101
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Jungbluth H. Myopathology in times of modern imaging. Neuropathol Appl Neurobiol 2018; 43:24-43. [PMID: 28111795 DOI: 10.1111/nan.12385] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 01/17/2017] [Accepted: 01/23/2017] [Indexed: 12/14/2022]
Abstract
Over the last two decades, muscle (magnetic resonance) imaging has become an important complementary tool in the diagnosis and differential diagnosis of inherited neuromuscular disorders, particularly in conditions where the pattern of selective muscle involvement is often more predictive of the underlying genetic background than associated clinical and histopathological features. Following an overview of different imaging modalities, the present review will give a concise introduction to systematic image analysis and interpretation in genetic neuromuscular disorders. The pattern of selective muscle involvement will be presented in detail in conditions such as the congenital or myofibrillar myopathies where muscle imaging is particularly useful to inform the (differential) diagnosis, and in disorders such as Duchenne or fascioscapulohumeral muscular dystrophy where the diagnosis is usually made on clinical grounds but where detailed knowledge of disease progression on the muscle imaging level may inform better understanding of the natural history. Utilizing the group of the congenital myopathies as an example, selected case studies will illustrate how muscle MRI can be used to inform the diagnostic process in the clinico-pathological context. Future developments, in particular, concerning the increasing use of whole-body MRI protocols and novel quantitative fat assessments techniques potentially relevant as an outcome measure, will be briefly outlined.
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Affiliation(s)
- H Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK.,Randall Division of Cell and Molecular Biophysics, Muscle Signalling Section, London, UK.,Department of Clinical and Basic Neuroscience, IoPPN, King's College, London, UK
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102
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Abstract
PURPOSE OF REVIEW This article uses a case-based approach to highlight the clinical features as well as recent advances in molecular genetics, muscle imaging, and pathophysiology of the congenital myopathies. RECENT FINDINGS Congenital myopathies refer to a heterogeneous group of genetic neuromuscular disorders characterized by early-onset muscle weakness, hypotonia, and developmental delay. Congenital myopathies are further classified into core myopathies, centronuclear myopathies, nemaline myopathies, and congenital fiber-type disproportion based on the key pathologic features found in muscle biopsies. Genotype and phenotype correlations are hampered by the diverse clinical variability of the genes responsible for congenital myopathies, ranging from a severe neonatal course with early death to mildly affected adults with late-onset disease. An increasing number of genes have been identified, which, in turn, are associated with overlapping morphologic changes in the myofibers. Precise genetic diagnosis has important implications for disease management, including family counseling; avoidance of anesthetic-related muscle injury for at-risk individuals; monitoring for potential cardiac, respiratory, or orthopedic complications; as well as for participation in clinical trials or potential genetic therapies. SUMMARY Collaboration with neuromuscular experts, geneticists, neuroradiologists, neuropathologists, and other specialists is needed to ensure accurate and timely diagnosis based on clinical and pathologic features. An integrated multidisciplinary model of care based on expert-guided standards will improve quality of care and optimize outcomes for patients and families with congenital myopathies.
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MESH Headings
- Adult
- Child
- Child, Preschool
- Female
- Genetic Therapy/trends
- Humans
- Infant
- Infant, Newborn
- Male
- Mutation/genetics
- Myopathies, Nemaline/genetics
- Myopathies, Nemaline/pathology
- Myopathies, Nemaline/therapy
- Myopathies, Structural, Congenital/genetics
- Myopathies, Structural, Congenital/pathology
- Myopathies, Structural, Congenital/therapy
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103
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Lollert A, Stihl C, Hötker AM, Mengel E, König J, Laudemann K, Gökce S, Düber C, Staatz G. Quantification of intramuscular fat in patients with late-onset Pompe disease by conventional magnetic resonance imaging for the long-term follow-up of enzyme replacement therapy. PLoS One 2018; 13:e0190784. [PMID: 29315315 PMCID: PMC5760036 DOI: 10.1371/journal.pone.0190784] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/20/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate a quantitative method based on conventional T1-weighted magnetic resonance (MR) imaging to assess fatty muscular degeneration in patients with late-onset Pompe disease and to compare it with semi-quantitative visual evaluation (the Mercuri score). In addition, a long-term retrospective data analysis was performed to evaluate treatment response to enzyme replacement therapy with alglucosidase alfa. METHODS MR images of the lumbar spine were acquired in 41 patients diagnosed with late-onset Pompe disease from 2006 through 2015. Two independent readers retrospectively evaluated fatty degeneration of the psoas and paraspinal muscles by applying the Mercuri score. Quantitative semi-automated muscle and fat tissue separation was performed, and inter-observer agreement and correlations with clinical parameters were assessed. Follow-up examinations were performed in 13 patients treated with alglucosidase alfa after a median of 39 months; in 7/13 patients, an additional follow-up examination was completed after a median of 63 months. RESULTS Inter-observer agreement was high. Measurements derived from the quantitative method correlated well with Medical Research Council scores of muscle strength, with moderate correlations found for the 6-minute walk test, the 4-step stair climb test, and spirometry in the supine position. A significant increase in the MR-derived fat fraction of the psoas muscle was found between baseline and follow-up 1 (P = 0.016), as was a significant decrease in the performance on the 6-minute walk test (P = 0.006) and 4-step stair climb test (P = 0.034), as well as plasma creatine kinase (P = 0.016). No statistically significant difference in clinical or MR-derived parameters was found between follow-up 1 and follow-up 2. CONCLUSIONS Quantification of fatty muscle degeneration using the semi-automated method can provide a more detailed overview of disease progression than semi-quantitative Mercuri scoring. MR-derived data correlated with clinical symptoms and patient exercise capacity. After an initial worsening, the fat fraction of the psoas muscle and performance on the 6-minute walk test stayed constant during long-term follow-up under enzyme replacement therapy.
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Affiliation(s)
- André Lollert
- Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- * E-mail:
| | - Clemens Stihl
- Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Andreas M. Hötker
- Department of Diagnostic and Interventional Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Eugen Mengel
- Villa Metabolica, Center of Pediatric and Adolescent Medicine, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jochem König
- Institute for Medical Biostatistics, Epidemiology and Informatics, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Katharina Laudemann
- Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Seyfullah Gökce
- Villa Metabolica, Center of Pediatric and Adolescent Medicine, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Gundula Staatz
- Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
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104
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Tasca G, Monforte M, Díaz-Manera J, Brisca G, Semplicini C, D'Amico A, Fattori F, Pichiecchio A, Berardinelli A, Maggi L, Maccagnano E, Løkken N, Marini-Bettolo C, Munell F, Sanchez A, Alshaikh N, Voermans NC, Dastgir J, Vlodavets D, Haberlová J, Magnano G, Walter MC, Quijano-Roy S, Carlier RY, van Engelen BGM, Vissing J, Straub V, Bönnemann CG, Mercuri E, Muntoni F, Pegoraro E, Bertini E, Udd B, Ricci E, Bruno C. MRI in sarcoglycanopathies: a large international cohort study. J Neurol Neurosurg Psychiatry 2018; 89:72-77. [PMID: 28889091 DOI: 10.1136/jnnp-2017-316736] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To characterise the pattern and spectrum of involvement on muscle MRI in a large cohort of patients with sarcoglycanopathies, which are limb-girdle muscular dystrophies (LGMD2C-2F) caused by mutations in one of the four genes coding for muscle sarcoglycans. METHODS Lower limb MRI scans of patients with LGMD2C-2F, ranging from severe childhood variants to milder adult-onset forms, were collected in 17 neuromuscular referral centres in Europe and USA. Muscle involvement was evaluated semiquantitatively on T1-weighted images according to a visual score, and the global pattern was assessed as well. RESULTS Scans from 69 patients were examined (38 LGMD2D, 18 LGMD2C, 12 LGMD2E and 1 LGMD2F). A common pattern of involvement was found in all the analysed scans irrespective of the mutated gene. The most and earliest affected muscles were the thigh adductors, glutei and posterior thigh groups, while lower leg muscles were relatively spared even in advanced disease. A proximodistal gradient of involvement of vasti muscles was a consistent finding in these patients, including the most severe ones. CONCLUSIONS Muscle involvement on MRI is consistent in patients with LGMD2C-F and can be helpful in distinguishing sarcoglycanopathies from other LGMDs or dystrophinopathies, which represent the most common differential diagnoses. Our data provide evidence about selective susceptibility or resistance to degeneration of specific muscles when one of the sarcoglycans is deficient, as well as preliminary information about progressive involvement of the different muscles over time.
