Near Infrared Spectroscopy Measurements of Mitochondrial Capacity Using Partial Recovery Curves

Maxwell D Sumner, Samuel Beard, Elizabeth K Pryor, Indrajit Das, Kevin K McCully, Maxwell D Sumner, Samuel Beard, Elizabeth K Pryor, Indrajit Das, Kevin K McCully

Abstract

Background: Near-infrared spectroscopy (NIRS) has been used to measure muscle mitochondrial capacity (mVO2max) as the recovery rate constant of muscle metabolism after exercise. The current method requires as many as 50 short ischemic occlusions to generate two recovery rate constants.

Purpose: To determine the validity and repeatability of using a 6-occlusion protocol versus one with 22 occlusions to measure muscle mitochondrial capacity. The order effect of performing multiple Mito6 test was also evaluated.

Method: In two independent data sets (bicep n = 7, forearm A n = 23), recovery curves were analyzed independently using both the 6 and 22 occlusion methods. A third data set (forearm B n = 16) was generated on the forearm muscles of healthy subjects using four 6-occlusion tests performed in succession. Recovery rate constants were generated using a MATLAB routine.

Results: When calculated from the same data set, the recovery rate constants were not significantly different between the 22 occlusion and 6 occlusion methods for the bicep (1.43 ± 0.33 min-1, 1.43 ± 0.35 min-1, p = 0.81) and the forearm A (1.97 ± 0.40 min-1, 1.97 ± 0.43 min-1, p = 0.90). Equivalence testing showed that the mean difference was not different than zero and the 90% confidence intervals were within 5% of the average rate constant. This was true for the Mito6 and the Mito5∗ approaches. Bland-Altman analysis showed a slope of 0.21 min-1 and an r of 0.045 for the bicep dataset and a slope of -0.01 min-1 and an r of 0.045 for the forearm A dataset. When performing the four 6-occlusion tests; recovery rate constants showed no order effects (1.50 ± 0.51 min-1, 1.42 ± 0.54 min-1, 1.26 ± 0.41 min-1, 1.29 ± 0.47 min-1, P > 0.05).

Conclusion: The Mito6 analysis is a valid and repeatable approach to measure mitochondrial capacity. The Mito6 protocol used fewer ischemic occlusion periods and multiple tests could be performed in succession in less time, increasing the practicality of the NIRS mitochondrial capacity test. There were no order effects for the rate constants of four repeated 6-occlusion tests of mitochondrial capacity, supporting the use of multiple tests to improve accuracy.

Keywords: NIRS; electrical stimulation; human subjects; muscle metabolism; skeletal muscle.

Copyright © 2020 Sumner, Beard, Pryor, Das and McCully.

Figures

FIGURE 1
FIGURE 1
A representative file of oxygen saturation during a mitochondrial capacity test in the bicep muscle group. The Mito22 analysis uses all of the ischemic cuffs in the test. The Mito6 analysis uses the first 6 ischemic cuffs (in bold) and a final resting cuff.
FIGURE 2
FIGURE 2
A representative file of oxygen saturation using a Mito6 protocol in the forearm muscle group. Mito6 analysis uses 6 ischemic cuffs and a final resting cuff.
FIGURE 3
FIGURE 3
(A) A comparison of the Mito22 and Mito6 analysis protocols using bicep muscle data. (B) A comparison of the Mito22 and Mito5∗ analysis protocols using bicep muscle data. (C) A comparison of the Mito22 and Mito6 analysis protocols using forearm A muscle data. (D) A comparison of the Mito22 and Mito5∗ analysis protocols using forearm A muscle data. For all figures, data is an average of two trials on the same subject. The gray dashed line represents the line of identity in all graphs.
FIGURE 4
FIGURE 4
Equivalence testing comparing the Mito 22 results to the Mito6 and Mito5∗ results for the bicep and forearm A data sets. The large symbols are the mean differences between the measurements, the small symbols with the gray lines are the 90% confidence intervals, and the small vertical dotted lines are the range of minimal significance difference (5%).
FIGURE 5
FIGURE 5
(A) A comparison of the Mito22 and Mito6 analysis protocols using bicep muscle data. (B) A comparison of the Mito22 and Mito6 analysis protocols using Above Midpoint Fit Biceps data. (C) A comparison of the Mito22 and Mito6 analysis protocols using Below Midpoint Fit Biceps data. For all figures the data include separate tests (two tests per subject). The gray dashed line represents the line of identity in all graphs.
FIGURE 6
FIGURE 6
The correlation between the slope of the pre-test resting cuff and the slope of the post-test resting cuff is shown. The resulting equation and R2-value show a weak positive relationship between pre-test resting cuff value and the post-test resting cuff value (R2 = 0.43, slope = 1.86).
FIGURE 7
FIGURE 7
(A) The initial metabolic rates, or the slope of the first cuff occlusion in each of the four mitochondrial tests, using the final resting cuff value as the curve endpoint. (B) The rate constants of the four tests of a Mito6 protocol. There is no statistical difference between the average of each of the four tests, and no order effect is seen as the Mito6 protocol progresses.

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Source: PubMed

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