title: Longer-term impact of hemiparetic stroke on skeletal muscle metabolism-A pilot study.
abstract: BACKGROUND
  Hemiparetic stroke leads to structural and metabolic alterations of skeletal muscle tissue, thereby contributing to functional impairment associated with stroke. In situ metabolic processes at tissue level in skeletal muscle have not been investigated. We hypothesize that muscular metabolic capacity is limited after hemiparetic stroke, and that changes affect rather the paretic than non-paretic limb.
  
  
  METHODS
  Nine male hemiparetic stroke survivors (age, 62±8years; BMI, 28±4kg/m2; median stroke latency, 23months ranging from 7 to 34months poststroke) underwent dynamic in situ measurements of carbohydrate and lipid metabolism at fasting condition and during oral glucose tolerance testing, using bilateral microdialysis. Results were compared to 8 healthy male subjects of similar age and BMI.
  
  
  RESULTS
  Tissue perfusion, fasting and postprandial profiles of interstitial metabolites glucose, pyruvate, lactate and glycerol did not differ between paretic and non-paretic muscle. Patients displayed higher fasting and postprandial dialysate glycerol levels compared to controls (P<0.001) with elevated plasma FFA (fasting FFA; 0.63±0.23 vs. 0.29±0.17mmol/L; P=0.004). Glycolytic activity was higher in patients vs. controls, with increased lactate production upon glucose load (P<0.001).
  
  
  CONCLUSIONS
  An elevated lipolytic and glycolytic activity on tissue level suggests an impaired substrate metabolism with blunted oxidative metabolism in bilateral skeletal muscle in patients after hemiparetic stroke. Muscular metabolic properties did not differ between paretic and non-paretic leg. Further work is needed to investigate the clinical impact of this impaired muscular metabolic capacity in post-stroke patients.
authors.affiliation: Center for Stroke Research Berlin, Charité Medical School Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Klaer
authors.affiliation: Experimental and Clinical Research Center-a joint co-operation between Charité Medical School Berlin and Max Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125 Berlin, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Mähler
authors.affiliation: Center for Stroke Research Berlin, Charité Medical School Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Nadja
authors.initials: N
authors.lastname: Scherbakov
authors.affiliation: Experimental and Clinical Research Center-a joint co-operation between Charité Medical School Berlin and Max Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125 Berlin, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Klug
authors.affiliation: Division of Innovative Clinical Trials, Department of Cardiology, University Medical Center Göttingen (UMG), RobertKochStr. 40, 37075 Göttingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
authors.affiliation: Experimental and Clinical Research Center-a joint co-operation between Charité Medical School Berlin and Max Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125 Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Boschmann
authors.affiliation: Center for Stroke Research Berlin, Charité Medical School Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany; Department of Cardiology, Charité Medical School Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: wolfram.doehner@charite.de.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Doehner
mesh_terms: D002151:Calorimetry; D050260:Carbohydrate Metabolism; D003430:Cross-Sectional Studies; D004734:Energy Metabolism / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D010291:Paresis / Q000209:etiology / Q000378:metabolism*; D010865:Pilot Projects; D020521:Stroke / Q000150:complications / Q000378:metabolism*; D013997:Time Factors
keywords: Calorimetry; Energy metabolism; Microdialysis; Mitochondrial function; Muscle tissue perfusion; Stroke