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Affiliation(s)
- Giorgio Tasca
- Istituto di Neurologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario 'A Gemelli', Rome, Italy
| | - Mauro Monforte
- Istituto di Neurologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario 'A Gemelli', Rome, Italy
| | - Jordi Díaz-Manera
- Department of Neurology, Neuromuscular Disorders Unit, Universitat Autonoma de Barcelona, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.,Muscular and Neurodegenerative Disease, Centro de Investigación Biomédica en Red en Enfermedades Raras, Barcelona, Spain
| | - Giacomo Brisca
- Center of Translational Myology and Neurodegenerative Diseases, Istituto Giannina Gaslini, Genova, Italy
| | | | - Adele D'Amico
- Unit of Neuromuscular and Neurodegenerative Diseases, Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Fabiana Fattori
- Unit of Neuromuscular and Neurodegenerative Diseases, Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Anna Pichiecchio
- Department of Neuroradiology, National Neurological Institute C Mondino, Pavia, Italy
| | - Angela Berardinelli
- Child Neurology and Psychiatry Unit, National Neurological Institute C Mondino, Pavia, Italy
| | - Lorenzo Maggi
- UO Neuroimmunologia e Malattie Neuromuscolari, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elio Maccagnano
- UO Neuroradiologia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Servizio di Diagnostica per Immagini, Centro Diagnostico Italiano, Milan, Italy
| | - Nicoline Løkken
- Copenhagen Neuromuscular Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Chiara Marini-Bettolo
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Francina Munell
- Department of Pediatric Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Angel Sanchez
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Nahla Alshaikh
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jahannaz Dastgir
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Dmitry Vlodavets
- Russian Children Neuromuscular Center, Veltischev Scientific Research Clinical Institute of Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Jana Haberlová
- Department of Paediatric Neurology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | | | - Maggie C Walter
- Friedrich-Baur-Institute, Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Susana Quijano-Roy
- Assistance Publique des Hôpitaux de Paris (AP-HP), Unité Neuromusculaire, Service de Pédiatrie, Hôpital Raymond Poincaré, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Garches, U1179 INSERM, Université de Versailles (UVSQ), Centre de Référence Neuromusculaire GNMH, FILNEMUS, France
| | - Robert-Yves Carlier
- Department of Radiology, Neurolocomotor Division, Raymond Poincaré Hospital, University Hospitals Paris-Ile-de-France West, Public Hospital Network of Paris, Garches, France
| | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - John Vissing
- Copenhagen Neuromuscular Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Volker Straub
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Carsten G Bönnemann
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Eugenio Mercuri
- Neuropsichiatria Infantile, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Elena Pegoraro
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Diseases, Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Bjarne Udd
- Department of Neurology, Neuromuscular Research Center, Tampere University and University Hospital, Rome, Italy.,Folkhälsan Institute of Genetics and the Department of Medical Genetics, University of Helsinki, Helsinki, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
| | - Enzo Ricci
- Istituto di Neurologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario 'A Gemelli', Rome, Italy
| | - Claudio Bruno
- Center of Translational Myology and Neurodegenerative Diseases, Istituto Giannina Gaslini, Genova, Italy
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105
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Bugiardini E, Morrow JM, Shah S, Wood CL, Lynch DS, Pitmann AM, Reilly MM, Houlden H, Matthews E, Parton M, Hanna MG, Straub V, Yousry TA. The Diagnostic Value of MRI Pattern Recognition in Distal Myopathies. Front Neurol 2018; 9:456. [PMID: 29997562 PMCID: PMC6028608 DOI: 10.3389/fneur.2018.00456] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 05/29/2018] [Indexed: 12/14/2022] Open
Abstract
Objective: Distal myopathies are a diagnostically challenging group of diseases. We wanted to understand the value of MRI in the current clinical setting and explore the potential for optimizing its clinical application. Methods: We retrospectively audited the diagnostic workup in a distal myopathy patient cohort, reassessing the diagnosis, whilst documenting the usage of MRI. We established a literature based distal myopathies MRI pattern template and assessed its diagnostic utility in terms of sensitivity, specificity, and potential impact on the diagnostic workup. Results: Fifty-five patients were included; in 38 with a comprehensive set of data the diagnostic work-up was audited. The median time from symptoms onset to diagnosis was 12.1 years. The initial genetic diagnostic rate was 39%; 18% were misdiagnosed as neuropathies and 13% as inclusion body myositis (IBM). Based on 21 publications we established a MRI pattern template. Its overall sensitivity (50%) and specificity (32%) were low. However in some diseases (e.g., MYOT-related myopathy, TTN-HMERF) MRI correctly identified the causative gene. The number of genes suggested by MRI pattern analysis was smaller compared to clinical work up (median 1 vs. 9, p < 0.0001) but fewer genes were correctly predicted (5/10 vs. 7/10). MRI analysis ruled out IBM in all cases. Conclusion: In the diagnostic work-up of distal myopathies, MRI is useful in assisting genetic testing and avoiding misdiagnosis (IBM). The overall low sensitivity and specificity limits its generalized use when traditional single gene test methods are applied. However, in the context of next generation sequencing MRI may represent a valuable tool for interpreting complex genetic results.
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Affiliation(s)
- Enrico Bugiardini
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Jasper M. Morrow
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Sachit Shah
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, United Kingdom
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Claire L. Wood
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle upon Tyne, United Kingdom
| | - David S. Lynch
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Alan M. Pitmann
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Mary M. Reilly
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Emma Matthews
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Matt Parton
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Michael G. Hanna
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle upon Tyne, United Kingdom
| | - Tarek A. Yousry
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Neuroradiological Academic Unit, UCL Institute of Neurology, London, United Kingdom
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
- *Correspondence: Tarek A. Yousry
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106
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ten Dam L, de Visser M. Dystrophic Myopathies. Clin Neuroradiol 2018. [DOI: 10.1007/978-3-319-61423-6_3-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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107
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Distal Myopathies. Neuromuscul Disord 2018. [DOI: 10.1007/978-981-10-5361-0_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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108
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Sporadic Inclusion Body Myositis: MRI Findings and Correlation With Clinical and Functional Parameters. AJR Am J Roentgenol 2017; 209:1340-1347. [DOI: 10.2214/ajr.17.17849] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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109
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[Imaging of primary muscular diseases : What do neurologists expect from radiologists?]. Radiologe 2017; 57:1005-1011. [PMID: 28986620 DOI: 10.1007/s00117-017-0309-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Imaging, in particular magnetic resonance imaging (MRI), has in recent years increasingly become a crucial tool for the diagnostics of inherited and acquired muscular diseases. The aim of imaging in neuromuscular disorders goes beyond the detection and quantification of degenerative muscular changes, such as fatty degeneration and includes recognition of very early signs of muscular pathologies presenting as muscular edema. Therefore, imaging is a valuable diagnostic method to support the clinical diagnosis and to narrow down the differential diagnoses, leading to specific additional diagnostic tests in order to establish the correct diagnosis. Although advances in MRI hardware and technology have led to a faster, more accurate and advanced image acquisition allowing whole body examination in a feasible fashion, the standardization of image acquisition and interpretation remains a challenge. The aim of this review article is to address the important and clinically relevant issues concerning the role of imaging of neuromuscular diseases in order to facilitate a good interdisciplinary management for the diagnostics and monitoring of neuromuscular diseases.
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110
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Renard D, Thouvenot E. Lower limb muscle atrophy on MRI as a guide in the diagnosis of muscle diseases. Acta Neurol Belg 2017; 117:635-636. [PMID: 28602008 DOI: 10.1007/s13760-017-0804-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Dimitri Renard
- Department of Neurology, Nîmes University Hospital, 4 Rue du Pr Debré, 30029, Nîmes, France.
| | - Eric Thouvenot
- Department of Neurology, Nîmes University Hospital, 4 Rue du Pr Debré, 30029, Nîmes, France
- Institut de Génomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Université Montpellier, 34094, Montpellier Cedex 5, France
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111
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112
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Angelini C, Fanin M. Limb girdle muscular dystrophies: clinical-genetical diagnostic update and prospects for therapy. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1367283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Corrado Angelini
- Department of Neurodegenerative Disorders, Neuromuscular Center, San Camillo Hospital IRCCS, Venice, Italy
| | - Marina Fanin
- Department of Neurosciences, University of Padova, Padova, Italy
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113
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Peric S, Maksimovic R, Banko B, Durdic M, Bjelica B, Bozovic I, Balcik Y, Pesovic J, Savic-Pavicevic D, Rakocevic-Stojanovic V. Magnetic resonance imaging of leg muscles in patients with myotonic dystrophies. J Neurol 2017; 264:1899-1908. [PMID: 28756605 DOI: 10.1007/s00415-017-8574-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/15/2017] [Accepted: 07/17/2017] [Indexed: 11/29/2022]
Abstract
Magnetic resonance imaging (MRI) of muscles has recently become a significant diagnostic procedure in neuromuscular disorders. There is a lack of muscle MRI studies in patients with myotonic dystrophy type 1 (DM1), especially type 2 (DM2). To analyze fatty infiltration of leg muscles, using 3.0 T MRI in patients with genetically confirmed DM1 and DM2 with different disease durations. The study comprised 21 DM1 and 10 DM2 adult patients. Muscle MRI was performed in axial plane of the lower limbs using T1-weighted (T1w) sequence. Six-point scale by Mercuri et al. was used. Fatty infiltration registered in at least one muscle of lower extremities was found in 71% of DM1 and 40% of DM2 patients. In DM1 patients, early involvement of the medial head of gastrocnemius and tibialis anterior muscles was observed with later involvement of other lower leg muscles and of anterior and posterior thigh compartments with relative sparing of the rectus femoris. In DM2, majority of patients had normal MRI findings. Early involvement of lower legs and posterior thighs was found in some patients. Less severe involvement of the medial head of the gastrocnemius compared to other lower leg muscles was also observed, while involvement of proximal muscles was rather diffuse than selective. It seems that both in DM1 and DM2 some muscles may be affected before weakness is clinically noted and vice versa. We described characteristic pattern and way of progression of muscle involvement in DM1 and DM2.
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Affiliation(s)
- Stojan Peric
- Neurology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, Belgrade, 11000, Serbia
| | - Ruzica Maksimovic
- Centre for Radiology and Magnetic Resonance Imaging, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojan Banko
- Centre for Radiology and Magnetic Resonance Imaging, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milica Durdic
- Centre for Radiology and Magnetic Resonance Imaging, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bogdan Bjelica
- Neurology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, Belgrade, 11000, Serbia
| | - Ivo Bozovic
- Neurology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, Belgrade, 11000, Serbia
| | - Yunus Balcik
- Neurology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, Belgrade, 11000, Serbia
| | - Jovan Pesovic
- Faculty of Biology, Centre for Human Molecular Genetics, University of Belgrade, Belgrade, Serbia
| | - Dusanka Savic-Pavicevic
- Faculty of Biology, Centre for Human Molecular Genetics, University of Belgrade, Belgrade, Serbia
| | - Vidosava Rakocevic-Stojanovic
- Neurology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, Belgrade, 11000, Serbia.
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114
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Giunta C, Baumann M, Fauth C, Lindert U, Abdalla EM, Brady AF, Collins J, Dastgir J, Donkervoort S, Ghali N, Johnson DS, Kariminejad A, Koch J, Kraenzlin M, Lahiri N, Lozic B, Manzur AY, Morton JEV, Pilch J, Pollitt RC, Schreiber G, Shannon NL, Sobey G, Vandersteen A, van Dijk FS, Witsch-Baumgartner M, Zschocke J, Pope FM, Bönnemann CG, Rohrbach M. A cohort of 17 patients with kyphoscoliotic Ehlers-Danlos syndrome caused by biallelic mutations in FKBP14: expansion of the clinical and mutational spectrum and description of the natural history. Genet Med 2017; 20:42-54. [PMID: 28617417 PMCID: PMC5763155 DOI: 10.1038/gim.2017.70] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/05/2017] [Indexed: 12/15/2022] Open
Abstract
Purpose In 2012 we reported in six individuals a clinical condition almost indistinguishable from PLOD1-kyphoscoliotic Ehlers–Danlos syndrome (PLOD1-kEDS), caused by biallelic mutations in FKBP14, and characterized by progressive kyphoscoliosis, myopathy, and hearing loss in addition to connective tissue abnormalities such as joint hypermobility and hyperelastic skin. FKBP14 is an ER-resident protein belonging to the family of FK506-binding peptidyl-prolyl cis–trans isomerases (PPIases); it catalyzes the folding of type III collagen and interacts with type III, type VI, and type X collagens. Only nine affected individuals have been reported to date. Methods We report on a cohort of 17 individuals with FKBP14-kEDS and the follow-up of three previously reported patients, and provide an extensive overview of the disorder and its natural history based on clinical, biochemical, and molecular genetics data. Results Based on the frequency of the clinical features of 23 patients from the present and previous cohorts, we define major and minor features of FKBP14-kEDS. We show that myopathy is confirmed by histology and muscle imaging only in some patients, and that hearing impairment is predominantly sensorineural and may not be present in all individuals. Conclusion Our data further support the extensive clinical overlap with PLOD1-kEDS and show that vascular complications are rare manifestations of FKBP14-kEDS.
