1
|
Kim S, Eun MY, Lee JJ, Seok HY. Further insights into afterdischarges as a diagnostic marker for myotonic dystrophy type 1. Neurol Sci 2024; 45:817-818. [PMID: 37821780 DOI: 10.1007/s10072-023-07121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Sohyeon Kim
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubeol-Daero, Dalseo-Gu, Daegu, 42601, Republic of Korea
| | - Mi-Yeon Eun
- Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Jae-Joon Lee
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubeol-Daero, Dalseo-Gu, Daegu, 42601, Republic of Korea
| | - Hung Youl Seok
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubeol-Daero, Dalseo-Gu, Daegu, 42601, Republic of Korea.
| |
Collapse
|
2
|
Yu S, Yue W, Guo T, Liu Y, Zhang Y, Khademi S, Zhou T, Xu Z, Song B, Wu T, Liu F, Tai Y, Yu X, Wang H. The effect of the subthreshold oscillation induced by the neurons' resonance upon the electrical stimulation-dependent instability. Front Neurosci 2023; 17:1178606. [PMID: 37229430 PMCID: PMC10203711 DOI: 10.3389/fnins.2023.1178606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/10/2023] [Indexed: 05/27/2023] Open
Abstract
Repetitive electrical nerve stimulation can induce a long-lasting perturbation of the axon's membrane potential, resulting in unstable stimulus-response relationships. Despite being observed in electrophysiology, the precise mechanism underlying electrical stimulation-dependent (ES-dependent) instability is still an open question. This study proposes a model to reveal a facet of this problem: how threshold fluctuation affects electrical nerve stimulations. This study proposes a new method based on a Circuit-Probability theory (C-P theory) to reveal the interlinkages between the subthreshold oscillation induced by neurons' resonance and ES-dependent instability of neural response. Supported by in-vivo studies, this new model predicts several key characteristics of ES-dependent instability and proposes a stimulation method to minimize the instability. This model provides a powerful tool to improve our understanding of the interaction between the external electric field and the complexity of the biophysical characteristics of axons.
Collapse
Affiliation(s)
- Shoujun Yu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Wenji Yue
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Tianruo Guo
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW, Australia
| | - Yonghong Liu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Yapeng Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Sara Khademi
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
- Institute of Polymeric Materials, Sahand University of Technology, Tabriz, Iran
| | - Tian Zhou
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Zhen Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Bing Song
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Tianzhun Wu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
- Key Laboratory of Health Bioinformatics, Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Fenglin Liu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Yanlong Tai
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| | - Xuefei Yu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Hao Wang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, China
| |
Collapse
|
3
|
Tahraoui-Bories J, Mérien A, González-Barriga A, Lainé J, Leteur C, Polvèche H, Carteron A, De Lamotte JD, Nicoleau C, Polentes J, Jarrige M, Gomes-Pereira M, Ventre E, Poydenot P, Furling D, Schaeffer L, Legay C, Martinat C. MBNL-dependent impaired development within the neuromuscular system in myotonic dystrophy type 1. Neuropathol Appl Neurobiol 2023; 49:e12876. [PMID: 36575942 PMCID: PMC10107781 DOI: 10.1111/nan.12876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/27/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022]
Abstract
AIMS Myotonic dystrophy type I (DM1) is one of the most frequent muscular dystrophies in adults. Although DM1 has long been considered mainly a muscle disorder, growing evidence suggests the involvement of peripheral nerves in the pathogenicity of DM1 raising the question of whether motoneurons (MNs) actively contribute to neuromuscular defects in DM1. METHODS By using micropatterned 96-well plates as a coculture platform, we generated a functional neuromuscular model combining DM1 and muscleblind protein (MBNL) knock-out human-induced pluripotent stem cells-derived MNs and human healthy skeletal muscle cells. RESULTS This approach led to the identification of presynaptic defects which affect the formation or stability of the neuromuscular junction at an early developmental stage. These neuropathological defects could be reproduced by the loss of RNA-binding MBNL proteins, whose loss of function in vivo is associated with muscular defects associated with DM1. These experiments indicate that the functional defects associated with MNs can be directly attributed to MBNL family proteins. Comparative transcriptomic analyses also revealed specific neuronal-related processes regulated by these proteins that are commonly misregulated in DM1. CONCLUSIONS Beyond the application to DM1, our approach to generating a robust and reliable human neuromuscular system should facilitate disease modelling studies and drug screening assays.
Collapse
Affiliation(s)
| | - Antoine Mérien
- INSERM/UEVE UMR 861, Université Paris Saclay, I-STEM, Corbeil-Essonnes, France
| | - Anchel González-Barriga
- INSERM, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, Paris, France
| | - Jeanne Lainé
- INSERM, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, Paris, France
| | | | | | | | | | | | | | | | - Mário Gomes-Pereira
- INSERM, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, Paris, France
| | | | | | - Denis Furling
- INSERM, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, Paris, France
| | - Laurent Schaeffer
- INMG, INSERM U1217, CNRS UMR5310, Université Lyon 1, Université de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Claire Legay
- CNRS, SPINN-Saint-Pères Paris Institute for the Neurosciences, Université Paris Cité, Paris, France
| | - Cécile Martinat
- INSERM/UEVE UMR 861, Université Paris Saclay, I-STEM, Corbeil-Essonnes, France
| |
Collapse
|
4
|
Goedee HS, Sleutjes BTHM, Bakers JNE, Kruithof WJ, Kruitwagen-van Reenen ET, van der Pol WL. Electrophysiology of fatigue in chronic inflammatory demyelinating polyneuropathy: Can it be useful? Clin Neurophysiol 2020; 131:2912-2914. [PMID: 33250076 DOI: 10.1016/j.clinph.2020.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 11/26/2022]
Affiliation(s)
- H Stephan Goedee
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, UMC Utrecht, Utrecht, the Netherlands.
| | - Boudewijn T H M Sleutjes
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, UMC Utrecht, Utrecht, the Netherlands
| | - Jaap N E Bakers
- Department of Rehabilitation, UMC Utrecht Brain Center, UMC Utrecht, Utrecht, the Netherlands
| | - Willeke J Kruithof
- Department of Rehabilitation, UMC Utrecht Brain Center, UMC Utrecht, Utrecht, the Netherlands
| | | | - W Ludo van der Pol
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, UMC Utrecht, Utrecht, the Netherlands
| |
Collapse
|
5
|
Neuropathy in sporadic inclusion body myositis: A multi-modality neurophysiological study. Clin Neurophysiol 2020; 131:2766-2776. [PMID: 32928695 DOI: 10.1016/j.clinph.2020.07.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 07/09/2020] [Accepted: 07/22/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Sporadic inclusion body myositis (sIBM) has been associated with neuropathy. This study employs nerve excitability studies to re-examine this association and attempt to understand underlying pathophysiological mechanisms. METHODS Twenty patients with sIBM underwent median nerve motor and sensory excitability studies, clinical assessments, conventional nerve conduction testing (NCS) and quantitative thermal threshold studies. These results were compared to established normal controls, or results from a normal cohort of older control individuals. RESULTS Seven sIBM patients (35%) demonstrated abnormalities in conventional NCS, with ten patients (50%) demonstrating abnormalities in thermal thresholds. Median nerve motor and sensory excitability differed significantly in sIBM patients when compared to normal controls. None of these neurophysiological markers correlated significantly with clinical markers of sIBM severity. CONCLUSION A concurrent neuropathy exists in a significant proportion of sIBM patients, with nerve excitability studies revealing changes possibly consistent with axolemmal depolarization or concurrent neuronal adaptation to myopathy. Neuropathy in sIBM does not correlate with muscle disease severity and may reflect a differing tissue response to a common pathogenic factor. SIGNIFICANCE This study affirms the presence of a concurrent neuropathy in a large proportion of sIBM patients that appears independent of the severity of myopathy.
Collapse
|
6
|
Boland‐Freitas R, Lee J, Howells J, Liang C, Corbett A, Nicholson G, Ng K. Sarcolemmal excitability in the myotonic dystrophies. Muscle Nerve 2017; 57:595-602. [DOI: 10.1002/mus.25962] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/25/2017] [Accepted: 09/02/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Robert Boland‐Freitas
- Department of Neurology and NeurophysiologyRoyal North Shore HospitalReserve RoadSt Leonards New South Wales Australia
- Department of NeurologyBlacktown HospitalBlacktown New South Wales Australia
| | - James Lee
- Department of Neurology and NeurophysiologyRoyal North Shore HospitalReserve RoadSt Leonards New South Wales Australia
| | - James Howells
- Sydney Medical SchoolCamperdown New South Wales Australia
| | - Christina Liang
- Department of Neurology and NeurophysiologyRoyal North Shore HospitalReserve RoadSt Leonards New South Wales Australia
| | - Alastair Corbett
- Department of NeurologyConcord HospitalConcord New South Wales Australia
| | - Garth Nicholson
- Department of Molecular MedicineConcord HospitalConcord New South Wales Australia
| | - Karl Ng
- Department of Neurology and NeurophysiologyRoyal North Shore HospitalReserve RoadSt Leonards New South Wales Australia
- Sydney Medical SchoolCamperdown New South Wales Australia
| |
Collapse
|
7
|
So M, Sugiura T, Yoshizawa S, Sobue K. Two Cases of Duchenne Muscular Dystrophy That Showed Different Reactions to Nerve Stimulation During Peripheral Nerve Block: A Case Report. ACTA ACUST UNITED AC 2017; 9:52-53. [PMID: 28459722 DOI: 10.1213/xaa.0000000000000524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In recent years, the technique of combined ultrasound and electrical stimulation-guided nerve block has been recommended. We present 2 patients with Duchenne muscular dystrophy who exhibited different muscle responses to nerve stimulation during the performance of peripheral nerve blocks for surgeries. Whereas a 2-year-old boy without severe disability showed the expected muscle contraction to electrical nerve stimulation, a 14-year-old boy with severe disability showed no muscle response. Our experience suggests that muscle responses to electrical nerve stimulation will vary with the stage of Duchenne muscular dystrophy.
Collapse
Affiliation(s)
- MinHye So
- From the Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | | | | | | |
Collapse
|
8
|
Bombelli F, Lispi L, Porrini SC, Giacanelli M, Terracciano C, Massa R, Petrucci A. Neuromuscular transmission abnormalities in myotonic dystrophy type 1: A neurophysiological study. Clin Neurol Neurosurg 2016; 150:84-88. [PMID: 27611986 DOI: 10.1016/j.clineuro.2016.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 08/10/2016] [Accepted: 08/21/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Weakness and fatigue are frequent symptoms in myotonic dystrophy type 1 (DM1), mainly as a result of muscle impairment. However, neuromuscular junction (NMJ) abnormalities could play an additional role in determining these manifestations. We aimed to document the possible NMJ involvement in DM1. PATIENTS AND METHODS In order to substantiate this hypothesis we performed low rate repetitive nerve stimulation (RNS) and single fiber electromyography (SFEMG), in 14 DM1 subjects. RESULTS RNS resulted abnormal in four patients while SFEMG revealed a pathological jitter in ten. A significative correlation was found between jitter values and decrementing response (p<0.000311; r=0.822). CONCLUSION These results suggest a possible involvement of NMJ in DM1.
Collapse
Affiliation(s)
- Francesco Bombelli
- Neuromuscular and Neurological Rare Diseases Centre, Neurology and Neurophysiology Unit, S. Camillo Forlanini Hospital, C. Gianicolense, 87-00152, Rome, Italy
| | - Ludovico Lispi
- Neuromuscular and Neurological Rare Diseases Centre, Neurology and Neurophysiology Unit, S. Camillo Forlanini Hospital, C. Gianicolense, 87-00152, Rome, Italy
| | - Sandro Costanzi Porrini
- Medical Genetics Unit, S. Camillo Forlanini Hospital, C. Gianicolense, 87-00152, Rome, Italy
| | - Manlio Giacanelli
- Neuromuscular and Neurological Rare Diseases Centre, Neurology and Neurophysiology Unit, S. Camillo Forlanini Hospital, C. Gianicolense, 87-00152, Rome, Italy
| | - Chiara Terracciano
- Neuromuscular Centre, Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, V.le Oxford, 81-00133, Rome, Italy
| | - Roberto Massa
- Neuromuscular Centre, Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, V.le Oxford, 81-00133, Rome, Italy
| | - Antonio Petrucci
- Neuromuscular and Neurological Rare Diseases Centre, Neurology and Neurophysiology Unit, S. Camillo Forlanini Hospital, C. Gianicolense, 87-00152, Rome, Italy.
| |
Collapse
|
9
|
Spitalieri P, Talarico RV, Botta A, Murdocca M, D'Apice MR, Orlandi A, Giardina E, Santoro M, Brancati F, Novelli G, Sangiuolo F. Generation of Human Induced Pluripotent Stem Cells from Extraembryonic Tissues of Fetuses Affected by Monogenic Diseases. Cell Reprogram 2016; 17:275-87. [PMID: 26474030 DOI: 10.1089/cell.2015.0003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The generation of human induced pluripotent stem cells (hiPSCs) derived from an autologous extraembryonic fetal source is an innovative personalized regenerative technology that can transform own-self cells into embryonic stem-like ones. These cells are regarded as a promising candidate for cell-based therapy, as well as an ideal target for disease modeling and drug discovery. Thus, hiPSCs enable researchers to undertake studies for treating diseases or for future applications of in utero therapy. We used a polycistronic lentiviral vector (hSTEMCCA-loxP) encoding OCT4, SOX2, KLF4, and cMYC genes and containing loxP sites, excisible by Cre recombinase, to reprogram patient-specific fetal cells derived from prenatal diagnosis for several genetic disorders, such as myotonic dystrophy type 1 (DM1), β-thalassemia (β-Thal), lymphedema-distichiasis syndrome (LDS), spinal muscular atrophy (SMA), cystic fibrosis (CF), as well as from wild-type (WT) fetal cells. Because cell types tested to create hiPSCs influence both the reprogramming process efficiency and the kinetics, we used chorionic villus (CV) and amniotic fluid (AF) cells, demonstrating how they represent an ideal cell resource for a more efficient generation of hiPSCs. The successful reprogramming of both CV and AF cells into hiPSCs was confirmed by specific morphological, molecular, and immunocytochemical markers and also by their teratogenic potential when inoculated in vivo. We further demonstrated the stability of reprogrammed cells over 10 and more passages and their capability to differentiate into the three embryonic germ layers, as well as into neural cells. These data suggest that hiPSCs-CV/AF can be considered a valid cellular model to accomplish pathogenesis studies and therapeutic applications.
