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Temporal Muscle as a Prognostic Tool in Patients with Stroke: A Systematic Review

Friday, May 3, 2024

Presenting Author(s)

Leonardo de Barros Oliveira (he/him/his)

Medical Student
Department of Neurosurgery, State University of Ponta Grossa, Paraná, Brazil

Co-Author(s)

SB

Savio Batista, n/a

Medical Student
Federal University of Rio de Janeiro
Rio De Janeiro, Rio de Janeiro, Brazil
Raphael Bertani, MD

Neurosurgeon
Department of Neurosurgery, University of São Paulo
S�o Paulo, SP, BR
PB

Pedro GLB Borges, n/a

Medical Student
Fundação Técnico-Educacional Souza Marques
Rio de Janeiro, Rio de Janeiro, Brazil
EF

Eberval G. Figueiredo, MD, PhD

Professor
Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo
Phoenix, Arizona, United States
PK

Pedro Henrique H. Karpinski, n/a

Medical student
State University of Ponta Grossa (Paraná, Brazil)
Ponta Grossa, Parana, Brazil
AP

Agostinho Pinheiro, n/a

Doctor
Department of Neurology, Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA, United States
NR

Nicollas N. Rabelo, n/a

Neurosurgeon
Department of Neurosurgery, University of São Paulo, São Paulo, São Paulo, Brazil.
RIBEIRAO PRETO, Brazil
GS

Gabriel Semioni, n/a

Medical Student
University of West of Santa Catarina, Santa Catarina, Joaçaba, Brazil, United States
MARCELO Porto Sousa (he/him/his)

Medical Student
Federal University of Rio de Janeiro
LW

Leonardo C. Welling, n/a (he/him/his)

Neurosurgeon
Department of Neurosurgery, State University of Ponta Grossa, Paraná, Brazil
Ponta Grossa, Parana, Brazil

Introduction: Stroke remains a critical neurological condition. Given the impact of sarcopenia on the prognosis of stroke patients and the connection between temporal muscle (TM) parameters and sarcopenia, the authors undertook a systematic review to uncover the evidence surrounding this subject.

Methods: Adhering to PRISMA, our systematic search covered PubMed, Cochrane, Embase, and Web of Science databases. Included articles had to examine the temporal muscle's prognostic value for stroke patients. The study specifically collected data on temporal muscle parameters at baseline, including thickness (TMT), volume (TMV), and area (TMA). The authors also recorded follow-up information, and the statistical test employed. The focus was on determining the significance and potential cutoff points for the correlation between temporal muscle parameters and patient outcomes. To assess bias, the ROBIN-E tool was utilized.

Results: rom 3559 articles retrieved, 23 were included, involving 4043 patients. From these 1948 had hemorrhagic and 1667 had ischemic strokes. The median average age and follow-up were 63 years and 6 months, respectively. The median average TMT, TMA, and TMV at admission were 5.8mm (3.63 - 10.9), 266.1mm² (168.2 - 297), and 17.7mm3 (16.3 - 18.5). The most utilized statistical tests were: Mann-Whitney (5 studies), Chi-square (4), and Wilcoxon rank-sum (4). Eighteen studies comprising 3135 patients demonstrated statistical significance of the TM as a prognostic tool, while the other five other studies did not. Two studies provided TMT cutoff values of 6.7mm and 3.83mm for men, and 4.9mm and 2.78mm for women respectively.

Conclusion : Our findings suggest that TM parameters hold promise in predicting stroke prognosis. Given the straightforward nature of measurement, the existing methodological limitations, the lack of a clear cutoff, and the potential for incorporating machine learning, the need for further studies is paramount.