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Affiliation(s)
- Cecilia Giunta
- Connective Tissue Unit, Division of Metabolism and Children's Research Centre, University Children's Hospital, Zurich, Switzerland
| | - Matthias Baumann
- Department of Pediatrics I, Pediatric Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christine Fauth
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
| | - Uschi Lindert
- Connective Tissue Unit, Division of Metabolism and Children's Research Centre, University Children's Hospital, Zurich, Switzerland
| | - Ebtesam M Abdalla
- Human Genetics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Angela F Brady
- Ehlers-Danlos Syndrome, National Diagnostic Service, Northwick Park and St. Mark's Hospitals, Harrow, UK
| | - James Collins
- Mercy Clinic Pediatric Neurology, Springfield, Missouri, and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jahannaz Dastgir
- Pediatric Neurology, Goryeb Children's Hospital, Morristown, New Jersey, USA
| | - Sandra Donkervoort
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Neeti Ghali
- Ehlers-Danlos Syndrome, National Diagnostic Service, Northwick Park and St. Mark's Hospitals, Harrow, UK
| | - Diana S Johnson
- Ehlers Danlos Syndrome National Diagnostic Service, Sheffield Children's Hospital, Sheffield, UK
| | | | - Johannes Koch
- Department of Pediatrics, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Marius Kraenzlin
- Medical Faculty of the University of Basel, and Clinic for Endocrinology, Diabetes & Metabolism, University Hospital Basel, Basel, Switzerland
| | - Nayana Lahiri
- South West Thames Regional Genetics Service, St. George's University Hospitals NHS Foundation Trust, UK
| | - Bernarda Lozic
- Department of Pediatrics University Hospital Centre Split, Split, Croatia
| | - Adnan Y Manzur
- Dubowitz Neuromuscular Centre, UCL Institute of Child Health, Great Ormond Street Hospital, London, UK
| | - Jenny E V Morton
- West Midlands Regional Clinical Genetics Service and Birmingham Health Partners Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
| | - Jacek Pilch
- Department of Pediatric Neurology, Medical University of Silesia, Katowice, Poland
| | - Rebecca C Pollitt
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Gudrun Schreiber
- Department of Pediatric Neurology, Children's Hospital, Kassel, Germany
| | - Nora L Shannon
- Nottingham Clinical Genetics Service, Nottingham City Hospital, Nottingham, UK
| | - Glenda Sobey
- Ehlers Danlos Syndrome National Diagnostic Service, Sheffield Children's Hospital, Sheffield, UK
| | - Anthony Vandersteen
- Maritime Medical Genetics Service, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Fleur S van Dijk
- Ehlers-Danlos Syndrome, National Diagnostic Service, Northwick Park and St. Mark's Hospitals, Harrow, UK
| | | | - Johannes Zschocke
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
| | - F Michael Pope
- North West Thames Regional Genetics Service, Kennedy Galton Centre, London, UK
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Marianne Rohrbach
- Connective Tissue Unit, Division of Metabolism and Children's Research Centre, University Children's Hospital, Zurich, Switzerland
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Abstract
PURPOSE OF REVIEW This review aims at covering the role of muscle MRI in supporting the diagnosis of myositis, in aiding to differentiate it from other muscle disorders, and in monitoring myositis patients over time by assessing response to treatment and by discriminating between muscle inflammation and chronic damage. RECENT FINDINGS MRI can assist in 'pattern recognition' of muscle involvement across numerous myopathies, including myositis. Novel applications of magnetic resonance such as cardiac MRI, MR elastography and blood oxigenation level-dependent magnetic resonance can shed light on different aspects of myositis and usefully complement conventional MRI in assessing patients with myositis. SUMMARY MRI can guide therapy by determining whether muscle weakness is related to edema (active inflammation) or muscle atrophy/fat replacement (chronic damage). There is a need to better standardize the assessment of MRI findings in myositis to provide defined outcome measures for use in clinical trials. VIDEO ABSTRACT.
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116
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Garibaldi M, Tasca G, Diaz-Manera J, Ottaviani P, Laschena F, Pantoli D, Gerevini S, Fiorillo C, Maggi L, Tasca E, D'Amico A, Musumeci O, Toscano A, Bruno C, Massa R, Angelini C, Bertini E, Antonini G, Pennisi EM. Muscle MRI in neutral lipid storage disease (NLSD). J Neurol 2017; 264:1334-1342. [PMID: 28503705 PMCID: PMC5502068 DOI: 10.1007/s00415-017-8498-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 04/23/2017] [Accepted: 04/25/2017] [Indexed: 01/28/2023]
Abstract
Neutral lipid storage disease (NLSD) is a rare inherited disorder of lipid metabolism resulting in lipid droplets accumulation in different tissues. Skeletal muscle could be affected in both two different form of disease: NLSD with myopathy (NLSD-M) and NLSD with ichthyosis (NLSD-I). We present the muscle imaging data of 12 patients from the Italian Network for NLSD: ten patients presenting NLSD-M and two patients with NLSD-I. In NLSD-M gluteus minimus, semimembranosus, soleus and gastrocnemius medialis in the lower limbs and infraspinatus in the upper limbs were the most affected muscles. Gracilis, sartorius, subscapularis, pectoralis, triceps brachii and sternocleidomastoid were spared. Muscle involvement was not homogenous and characteristic “patchy” replacement was observed in at least one muscle in all the patients. Half of the patients showed one or more STIR positive muscles. In both NLSD-I cases muscle involvement was not observed by T1-TSE sequences, but one of them showed positive STIR images in more than one muscle in the leg. Our data provides evidence that muscle imaging can identify characteristic alterations in NLSD-M, characterized by a specific pattern of muscle involvement with “patchy” areas of fatty replacement. Larger cohorts are needed to assess if a distinct pattern of muscle involvement exists also for NLSD-I.
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Affiliation(s)
- Matteo Garibaldi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy.
| | - Giorgio Tasca
- Institute of Neurology, Policlinico "A.Gemelli" Foundation University Hospital, Rome, Italy
| | - Jordi Diaz-Manera
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | | | - Francesco Laschena
- Department of Radiology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy
| | - Donatella Pantoli
- Neuroradiology Unit, Department of Radiology, San Filippo Neri Hospital, Rome, Italy
| | | | - Chiara Fiorillo
- Pediatric Neurology and Muscular Disorders, Istituto Giannina Gaslini, Genoa, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Adele D'Amico
- Unit of Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - Olimpia Musumeci
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Claudio Bruno
- Pediatric Neurology and Muscular Disorders, Istituto Giannina Gaslini, Genoa, Italy
| | - Roberto Massa
- Department of Systems Medicine (Neurology), University of Rome Tor Vergata, Rome, Italy
| | | | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
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117
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Muscle MRI in pediatrics: clinical, pathological and genetic correlation. Pediatr Radiol 2017; 47:724-735. [PMID: 28102454 DOI: 10.1007/s00247-016-3777-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/31/2016] [Accepted: 12/28/2016] [Indexed: 10/20/2022]
Abstract
Pediatric myopathies comprise a very heterogeneous group of disorders that may develop at different ages and affect different muscle groups. Its diagnosis is sometimes difficult and must be confirmed by muscle biopsy and/or genetic analysis. In recent years, muscle involvement patterns observed on MRI have become a valuable tool, aiding clinical diagnosis and enriching pathological and genetic assessments. We selected eight myopathy cases from our institutional database in which the pattern of muscle involvement observed on MRI was almost pathognomonic and could therefore contribute to establishing diagnosis. Muscle biopsy, genetic diagnosis or both confirmed all cases.
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118
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Mulroy E, Ghaoui R, Hutchinson D, Rodrigues M, Lek M, MacArthur DG, Cooper ST, Clarke NF, Roxburgh R. A 'limb-girdle muscular dystrophy' responsive to asthma therapy. Pract Neurol 2017; 17:327-331. [PMID: 28433973 DOI: 10.1136/practneurol-2017-001598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Eoin Mulroy
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Roula Ghaoui
- Institute for Neuroscience and Muscle Research, Kid's Research Institute, Children's Hospital at Westmead, Westmead, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - David Hutchinson
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Miriam Rodrigues
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Monkol Lek
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Daniel G MacArthur
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sandra T Cooper
- Institute for Neuroscience and Muscle Research, Kid's Research Institute, Children's Hospital at Westmead, Westmead, Australia
| | - Nigel F Clarke
- Institute for Neuroscience and Muscle Research, Kid's Research Institute, Children's Hospital at Westmead, Westmead, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Richard Roxburgh
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand.,Centre for Brain Research, University of Auckland, Auckland, New Zealand
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119
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Bonati U, Holiga Š, Hellbach N, Risterucci C, Bergauer T, Tang W, Hafner P, Thoeni A, Bieri O, Gerlach I, Marquet A, Khwaja O, Sambataro F, Bertolino A, Dukart J, Fischmann A, Fischer D, Czech C. Longitudinal characterization of biomarkers for spinal muscular atrophy. Ann Clin Transl Neurol 2017; 4:292-304. [PMID: 28491897 PMCID: PMC5420809 DOI: 10.1002/acn3.406] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/05/2017] [Indexed: 12/27/2022] Open
Abstract
Objective Recent advances in understanding Spinal Muscular Atrophy (SMA) etiopathogenesis prompted development of potent intervention strategies and raised need for sensitive outcome measures capable of assessing disease progression and response to treatment. Several biomarkers have been proposed; nevertheless, no general consensus has been reached on the most feasible ones. We observed a wide range of measures over 1 year to assess their ability to monitor the disease status and progression. Methods 18 SMA patients and 19 healthy volunteers (HV) were followed in this 52‐weeks observational study. Quantitative‐MRI (qMRI) of both thighs and clinical evaluation of motor function was performed at baseline, 6, 9 and 12 months follow‐up. Blood samples were taken in patients for molecular characterization at screening, 9 and 12 month follow‐up. Progression, responsiveness and reliability of collected indices were quantified. Correlation analysis was performed to test for potential associations. Results QMRI indices, clinical scales and molecular measures showed high to excellent reliability. Significant differences were found between qMRI of SMA patients and HV. Significant associations were revealed between multiple qMRI measures and functional clinical scales. None of the qMRI, clinical, or molecular measures was able to detect significant disease progression over 1 year. Interpretation We probed a variety of quantitative measures for SMA in a slowly‐progressing disease population over 1 year. The presented measures demonstrated potential to provide a closer link to underlying disease biology as compared to conventional functional scales. The proposed biomarker framework can guide implementation of more sensitive endpoints in future clinical trials and prove their utility in search for novel disease‐modifying therapies.
