| Summary: | Temporal muscle thickness (TMT) was investigated as a novel surrogate marker on MRI examinations of the brain, to detect patients who may be at risk for sarcopenia. TMT was analyzed in a retrospective, normal collective cohort (<i>n</i> = 624), to establish standard reference values. These reference values were correlated with grip strength measurements and body mass index (BMI) in 422 healthy volunteers and validated in a prospective cohort (<i>n</i> = 130) of patients with various neurological disorders. Pearson correlation revealed a strong association between TMT and grip strength (retrospective cohort, ρ = 0.746; <i>p</i> < 0.001; prospective cohort, ρ = 0.649; <i>p</i> < 0.001). A low or no association was found between TMT and age (retrospective cohort, R<sup>2</sup> correlation coefficient 0.20; <i>p</i> < 0.001; prospective cohort, ρ = −0.199; <i>p</i> = 0.023), or BMI (retrospective cohort, ρ = 0.116; <i>p</i> = 0.042; prospective cohort, ρ = 0.227; <i>p</i> = 0.009), respectively. Male patients with temporal wasting and unintended weight loss, respectively, showed significantly lower TMT values (<i>p</i> = 0.04 and <i>p</i> = 0.015, unpaired <i>t</i>-test). TMT showed a high correlation with muscle strength in healthy individuals and in patients with various neurological disorders. Therefore, TMT should be integrated into the diagnostic workup of neurological patients, to prevent, delay, or treat sarcopenia.
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