Impact of Combined Neuromuscular Electrical Stimulation (Comb-NMES) on Glucose Signaling and Muscle Myofiber Distribution in a Patient with Acute Spinal Cord Injury and Lower Motor Neuron Lesion

This case report investigates how a new method of combined neuromuscular electrical stimulation (Comb-NMES) affects muscle glucose use, fiber types, and metabolism in a patient who recently suffered a spinal cord injury (SCI) and has lower motor neuron lesions (LMNLs). The patient, a 32-year-old male with a complete T9 SCI, underwent ten Comb-NMES sessions focusing on the quadriceps muscles. Before and after these sessions, researchers analyzed muscle biopsies and blood samples to see changes in muscle fiber types, key metabolic proteins, and levels of insulin, glucose, and lipids. The study found that the Comb-NMES intervention led to significant improvements in the patient's metabolic control and muscle glucose metabolism. This suggests Comb-NMES could be a promising way to improve muscle and metabolic health in SCI patients with LMNLs.

• 1
  The intervention led to a 74.7% reduction in fasting insulin levels and a 28.2% reduction in fasting glucose levels, indicating improved metabolic control.
• 2
  Muscle analysis revealed significant increases in CaMK II, Hexokinase II, and IRS-1, suggesting enhanced glucose metabolism within the muscle tissue.
• 3
  There was a substantial increase in type IIx muscle fibers (140%) and a minimal increase in type I fibers (3%), while type IIa fibers slightly decreased (15%).