal nerve histology. Muscle Nerve. 2002;26(4):499–505.

    Article  PubMed  Google Scholar 

  27. Gutmann L, Blumenthal D, Gutmann L, Schochet SS. Acute type II myofiber atrophy in critical illness. Neurology. 1996;46(3):819–21.

    Article  CAS  PubMed  Google Scholar 

  28. Ahlbeck K, Fredriksson K, Rooyackers O, Maback G, Remahl S, Ansved T, et al. Signs of critical illness polyneuropathy and myopathy can be seen early in the ICU course. Acta Anaesthesiol Scand. 2009;53(6):717–23.

    Article  CAS  PubMed  Google Scholar 

  29. De Letter MA, van Doorn PA, Savelkoul HF, Laman JD, Schmitz PI, Op de Coul AA, et al. Critical illness polyneuropathy and myopathy (CIPNM): evidence for local immune activation by cytokine-expression in the muscle tissue. J Neuroimmunol. 2000;106(1–2):206–13.

    Article  PubMed  Google Scholar 

  30. Khaleeli AA, Edwards RH, Gohil K, McPhail G, Rennie MJ, Round J, et al. Corticosteroid myopathy: a clinical and pathological study. Clin Endocrinol. 1983;18(2):155–66.

    Article  CAS  Google Scholar 

  31. Danon MJ, Carpenter S. Myopathy with thick filament (myosin) loss following prolonged paralysis with vecuronium during steroid treatment. Muscle Nerve. 1991;14(11):1131–9.

    Article  CAS  PubMed  Google Scholar 

  32. De Jonghe B, Sharshar T, Lefaucheur JP, Authier FJ, Durand-Zaleski I, Boussarsar M, et al. Paresis acquired in the intensive care unit: a prospective multicenter study. JAMA. 2002;288(22):2859–67.

    Article  PubMed  Google Scholar 

  33. Zochodne DW, Bolton CF, Wells GA, Gilbert JJ, Hahn AF, Brown JD, et al. Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. Brain. 1987;110(Pt 4):819–41.

    Article  PubMed  Google Scholar 

  34. Dos Santos C, Hussain SN, Mathur S, Picard M, Herridge M, Correa J, et al. Mechanisms of chronic muscle wasting and dysfunction after an intensive care unit stay. A pilot study. Am J Respir Crit Care Med. 2016;194(7):821–30.

    Article  PubMed  Google Scholar 

  35. Chen L, Nelson DR, Zhao Y, Cui Z, Johnston JA. Relationship between muscle mass and muscle strength, and the impact of comorbidities: a population-based, cross-sectional study of older adults in the United States. BMC Geriatr. 2013;13:74.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Fredriksson K, Hammarqvist F, Strigard K, Hultenby K, Ljungqvist O, Wernerman J, et al. Derangements in mitochondrial metabolism in intercostal and leg muscle of critically ill patients with sepsis-induced multiple organ failure. Am J Physiol Endocrinol Metab. 2006;291(5):E1044–50.

    Article  CAS  PubMed  Google Scholar 

  37. Jiroutkova K, Krajcova A, Ziak J, Fric M, Waldauf P, Dzupa V, et al. Mitochondrial function in skeletal muscle of patients with protracted critical illness and ICU-acquired weakness. Crit Care. 2015;19:448.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Brealey D, Brand M, Hargreaves I, Heales S, Land J, Smolenski R, et al. Association between mitochondrial dysfunction and severity and outcome of septic shock. Lancet. 2002;360(9328):219–23.

    Article  CAS  PubMed  Google Scholar 

  39. Carre JE, Orban JC, Re L, Felsmann K, Iffert W, Bauer M, et al. Survival in critical illness is associated with early activation of mitochondrial biogenesis. Am J Respir Crit Care Med. 2010;182(6):745–51.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Weber-Carstens S, Schneider J, Wollersheim T, Assmann A, Bierbrauer J, Marg A, et al. Critical illness myopathy and GLUT4: significance of insulin and muscle contraction. Am J Respir Crit Care Med. 2013;187(4):387–96.

    Article  CAS  PubMed  Google Scholar 

  41. Weber-Carstens S, Koch S, Spuler S, Spies CD, Bubser F, Wernecke KD, et al. Nonexcitable muscle membrane predicts intensive care unit-acquired paresis in mechanically ventilated, sedated patients. Crit Care Med. 2009;37(9):2632–7.

    Article  PubMed  Google Scholar 

  42. Rich MM, Teener JW, Raps EC, Schotland DL, Bird SJ. Muscle is electrically inexcitable in acute quadriplegic myopathy. Neurology. 1996;46(3):731–6.

    Article  CAS  PubMed  Google Scholar 

  43. Friedrich O, Reid MB, Van den Berghe G, Vanhorebeek I, Hermans G, Rich MM, et al. The sick and the weak: neuropathies/myopathies in the critically ill. Physiol Rev. 2015;95(3):1025–109.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Axer H, Grimm A, Pausch C, Teschner U, Zinke J, Eisenach S, et al. The impairment of small nerve fibers in severe sepsis and septic shock. Crit Care. 2016;20:64.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Fenzi F, Latronico N, Refatti N, Rizzuto N. Enhanced expression of E-selectin on the vascular endothelium of peripheral nerve in critically ill patients with neuromuscular disorders. Acta Neuropathol. 2003;106(1):75–82.

    CAS  PubMed  Google Scholar 

  46. Hermans G, Schrooten M, Van Damme P, Berends N, Bouckaert B, De Vooght W, et al. Benefits of intensive insulin therapy on neuromuscular complications in routine daily critical care practice: a retrospective study. Crit Care. 2009;13(1):R5.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Hermans G, Wilmer A, Meersseman W, Milants I, Wouters PJ, Bobbaers H, et al. Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit. Am J Respir Crit Care Med. 2007;175(5):480–9.

    Article  CAS  PubMed  Google Scholar 

  48. Nishikawa T, Edelstein D, Du XL, Yamagishi S, Matsumura T, Kaneda Y, et al. Normalizing mitochondrial superoxide production blocks three pathways of hyperglycaemic damage. Nature. 2000;404(6779):787–90.

    Article  CAS  PubMed  Google Scholar 

  49. Shimizu F, Sano Y, Haruki H, Kanda T. Advanced glycation end-products induce basement membrane hypertrophy in endoneurial microvessels and disrupt the blood-nerve barrier by stimulating the release of TGF-beta and vascular endothelial growth factor (VEGF) by pericytes. Diabetologia. 2011;54(6):1517–26.

    Article  CAS  PubMed  Google Scholar 

  50. Koch S, Bierbrauer J, Haas K, Wolter S, Grosskreutz J, Luft FC, et al. Critical illness polyneuropathy in ICU patients is related to reduced motor nerve excitability caused by reduced sodium permeability. Intensive Care Med Exp. 2016;4(1):10.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Steffen Weber-Carstens .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 European Society of Intensive Care Medicine

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Grunow, J.J., Wollersheim, T., Weber-Carstens, S. (2020). Neuromyopathy: Histological and Molecular Findings. In: Preiser, JC., Herridge, M., Azoulay, E. (eds) Post-Intensive Care Syndrome. Lessons from the ICU. Springer, Cham. https://doi.org/10.1007/978-3-030-24250-3_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-24250-3_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24249-7

  • Online ISBN: 978-3-030-24250-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics