{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T14:21:25Z","timestamp":1761402085864},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Summary:<\/jats:title>\n          <jats:p>There is extensive evidence in the literature that both peripheral nerve fibers and muscle fibers are affected in the course of intensive care unit-acquired weakness. Peripheral nerve lesion is characterized by axonal degeneration, without inflammatory changes. Muscle fiber involvement is characterized by muscle fiber atrophy and loss of thick filaments, predominantly involving type 2 fibers, but myonecrosis (\u201cacute necrotizing myopathy of intensive care\u201d) has also been reported. Steroids can precipitate thick myofilament damage, probably to some extent also triggered by immobilization and neuromuscular junction blockade. Sepsis and a systemic inflammatory response cause muscle fiber injury because of the release of cytokines and chemokines that modulate enzymatic reactions related to proteolysis. Regarding axonal injury, hyperglycemia, hypoalbuminemia, inflammatory response, and hypoperfusion are accepted risk factors. Nerve and muscle biopsy are the best methods for detection of structural abnormalities, but these are invasive investigations; although not suitable for repeated studies, in selected cases, biopsies may have a role in diagnosis.<\/jats:p>","DOI":"10.1097\/wnp.0000000000000660","type":"journal-article","created":{"date-parts":[[2020,5,2]],"date-time":"2020-05-02T03:37:51Z","timestamp":1588390671000},"page":"197-199","source":"Crossref","is-referenced-by-count":9,"title":["Intensive Care Unit-Acquired Weakness: Neuropathology"],"prefix":"10.1097","volume":"37","author":[{"given":"Michael","family":"Swash","sequence":"first","affiliation":[{"name":"Departments of Neurology and Neuroscience, Barts and the London School of Medicine, Royal London Hospital, Queen Mary University of London, London, United Kingdom;"},{"name":"Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Univeridade de Lisboa, Lisbon, Portugal; and"}]},{"given":"Mamede","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Univeridade de Lisboa, Lisbon, Portugal; and"},{"name":"Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universit\u00e1rio de Lisboa Norte, Lisbon, Portugal."}]}],"member":"276","reference":[{"key":"R1-20230826","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1093\/brain\/110.4.819","article-title":"Critical illness polyneuropathy: a complication of sepsis and multiple organ failure","volume":"110","author":"Zochodne","year":"1987","journal-title":"Brain"},{"key":"R2-20230826","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1136\/jnnp.47.11.1223","article-title":"Polyneuropathy in critically ill patients","volume":"47","author":"Bolton","year":"1984","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R3-20230826","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/S0140-6736(77)91471-4","article-title":"Severe myopathy after status asthmaticus","volume":"2","author":"MacFarlane","year":"1977","journal-title":"Lancet"},{"key":"R4-20230826","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1212\/WNL.29.1.100","article-title":"Acute myopathy with selective lysis of myosin filaments","volume":"29","author":"Sher","year":"1979","journal-title":"Neurology"},{"key":"R5-20230826","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1002\/mus.880141115","article-title":"Myopathy with thick filament (myosin) loss following prolonged paralysis with vecuronium during steroid treatment","volume":"14","author":"Danon","year":"1991","journal-title":"Muscle Nerve"},{"key":"R6-20230826","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1002\/(SICI)1097-4598(199802)21:2<266::AID-MUS26>3.0.CO;2-Z","article-title":"Recurrent acute quadriplegic myopathy with myosin deficiency","volume":"21","author":"Kuntzer","year":"1998","journal-title":"Muscle Nerve"},{"key":"R7-20230826","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1002\/ana.410400415","article-title":"Acute myopathy of intensive care: clinical, electromyographic, and pathological aspects","volume":"40","author":"Lacomis","year":"1996","journal-title":"Ann Neurol"},{"key":"R8-20230826","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1002\/mus.10233","article-title":"Quadriplegic areflexic ICU illness: selective thick filament loss and normal nerve histology","volume":"26","author":"Sander","year":"2002","journal-title":"Muscle Nerve"},{"key":"R9-20230826","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1002\/path.1711640406","article-title":"Necrotizing myopathy in critically-ill patients","volume":"164","author":"Helliwell","year":"1991","journal-title":"J Pathol"},{"key":"R10-20230826","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/00005072-199307000-00006","article-title":"A syndrome of acute severe muscle necrosis in intensive care unit patients","volume":"52","author":"Ramsay","year":"1993","journal-title":"J