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Affiliation(s)
- Ulrike Bonati
- Division of Neuropediatrics University of Basel Children's Hospital Spitalstrasse 334056 Basel Switzerland.,Department of Neurology University of Basel Hospital Petersgraben 44031 Basel Switzerland
| | - Štefan Holiga
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland.,Max Planck Institute for Human Cognitive and Brain Sciences Stephan str. 1A04103 Leipzig Germany
| | - Nicole Hellbach
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Céline Risterucci
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Tobias Bergauer
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Wakana Tang
- Roche Molecular Diagnostics Research Genomics & Oncology Roche Molecular Systems Inc.4300 Hacienda Dr Pleasanton 94588 California USA
| | - Patricia Hafner
- Division of Neuropediatrics University of Basel Children's Hospital Spitalstrasse 334056 Basel Switzerland.,Department of Neurology University of Basel Hospital Petersgraben 44031 Basel Switzerland.,University Clinics of Internal Medicine Kantonsspital Baselland Bruderholz 4101 Switzerland
| | - Alain Thoeni
- MIAC AG c/o University of Basel Hospital Mittlere-Strasse 834031 Basel Switzerland.,Department of Radiology University of Basel Hospital Petersgraben 44031 Basel Switzerland
| | - Oliver Bieri
- Department of Radiology University of Basel Hospital Petersgraben 44031 Basel Switzerland
| | - Irene Gerlach
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Anne Marquet
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Omar Khwaja
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Fabio Sambataro
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Alessandro Bertolino
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Juergen Dukart
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
| | - Arne Fischmann
- Department of Radiology University of Basel Hospital Petersgraben 44031 Basel Switzerland.,Hirslanden Klinik St. Anna St. Anna-Strasse 326006 Luzern Switzerland
| | - Dirk Fischer
- Division of Neuropediatrics University of Basel Children's Hospital Spitalstrasse 334056 Basel Switzerland.,Department of Neurology University of Basel Hospital Petersgraben 44031 Basel Switzerland
| | - Christian Czech
- Roche Pharma and Early Development Neuroscience, Ophthalmology and Rare Diseases Roche Innovation Center Basel F. Hoffmann-La Roche Ltd Grenzacherstrasse 1244070 Basel Switzerland
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Day J, Patel S, Limaye V. The role of magnetic resonance imaging techniques in evaluation and management of the idiopathic inflammatory myopathies. Semin Arthritis Rheum 2017; 46:642-649. [DOI: 10.1016/j.semarthrit.2016.11.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/01/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
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121
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Fu J, Zheng YM, Jin SQ, Yi JF, Liu XJ, Lyn H, Wang ZX, Zhang W, Xiao JX, Yuan Y. "Target" and "Sandwich" Signs in Thigh Muscles have High Diagnostic Values for Collagen VI-related Myopathies. Chin Med J (Engl) 2017; 129:1811-6. [PMID: 27453230 PMCID: PMC4976569 DOI: 10.4103/0366-6999.186638] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Collagen VI-related myopathies are autosomal dominant and recessive hereditary myopathies, mainly including Ullrich congenital muscular dystrophy (UCMD) and Bethlem myopathy (BM). Muscle magnetic resonance imaging (MRI) has been widely used to diagnosis muscular disorders. The purpose of this study was to evaluate the diagnostic value of thigh muscles MRI for collagen VI-related myopathies. Methods: Eleven patients with collagen VI gene mutation-related myopathies were enrolled in this study. MRI of the thigh muscles was performed in all patients with collagen VI gene mutation-related myopathies and in 361 patients with other neuromuscular disorders (disease controls). T1-weighted images were used to assess fatty infiltration of the muscles using a modified Mercuri's scale. We assessed the sensitivity and specificity of the MRI features of collagen VI-related myopathies. The relationship between fatty infiltration of muscles and specific collagen VI gene mutations was also investigated. Results: Eleven patients with collagen VI gene mutation-related myopathies included six UCMD patients and five BM patients. There was no significant difference between UCMD and BM patients in the fatty infiltration of each thigh muscle except sartorius (P = 0.033); therefore, we combined the UCMD and BM data. Mean fatty infiltration scores were 3.1 and 3.0 in adductor magnus and gluteus maximus, while the scores were 1.3, 1.3, and 1.5 in gracilis, adductor longus, and sartorius, respectively. A “target” sign in rectus femoris (RF) was present in seven cases, and a “sandwich” sign in vastus lateralis (VL) was present in ten cases. The “target” and “sandwich” signs had sensitivities of 63.6% and 90.9% and specificities of 97.3% and 96.9% for the diagnosis of collagen VI-related myopathies, respectively. Fatty infiltration scores were 2.0–3.0 in seven patients with mutations in the triple-helical domain, and 1.0–1.5 in three of four patients with mutations in the N- or C-domain of the collagen VI genes. Conclusions: The “target” sign in RF and “sandwich” sign in VL are common MRI features and are useful for the diagnosis of collagen VI-related myopathies. The severity of fatty infiltration of muscles may have a relationship with the mutation location of collagen VI gene.
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Affiliation(s)
- Jun Fu
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Yi-Ming Zheng
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Su-Qin Jin
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Jun-Fei Yi
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Xiu-Juan Liu
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - He Lyn
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Zhao-Xia Wang
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Jiang-Xi Xiao
- Department of Radiology, Peking University First Hospital, Beijing 100034, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
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122
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Pichiecchio A, Rossi M, Cinnante C, Colafati GS, Icco R, Parini R, Menni F, Furlan F, Burlina A, Sacchini M, Donati MA, Fecarotta S, Casa RD, Deodato F, Taurisano R, Rocco M. Muscle MRI of classic infantile pompe patients: Fatty substitution and edema‐like changes. Muscle Nerve 2017; 55:841-848. [DOI: 10.1002/mus.25417] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 07/18/2016] [Accepted: 09/23/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Anna Pichiecchio
- Neuroradiology DepartmentC. Mondino National Neurological InstituteVia Mondino2 ‐ 27100Pavia Italy
| | - Marta Rossi
- Child Neuropsychiatry UnitDepartment of Brain and Behavioral Sciences, University of PaviaPavia Italy
| | - Claudia Cinnante
- Unit of NeuroradiologyDepartment of Neuroscience, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of MilanMilan Italy
| | | | - Roberto Icco
- Neurology UnitDepartment of Brain and Behavioral Sciences, University of PaviaPavia Italy
| | - Rossella Parini
- Unit of Rare Metabolic Diseases, San Gerardo HospitalMonza Italy
| | - Francesca Menni
- Pediatric Highly Intensive Care UnitDepartment of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilano Italy
| | - Francesca Furlan
- Unit of Metabolic DiseasesAzienda Ospedaliera UniversitariaPadua Italy
| | - Alberto Burlina
- Unit of Metabolic DiseasesAzienda Ospedaliera UniversitariaPadua Italy
| | - Michele Sacchini
- Metabolic and Neuromuscular UnitAOU Meyer HospitalFlorence Italy
| | | | - Simona Fecarotta
- Department of Translational Medicine‐Section of PediatricsFederico II UniversityNaples Italy
| | - Roberto Della Casa
- Department of Translational Medicine‐Section of PediatricsFederico II UniversityNaples Italy
| | | | | | - Maja Rocco
- Unit of Rare DiseasesDepartment of Pediatrics, Giannina Gaslini InstituteGenoa Italy
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123
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Andersson H, Kirkhus E, Garen T, Walle-Hansen R, Merckoll E, Molberg Ø. Comparative analyses of muscle MRI and muscular function in anti-synthetase syndrome patients and matched controls: a cross-sectional study. Arthritis Res Ther 2017; 19:17. [PMID: 28122635 PMCID: PMC5264447 DOI: 10.1186/s13075-017-1219-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/03/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) of thigh muscles is increasingly used to assess disease activity and damage extent in chronic myositis, but the validity of the findings is not clear. Here, the primary aim was to compare thigh MRI findings in patients having chronic myositis associated with anti-synthetase syndrome (ASS) and in matched healthy controls. METHODS Cross-sectional analyses of thigh muscle MRI, muscular function and creatinine kinase (CK) were performed in 68 ASS patients (median disease duration 71 months) and 67 controls matched for age and gender. MRI changes associated with disease activity (edema in muscles and fascia) and damage (fatty replacement and muscle volume reduction) were assessed semiquantitatively, giving a total MRI score of 0-78 (total edema 0-42 and total damage 0-36). RESULTS ASS patients had higher total MRI score than the matched controls (14.1 versus 3.0; p < 0.001) and less muscle strength (p < 0.001). Muscle edema was more frequent in ASS patients than controls (38% versus 12%), as was fatty replacement (42% versus 4%). In ASS patients, we found that the total edema score correlated with CK, but 23% of the patients with normal CK had score > 18. Muscle compartment analyses in ASS patients showed that muscle edema was most pronounced anteriorly, while fatty replacement dominated posteriorly. CONCLUSIONS This study showed, for the first time, the magnitude of difference in muscle MRI findings between chronic myositis cases and matched controls. In ASS patients, muscle MRI appeared to provide useful complementary information to muscle strength and CK levels in the assessment of myositis.
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Affiliation(s)
- Helena Andersson
- Institute of Clinical Medicine, Department of Rheumatology, Oslo University Hospital, Pb 4950 Nydalen, 0424, Oslo, Norway.
| | - Eva Kirkhus
- Department of Radiology, Oslo University Hospital, Oslo, Norway
| | - Torhild Garen
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | | | - Else Merckoll
- Department of Radiology, Oslo University Hospital, Oslo, Norway
| | - Øyvind Molberg
- Institute of Clinical Medicine, Department of Rheumatology, Oslo University Hospital, Pb 4950 Nydalen, 0424, Oslo, Norway
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124
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Ten Dam L, van der Kooi AJ, Verhamme C, Wattjes MP, de Visser M. Muscle imaging in inherited and acquired muscle diseases. Eur J Neurol 2016; 23:688-703. [PMID: 27000978 DOI: 10.1111/ene.12984] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 01/18/2016] [Indexed: 02/05/2023]
Abstract
In this review we discuss the use of conventional (computed tomography, magnetic resonance imaging, ultrasound) and advanced muscle imaging modalities (diffusion tensor imaging, magnetic resonance spectroscopy) in hereditary and acquired myopathies. We summarize the data on specific patterns of muscle involvement in the major categories of muscle disease and provide recommendations on how to use muscle imaging in this field of neuromuscular disorders.
