Sex differences in neuromuscular and biological determinants of isometric maximal force.

gut microbiota miRNA muscle force muscle proteins neuromuscular determinants sex differences

Journal

Acta physiologica (Oxford, England)
ISSN: 1748-1716
Titre abrégé: Acta Physiol (Oxf)
Pays: England
ID NLM: 101262545

Informations de publication

Date de publication:
22 Feb 2024
Historique:
revised: 29 01 2024
received: 21 11 2023
accepted: 09 02 2024
medline: 22 2 2024
pubmed: 22 2 2024
entrez: 22 2 2024
Statut: aheadofprint

Résumé

Force expression is characterized by an interplay of biological and molecular determinants that are expected to differentiate males and females in terms of maximal performance. These include muscle characteristics (muscle size, fiber type, contractility), neuromuscular regulation (central and peripheral factors of force expression), and individual genetic factors (miRNAs and gene/protein expression). This research aims to comprehensively assess these physiological variables and their role as determinants of maximal force difference between sexes. Experimental evaluations include neuromuscular components of isometric contraction, intrinsic muscle characteristics (proteins and fiber type), and some biomarkers associated with muscle function (circulating miRNAs and gut microbiome) in 12 young and healthy males and 12 females. Male strength superiority appears to stem primarily from muscle size while muscle fiber-type distribution plays a crucial role in contractile properties. Moderate-to-strong pooled correlations between these muscle parameters were established with specific circulating miRNAs, as well as muscle and plasma proteins. Muscle size is crucial in explaining the differences in maximal voluntary isometric force generation between males and females with similar fiber type distribution. Potential physiological mechanisms are seen from associations between maximal force, skeletal muscle contractile properties, and biological markers.

Identifiants

pubmed: 38385696
doi: 10.1111/apha.14118
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e14118

Subventions

Organisme : Italian Ministry of Education, University, and Research (MIUR) program's Departments of Excellence
ID : 2018-2022
Organisme : Fondazione Perugia
ID : 2019.0326