Neuropathol Exp Neurol"},{"key":"R11-20230826","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/mus.880170305","article-title":"Acute necrotizing myopathy of intensive care: electrophysiological studies","volume":"17","author":"Zochodne","year":"1994","journal-title":"Muscle Nerve"},{"key":"R12-20230826","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/S0165-5728(99)00252-0","article-title":"Critical illness polyneuropathy and myopathy (CIPNM): evidence for local immune activation by cytokine-expression in the muscle tissue","volume":"106","author":"De Letter","year":"2000","journal-title":"J Neuroimmunol"},{"key":"R13-20230826","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1212\/WNL.50.1.46","article-title":"Acute myopathy after liver transplantation","volume":"50","author":"Campellone","year":"1998","journal-title":"Neurology"},{"key":"R14-20230826","first-page":"1042","article-title":"Intensive-care-unit-acquired muscle weakness","volume":"51","author":"Deem","year":"2006","journal-title":"Respir Care"},{"key":"R15-20230826","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1212\/01.WNL.0000098886.90030.67","article-title":"Muscle weakness in critically ill children","volume":"61","author":"Banwell","year":"2003","journal-title":"Neurology"},{"key":"R16-20230826","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jns.2018.11.023","article-title":"Central nervous system involvement in patients with critical illness polyneuropathy","volume":"396","author":"Murayama","year":"2019","journal-title":"J Neurol Sci"},{"key":"R17-20230826","doi-asserted-by":"crossref","first-page":"e13172","DOI":"10.1111\/apha.13172","article-title":"Vamorolone treatment improves skeletal muscle outcome in a critical illness myopathy rat model","volume":"225","author":"Akkad","year":"2019","journal-title":"Acta Physiol (Oxf)"},{"key":"R18-20230826","doi-asserted-by":"crossref","first-page":"e13205","DOI":"10.1111\/apha.13205","article-title":"Critical illness myopathy: glucocorticoids revisited?","volume":"225","author":"Z'Graggen","year":"2019","journal-title":"Acta Physiol (Oxf)"},{"key":"R19-20230826","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1001\/archneur.1972.00490150045008","article-title":"Experimental core-like lesions and nemaline rods. A correlative morphological and physiological study","volume":"27","author":"Kai-pati","year":"1972","journal-title":"Arch Neurol"},{"key":"R20-20230826","doi-asserted-by":"crossref","first-page":"R1165","DOI":"10.1152\/ajpregu.2000.279.4.R1165","article-title":"NF-kappaB mediates the protein loss induced by TNF-alpha in differentiated skeletal muscle myotubes","volume":"279","author":"Li","year":"2000","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"R21-20230826","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00024382-199701000-00001","article-title":"Regulation of skeletal muscleprotein turnover during sepsis: mechanisms and mediators","volume":"7","author":"Cooney","year":"1997","journal-title":"Shock"},{"key":"R22-20230826","doi-asserted-by":"crossref","first-page":"2056","DOI":"10.1152\/japplphysiol.01138.2006","article-title":"Free radical-mediated skeletal muscle dysfunction in inflammatory conditions","volume":"102","author":"Supinski","year":"2007","journal-title":"J Appl Physiol"},{"key":"R23-20230826","doi-asserted-by":"crossref","first-page":"S354","DOI":"10.1097\/CCM.0b013e3181b6e439","article-title":"Sepsis-induced myopathy","volume":"37","author":"Callahan","year":"2009","journal-title":"Crit Care Med"},{"key":"R24-20230826","doi-asserted-by":"crossref","first-page":"219\u2014223","DOI":"10.1016\/S0140-6736(02)09459-X","article-title":"Association between mitochondrial dysfunction and severity and outcome of septic shock","volume":"360","author":"Brealey","year":"2002","journal-title":"Lancet"},{"key":"R25-20230826","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S1474-4422(11)70178-8","article-title":"Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis","volume":"10","author":"Latronico","year":"2011","journal-title":"Lancet Neurol"},{"key":"R26-20230826","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s00401-003-0704-3","article-title":"Enhanced expression of E-selectin on the vascular endothelium of peripheral nerve in critically ill patients with neuromuscular disorders","volume":"106","author":"Fenzi","year":"2003","journal-title":"Acta Neuropathol (Berl)"}],"container-title":["Journal of Clinical Neurophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/WNP.0000000000000660","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T03:29:59Z","timestamp":1693020599000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/WNP.0000000000000660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/wnp.0000000000000660","relation":{},"ISSN":["0736-0258"],"issn-type":[{"value":"0736-0258","type":"print"}],"subject":[],"published":{"date-parts":[[2020,5]]}}}