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Affiliation(s)
- L Ten Dam
- Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands
| | - A J van der Kooi
- Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands
| | - C Verhamme
- Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands
| | - M P Wattjes
- Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - M de Visser
- Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands
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125
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Magnetic resonance imaging patterns of muscle involvement in genetic muscle diseases: a systematic review. J Neurol 2016; 264:1320-1333. [PMID: 27888415 DOI: 10.1007/s00415-016-8350-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 11/16/2016] [Accepted: 11/17/2016] [Indexed: 12/25/2022]
Abstract
A growing body of the literature supports the use of magnetic resonance imaging as a potential biomarker for disease severity in the hereditary myopathies. We performed a systematic review of the medical literature to evaluate patterns of fat infiltration observed in magnetic resonance imaging studies of muscular dystrophy and congenital myopathy. Searches were performed using MEDLINE, EMBASE, and grey literature databases. Studies that described fat infiltration of muscles in patients with muscular dystrophy or congenital myopathy were selected for full-length review. Data on preferentially involved or spared muscles were extracted for analysis. A total of 2172 titles and abstracts were screened, and 70 publications met our criteria for inclusion in the systematic review. There were 23 distinct genetic disorders represented in this analysis. In most studies, preferential involvement and sparing of specific muscles were reported. We conclude that magnetic resonance imaging studies can be used to identify distinct patterns of muscle involvement in the hereditary myopathies. However, larger studies and standardized methods of reporting are needed to develop imaging as a diagnostic tool in these diseases.
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126
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Pfeffer G, Povitz M. Respiratory management of patients with neuromuscular disease: current perspectives. Degener Neurol Neuromuscul Dis 2016; 6:111-118. [PMID: 30050373 PMCID: PMC6053085 DOI: 10.2147/dnnd.s87323] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Neuromuscular ventilatory weakness can be difficult to recognize because the symptoms can be nocturnal, nonspecific, or attributed to other conditions. The presence of respiratory muscle weakness suggests a number of possible heterogeneous conditions, including neurodegenerative, autoimmune, and genetic neuromuscular diseases. In some conditions, disease-modifying management exists, but in the absence of such intervention, supportive respiratory therapy can improve quality of life and survival. In this review, we discuss the differential diagnosis and diagnostic approach to chronic neuromuscular respiratory weakness. We also review the clinical assessment and management of respiratory failure in these conditions.
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Affiliation(s)
- Gerald Pfeffer
- Department of Clinical Neurosciences, .,Hotchkiss Brain Institute, University of Calgary, Calgary, AB,
| | - Marcus Povitz
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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127
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128
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Harris E, McEntagart M, Topf A, Lochmüller H, Bushby K, Sewry C, Straub V. Clinical and neuroimaging findings in two brothers with limb girdle muscular dystrophy due to LAMA2 mutations. Neuromuscul Disord 2016; 27:170-174. [PMID: 27932089 DOI: 10.1016/j.nmd.2016.10.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 10/27/2016] [Indexed: 11/28/2022]
Abstract
Recessive mutations in LAMA2 commonly cause congenital muscular dystrophy (MDC1A) and, rarely, limb girdle muscular dystrophy (LGMD). We report 2 brothers who presented in adulthood with LGMD due to novel mutations in LAMA2 identified by whole exome sequencing (WES). Muscle biopsy more than 30 years ago demonstrated dystrophic changes but was not available for immunoanalysis. Muscle MRI demonstrated involvement of peripheral muscle with internal sparing classically seen in collagen-VI related disorders. Extensive genetic testing, including COL6A1/2/3, was performed prior to WES. Subsequent skin biopsy immunoanalysis demonstrated laminin α2 partial absence. The phenotype of the patients was notable for novel central nervous system findings, namely bilateral signal changes in the globi pallidi, and presence of dilated cardiomyopathy (DCM). They also illustrate the similarity in muscle MRI in collagen VI and laminin α2-related disorders, both of which are due to mutations in genes encoding extracellular matrix proteins.
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Affiliation(s)
- Elizabeth Harris
- Newcastle University John Walton Muscular Dystrophy Research Centre, Newcastle upon Tyne, UK
| | | | - Ana Topf
- Newcastle University John Walton Muscular Dystrophy Research Centre, Newcastle upon Tyne, UK
| | - Hanns Lochmüller
- Newcastle University John Walton Muscular Dystrophy Research Centre, Newcastle upon Tyne, UK
| | - Kate Bushby
- Newcastle University John Walton Muscular Dystrophy Research Centre, Newcastle upon Tyne, UK
| | - Caroline Sewry
- UCL Institute of Child Health, Dubowitz Neuromuscular Centre, London, UK; Wolfson Centre for Inherited Neuromuscular Disorders RJAH Orthopaedic Hospital, Oswestry SY10 7AG, UK
| | - Volker Straub
- Newcastle University John Walton Muscular Dystrophy Research Centre, Newcastle upon Tyne, UK.
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129
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Muscle MRI in Duchenne muscular dystrophy: Evidence of a distinctive pattern. Neuromuscul Disord 2016; 26:768-774. [DOI: 10.1016/j.nmd.2016.09.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 07/24/2016] [Accepted: 09/01/2016] [Indexed: 11/23/2022]
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130
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Jin S, Du J, Wang Z, Zhang W, Lv H, Meng L, Xiao J, Yuan Y. Heterogeneous characteristics of MRI changes of thigh muscles in patients with dysferlinopathy. Muscle Nerve 2016; 54:1072-1079. [PMID: 27251469 DOI: 10.1002/mus.25207] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 05/18/2016] [Accepted: 05/31/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the pattern of thigh muscle MRI changes in a large cohort of patients with dysferlinopathy. METHODS MRI of the thigh was performed in 60 patients. We correlated the scale of muscle involvement on MRI with the modified Gardner-Medwin and Walton (GM-W) scale and disease duration. We also analyzed the relationship between muscle changes and genetic mutations. RESULTS Fatty infiltration and edema were observed in 95.50% and 86.67% of patients, respectively. The hamstring muscles had the highest frequency and mean score of fatty infiltration, although a posterior-dominant pattern was found in only 56%. Edema most commonly and severely affected the quadriceps and adductor magnus muscles. Fatty infiltration score correlated positively with disease duration and GM-W scale. CONCLUSIONS The pattern of fatty infiltration was heterogeneous in dysferlinopathy patients. Muscle edema was common. Fatty infiltration can be used to assess disease progression. Muscle Nerve 54: 1072-1079, 2016.
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Affiliation(s)
- Suqin Jin
- Department of Neurology, Peking University First Hospital, 8 Xishiku St, Xicheng District, Beijing, 100034, PR. China
| | - Jing Du
- Department of Radiology, Peking University First Hospital, Beijing, 100034, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, 8 Xishiku St, Xicheng District, Beijing, 100034, PR. China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, 8 Xishiku St, Xicheng District, Beijing, 100034, PR. China
| | - He Lv
- Department of Neurology, Peking University First Hospital, 8 Xishiku St, Xicheng District, Beijing, 100034, PR. China
| | - Lingchao Meng
- Department of Neurology, Peking University First Hospital, 8 Xishiku St, Xicheng District, Beijing, 100034, PR. China
| | - Jiangxi Xiao
- Department of Radiology, Peking University First Hospital, Beijing, 100034, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, 8 Xishiku St, Xicheng District, Beijing, 100034, PR. China
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C A Araujo E, Azzabou N, Vignaud A, Guillot G, Carlier PG. Quantitative ultrashort TE imaging of the short-T 2 components in skeletal muscle using an extended echo-subtraction method. Magn Reson Med 2016; 78:997-1008. [PMID: 27699843 DOI: 10.1002/mrm.26489] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 08/19/2016] [Accepted: 09/12/2016] [Indexed: 11/12/2022]
Abstract
PURPOSE To introduce an ultrashort echo time (UTE) based method for quantitative mapping of short-T2 signals in skeletal muscle (SKM) in the presence of fat, with the aim of monitoring SKM fibrosis. METHODS From a set of at least five UTE images of the same slice, a long- T2* map, a fat-fraction map, and a map of short-T2 -signal fraction are extracted. The method was validated by numerical simulations and in vitro studies on collagen solutions. Finaly, the method was applied to image the short-T2 signals in the leg of eight healthy volunteers. RESULTS The imaged short-T2 -signal fractions in the collagen solutions correlated with their respective collagen concentrations ( R=0.999, P=0.009). Short-T2 tissues such as cortical bone and fasciae were highlighted in the resulting short-T2 fraction maps. A significant fraction of short-T2 signal was systematically observed in the skeletal muscle of all of the subjects (4.5±1.2%). CONCLUSION The proposed method allows the quantitative imaging of short-T2 components in tissues containing fat. By also having the fat-fraction and T2* maps as outcomes, long-T2 suppression is accomplished without requiring modifications to the basic UTE sequence. Although the hypersignal observed in the fasciae suggests that the short-T2 signal observed in SKM might arise from interstitial connective tissue, further investigation is necessary to confirm this statement. Magn Reson Med 78:997-1008, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Ericky C A Araujo
- NMR Laboratory, Institute of Myology, Pitié-Salpêtrière University Hospital, Paris, France.,CEA/DRF/I2BM/MIRCen, Fontenay aux Roses, France
| | - N Azzabou
- NMR Laboratory, Institute of Myology, Pitié-Salpêtrière University Hospital, Paris, France.,CEA/DRF/I2BM/MIRCen, Fontenay aux Roses, France
| | - A Vignaud
- CEA/DRF/I2BM/NeuroSpin/UNIRS, Gif Sur Yvette, France
| | - G Guillot
- IR4M UMR8081, CNRS, University of Paris-Sud, University of Paris-Saclay, Orsay, France
| | - P G Carlier
- NMR Laboratory, Institute of Myology, Pitié-Salpêtrière University Hospital, Paris, France.,CEA/DRF/I2BM/MIRCen, Fontenay aux Roses, France
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133
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van den Bogaart FJA, Claeys KG, Kley RA, Kusters B, Schrading S, Kamsteeg EJ, Voermans NC. Widening the spectrum of filamin-C myopathy: Predominantly proximal myopathy due to the p.A193T mutation in the actin-binding domain of FLNC. Neuromuscul Disord 2016; 27:73-77. [PMID: 27816332 DOI: 10.1016/j.nmd.2016.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 09/13/2016] [Accepted: 09/20/2016] [Indexed: 12/13/2022]
Abstract
We report three patients with a predominantly proximal myopathy due to p.A193T mutation in the actin-binding domain of FLNC, which has so far only been associated with a distal myopathy. They presented with a late onset myopathy characterized by predominant limb-girdle and proximal weakness. We describe the clinical, electrophysiological, pathological, muscle imaging and genetic features. One of our patients did not have typical histological features for a myofibrillar myopathy in muscle biopsy. This observation is important for the recognition of the full clinical spectrum of filamin-C-related myopathies. Muscle imaging has an important role in distinguishing the different filamin-C myopathy types.