Informations de copyright

© 2024 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

Références

Bishop P, Cureton K, Collins M. Sex difference in muscular strength in equally-trained men and women. Ergonomics. 1987;30(4):675-687.
Miller AE, MacDougall JD, Tarnopolsky MA, Sale DG. Gender differences in strength and muscle fiber characteristics. Eur J Appl Physiol Occup Physiol. 1993;66(3):254-262.
Hunter SK. Sex differences in human fatigability: mechanisms and insight to physiological responses. Acta Physiol (Oxf). 2014;210(4):768-789.
Lulic-Kuryllo T, Inglis JG. Sex differences in motor unit behaviour: a review. J Electromyogr Kinesiol. 2022;66:102689.
Landen S, Hiam D, Voisin S, Jacques M, Lamon S, Eynon N. Physiological and molecular sex differences in human skeletal muscle in response to exercise training. J Physiol. 2023;601(3):419-434.
Misner JE, Massey BH, Going SB, Bemben MG, Ball TE. Sex differences in static strength and fatigability in three different muscle groups. Res Q Exerc Sport. 1990;61(3):238-242.
Herda TJ, Trevino MA, Sterczala AJ, et al. Muscular strength and power are correlated with motor unit action potential amplitudes, but not myosin heavy chain isoforms in sedentary males and females. J Biomech. 2019;86:251-255.
Trevino MA, Sterczala AJ, Miller JD, et al. Sex-related differences in muscle size explained by amplitudes of higher-threshold motor unit action potentials and muscle fibre typing. Acta Physiol (Oxf). 2019;225(4):e13151.
Nuzzo JL. Sex differences in skeletal muscle fiber types: a meta-analysis. Clin Anat. 2023;37:81-91.
Staron RS, Hagerman FC, Hikida RS, et al. Fiber type composition of the vastus lateralis muscle of young men and women. J Histochem Cytochem. 2000;48(5):623-629.
Parra ME, Sterczala AJ, Miller JD, Trevino MA, Dimmick HL, Herda TJ. Sex-related differences in motor unit firing rates and action potential amplitudes of the first dorsal interosseous during high-, but not low-intensity contractions. Exp Brain Res. 2020;238(5):1133-1144.
Goldspink G, Scutt A, Loughna PT, Wells DJ, Jaenicke T, Gerlach GF. Gene expression in skeletal muscle in response to stretch and force generation. Am J Phys. 1992;262(3 Pt 2):R356-R363.
Hitachi K, Tsuchida K. Role of microRNAs in skeletal muscle hypertrophy. Front Physiol. 2013;4:408.
Fochi S, Giuriato G, De Simone T, et al. Regulation of microRNAs in satellite cell renewal, muscle function, sarcopenia and the role of exercise. Int J Mol Sci. 2020;21(18):6732.
Bartel DP. Metazoan microRNAs. Cell. 2018;173(1):20-51.
Gebert LFR, MacRae IJ. Regulation of microRNA function in animals. Nat Rev Mol Cell Biol. 2019;20(1):21-37.
Michlewski G, Caceres JF. Post-transcriptional control of miRNA biogenesis. RNA. 2019;25(1):1-16.
Saliminejad K, Khorram Khorshid HR, Soleymani Fard S, Ghaffari SH. An overview of microRNAs: biology, functions, therapeutics, and analysis methods. J Cell Physiol. 2019;234(5):5451-5465.
Yang W, Yang L, Wang J, et al. Msi2-mediated MiR7a-1 processing repression promotes myogenesis. J Cachexia Sarcopenia Muscle. 2022;13(1):728-742.
Dalle Carbonare L, Dorelli G, Li Vigni V, et al. Physical activity modulates miRNAs levels and enhances MYOD expression in myoblasts. Stem Cell Rev Rep. 2022;18(5):1865-1874.
Soplinska A, Zareba L, Wicik Z, et al. MicroRNAs as biomarkers of systemic changes in response to endurance exercise-a comprehensive review. Diagnostics (Basel). 2020;10(10):813.
Dai R, Ahmed SA. Sexual dimorphism of miRNA expression: a new perspective in understanding the sex bias of autoimmune diseases. Ther Clin Risk Manag. 2014;10:151-163.
Cui C, Yang W, Shi J, et al. Identification and analysis of human sex-biased MicroRNAs. Genomics Proteomics Bioinformatics. 2018;16(3):200-211.
Meder B, Backes C, Haas J, et al. Influence of the confounding factors age and sex on microRNA profiles from peripheral blood. Clin Chem. 2014;60(9):1200-1208.
Oliva M, Munoz-Aguirre M, Kim-Hellmuth S, et al. The impact of sex on gene expression across human tissues. Science. 2020;369(6509):eaba3066.
Boytar AN, Skinner TL, Wallen RE, Jenkins DG, Dekker Nitert M. The effect of exercise prescription on the human gut microbiota and comparison between clinical and apparently healthy populations: a systematic review. Nutrients. 2023;15(6):1534.
Sherwin E, Sandhu KV, Dinan TG, Cryan JF. May the force Be with you: the light and dark sides of the microbiota-gut-brain Axis in neuropsychiatry. CNS Drugs. 2016;30(11):1019-1041.
Miranda-Comas G, Petering RC, Zaman N, Chang R. Implications of the gut microbiome in sports. Sports Health. 2022;14(6):894-898.
