{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:17:03Z","timestamp":1773965823556,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T00:00:00Z","timestamp":1745107200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["497320374"],"award-info":[{"award-number":["497320374"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Quantitative muscle MRI commonly evaluates disease activity and muscle wasting in Duchenne muscular dystrophy (DMD). Disturbances in ion homeostasis contribute to DMD pathophysiology, but their relationships with disease progression is unclear.\n 23<\/jats:sup>\n Na MRI may provide insights into the disease course and treatment response. This longitudinal study assessed whether sodium levels are elevated in DMD patients regardless of fat fraction (FF) and whether baseline sodium levels influence FF changes over time. Additionally, we quantified the effect of slice selection on measured sodium values.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Thirteen DMD boys (age 7.8\u2009\u00b1\u20092.4\u2009years) underwent MRI of lower leg muscles at 3T at three visits, spaced 6\u2009months apart. We assessed FF for disease progression and water T\n 2<\/jats:sub>\n , pH, apparent tissue sodium concentration (aTSC), and intracellular\u2010weighted\n 23<\/jats:sup>\n Na signal (ICwS) for disease activity. Fourteen healthy boys (age 9.5\u2009\u00b1\u20091.7\u2009years) underwent the same MRI protocol once. Linear regression and mixed\u2010effect modelling were used to examine sodium level increases and their impact on FF changes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In DMD, muscles with FF\u2009<\u200910% exhibited significantly elevated aTSC (24.8\u2009\u00b1\u20094.6\u2009mM vs. 14.5\u2009\u00b1\u20092.1\u2009mM in controls,\n p<\/jats:italic>\n \u2009<\u20090.001) and higher ICwS (23.6\u2009\u00b1\u20092.5\u2009a.u. vs. 14.1\u2009\u00b1\u20092.1\u2009a.u.,\n p<\/jats:italic>\n \u2009<\u20090.001). At Visit 1, FF values showed a significant negative association with aTSC (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u221217.30,\n p<\/jats:italic>\n \u2009=\u20090.016) and ICwS (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u221221.02,\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n \n The first mixed\u2010effect model, which assessed aTSC alone, showed no significant effect on FF progression but indicated a weak trend (\n p<\/jats:italic>\n \u2009=\u20090.098). The second, more comprehensive model\u2014incorporating also ICwS and water T\n 2<\/jats:sub>\n \u2014revealed that FF changes were positively associated with aTSC (\n p<\/jats:italic>\n \u2009=\u20090.0023) and negatively associated with ICwS and wT\n 2<\/jats:sub>\n (\n p<\/jats:italic>\n \u2009<\u20090.001 and\n p<\/jats:italic>\n \u2009=\u20090.025, respectively), with ICwS showing a significant interaction with time (\n p<\/jats:italic>\n \u2009=\u20090.0033).\n <\/jats:p>\n Varying slice positioning and slice number demonstrated minimal impact on aTSC and ICwS, with low CV (2%\u20134%) in the mid\u2010belly region.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The study demonstrates significant MRI\u2010based changes related to dystrophic alterations in DMD. We identified early alterations in sodium homeostasis, independent of FF. Our findings suggest that the relationship between sodium levels and FF progression is complex and may not be fully explained by total sodium measurements alone. Given the small sample size, further validation in larger cohorts is needed. Combined\n 1<\/jats:sup>\n H and\n 23<\/jats:sup>\n Na\u2010MRI may offer deeper insights into how metabolic and ionic changes interact with FF progression and overall disease activity.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcsm.13812","type":"journal-article","created":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T19:37:16Z","timestamp":1745177836000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Longitudinal Follow\u2010Up of Patients With Duchenne Muscular Dystrophy Using Quantitative\n 23<\/sup>\n Na and\n 1<\/sup>\n H MRI"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9734-4632","authenticated-orcid":false,"given":"Teresa","family":"Gerhalter","sequence":"first","affiliation":[{"name":"Institute of Radiology University Hospital Erlangen FAU Erlangen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Marty","sequence":"additional","affiliation":[{"name":"NMR Laboratory Neuromuscular Investigation Center, Institute of Myology Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena\u00a0V.","family":"Gast","sequence":"additional","affiliation":[{"name":"Institute of Radiology University Hospital Erlangen FAU Erlangen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Roemer","sequence":"additional","affiliation":[{"name":"Institute of Radiology University Hospital Erlangen FAU Erlangen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre\u2010Yves","family":"Baudin","sequence":"additional","affiliation":[{"name":"NMR Laboratory Neuromuscular Investigation Center, Institute of Myology Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina","family":"Trollmann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division Neuropediatrics FAU Erlangen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Uder","sequence":"additional","affiliation":[{"name":"Institute of Radiology University Hospital Erlangen FAU Erlangen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre\u00a0G.","family":"Carlier","sequence":"additional","affiliation":[{"name":"Saint\u2010Luc University Hospital Brussels Belgium"},{"name":"Erasme University Hospital Brussels Belgium"},{"name":"Li\u00e8ge State University Li\u00e8ge Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin\u00a0M.","family":"Nagel","sequence":"additional","affiliation":[{"name":"Institute of Radiology University Hospital Erlangen FAU Erlangen Germany"},{"name":"Division of Medical Physics in Radiology DKFZ Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30024-3"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-021-01862-w"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10040820"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27463"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008939"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009012"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009244"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24599"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13063"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-015-9825-9"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.21037\/qims-20-39"},{"key":"e_1_2_10_13_1","first-page":"2","article-title":"23Na MRI and Myometry to Compare Eplerenone vs. Glucocorticoid Treatment in Duchenne Dystrophy","volume":"36","author":"Glemser P. 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