Collapse
Affiliation(s)
- Paola Spitalieri
- 1 Department of Biomedicine and Prevention, Tor Vergata University of Rome , Rome, 00133, Italy
| | - Rosa V Talarico
- 1 Department of Biomedicine and Prevention, Tor Vergata University of Rome , Rome, 00133, Italy
| | - Annalisa Botta
- 1 Department of Biomedicine and Prevention, Tor Vergata University of Rome , Rome, 00133, Italy
| | - Michela Murdocca
- 1 Department of Biomedicine and Prevention, Tor Vergata University of Rome , Rome, 00133, Italy
| | | | - Augusto Orlandi
- 1 Department of Biomedicine and Prevention, Tor Vergata University of Rome , Rome, 00133, Italy
| | - Emiliano Giardina
- 1 Department of Biomedicine and Prevention, Tor Vergata University of Rome , Rome, 00133, Italy .,3 Molecular Genetics Laboratory UILDM , Santa Lucia Foundation, Rome, 00142, Italy
| | | | - Francesco Brancati
- 2 Department of Laboratory Medicine, Policlinic of Tor Vergata , Rome, 00133, Italy
| | - Giuseppe Novelli
- 1 Department of Biomedicine and Prevention, Tor Vergata University of Rome , Rome, 00133, Italy .,2 Department of Laboratory Medicine, Policlinic of Tor Vergata , Rome, 00133, Italy
| | - Federica Sangiuolo
- 1 Department of Biomedicine and Prevention, Tor Vergata University of Rome , Rome, 00133, Italy .,2 Department of Laboratory Medicine, Policlinic of Tor Vergata , Rome, 00133, Italy
| |
Collapse
|
10
|
Liu Q, Zheng YF, Zhu YP, Ling SQ, Li WR. Clinical, pathological and genetic characteristics of a pedigree with myotonic dystrophy type 1. Exp Ther Med 2015; 10:1931-1936. [PMID: 26640575 DOI: 10.3892/etm.2015.2738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 07/23/2015] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to investigate the clinical, pathological and molecular genetic characteristics of a pedigree with myotonic dystrophy type 1 (DM1). A series of clinical data from a pedigree with DM1 were collected. Muscle biopsy revealed a typical nuclear ingression within numerous muscle fibers following hematoxylin and eosin staining. Genomic DNA was extracted from the venous blood of two patients and the triplet-primed polymerase chain reaction method was performed to amplify the dystrophia myotonic protein kinase (DMPK) gene. The amplified products were subjected to gene sequencing by capillary fluorescence electrophoresis, and a pathogenic mutation in the DMPK gene comprising >50 cytosine-thymine-guanine repeat sequences was found. DM1 includes multi-system damage, as well as skeletal muscle involvement, and can affect the central nervous system, endocrine glands, skin and heart. A skeletal muscle biopsy and genetic testing can confirm the diagnosis and clarify the severity of the disease. In addition, it is necessary to distinguish DM1 from DM2.
Collapse
Affiliation(s)
- Qing Liu
- Department of Neurology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China
| | - Yu-Fei Zheng
- Department of Neurology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China
| | - Yan-Ping Zhu
- Department of Neurology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China
| | - Shi-Qing Ling
- Department of Neurology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China
| | - Wei-Rong Li
- Department of Neurology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China
| |
Collapse
|
11
|
Moore D, Menon P, Vucic S. Clarifying distal axonal properties of the median nerve. Muscle Nerve 2012; 45:492-9. [PMID: 22431081 DOI: 10.1002/mus.22339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Although length-dependent axonal excitability changes have been reported in the median nerve, the mechanisms underlying these changes remain to be further clarified. METHODS Axonal excitability studies were performed on median nerve at the palm and wrist in 20 healthy controls, with responses recorded over the abductor pollicis brevis. RESULTS The strength-duration time constant was significantly shorter (palm: 0.35 ± 0.01 ms; wrist: 0.48 ± 0.03 ms; P < 0.001), whereas rheobase was significantly increased (palm: 2.90 ± 1.12 mA; wrist: 2.09 ± 1.11 mA; P < 0.05) at the palm. In addition, there was a significant increase in depolarizing threshold electrotonus at 90-100 ms (P < 0.001) and a reduction in S2 accommodation (P < 0.001) and late subexcitability (P < 0.001) at the palm. The changes in excitability were independent of factors influencing median nerve cross-sectional area. CONCLUSIONS The present study reveals significant length dependent changes in median nerve excitability which may reflect differences in intrinsic membrane properties.
Collapse
Affiliation(s)
- Dominic Moore
- Sydney Medical School Westmead, University of Sydney, Sydney, New South Wales, Australia
| | | | | |
Collapse
|
12
|
Bergmans J. Serendipity in nerve excitability research. Clin Neurophysiol 2012; 123:422-3. [DOI: 10.1016/j.clinph.2011.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 08/02/2011] [Accepted: 08/03/2011] [Indexed: 12/14/2022]
|
13
|
Boërio D, Lefaucheur JP, Bassez G, Hogrel JY. Central and peripheral components of exercise-related fatigability in myotonic dystrophy type 1. Acta Neurol Scand 2012; 125:38-46. [PMID: 22188374 DOI: 10.1111/j.1600-0404.2011.01497.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fatigue frequently occurs in myotonic dystrophy type 1 (DM1), but its pathophysiology remains unclear. This study assessed central and peripheral components of exercise-related fatigability in patients with DM1, compared to controls. METHODS Examinations were performed before and after a contraction of the abductor digiti minimi (ADM) muscle sustained for 45 s at 60% of maximal voluntary contraction (MVC). Myoelectric activity was recorded using high spatial resolution surface EMG during twitch stimulations and MVC and was characterized by root mean square, mean power frequency (MPF), and muscle fiber conduction velocity (MFCV). Peripheral nerve excitability was assessed by stimulating the ulnar nerve at the wrist with ADM recordings. Motor cortex excitability testing to transcranial magnetic stimulation included measures of intracortical facilitation and inhibition of motor evoked potentials (MEPs) in ADM muscle. RESULTS At baseline, patients with DM1 showed altered peripheral nerve and cortical excitability (reduced intracortical facilitation) associated with impaired myoelectric properties. During the fatiguing exercise, the force remained stable, while MPF and MFCV decreased in both DM1 and control groups. After exercise, only refractoriness was reduced in patients with DM1, whereas controls showed marked neuromuscular and cortical changes. CONCLUSION Patients with DM1 showed altered excitability of various cortical and neuromuscular components at baseline. However, most of excitability parameters did not vary after exercise in patients with DM1, in contrast to controls. This suggests that excitability properties, frankly altered at baseline, were not prone to be affected further after exercise in patients with DM1.
Collapse
Affiliation(s)
- D Boërio
- Institut de Myologie, UPMC UMR S, INSERM U, CNRS UMR, GH Pitié-Salpêtrière, Paris, France
| | | | | | | |
Collapse
|
14
|
Peripheral neuropathy is linked to a severe form of myotonic dystrophy in transgenic mice. J Neuropathol Exp Neurol 2011; 70:678-85. [PMID: 21760538 DOI: 10.1097/nen.0b013e3182260939] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is a multisystem disorder with a variable phenotype. The involvement of peripheral nerves in DM1 disease is controversial. The DM1 animal model DM300 transgenic mice that carry 350 to 500 CTG repeats express a mild DM1 phenotype but do not exhibit motor or sensory pathology. Here, we investigated the presence or absence of peripheral neuropathy in transgenic mice (DMSXL) that carry more than 1,300 CTG repeats and display a severe form of DM1. Electrophysiologic, histologic, and morphometric methods were used to investigate the structure and function of peripheral nerves. We observed lower compound muscle action potentials recorded from hind limb muscles and slowing of sciatic nerve conduction velocity in DMSXL versus control mice. Morphometric analyses showed an axonopathy and neuronopathy in the DMSXL mice characterized by a decrease in numbers of myelinated motor axons in sciatic nerve and in spinal cord motor neurons. Pathologic alterations in the structure of hind limb neuromuscular junctions were also detected in the DMSXL mice. These results suggest that peripheral neuropathy can be linked to a large CTG expansion and a severe form of DM1.
Collapse
|
15
|
Bae JS, Kim SG, Lim JC, Chung EJ, Kim OK. Peripheral nerve axon involvement in myotonic dystrophy type 1, measured using the automated nerve excitability test. J Clin Neurol 2011; 7:90-5. [PMID: 21779297 PMCID: PMC3131544 DOI: 10.3988/jcn.2011.7.2.90] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 12/23/2010] [Accepted: 12/23/2010] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose Primary involvement of the peripheral nerves in myotonic dystrophy type I (MyD1) is controversial. We investigated whether the involvement of peripheral nerves is a primary event of MyD1 or secondary to another complication such as diabetes mellitus (DM). Methods The subjects comprised 12 patients with MyD1, 12 with DM and no peripheral nerve involvement, and 25 healthy volunteers. We measured multiple excitability indices in the median motor axons. The strength-duration time constant was calculated from the duration-charge curve, the threshold electrotonus and current-threshold relationships were calculated from the sequential subthreshold current, and the recovery cycle was derived from double suprathreshold stimulation. Results The depolarizing and hyperpolarizing threshold electrotonus were significantly reduced and exhibited increased refractoriness in the MyD1 group compared with the DM and control groups. The SDTC, superexcitability, and subexcitability were not significantly altered in the MyD1 group. Conclusions The MyD1 group exhibited a depolarized axonal membrane potential. The significant differences in peripheral nerve excitability between the MyD1 group and the DM and normal control groups suggest that peripheral neuropathy is a primary event in MyD1 rather than a secondary complication of DM.
Collapse
Affiliation(s)
- Jong Seok Bae
- Department of Neurology, Inje University College of Medicine, Busan, Korea.
| | | | | | | | | |
Collapse
|
16
|
Marteyn A, Maury Y, Gauthier MM, Lecuyer C, Vernet R, Denis JA, Pietu G, Peschanski M, Martinat C. Mutant human embryonic stem cells reveal neurite and synapse formation defects in type 1 myotonic dystrophy. Cell Stem Cell 2011; 8:434-44. [PMID: 21458401 DOI: 10.1016/j.stem.2011.02.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 11/28/2010] [Accepted: 02/10/2011] [Indexed: 01/01/2023]
Abstract
Myotonic dystrophy type 1 (DM1) is a multisystem disorder affecting a variety of organs, including the central nervous system. By using neuronal progeny derived from human embryonic stem cells carrying the causal DM1 mutation, we have identified an early developmental defect in genes involved in neurite formation and the establishment of neuromuscular connections. Differential gene expression profiling and quantitative RT-PCR revealed decreased expression of two members of the SLITRK family in DM1 neural cells and in DM1 brain biopsies. In addition, DM1 motoneuron/muscle cell cocultures showed alterations that are consistent with the known role of SLITRK genes in neurite outgrowth, neuritogenesis, and synaptogenesis. Rescue and knockdown experiments suggested that the functional defects can be directly attributed to SLITRK misexpression. These neuropathological mechanisms may be clinically significant for the functional changes in neuromuscular connections associated with DM1.
Collapse
Affiliation(s)
- Antoine Marteyn
- INSERM/UEVE UMR 861, I-STEM AFM, 5 rue H. Desbruères, Evry Cedex, France
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Abstract
Myotonic dystrophies (dystrophia myotonica, or DM) are inherited disorders characterized by myotonia and progressive muscle degeneration, which are variably associated with a multisystemic phenotype. To date, two types of myotonic dystrophy, type 1 (DM1) and type 2 (DM2), are known to exist; both are autosomal dominant disorders caused by expansion of an untranslated short tandem repeat DNA sequence (CTG)(n) and (CCTG)(n), respectively. These expanded repeats in DM1 and DM2 show different patterns of repeat-size instability. Phenotypes of DM1 and DM2 are similar but there are some important differences, most conspicuously in the severity of the disease (including the presence or absence of the congenital form), muscles primarily affected (distal versus proximal), involved muscle fiber types (type 1 versus type 2 fibers), and some associated multisystemic phenotypes. The pathogenic mechanism of DM1 and DM2 is thought to be mediated by the mutant RNA transcripts containing expanded CUG and CCUG repeats. Strong evidence supports the hypothesis that sequestration of muscle-blind like (MBNL) proteins by these expanded repeats leads to misregulated splicing of many gene transcripts in corroboration with the raised level of CUG-binding protein 1. However, additional mechanisms, such as changes in the chromatin structure involving CTCN-binding site and gene expression dysregulations, are emerging. Although treatment of DM1 and DM2 is currently limited to supportive therapies, new therapeutic approaches based on pathogenic mechanisms may become feasible in the near future.
Collapse
Affiliation(s)
- Tetsuo Ashizawa
- Department of Neurology, McKnight Brain Institute, The University of Texas Medical Branch, Galveston, TX, USA.
| | | |
Collapse
|
18
|
Park SB, Lin CSY, Krishnan AV, Goldstein D, Friedlander ML, Kiernan MC. Utilizing natural activity to dissect the pathophysiology of acute oxaliplatin-induced neuropathy. Exp Neurol 2010; 227:120-7. [PMID: 20965170 DOI: 10.1016/j.expneurol.2010.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 10/06/2010] [Accepted: 10/07/2010] [Indexed: 12/14/2022]
Abstract
Oxaliplatin is first-line chemotherapy for colorectal cancer, but produces dose-limiting neurotoxicity. Acute neurotoxicity following infusion produces symptoms including cold-triggered fasciculations and cramps, with subsequent chronic neuropathy developing at higher cumulative doses. Axonal excitability studies were undertaken in 15 oxaliplatin-treated patients before and immediately after oxaliplatin infusion to determine whether the mechanisms underlying acute neurotoxicity altered resting membrane potential or Na(+)/K(+) pump function. Excitability properties were assessed before and after maximal voluntary contraction (MVC) of the abductor pollicis brevis. Following oxaliplatin infusion, abnormalities developed in the recovery cycle with refractoriness markedly increased. Following activity, changes developed consistent with axonal hyperpolarization, with proportional changes pre- and post-oxaliplatin in normalized threshold. However, recovery cycle parameters following activity were significantly and disproportionally enhanced post-oxaliplatin, with partial normalization of the recovery cycle curve post-activity. Patients with the most abnormal change in the recovery cycle after infusion demonstrated the greatest changes post-contraction. Prominent abnormalities developed in Na(+) channel-associated parameters in response to natural activity, without significant alteration in axonal membrane potential or Na(+)/K(+) pump function. Findings from the present series suggest that oxaliplatin affects nerve excitability through voltage-dependent mechanisms, with specific effects mediated through axonal Na(+) channel inactivation.