Chen H, Shen L, Liu Y, et al. Strength exercise confers protection in central nervous system autoimmunity by altering the gut microbiota. Front Immunol. 2021;12:628629.
Dohnalova L, Lundgren P, Carty JRE, et al. A microbiome-dependent gut-brain pathway regulates motivation for exercise. Nature. 2022;612(7941):739-747.
Chen YM, Wei L, Chiu YS, et al. Lactobacillus plantarum TWK10 supplementation improves exercise performance and increases muscle mass in mice. Nutrients. 2016;8(4):205.
Kim YS, Unno T, Kim BY, Park MS. Sex differences in gut microbiota. World J Mens Health. 2020;38(1):48-60.
Gandevia SC. Spinal and supraspinal factors in human muscle fatigue. Physiol Rev. 2001;81(4):1725-1789.
Ansdell P, Thomas K, Howatson G, Hunter S, Goodall S. Contraction intensity and sex differences in knee-extensor fatigability. J Electromyogr Kinesiol. 2017;37:68-74.
Wust RC, Morse CI, de Haan A, Jones DA, Degens H. Sex differences in contractile properties and fatigue resistance of human skeletal muscle. Exp Physiol. 2008;93(7):843-850.
Murray BE, Froemming GR, Maguire PB, Ohlendieck K. Excitation-contraction-relaxation cycle: role of Ca2+−regulatory membrane proteins in normal, stimulated and pathological skeletal muscle (review). Int J Mol Med. 1998;1(4):677-687.
Nishi H, Ono K, Iwanaga Y, et al. MicroRNA-15b modulates cellular ATP levels and degenerates mitochondria via Arl2 in neonatal rat cardiac myocytes. J Biol Chem. 2010;285(7):4920-4930.
Siengdee P, Trakooljul N, Murani E, Schwerin M, Wimmers K, Ponsuksili S. MicroRNAs regulate cellular ATP levels by targeting mitochondrial energy metabolism genes during C2C12 myoblast differentiation. PLoS One. 2015;10(5):e0127850.
Maffiuletti NA, Aagaard P, Blazevich AJ, Folland J, Tillin N, Duchateau J. Rate of force development: physiological and methodological considerations. Eur J Appl Physiol. 2016;116(6):1091-1116.
Andersen LL, Aagaard P. Influence of maximal muscle strength and intrinsic muscle contractile properties on contractile rate of force development. Eur J Appl Physiol. 2006;96(1):46-52.
D'Emanuele S, Maffiuletti NA, Tarperi C, Rainoldi A, Schena F, Boccia G. Rate of force development as an indicator of neuromuscular fatigue: a scoping review. Front Hum Neurosci. 2021;15:701916.
Del Vecchio A, Negro F, Holobar A, et al. You are as fast as your motor neurons: speed of recruitment and maximal discharge of motor neurons determine the maximal rate of force development in humans. J Physiol. 2019;597(9):2445-2456.
Hannah R, Minshull C, Buckthorpe MW, Folland JP. Explosive neuromuscular performance of males versus females. Exp Physiol. 2012;97(5):618-629.
Behm DG, Sale DG. Voluntary and evoked muscle contractile characteristics in active men and women. Can J Appl Physiol. 1994;19(3):253-265.
Bell DG, Jacobs I. Electro-mechanical response times and rate of force development in males and females. Med Sci Sports Exerc. 1986;18(1):31-36.
Inglis JG, Gabriel DA. Sex differences in motor unit discharge rates at maximal and submaximal levels of force output. Appl Physiol Nutr Metab. 2020;45(11):1197-1207.
Inglis JG, McIntosh K, Gabriel DA. Neural, biomechanical, and physiological factors involved in sex-related differences in the maximal rate of isometric torque development. Eur J Appl Physiol. 2017;117(1):17-26.
Holtermann A, Roeleveld K, Vereijken B, Ettema G. The effect of rate of force development on maximal force production: acute and training-related aspects. Eur J Appl Physiol. 2007;99(6):605-613.
Harridge SD, Bottinelli R, Canepari M, et al. Whole-muscle and single-fibre contractile properties and myosin heavy chain isoforms in humans. Pflugers Arch. 1996;432(5):913-920.
Klitgaard H, Mantoni M, Schiaffino S, et al. Function, morphology and protein expression of ageing skeletal muscle: a cross-sectional study of elderly men with different training backgrounds. Acta Physiol Scand. 1990;140(1):41-54.
Korhonen MT, Cristea A, Alen M, et al. Aging, muscle fiber type, and contractile function in sprint-trained athletes. J Appl Physiol (1985). 2006;101(3):906-917.
Miller BF, Olesen JL, Hansen M, et al. Coordinated collagen and muscle protein synthesis in human patella tendon and quadriceps muscle after exercise. J Physiol. 2005;567(Pt 3):1021-1033.
Marqueti RC, Prestes J, Wang CC, et al. Biomechanical responses of different rat tendons to nandrolone decanoate and load exercise. Scand J Med Sci Sports. 2011;21(6):e91-e99.
Hansen M, Kongsgaard M, Holm L, et al. Effect of estrogen on tendon collagen synthesis, tendon structural characteristics, and biomechanical properties in postmenopausal women. J Appl Physiol (1985). 2009;106(4):1385-1393.