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Affiliation(s)
| | - Kristl G Claeys
- Department of Neurology and Institute of Neuropathology, RWTH Aachen University, Aachen, Germany; Department of Neurology, University Hospitals Leuven and University of Leuven (KU Leuven), Leuven, Belgium
| | - Rudolf A Kley
- Department of Neurology, Heimer Institute for Muscle Research, Ruhr-University Bochum, Bochum, Germany
| | - Benno Kusters
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Simone Schrading
- Department of Radiology, RWTH Aachen University, Aachen, Germany
| | - Erik J Kamsteeg
- Department of Human Genetics, Radboud University Medical Centre, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands.
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134
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Elessawy SS, Abdelsalam EM, Abdel Razek E, Tharwat S. Whole-body MRI for full assessment and characterization of diffuse inflammatory myopathy. Acta Radiol Open 2016; 5:2058460116668216. [PMID: 27708860 PMCID: PMC5034335 DOI: 10.1177/2058460116668216] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/15/2016] [Indexed: 12/21/2022] Open
Abstract
Background Conventional magnetic resonance imaging (MRI) is a highly valuable tool for full assessment of the extent of bilateral symmetrical diffuse inflammatory myopathy, owing to its high sensitivity in the detection of edema which correlates with, and sometimes precedes, clinical findings. Purpose To evaluate the use of whole-body (WB)-MRI in characterization and full assessment of the extent and distribution of diffuse inflammatory myopathy. Material and Methods A prospective study on 15 patients presenting with clinical evidence of inflammatory myopathy. It included 4 boys/men and 11 girls/women (age range, 6–44 years; mean age, 25.5 years). 1.5 T WB-MRI was performed and the distribution and extent of disease severity was assessed according to muscle edema on STIR images. Results Four cases of dermatomyositis showed lower limb disease predilection with edema in gluteal, thigh, and calf muscles. The same finding was seen in one case with recurrent polymyositis and three cases with overlap myositis with systemic lupus erythematosus (SLE). Bilateral upper and lower limb myositis was demonstrated in three cases of polymyositis and one case of overlap myositis with scleroderma. Bilateral edema involving all scanned muscle groups was detected in three cases of polymyositis with paraneoplastic syndrome, SLE, and severe active dermatomyositis (including the neck muscles). Conclusion WB-MRI is the diagnostic modality of choice for cases of inflammatory myopathy. It accurately detects the most severely affected muscles candidate for biopsy and provides a reliable baseline study for follow-up of disease progression as well as response to treatment.
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Affiliation(s)
- Saleh Saleh Elessawy
- Radiodiagnosis Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Eman Abdel Razek
- Physical Medicine, Rheumatology and Rehabilitation Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samar Tharwat
- Internal Medicine Department, Rheumatology and Immunology Unit, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Young HJ, Southern WM, Mccully KK. Comparisons of ultrasound-estimated intramuscular fat with fitness and health indicators. Muscle Nerve 2016; 54:743-9. [DOI: 10.1002/mus.25105] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 03/01/2016] [Accepted: 03/07/2016] [Indexed: 01/17/2023]
Affiliation(s)
- Hui-Ju Young
- Department of Kinesiology; University of Georgia; Athens Georgia USA
| | | | - Kevin K. Mccully
- Department of Kinesiology; University of Georgia; Athens Georgia USA
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136
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Albuquerque MAVD, Abath Neto O, Silva FMAD, Zanoteli E, Reed UC. Limb-girdle muscular dystrophy type 2A in Brazilian children. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 73:993-7. [PMID: 26677118 DOI: 10.1590/0004-282x20150168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/14/2015] [Indexed: 11/22/2022]
Abstract
UNLABELLED Calpainopathy is an autosomal recessive limb girdle muscular dystrophy (LGMD2A) caused by mutations in CAPN3 gene. OBJECTIVE To present clinical and histological findings in six children with a molecular diagnosis of LGMD2A and additionally the MRI findings in two of them. METHOD We retrospectively assessed medical records of 6 patients with mutation on CAPN3 gene. RESULTS All patients were female (three to 12 years). The mean of age of disease onset was 9 years. All of them showed progressive weakness with predominance in lower limbs. Other findings were scapular winging, joint contractures and calf hypertrophy. One female had a more severe phenotype than her dizygotic twin sister that was confirmed by muscle MRI. Muscle biopsies showed a dystrophic pattern in all patients. CONCLUSION In this cohort of children with LGMD2A, the clinical aspects were similar to adults with the same disorder.
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Affiliation(s)
| | - Osório Abath Neto
- Departamento de Neurologia, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Edmar Zanoteli
- Departamento de Neurologia, Universidade de São Paulo, Sao Paulo, SP, Brazil
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Tasca G, Monforte M, Ottaviani P, Pelliccioni M, Frusciante R, Laschena F, Ricci E. Magnetic resonance imaging in a large cohort of facioscapulohumeral muscular dystrophy patients: Pattern refinement and implications for clinical trials. Ann Neurol 2016; 79:854-864. [DOI: 10.1002/ana.24640] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/31/2016] [Accepted: 03/14/2016] [Indexed: 01/11/2023]
Affiliation(s)
| | - Mauro Monforte
- Institute of Neurology; Catholic University School of Medicine; Rome
| | | | - Marco Pelliccioni
- Italian Union against Muscular Dystrophy (UILDM), Rome Section; Rome Italy
| | | | | | - Enzo Ricci
- Institute of Neurology; Catholic University School of Medicine; Rome
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138
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Quantitative MR imaging in fracture dating—Initial results. Forensic Sci Int 2016; 261:61-9. [DOI: 10.1016/j.forsciint.2016.01.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/13/2015] [Accepted: 01/18/2016] [Indexed: 01/08/2023]
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139
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Gómez-Andrés D, Dabaj I, Mompoint D, Hankiewicz K, Azzi V, Ioos C, Romero NB, Ben Yaou R, Bergounioux J, Bonne G, Richard P, Estournet B, Yves-Carlier R, Quijano-Roy S. Pediatric laminopathies: Whole-body magnetic resonance imaging fingerprint and comparison with Sepn1
myopathy. Muscle Nerve 2016; 54:192-202. [DOI: 10.1002/mus.25018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 12/04/2015] [Accepted: 12/13/2015] [Indexed: 01/15/2023]
Affiliation(s)
- David Gómez-Andrés
- Servicio de Pediatría, Hospital Universitario Infanta Sofía, Departamento de Anatomía, Histología y Neurociencia, Universidad Autónoma de Madrid, TRADESMA; IdiPaz, Madrid España
- Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
- Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye, Réseau National Français de la Filière Neuromusculaire (FILNEMUS)
| | - Ivana Dabaj
- Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
- Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye, Réseau National Français de la Filière Neuromusculaire (FILNEMUS)
| | - Dominique Mompoint
- Assistance Publique des Hôpitaux de Paris, Service d'Imagerie Médicale, Pôle Neuro-locomoteur, Hôpital R. Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
| | - Karolina Hankiewicz
- Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye, Réseau National Français de la Filière Neuromusculaire (FILNEMUS)
| | - Viviane Azzi
- Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
| | - Christine Ioos
- Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
| | - Norma B. Romero
- Institut de Myologie, Groupe Hospitalier-Universitaire La Pitié-Salpêtrìre, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie-Paris VI; Paris France
| | - Rabah Ben Yaou
- Institut de Myologie, Groupe Hospitalier-Universitaire La Pitié-Salpêtrìre, Assistance Publique des Hôpitaux de Paris, Sorbonne Universités; UPMC Universitaire Paris 06, INSERM UMRS974, CNRS FRE3617, Center of Research in Myology Paris France
| | - Jean Bergounioux
- Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
| | - Giséle Bonne
- Institut de Myologie, Groupe Hospitalier-Universitaire La Pitié-Salpêtrìre, Assistance Publique des Hôpitaux de Paris, Sorbonne Universités; UPMC Universitaire Paris 06, INSERM UMRS974, CNRS FRE3617, Center of Research in Myology Paris France
| | - Pascale Richard
- Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Charles Foix, UF Cardiogénétique et Myogénétique, Service de Biochimie Métabolique, Equipe “Génomique et Physiopathologie des Maladies Cardiovasculaires, Institute of Cardiometabolism and Nutrition”; Paris France
| | - Brigitte Estournet
- Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
- Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye, Réseau National Français de la Filière Neuromusculaire (FILNEMUS)
| | - Robert Yves-Carlier
- Assistance Publique des Hôpitaux de Paris, Service d'Imagerie Médicale, Pôle Neuro-locomoteur, Hôpital R. Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
- Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye, Réseau National Français de la Filière Neuromusculaire (FILNEMUS)
| | - Susana Quijano-Roy
- Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, Université de Versailles-St Quentin, U1179 UVSQ-INSERM; France
- Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye, Réseau National Français de la Filière Neuromusculaire (FILNEMUS)
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Finlayson S, Morrow JM, Rodriguez Cruz PM, Sinclair CDJ, Fischmann A, Thornton JS, Knight S, Norbury R, White M, Al-Hajjar M, Carboni N, Jayawant S, Robb SA, Yousry TA, Beeson D, Palace J. Muscle magnetic resonance imaging in congenital myasthenic syndromes. Muscle Nerve 2016; 54:211-9. [PMID: 26789134 PMCID: PMC4982021 DOI: 10.1002/mus.25035] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 12/27/2015] [Accepted: 01/06/2016] [Indexed: 11/26/2022]
Abstract
Introduction In this study we investigated muscle magnetic resonance imaging in congenital myasthenic syndromes (CMS). Methods Twenty‐six patients with 9 CMS subtypes and 10 controls were imaged. T1‐weighted (T1w) and short‐tau inversion recovery (STIR) 3‐Tesla MRI images obtained at thigh and calf levels were scored for severity. Results Overall mean the T1w score was increased in GFPT1 and DPAGT1 CMS. T1w scans of the AChR‐deficiency, COLQ, and CHAT subjects were indistinguishable from controls. STIR images from CMS patients did not differ significantly from those of controls. Mean T1w score correlated with age in the CMS cohort. Conclusions MRI appearances ranged from normal to marked abnormality. T1w images seem to be especially abnormal in some CMS caused by mutations of proteins involved in the glycosylation pathway. A non‐selective pattern of fat infiltration or a normal‐appearing scan in the setting of significant clinical weakness should suggest CMS as a potential diagnosis. Muscle MRI could play a role in differentiating CMS subtypes. Muscle Nerve54: 211–219, 2016