Collapse
Affiliation(s)
- Susanna B Park
- Prince of Wales Clinical School, Barker Street, Randwick, Sydney, NSW 2063, Australia
| | | | | | | | | | | |
Collapse
|
19
|
Chemotherapy-induced peripheral neuropathy: clinical features, diagnosis, prevention and treatment strategies. Clin Transl Oncol 2010; 12:81-91. [DOI: 10.1007/s12094-010-0474-z] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
20
|
Krishnan AV, Pussell BA, Kiernan MC. Neuromuscular disease in the dialysis patient: an update for the nephrologist. Semin Dial 2009; 22:267-78. [PMID: 19386072 DOI: 10.1111/j.1525-139x.2008.00555.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Neuromuscular disease is an extremely common complication of end-stage kidney disease (ESKD), manifesting in almost all dialysis patients, and leading to weakness, reduced exercise capacity, and disability. Recent studies have suggested that hyperkalemia may underlie the development of neuropathy. As such, maintenance of serum K(+) within normal limits between periods of dialysis in ESKD patients manifesting early neuropathic symptoms may reduce neuropathy development and progression. For patients with more severe neuropathic syndromes, increased dialysis frequency or a switch to high-flux dialysis may prevent further deterioration, while ultimately, renal transplantation is required to improve and restore nerve function. Exercise training programs are beneficial for ESKD patients with muscle weakness due to neuropathy or myopathy, and are capable of improving exercise tolerance and quality of life. Specific treatments have recently been evaluated for symptoms of autonomic neuropathy, including sildenafil for impotence and midodrine for intra-dialytic hypotension, and have been shown to be effective and well tolerated. Other important management strategies for neuropathy include attention to foot care to prevent callus and ulceration, vitamin supplementation, and erythropoietin. Treatment with membrane-stabilizing agents, such as amitryptiline and gabapentin, are highly effective in patients with painful neuropathy.
Collapse
Affiliation(s)
- Arun V Krishnan
- Prince of Wales Medical Research Institute, Barker Street, Randwick, Sydney, NSW 2031, Australia
| | | | | |
Collapse
|
21
|
Krishnan AV, Lin CSY, Kiernan MC. Activity-dependent excitability changes suggest Na+/K+ pump dysfunction in diabetic neuropathy. Brain 2008; 131:1209-16. [PMID: 18362098 DOI: 10.1093/brain/awn052] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Arun V Krishnan
- Prince of Wales Medical Research Institute, Prince of Wales Clinical School, University of New South Wales, Randwick, Sydney, NSW, Australia
| | | | | |
Collapse
|
22
|
Krishnan AV, Lin CSY, Park SB, Kiernan MC. Assessment of nerve excitability in toxic and metabolic neuropathies. J Peripher Nerv Syst 2008; 13:7-26. [DOI: 10.1111/j.1529-8027.2008.00155.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
23
|
Boërio D, Hogrel JY, Bassez G, Lefaucheur JP. Neuromuscular excitability properties in myotonic dystrophy type 1. Clin Neurophysiol 2007; 118:2375-82. [PMID: 17890147 DOI: 10.1016/j.clinph.2007.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Revised: 07/05/2007] [Accepted: 07/28/2007] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study neuromuscular excitability in patients with dystrophia myotonica type 1 (DM1). METHODS The neuromuscular recovery cycle following motor nerve stimulation was assessed in 16 DM1 patients who had no sign of peripheral neuropathy or diabetes. Compound muscle action potentials were recorded from the adductor digiti minimi muscle to ulnar nerve stimulation at the wrist. Paired pulses were delivered, consisting of a conditioning stimulus of supramaximal intensity, followed by a submaximal test stimulus. Interstimuli intervals (ISIs) ranged between 1 and 8ms. Durations of the absolute and relative refractory periods (ARP, RRP) and percentages of refractoriness and supernormality at ISIs of 2.6 and 7ms, respectively, were computed using a subtraction method. The results obtained in the series of DM1 patients were compared to those obtained in six patients with other forms of myotonia and to normative values established in a series of age-matched healthy subjects. Correlations were made between excitability parameters, the number of cytosine-thymine-guanine (CTG) repeats, and the severity of myotonia, scored clinically. RESULTS Compared to controls, DM1 patients presented prolonged durations of ARP and RRP, increased refractoriness and reduced supernormality. The decrease in refractoriness correlated with both the number of CTG repeats and the severity of myotonia. CONCLUSIONS Changes in the recovery cycle following supramaximal motor nerve stimulation revealed the existence of subtle alterations of neuromuscular excitability in DM1 patients. SIGNIFICANCE Increase in refractoriness together with a reduced supernormality was consistent with a process of membrane depolarization. Such a depolarization may be related to the loss of chloride channels or to alterations in sodium conductance in the motor axon or the muscle fiber.