Cook JL, Bass SL, Black JE. Hormone therapy is associated with smaller Achilles tendon diameter in active post-menopausal women. Scand J Med Sci Sports. 2007;17(2):128-132.
Maillot G, Lacroix-Triki M, Pierredon S, et al. Widespread estrogen-dependent repression of micrornas involved in breast tumor cell growth. Cancer Res. 2009;69(21):8332-8340.
Mao L, Liu S, Hu L, et al. miR-30 family: a promising regulator in development and disease. Biomed Res Int. 2018;2018:9623412.
Hu F, Wang M, Xiao T, et al. miR-30 promotes thermogenesis and the development of beige fat by targeting RIP140. Diabetes. 2015;64(6):2056-2068.
Huang Z, Huang H, Shen M, et al. MicroRNA-155-5p modulates the progression of acute respiratory distress syndrome by targeting interleukin receptors. Bioengineered. 2022;13(5):11732-11741.
Wen Q, Wang Y, Pan Q, et al. MicroRNA-155-5p promotes neuroinflammation and central sensitization via inhibiting SIRT1 in a nitroglycerin-induced chronic migraine mouse model. J Neuroinflammation. 2021;18(1):287.
Sandri M. Protein breakdown in muscle wasting: role of autophagy-lysosome and ubiquitin-proteasome. Int J Biochem Cell Biol. 2013;45(10):2121-2129.
Ghafouri-Fard S, Khoshbakht T, Hussen BM, Jamal HH, Taheri M, Hajiesmaeili M. A comprehensive review on function of miR-15b-5p in malignant and non-malignant disorders. Front Oncol. 2022;12:870996.
Chen Y, Wang X. miRDB: an online database for prediction of functional microRNA targets. Nucleic Acids Res. 2019;48(D1):D127-D131.
Welten SM, Bastiaansen AJ, de Jong RC, et al. Inhibition of 14q32 MicroRNAs miR-329, miR-487b, miR-494, and miR-495 increases neovascularization and blood flow recovery after ischemia. Circ Res. 2014;115(8):696-708.
Renteria I, Garcia-Suarez PC, Fry AC, et al. The molecular effects of BDNF synthesis on skeletal muscle: a mini-review. Front Physiol. 2022;13:934714.
Griesbeck O, Parsadanian AS, Sendtner M, Thoenen H. Expression of neurotrophins in skeletal muscle: quantitative comparison and significance for motoneuron survival and maintenance of function. J Neurosci Res. 1995;42(1):21-33.
Mousavi K, Parry DJ, Jasmin BJ. BDNF rescues myosin heavy chain IIB muscle fibers after neonatal nerve injury. Am J Physiol Cell Physiol. 2004;287(1):C22-C29.
Cuppini R, Sartini S, Agostini D, et al. Bdnf expression in rat skeletal muscle after acute or repeated exercise. Arch Ital Biol. 2007;145(2):99-110.
Ogborn DI, Gardiner PF. Effects of exercise and muscle type on BDNF, NT-4/5, and TrKB expression in skeletal muscle. Muscle Nerve. 2010;41(3):385-391.
Jimenez-Maldonado A, Cerna-Cortes J, Castro-Rodriguez EM, et al. Effects of moderate- and high-intensity chronic exercise on brain-derived neurotrophic factor expression in fast and slow muscles. Muscle Nerve. 2016;53(3):446-451.
Onoki T, Izumi Y, Takahashi M, et al. Skeletal muscle-specific Keap1 disruption modulates fatty acid utilization and enhances exercise capacity in female mice. Redox Biol. 2021;43:101966.
Gao L, Kumar V, Vellichirammal NN, et al. Functional, proteomic and bioinformatic analyses of Nrf2- and Keap1- null skeletal muscle. J Physiol. 2020;598(23):5427-5451.
Mourkioti F, Rosenthal N. NF-kappaB signaling in skeletal muscle: prospects for intervention in muscle diseases. J Mol Med (Berl). 2008;86(7):747-759.
Li H, Malhotra S, Kumar A. Nuclear factor-kappa B signaling in skeletal muscle atrophy. J Mol Med (Berl). 2008;86(10):1113-1126.
Hardin BJ, Campbell KS, Smith JD, et al. TNF-alpha acts via TNFR1 and muscle-derived oxidants to depress myofibrillar force in murine skeletal muscle. J Appl Physiol (1985). 2008;104(3):694-699.
Lay C, Rigottier-Gois L, Holmstrom K, et al. Colonic microbiota signatures across five northern European countries. Appl Environ Microbiol. 2005;71(7):4153-4155.
Yuan X, Chen R, Zhang Y, Lin X, Yang X. Sexual dimorphism of gut microbiota at different pubertal status. Microb Cell Factories. 2020;19(1):152.
Kovacs A, Ben-Jacob N, Tayem H, Halperin E, Iraqi FA, Gophna U. Genotype is a stronger determinant than sex of the mouse gut microbiota. Microb Ecol. 2011;61(2):423-428.
Peng C, Xu X, Li Y, et al. Sex-specific association between the gut microbiome and high-fat diet-induced metabolic disorders in mice. Biol Sex Differ. 2020;11(1):5.
Verma R, Balhara YP, Gupta CS. Gender differences in stress response: role of developmental and biological determinants. Ind Psychiatry J. 2011;20(1):4-10.
Magne F, Gotteland M, Gauthier L, et al. The firmicutes/bacteroidetes ratio: a relevant marker of gut dysbiosis in obese patients? Nutrients. 2020;12(5):1474.
Mariat D, Firmesse O, Levenez F, et al. The firmicutes/bacteroidetes ratio of the human microbiota changes with age. BMC Microbiol. 2009;9:123.