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Affiliation(s)
- Sarah Finlayson
- Nuffield Department of Clinical Neurosciences, University of Oxford and Oxford Radcliffe Hospitals NHS Trust, Oxford, UK
| | - Jasper M Morrow
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Pedro M Rodriguez Cruz
- Nuffield Department of Clinical Neurosciences, University of Oxford and Oxford Radcliffe Hospitals NHS Trust, Oxford, UK
| | | | - Arne Fischmann
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - John S Thornton
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Steve Knight
- University of Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, UK
| | - Ray Norbury
- University of Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, UK
| | - Mel White
- Department of Paediatrics, University of Oxford and Children's Hospital, Oxford, UK
| | - Michal Al-Hajjar
- Nuffield Department of Clinical Neurosciences, University of Oxford and Oxford Radcliffe Hospitals NHS Trust, Oxford, UK
| | - Nicola Carboni
- Neurology Department, Hospital San Francesco of Nuoro, Sardinia, Italy
| | - Sandeep Jayawant
- Department of Paediatrics, University of Oxford and Children's Hospital, Oxford, UK
| | - Stephanie A Robb
- Dubowitz Neuromuscular Centre, Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Tarek A Yousry
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - David Beeson
- Neurosciences Group, Weatherall Institute of Molecular Medicine, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jacqueline Palace
- Nuffield Department of Clinical Neurosciences, University of Oxford and Oxford Radcliffe Hospitals NHS Trust, Oxford, UK
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Willcocks RJ, Rooney WD, Triplett WT, Forbes SC, Lott DJ, Senesac CR, Daniels MJ, Wang DJ, Harrington AT, Tennekoon GI, Russman BS, Finanger EL, Byrne BJ, Finkel RS, Walter GA, Sweeney HL, Vandenborne K. Multicenter prospective longitudinal study of magnetic resonance biomarkers in a large duchenne muscular dystrophy cohort. Ann Neurol 2016; 79:535-47. [PMID: 26891991 DOI: 10.1002/ana.24599] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/11/2015] [Accepted: 01/02/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to describe Duchenne muscular dystrophy (DMD) disease progression in the lower extremity muscles over 12 months using quantitative magnetic resonance (MR) biomarkers, collected across three sites in a large cohort. METHODS A total of 109 ambulatory boys with DMD (8.7 ± 2.0 years; range, 5.0-12.9) completed baseline and 1-year follow-up quantitative MR imaging (transverse relaxation time constant; MRI-T2 ), MR spectroscopy (fat fraction and (1) H2 O T2 ), and 6-minute walk test (6MWT) measurements. A subset of boys completed additional measurements after 3 or 6 months. RESULTS MRI-T2 and fat fraction increased significantly over 12 months in all age groups, including in 5- to 6.9-year-old boys. Significant increases in vastus lateralis (VL) fat fraction were observed in 3 and 6 months. Even in boys whose 6MWT performance improved or remained stable over 1 year, significant increases in MRI-T2 and fat fraction were found. Of all the muscles examined, the VL and biceps femoris long head were the most responsive to disease progression in boys with DMD. INTERPRETATION MR biomarkers are responsive to disease progression in 5- to 12.9-year-old boys with DMD and able to detect subclinical disease progression in DMD, even within short (3-6 months) time periods. The measured sensitivity of MR biomarkers in this multicenter study may be critically important to future clinical trials, allowing for smaller sample sizes and/or shorter study windows in this fatal rare disease.
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Affiliation(s)
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR
| | | | - Sean C Forbes
- Department of Physical Therapy, University of Florida, Gainesville, FL
| | - Donovan J Lott
- Department of Physical Therapy, University of Florida, Gainesville, FL
| | - Claudia R Senesac
- Department of Physical Therapy, University of Florida, Gainesville, FL
| | - Michael J Daniels
- Department of Statistics & Data Sciences and Department of Integrative Biology, University of Texas at Austin, Austin, TX
| | - Dah-Jyuu Wang
- Division of Neurology and Department of Radiology, the Children's Hospital of Philadelphia, Philadelphia, PA
| | | | | | - Barry S Russman
- Departments of Pediatrics and Neurology, Oregon Health & Science University, Shriners Hospital for Children, Portland, OR
| | - Erika L Finanger
- Departments of Pediatrics and Neurology, Oregon Health & Science University, Shriners Hospital for Children, Portland, OR
| | - Barry J Byrne
- Department of Pediatrics and Molecular Genetics and Microbiology, Powell Gene Therapy Center University of Florida, Gainesville, FL
| | - Richard S Finkel
- Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, FL
| | - Glenn A Walter
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL
| | - H Lee Sweeney
- Department of Physiology, University of Pennsylvania, Philadelphia, PA
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142
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Where do we stand in trial readiness for autosomal recessive limb girdle muscular dystrophies? Neuromuscul Disord 2015; 26:111-25. [PMID: 26810373 DOI: 10.1016/j.nmd.2015.11.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 11/27/2015] [Accepted: 11/29/2015] [Indexed: 12/20/2022]
Abstract
Autosomal recessive limb girdle muscular dystrophies (LGMD2) are a group of genetically heterogeneous diseases that are typically characterised by progressive weakness and wasting of the shoulder and pelvic girdle muscles. Many of the more than 20 different conditions show overlapping clinical features with other forms of muscular dystrophy, congenital, myofibrillar or even distal myopathies and also with acquired muscle diseases. Although individually extremely rare, all types of LGMD2 together form an important differential diagnostic group among neuromuscular diseases. Despite improved diagnostics and pathomechanistic insight, a curative therapy is currently lacking for any of these diseases. Medical care consists of the symptomatic treatment of complications, aiming to improve life expectancy and quality of life. Besides well characterised pre-clinical tools like animal models and cell culture assays, the determinants of successful drug development programmes for rare diseases include a good understanding of the phenotype and natural history of the disease, the existence of clinically relevant outcome measures, guidance on care standards, up to date patient registries, and, ideally, biomarkers that can help assess disease severity or drug response. Strong patient organisations driving research and successful partnerships between academia, advocacy, industry and regulatory authorities can also help accelerate the elaboration of clinical trials. All these determinants constitute aspects of translational research efforts and influence patient access to therapies. Here we review the current status of determinants of successful drug development programmes for LGMD2, and the challenges of translating promising therapeutic strategies into effective and accessible treatments for patients.
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143
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Pichiecchio A, Berardinelli A, Moggio M, Rossi M, Balottin U, Comi GP, Bastianello S. Asymptomatic Pompe disease: Can muscle magnetic resonance imaging facilitate diagnosis? Muscle Nerve 2015; 53:326-7. [DOI: 10.1002/mus.24936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Anna Pichiecchio
- Neuroradiology Department; C. Mondino National Neurological Institute; Pavia Italy
| | - Angela Berardinelli
- Child Neuropsychiatry Unit, Regional Referral Centre for Neuromuscular Disease in Childhood, C. Mondino National Neurological Institute; Pavia Italy
| | - Maurizio Moggio
- Neuromuscular Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center; University of Milan; Milan Italy
| | - Marta Rossi
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences; University of Pavia; Pavia Italy
| | - Umberto Balottin
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences; University of Pavia; Pavia Italy
| | - Giacomo Pietro Comi
- Neuromuscular Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center; University of Milan; Milan Italy
| | - Stefano Bastianello
- Neuroradiology Department; C. Mondino National Neurological Institute; Pavia Italy
- Child Neuropsychiatry Unit, Regional Referral Centre for Neuromuscular Disease in Childhood, C. Mondino National Neurological Institute; Pavia Italy
- Neuromuscular Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center; University of Milan; Milan Italy
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences; University of Pavia; Pavia Italy
- Department of Brain and Behavioral Sciences; University of Pavia; Pavia Italy
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144
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Quantitative Skeletal Muscle MRI: Part 1, Derived T2 Fat Map in Differentiation Between Boys With Duchenne Muscular Dystrophy and Healthy Boys. AJR Am J Roentgenol 2015. [PMID: 26204309 DOI: 10.2214/ajr.14.13754] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to validate derived T2 maps as an objective measure of muscular fat for discrimination between boys with Duchenne muscular dystrophy (DMD) and healthy boys. SUBJECTS AND METHODS Forty-two boys with DMD (mean age, 9.9 years) and 31 healthy boys (mean age, 11.4 years) were included in the study. Age, body mass index, and clinical function scale grade were evaluated. T1-weighted MR images and T2 maps with and without fat suppression were obtained. Fatty infiltration was graded 0-4 on T1-weighted images, and derived T2 fat values (difference between mean T2 values from T2 maps with and without fat suppression) of the gluteus maximus and vastus lateralis muscles were calculated. Group comparisons were performed. The upper limit of the 95% reference interval of T2 fat values from the control group was applied. RESULTS There was no significant difference in age or body mass index between groups. All healthy boys and 19 boys (45.2%) with DMD had a normal clinical function scale grade. Grade 1 fatty infiltration was seen in 90.3% (gluteus maximus) and 71.0% (vastus lateralis) of healthy boys versus 33.3% (gluteus maximus) and 52.4% (vastus lateralis) of boys with DMD. T2 fat values of boys with DMD were significantly longer than in the control group (p < 0.001). Using a 95% reference interval for healthy boys for the gluteus maximus (28.3 milliseconds) allowed complete separation from boys with DMD (100% sensitivity, 100% specificity), whereas the values for the vastus lateralis (7.28 milliseconds) resulted in 83.3% sensitivity and 100% specificity. CONCLUSION Measurement of muscular fat with T2 maps is accurate for differentiating boys with DMD from healthy boys.
