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Advanced Neurology

REVIEW ARTICLE
A novel approach to mitigate muscle atrophy in

Guillain-Barre syndrome

Kevin Cheung *, Sussan Askari , and Matti D. Allen 2,3
1
2
1 School of Medicine, Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
2 Department of Physical Medicine and Rehabilitation, Faculty of Health Sciences, Queen’s University,
Kingston, Ontario, Canada
3 School of Kinesiology, Faculty of Arts and Sciences, Queen’s University, Kingston, Ontario, Canada

Abstract

Guillain-Barre syndrome (GBS) is the most common cause of acute paralytic neuropathy
worldwide. GBS manifests as rapidly progressive, symmetrical numbness, paresthesia,
and weakness secondary to either peripheral nerve demyelination or axonal loss.
Despite effective disease modifying therapies (e.g., intravenous immunoglobulin)
and individualized rehabilitation programs, many individuals recovering from
GBS experience substantial muscle atrophy and incomplete recovery of strength
with resultant long-term functional impairment. This narrative review explores the
therapeutic potential of omega-3 fatty acid supplementation on enhancing recovery
of people with GBS. This purported benefit may occur through several potential
mechanisms, supported indirectly through studies using both experimental animal
and clinical human models. These mechanisms include: (i) Anti-atrophic effects
on skeletal muscle undergoing disuse and systemic inflammation; (ii) the use of
omega-3s as a key building block comprising myelin; (iii) immune modulating effects
*Corresponding author: optimizing conditions for remyelination; and (iv) preventing excitotoxic-like neuron
Kevin Cheung
(Kevin.Cheung@queensu.ca) death. The physiological mechanisms are explored in detail with examination of
relevant clinical trials conducted to date. Through this exploration, there is sufficient
Citation: Cheung K, Askari S,
Allen MD, 2023, A novel approach support to justify future investigations directly examining the role omega-3 fatty acid
to mitigate muscle atrophy supplementation may play as an adjunctive intervention that could have significant
in Guillain-Barre syndrome. benefit at low cost and minimal risk of adverse events.
Adv Neuro, 2(2): 280.
https://doi.org/10.36922/an.280
Received: November 30, 2022 Keywords: Guillain-Barre syndrome; Fatty acids, Omega-3; Nutritional support; Muscular
atrophy
Accepted: March 27, 2023
Published Online: April 10, 2023
Copyright: © 2023 Author(s).
This is an Open-Access article 1. Introduction
distributed under the terms of the
Creative Commons Attribution Guillain-Barre syndrome (GBS) is an umbrella term describing a group of related
License, permitting distribution, autoimmune disorders of the peripheral nervous system (PNS). It is the most common
and reproduction in any medium,
[1]
provided the original work is cause of acute paralytic neuropathy worldwide . The onset of GBS is typically
properly cited. preceded by an infection or through an aberrant autoimmune response targeting the
[1]
Publisher’s Note: AccScience PNS through molecular mimicry . Broadly, GBS can be categorized into subtypes
Publishing remains neutral with based on the pathophysiological process involved: (i) primary demyelinating (i.e.,
regard to jurisdictional claims in
published maps and institutional acute inflammatory demyelinating polyneuropathy [AIDP]) and (ii) axonal loss
affiliations. (i.e., acute motor axonal neuropathy [AMAN] and acute motor and sensory axonal

Volume 2 Issue 2 (2023) 1 https://doi.org/10.36922/an.280