Hughes RL. A review of the role of the gut microbiome in personalized sports nutrition. Front Nutr. 2019;6:191.
Dalton A, Mermier C, Zuhl M. Exercise influence on the microbiome-gut-brain axis. Gut Microbes. 2019;10(5):555-568.
Forsythe P, Kunze WA, Bienenstock J. On communication between gut microbes and the brain. Curr Opin Gastroenterol. 2012;28(6):557-562.
Forsythe P, Bienenstock J, Kunze WJAEMB. Microbial endocrinology and the microbiota-gut-brain axis. Adv Exp Med Biol. 2014;17(817):3-24.
Fimland MS, Helgerud J, Gruber M, Leivseth G, Hoff J. Functional maximal strength training induces neural transfer to single-joint tasks. Eur J Appl Physiol. 2009;107(1):21-29.
Tøien T, Unhjem R, Øren TS, Kvellestad ACG, Hoff J, Wang E. Neural plasticity with age: unilateral maximal strength training augments efferent neural drive to the contralateral limb in older adults. J Gerontol A Biol Sci Med Sci. 2017;73(5):596-602.
Monda V, Villano I, Messina A, et al. Exercise modifies the gut microbiota with positive health effects. Oxidative Med Cell Longev. 2017;2017:3831972.
Cook MD, Allen JM, Pence BD, et al. Exercise and gut immune function: evidence of alterations in colon immune cell homeostasis and microbiome characteristics with exercise training. Immunol Cell Biol. 2016;94(2):158-163.
Clauss M, Gerard P, Mosca A, Leclerc M. Interplay between exercise and gut microbiome in the context of human health and performance. Front Nutr. 2021;8:637010.
Faul F, Erdfelder E, Lang AG, Buchner A. G*power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-191.
Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Routledge; 1988.
Venturelli M, Ce E, Paneroni M, et al. Safety procedures for exercise testing in the scenario of COVID-19: a position statement of the Societa Italiana Scienze Motorie e Sportive. Sport Sci Health. 2020;16(4):601-607.
Jensen BL, Persson PB. Good publication practice in physiology 2021. Acta Physiol. 2022;234(1):e13741.
Elias LJ, Bryden MP. Footedness is a better predictor of language lateralisation than handedness. Laterality. 1998;3(1):41-51.
Vernillo G, Barbi C, Temesi J, et al. Reliability of relaxation properties of knee-extensor muscles induced by transcranial magnetic stimulation. Neurosci Lett. 2022;782:136694.
Vernillo G, Khassetarash A, Millet GY, Temesi J. Use of transcranial magnetic stimulation to assess relaxation rates in unfatigued and fatigued knee-extensor muscles. Exp Brain Res. 2021;239(1):205-216.
Ansdell P, Brownstein CG, Skarabot J, et al. Menstrual cycle-associated modulations in neuromuscular function and fatigability of the knee extensors in eumenorrheic women. J Appl Physiol (1985). 2019;126(6):1701-1712.
Cavedon V, Milanese C, Laginestra FG, et al. Bone and skeletal muscle changes in oldest-old women: the role of physical inactivity. Aging Clin Exp Res. 2020;32(2):207-214.
Sarto F, Sporri J, Fitze DP, Quinlan JI, Narici MV, Franchi MV. Implementing ultrasound imaging for the assessment of muscle and tendon properties in elite sports: practical aspects, methodological considerations and future directions. Sports Med. 2021;51(6):1151-1170.
Mathis J, de Quervain D, Hess CW. Dependence of the transcranially induced silent period on the ‘instruction set’ and the individual reaction time. Electroencephalogr Clin Neurophysiol. 1998;109(5):426-435.
Meola G, Bugiardini E, Cardani R. Muscle biopsy. J Neurol. 2012;259(4):601-610.
Moro T, Brightwell CR, Phalen DE, et al. Low skeletal muscle capillarization limits muscle adaptation to resistance exercise training in older adults. Exp Gerontol. 2019;127:110723.
Moro T, Brightwell CR, Volpi E, Rasmussen BB, Fry CS. Resistance exercise training promotes fiber type-specific myonuclear adaptations in older adults. J Appl Physiol (1985). 2020;128(4):795-804.
Walker JM. The bicinchoninic acid (BCA) assay for protein quantitation. Methods Mol Biol. 1994;32:5-8.
Bartolini D, Commodi J, Piroddi M, et al. Glutathione S-transferase pi expression regulates the Nrf2-dependent response to hormetic diselenides. Free Radic Biol Med. 2015;88(Pt B):466-480.
Chen H, Zhou Y, Wang ZY, et al. Exosomal microRNA profiles from serum and cerebrospinal fluid in neurosyphilis. Sex Transm Infect. 2019;95(4):246-250.
Li Q, Chang Y, Zhang K, Chen H, Tao S, Zhang Z. Implication of the gut microbiome composition of type 2 diabetic patients from northern China. Sci Rep. 2020;10(1):5450.
Love MI, Huber W, Anders S. Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2. Genome Biol. 2014;15(12):550.
Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc. 2009;41(1):3-13.

