title: Unaffected arm muscle hypercatabolism in dysphagic subacute stroke patients: the effects of essential amino acid supplementation.
abstract: Alterations in muscle protein turnover of the unaffected side of stroke patients could contribute to physical disability. We investigated whether hypercatabolic activity occurred in unaffected arm muscle and whether supplemented essential amino acids (EAAs) could limit muscle hypercatabolism (MH). Thirty-eight dysphagic subacute stroke subjects (<3 months after acute event) (29 males+9 females; 69.7±11.4 yrs) were enrolled and randomized to receive 8 g/day EAAs (n=19; EAA group) or isocaloric placebo (maltodextrin; n=19, Plac group). Before randomization, all patients had their arterial (A) and venous (V) amino acids measured and muscle (A-V) differences calculated in the unaffected arm. Eight matched and healthy subjects served as controls. When compared to healthy controls, the entire stroke population showed significant muscle release (=negative value A-V) of the amino acid phenylalanine (phenyl-) indicating a prevalence of MH. Moreover, randomized EAA and Plac groups had similar rates of MH. After 38 days from the start of the protocol, the EAA group but not the Plac group had MH converted to balanced protein turnover or anabolic activity. We concluded that muscle protein metabolism of the unaffected arm of dysphagic subacute stroke individuals could be characterized by MH which can be corrected by supplemented EAAs.
authors.affiliation: Servizio di Fisiopatologia Metabolico-Nutrizionale e Nutrizione Clinica, Centro Medico di Montescano, IRCCS, Via per Montescano 31, 27040 Montescano, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Aquilani
authors.affiliation: Unità di Riabilitazione Neuromotoria, Unità Gravi Cerebrolesioni Acquisite, Centro Medico di Montescano, IRCCS, Via per Montescano 31, 27040 Montescano, Italy.
authors.forename: Mirella
authors.initials: M
authors.lastname: Boselli
authors.affiliation: Laboratorio Universitario per lo Studio delle Attività Motorie nelle Malattie Rare (LUSAMMR), Via Ugo Foscolo 13, 27058 Voghera, Italy ; Dipartimento di Medicina Molecolare, Università degli Studi di Pavia, Viale Taramelli 3/B, 27100 Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Antona
authors.affiliation: Direzione Scientifica Centrale, Fondazione S. Maugeri, IRCCS, Via Salvatore Maugeri 10, 27100 Pavia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Baiardi
authors.affiliation: Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Viale Taramelli 14, 27100 Pavia, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Boschi
authors.affiliation: Dipartimento di Medicina Molecolare, Università degli Studi di Pavia, Viale Taramelli 3/B, 27100 Pavia, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Viglio
authors.affiliation: Dipartimento di Biologia e Biotecnologie "Lazzaro Spallanzani," Università degli Studi di Pavia, Via Ferrata 9, 27100 Pavia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Iadarola
authors.affiliation: Istituto Scientifico di Lumezzane (Brescia) Fondazione S. Maugeri, IRCCS, Via Mazzini 9 Lumezzane, 25065 Brescia, Italy.
authors.forename: Evasio
authors.initials: E
authors.lastname: Pasini
authors.affiliation: Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Viale Taramelli 14, 27100 Pavia, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Barbieri
authors.affiliation: Dipartimento di Biologia e Biotecnologie "Lazzaro Spallanzani," Università degli Studi di Pavia, Via Ferrata 9, 27100 Pavia, Italy.
authors.forename: Maurizia
authors.initials: M
authors.lastname: Dossena
authors.affiliation: Dipartimento di Biologia e Biotecnologie "Lazzaro Spallanzani," Università degli Studi di Pavia, Via Ferrata 9, 27100 Pavia, Italy.
authors.forename: Andria Innocenza
authors.initials: AI
authors.lastname: Bongiorno
authors.affiliation: Dipartimento di Biologia e Biotecnologie "Lazzaro Spallanzani," Università degli Studi di Pavia, Via Ferrata 9, 27100 Pavia, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Verri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000601:Amino Acids, Essential / Q000008:administration & dosage* / Q000009:adverse effects; D001132:Arm / Q000503:physiopathology*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008297:Male; D008660:Metabolism / Q000187:drug effects; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D020521:Stroke / Q000178:diet therapy / Q000378:metabolism* / Q000473:pathology
chemical_list: D000601:Amino Acids, Essential; D007328:Insulin