Collapse
Affiliation(s)
- Delphine Boërio
- Service de Physiologie--Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique--Hôpitaux de Paris, Créteil, France
| | | | | | | |
Collapse
|
24
|
Gantelet E, Kraftsik R, Delaloye S, Gourdon G, Kuntzer T, Barakat-Walter I. The expansion of 300 CTG repeats in myotonic dystrophy transgenic mice does not induce sensory or motor neuropathy. Acta Neuropathol 2007; 114:175-85. [PMID: 17318633 DOI: 10.1007/s00401-007-0205-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 01/30/2007] [Accepted: 01/30/2007] [Indexed: 10/23/2022]
Abstract
Although many studies have been carried out to verify the involvement of the peripheral nervous system (PNS) in dystrophia myotonica (DM1) patients, the results remain controversial. The generation of DM1 transgenic mice displaying the human DM1 phenotype provides a useful tool to investigate the type and incidence of structural abnormalities in the PNS. In the present study, the morphological and morphometric analysis of semi-thin sections of sciatic and sural nerves, lumbar dorsal root ganglia (DRG) and lumbar spinal cords revealed that in DM1 transgenic mice carrying 300 CTG repeats, there is no change in the number and diameter of myelinated axons compared to wild type. Only a non-significant reduction in the percentage of thin myelinated axons was detected in electron micrographs of ultra-thin sciatic nerve sections. Analysis of the number of neurons did not reveal a loss in number of either sensory neurons in the lumbar DRG or motor neurons in the lumbar spinal cord in these DM1 mice. Furthermore, in hind limb muscle sections, stained with a neurofilament antibody and alpha-bungarotoxin, the intramuscular axon arborization appeared normal in DM1 mice and undistinguishable from that in wild-type mice. Moreover, in DM1 mice, there was no irregularity in the structure or an increase in the endplate area. Also statistical analysis did not show an increase in endplate density or in the concentration of acetylcholine receptors. Altogether, these results suggest that 300 CTG repeats are not sufficient to induce axonopathy, demyelination or neuronopathies in this transgenic mouse model.
Collapse
Affiliation(s)
- E Gantelet
- Laboratory of Neurology Research, Lausanne University Hospital (CHUV), rue du Bugnon 46, 1011, Lausanne, Switzerland
| | | | | | | | | | | |
Collapse
|
25
|
Krishnan AV, Kiernan MC. Uremic neuropathy: clinical features and new pathophysiological insights. Muscle Nerve 2007; 35:273-90. [PMID: 17195171 DOI: 10.1002/mus.20713] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Neuropathy is a common complication of end-stage kidney disease (ESKD), typically presenting as a distal symmetrical process with greater lower-limb than upper-limb involvement. The condition is of insidious onset, progressing over months. and has been estimated to be present in 60%-100% of patients on dialysis. Neuropathy generally only develops at glomerular filtration rates of less than 12 ml/min. The most frequent clinical features reflect large-fiber involvement, with paresthesias, reduction in deep tendon reflexes, impaired vibration sense, muscle wasting, and weakness. Nerve conduction studies demonstrate findings consistent with a generalized neuropathy of the axonal type. Patients may also develop autonomic features, with postural hypotension, impaired sweating, diarrhea, constipation, or impotence. The development of uremic neuropathy has been related previously to the retention of neurotoxic molecules in the middle molecular range, although this hypothesis lacked formal proof. Studies utilizing novel axonal excitability techniques have recently shed further light on the pathophysiology of this condition. Nerves of uremic patients have been shown to exist in a chronically depolarized state prior to dialysis, with subsequent improvement and normalization of resting membrane potential after dialysis. The degree of depolarization correlates with serum K(+), suggesting that chronic hyperkalemic depolarization plays an important role in the development of nerve dysfunction in ESKD. These recent findings suggest that maintenance of serum K(+) within normal limits between periods of dialysis, rather than simple avoidance of hyperkalemia, is likely to reduce the incidence and severity of uremic neuropathy.
Collapse
Affiliation(s)
- Arun V Krishnan
- Prince of Wales Medical Research Institute and Prince of Wales Clinical School, University of New South Wales, Barker Street, Randwick, Sydney, NSW 2031, Australia
| | | |
Collapse
|