Auteurs

Gaia Giuriato (G)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.

Maria Grazia Romanelli (MG)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Desirée Bartolini (D)

Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy.

Gianluca Vernillo (G)

Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
Department of Social Sciences, University of Alberta - Augustana Campus, Camrose, Alberta, Canada.

Anna Pedrinolla (A)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy.

Tatiana Moro (T)

Department of Biomedical Sciences, University of Padova, Padova, Italy.

Martino Franchi (M)

Department of Biomedical Sciences, University of Padova, Padova, Italy.

Elena Locatelli (E)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Mehran Emadi Andani (ME)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Fabio Giuseppe Laginestra (FG)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Department of Anesthesiology, University of Utah, Utah, USA.

Chiara Barbi (C)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Gloria Fiorini Aloisi (GF)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Valentia Cavedon (V)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Chiara Milanese (C)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Elisa Orlandi (E)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Tonia De Simone (T)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Stefania Fochi (S)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Cristina Patuzzo (C)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Giovanni Malerba (G)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Paolo Fabene (P)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Massimo Donadelli (M)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Anna Maria Stabile (AM)

Department of Medicine and Surgery, Section of Human Anatomy, Clinical and Forensic, School of Medicine, University of Perugia, Perugia, Italy.

Alessandra Pistilli (A)

Department of Medicine and Surgery, Section of Human Anatomy, Clinical and Forensic, School of Medicine, University of Perugia, Perugia, Italy.

Mario Rende (M)

Department of Medicine and Surgery, Section of Human Anatomy, Clinical and Forensic, School of Medicine, University of Perugia, Perugia, Italy.

Francesco Galli (F)

Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy.

Federico Schena (F)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Massimo Venturelli (M)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Department of Internal Medicine, University of Utah, Utah, USA.

Classifications MeSH