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145
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Maurer B, Walker UA. Role of MRI in Diagnosis and Management of Idiopathic Inflammatory Myopathies. Curr Rheumatol Rep 2015; 17:67. [DOI: 10.1007/s11926-015-0544-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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146
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Hankiewicz K, Carlier RY, Lazaro L, Linzoain J, Barnerias C, Gómez-Andrés D, Avila-Smirnow D, Ferreiro A, Estournet B, Guicheney P, Germain DP, Richard P, Bulacio S, Mompoint D, Quijano-Roy S. Whole-body muscle magnetic resonance imaging in SEPN1-related myopathy shows a homogeneous and recognizable pattern. Muscle Nerve 2015; 52:728-35. [PMID: 25808192 DOI: 10.1002/mus.24634] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The aim of this study was to delineate the spectrum of muscle involvement in patients with a myopathy due to mutations in SEPN1 (SEPN1-RM). METHODS Whole-body magnetic resonance imaging (WBMRI) was used in 9 patients using T1-weighted turbo spin-echo (T1-TSE) sequences and short tau inversion recovery (STIR) in 5 patients. RESULTS Analysis of signal and volume abnormalities by T1-TSE sequences in 109 muscles showed a homogeneous pattern characterized by a recognizable combination of atrophy and signal abnormalities in selected muscles of the neck, trunk, pelvic girdle, and lower limbs. Severe wasting of sternocleidomastoid muscle and atrophy of semimembranosus were detected. Selective paraspinal, gluteus maximus, and thigh muscle involvement was also observed. The lower leg was less constantly affected. CONCLUSIONS WBMRI scoring of altered signal and atrophy in muscle can be represented by heatmaps and is associated with a homogeneous, recognizable pattern in SEPN1-RM, distinct from other genetic muscle diseases.
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Affiliation(s)
- Karolina Hankiewicz
- Assistance Publique des Hôpitaux de Paris (AP-HP), Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, France
| | - Robert Y Carlier
- AP-HP, Service d'Imagerie Médicale, Pôle Neuro-locomoteur, Hôpital R. Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, France.,Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Réseau National Français de la Filiére Neuromusculaire (FILNEMUS).,Université de Versailles-St Quentin, U1179 UVSQ - INSERM, Montigny, France
| | - Leila Lazaro
- Service de Pédiatrie, Centre Hospitalier Côte Basque, Pays Basque, France
| | - Javier Linzoain
- Instituto de Neurología Infanto Juvenil - Centro de estudio y tratamiento de epilepsia y sueño (CETES), Córdoba, Argentina
| | - Christine Barnerias
- Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Réseau National Français de la Filiére Neuromusculaire (FILNEMUS).,AP-HP, Service de Neurologie Pédiatrique, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - David Gómez-Andrés
- Assistance Publique des Hôpitaux de Paris (AP-HP), Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, France.,Servicio de Neurología Pediátrica del Hospital Universitario La Paz, TRADESMA, IdiPaz, Universidad Autónoma de Madrid, Madrid, España
| | - Daniela Avila-Smirnow
- Assistance Publique des Hôpitaux de Paris (AP-HP), Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, France.,Unidad de Neurología, División de pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Unidad de Neurología, Servicio de Pediatría, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
| | - Ana Ferreiro
- Assistance Publique des Hôpitaux de Paris (AP-HP), Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, France.,Inserm, U787 Myology group, Institut de Myologie, Groupe Hospitalier Pitié-Salpêtrière, UPMC, UMRS 787, Paris, France.,AP-HP, Centre de Référence des Maladies Neuromusculaires Paris-Est, Service de Neurologie, GH Pitie-Salpêtrière, Paris, France
| | - Brigitte Estournet
- Assistance Publique des Hôpitaux de Paris (AP-HP), Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, France.,Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Réseau National Français de la Filiére Neuromusculaire (FILNEMUS)
| | - Pascale Guicheney
- Sorbonne Universités, UPMC Universitaire Paris 06, INSERM UMR S1166, Paris, France
| | - Dominique P Germain
- University of Versailles - St Quentin en Yvelines, Division of Medical Genetics, U1179 UVSQ - INSERM, Montigny, France
| | - Pascale Richard
- AP-HP, U. F. Cardiogénétique et Myogénétique, Service de Biochimie Métabolique, G. H. Pitié-Salpêtriére, Inserm, UMRS 974, Paris, France
| | - Sebastian Bulacio
- Servicio de Resonancia Magnética Nuclear, Instituto Conci Carpinella, Córdoba, Argentina
| | - Dominique Mompoint
- AP-HP, Service d'Imagerie Médicale, Pôle Neuro-locomoteur, Hôpital R. Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, France
| | - Susana Quijano-Roy
- Assistance Publique des Hôpitaux de Paris (AP-HP), Service de Pédiatrie, Hôpital Raymond Poincaré, Garches, Hôpitaux Universitaires Paris-Ile-de-France Ouest, France.,Centre de Référence de Maladies Neuromusculaires Garches-Necker-Mondor-Hendaye (GNMH), Réseau National Français de la Filiére Neuromusculaire (FILNEMUS).,Université de Versailles-St Quentin, U1179 UVSQ - INSERM, Montigny, France
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147
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Young HJ, Jenkins NT, Zhao Q, Mccully KK. Measurement of intramuscular fat by muscle echo intensity. Muscle Nerve 2015; 52:963-71. [PMID: 25787260 DOI: 10.1002/mus.24656] [Citation(s) in RCA: 271] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 03/06/2015] [Accepted: 03/11/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The aim of this study was to compare ultrasound echo intensity (EI) with high-resolution T1 -weighted MRI and to establish calibration equations to estimate percent intramuscular fat from EI. METHODS Thirty-one participants underwent both ultrasound and MRI testing of 4 muscles: rectus femoris (RF); biceps femoris (BF); tibialis anterior (TA); and medial gastrocnemius (MG). RESULTS Strong correlations were found between MRI percent fat and muscle EI after correcting for subcutaneous fat thickness (r = 0.91 in RF, r = 0.80 in BF, r = 0.80 in TA, r = 0.76 in MG). Three types of calibration equations were established. CONCLUSIONS Muscle ultrasound is a practical and reproducible method that can be used as an imaging technique for examination of percent intramuscular fat. Future ultrasound studies are needed to establish equations for other muscle groups to enhance its use in both research and clinical settings.
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Affiliation(s)
- Hui-Ju Young
- Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Nathan T Jenkins
- Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Qun Zhao
- Department of Physics and BioImaging Research Center, University of Georgia, Athens, Georgia, USA
| | - Kevin K Mccully
- Department of Kinesiology, University of Georgia, Athens, Georgia, USA
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Differential isoform expression and selective muscle involvement in muscular dystrophies. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 185:2833-42. [PMID: 26269091 DOI: 10.1016/j.ajpath.2015.06.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 06/18/2015] [Accepted: 06/22/2015] [Indexed: 12/23/2022]
Abstract
Despite the expression of the mutated gene in all muscles, selective muscles are involved in genetic muscular dystrophies. Different muscular dystrophies show characteristic patterns of fatty degenerative changes by muscle imaging, even to the extent that the patterns have been used for diagnostic purposes. However, the underlying molecular mechanisms explaining the selective involvement of muscles are not known. To test the hypothesis that different muscles may express variable amounts of different isoforms of muscle genes, we applied a custom-designed exon microarray containing probes for 57 muscle-specific genes to assay the transcriptional profiles in sets of human adult lower limb skeletal muscles. Quantitative real-time PCR and whole transcriptome sequencing were used to further analyze the results. Our results demonstrate significant variations in isoform and gene expression levels in anatomically different muscles. Comparison of the known patterns of selective involvement of certain muscles in two autosomal dominant titinopathies and one autosomal dominant myosinopathy, with the isoform and gene expression results, shows a correlation between the specific muscles involved and significant differences in the level of expression of the affected gene and exons in these same muscles compared with some other selected muscles. Our results suggest that differential expression levels of muscle genes and isoforms are one determinant in the selectivity of muscle involvement in muscular dystrophies.
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149
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Bioimpedance Analysis as a Method to Evaluate the Proportion of Fatty and Muscle Tissues in Progressive Myopathy in Pompe Disease. JIMD Rep 2015; 26:45-51. [PMID: 26253708 DOI: 10.1007/8904_2015_473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 06/08/2015] [Accepted: 06/10/2015] [Indexed: 12/04/2022] Open
Abstract
During progressive myopathy, the space of atrophic muscle tissue is gradually filled by fatty tissue. The proportion of these two tissue types relative to body mass provides an indication of the extent of muscle tissue destruction, i.e., the progression and severity of the disease.In this study we use Pompe disease as an example to report the new possibility of using bioimpedance analysis (BIA) to assess the relative proportion of fatty and muscle tissue in diseases associated with muscle atrophy, thus enabling the assessment of disease progression and the effectiveness of treatment. Results from BIA analysis were compared with magnetic resonance images.The results of muscle magnetic resonance images and BIA analysis were similar, which suggests that BIA may provide valuable diagnostic guidance for the assessment of the progression of the disorder.
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150
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Magnetic Resonance Assessment of Hypertrophic and Pseudo-Hypertrophic Changes in Lower Leg Muscles of Boys with Duchenne Muscular Dystrophy and Their Relationship to Functional Measurements. PLoS One 2015; 10:e0128915. [PMID: 26103164 PMCID: PMC4477876 DOI: 10.1371/journal.pone.0128915] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/01/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction The primary objectives of this study were to evaluate contractile and non-contractile content of lower leg muscles of boys with Duchenne muscular dystrophy (DMD) and determine the relationships between non-contractile content and functional abilities. Methods Lower leg muscles of thirty-two boys with DMD and sixteen age matched unaffected controls were imaged. Non-contractile content, contractile cross sectional area and non-contractile cross sectional area of lower leg muscles (tibialis anterior, extensor digitorum longus, peroneal, medial gastrocnemius and soleus) were assessed by magnetic resonance imaging (MRI). Muscle strength, timed functional tests and the Brooke lower extremity score were also assessed. Results Non-contractile content of lower leg muscles (peroneal, medial gastrocnemius, and soleus) was significantly greater than control group (p<0.05). Non-contractile content of lower leg muscles correlated with Brooke score (rs = 0.64-0.84) and 30 feet walk (rs = 0.66-0.80). Dorsiflexor (DF) and plantarflexor (PF) specific torque was significantly different between the groups. Discussion Overall, non-contractile content of the lower leg muscles was greater in DMD than controls. Furthermore, there was an age dependent increase in contractile content in the medial gastrocnemius of boys with DMD. The findings of this study suggest that T1 weighted MR images can be used to monitor disease progression and provide a quantitative estimate of contractile and non-contractile content of tissue in children with DMD.
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