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Advanced Neurology A novel approach to mitigate muscle atrophy in GBS

A B

Figure 2. (A) Conceptual illustration demonstrating nerve-related mechanisms of muscle atrophy within GBS. 1 Neurogenic atrophy – muscle fiber
atrophy and death following loss of innervating motor neuron. 2 Demyelination – disruptions in saltatory conduction causing conduction failure and
secondary disuse atrophy. (B) Conceptual illustration demonstrating how omega-3 fatty acid supplementation could mitigate GBS-related muscle atrophy.
A Upregulation of myelin mRNA translation and eventual synthesis of remyelination building block. B Prevention of excitotoxic effect of calcium ion influx
through unregulated pores. C Immune modulation through the suppression of TNF-α formation in surrounding macrophages. D As a direct building
block for the remyelination process.

rehabilitation during the acute phase of disease, comprising Omega-3 fatty acids are considered extremely safe and
gentle strengthening, progressive resistance exercises, have very few recorded adverse effects, which include
general conditioning, and gait retraining . A secondary potentially increasing LDL levels and a dose-related
[51]
rehabilitation phase later on in recovery has been suggested increase in bleeding time; however, these effects appear
to aid with additional reconditioning . One important clinically in signficant . Two omega-3 fatty acids in
[54]
[59]
principle for the GBS patient is to avoid overly intense or particular, eicosapentaenoic acid (EPA; 20:5n-3) and
prolonged exercise causing excessive fatigue, which has docosahexaenoic acid (DHA; 22:6n-3), have been the
been shown to lead to negative outcomes, including loss of most extensively studied and are the focus of this paper .
[60]
function and respiratory failure . Humans can convert dietary alpha-linolenic acid to
[56]
[55]
[61]
EPA and DHA, but this ability is somewhat limited .
3. Omega-3 fatty acid supplementation: A Therefore, to raise the levels of EPA and DHA, these
potential novel intervention fatty acids must be consumed directly from foods and/or
Omega-3 fatty acids are polyunsaturated fatty acids with dietary supplements. Recommended omega-3 intake for
[62]
a first double bond between the 3 and 4 carbons from males and females are 1.6 and 1.1 g/day, respectively .
rd
th
the methyl terminal . The purported positive health 3.1. Omega-3 fatty acids and mitigation of muscle
[57]
benefits of omega-3 fatty acid ingestion are vast and have atrophy
been widely studied in a variety of settings, including
cardiac health, neurodevelopment, cancer prevention, Some of the effects of omega-3 fatty acids, such as
age-related macular degeneration, cognitive decline/ antioxidant and anti-inflammatory properties, have been
Alzheimer’s dementia, and rheumatoid arthritis, among well established. The attenuation of muscle atrophy is a
many others . Of note, omega-3 fatty acids have been less established property that has recently gained more
[57]
repeatedly demonstrated to have anti-inflammatory and traction. McGlory et al. performed a randomized, double-
anti-oxidant properties, as well as having direct bioactive blind, repeated measure study, which demonstrated the
signaling effects on specific tissue types . These effects are attenuation of disuse atrophy in young women, secondary
[57]
often the result of increased ratio of omega-3 fatty acids to to unilateral leg immobilization with implementation of a
omega-6 fatty acids in cellular membranes . 4-week omega-3 fatty acid-rich nutritional program before
[58]
Volume 2 Issue 2 (2023) 5 https://doi.org/10.36922/an.280