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Garmendia J, Labayru G, Souto Barreto PD, Vergara I, de Munain AL, Sistiaga A. Common Characteristics Between Frailty and Myotonic Dystrophy Type 1: A Narrative Review. Aging Dis 2024:AD.2024.0950. [PMID: 39325937 DOI: 10.14336/ad.2024.0950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 08/29/2024] [Indexed: 09/28/2024] Open
Abstract
Myotonic dystrophy type 1 (DM1) is an inherited neuromuscular disorder often considered a model of accelerated aging due to the early appearance of certain age-related clinical manifestations and cellular and molecular aging markers. Frailty, a state of vulnerability related to aging, has been recently studied in neurological conditions but has received considerably less attention in neuromuscular disorders. This narrative review aims to describe 1) the common characteristics between Fried's frailty phenotype criteria (muscular weakness, slow gait speed, weight loss, exhaustion/fatigue, and low physical activity) and DM1, and 2) the psychological and social factors potentially contributing to frailty in DM1. This review gathered evidence suggesting that DM1 patients meet four of the five frailty phenotype criteria. Additionally, longitudinal studies report the deterioration of these criteria over time in DM1. Patients also exhibit psychological/cognitive and social factors that might contribute to frailty. Monitoring frailty criteria in the DM1 population could help to implement timely preventions and interventions to reduce the disease burden and severity of frailty symptoms.
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Affiliation(s)
- Joana Garmendia
- Department of Clinical and Health Psychology and Research Methodology, Psychology Faculty, University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Gipuzkoa, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Madrid, Spain
| | - Garazi Labayru
- Department of Clinical and Health Psychology and Research Methodology, Psychology Faculty, University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Gipuzkoa, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Madrid, Spain
- Neuroscience Area, Biogipuzkoa Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Philipe de Souto Barreto
- Institute on Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- CERPOP UMR 1295, Inserm, Université Paul Sabatier, Toulouse, France
| | - Itziar Vergara
- Osakidetza Health Care Directorate, PC-IHO Research Unit of Gipuzkoa, Donostia-San Sebastián, Gipuzkoa, Spain
- Primary Care Group, Biogipuzkoa Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Spain
| | - Adolfo López de Munain
- Neurology Department, Donostia University Hospital, Donostia-San Sebastián, Gipuzkoa, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Madrid, Spain
- Neuroscience Area, Biogipuzkoa Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Andone Sistiaga
- Department of Clinical and Health Psychology and Research Methodology, Psychology Faculty, University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Gipuzkoa, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Madrid, Spain
- Neuroscience Area, Biogipuzkoa Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
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Knak KL, Sheikh AM, Witting N, Vissing J. Responsiveness of outcome measures in myotonic dystrophy type 1. Ann Clin Transl Neurol 2020; 7:1382-1391. [PMID: 32672404 PMCID: PMC7448158 DOI: 10.1002/acn3.51129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/07/2020] [Accepted: 06/18/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE As myotonic dystrophy type 1(DM1) evolves slowly and interventional trials often have a short duration, responsive outcomes in DM1 are needed. The objective of this study was to determine the responsiveness of muscle strength, balance, and functional mobility measurements after a 1-year follow-up period in individuals with DM1. METHODS Sixty-three adults with noncongenital DM1 completed the following assessments at baseline and at 1-year follow-up: Handheld dynamometry (lower limbs), stationary dynamometry (lower limbs), step test, timed-up-and-go test (TUG), modified clinical test of sensory integration and balance (mCTSIB), feet-together stance, tandem stance, one-leg stance, 10-meter walk test, and sit-to-stand test. RESULTS Change was captured by stationary dynamometry (proximal flexor and extensor muscles), handheld dynamometry (proximal flexor and distal extensor muscles), TUG, and mCTSIB (P ≤ 0.04). Ceiling or floor effects were shown for most static balance tests. INTERPRETATION Overall, adequate responsiveness was shown for both muscle strength dynamometers, TUG and mCTSIB. These outcomes are therefore likely candidate endpoints for clinical trials lasting 1 year. Most static balance tests are not responsive and not recommended in a heterogeneous DM1 population.
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Affiliation(s)
- Kirsten L Knak
- Rigshospitalet, Department of Neurology, Juliane Maries Vej 28, Copenhagen, DK-2100, Denmark
| | - Aisha M Sheikh
- Rigshospitalet, Department of Neurology, Juliane Maries Vej 28, Copenhagen, DK-2100, Denmark
| | - Nanna Witting
- Rigshospitalet, Department of Neurology, Juliane Maries Vej 28, Copenhagen, DK-2100, Denmark
| | - John Vissing
- Rigshospitalet, Department of Neurology, Juliane Maries Vej 28, Copenhagen, DK-2100, Denmark
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Nicolau S, Liewluck T, Milone M. Myopathies with finger flexor weakness: Not only inclusion-body myositis. Muscle Nerve 2020; 62:445-454. [PMID: 32478919 DOI: 10.1002/mus.26914] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/29/2020] [Accepted: 05/03/2020] [Indexed: 12/11/2022]
Abstract
Muscle disorders are characterized by differential involvement of various muscle groups. Among these, weakness predominantly affecting finger flexors is an uncommon pattern, most frequently found in sporadic inclusion-body myositis. This finding is particularly significant when the full range of histopathological findings of inclusion-body myositis is not found on muscle biopsy. Prominent finger flexor weakness, however, is also observed in other myopathies. It occurs commonly in myotonic dystrophy types 1 and 2. In addition, individual reports and small case series have documented finger flexor weakness in sarcoid and amyloid myopathy, and in inherited myopathies caused by ACTA1, CRYAB, DMD, DYSF, FLNC, GAA, GNE, HNRNPDL, LAMA2, MYH7, and VCP mutations. Therefore, the finding of finger flexor weakness requires consideration of clinical, myopathological, genetic, electrodiagnostic, and sometimes muscle imaging findings to establish a diagnosis.
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Affiliation(s)
- Stefan Nicolau
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
| | - Teerin Liewluck
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
| | - Margherita Milone
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
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Overend G, Légaré C, Mathieu J, Bouchard L, Gagnon C, Monckton DG. Allele length of the DMPK CTG repeat is a predictor of progressive myotonic dystrophy type 1 phenotypes. Hum Mol Genet 2020; 28:2245-2254. [PMID: 31220271 DOI: 10.1093/hmg/ddz055] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 12/13/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is an autosomal dominant inherited disorder caused by expansion of a germline and somatically unstable CTG repeat in the DMPK gene. Previously, CTG repeat length at birth has been correlated to patient age at symptom onset. Attempts to correlate CTG repeat length with progressive DM1 phenotypes, such as muscle power, have proven difficult. To better correlate genotype with progressive phenotypes, we have measured CTG repeat tract length and screened for interrupting variant repeats in 192 study participants from a well-characterized Canadian cohort. We have assessed genotype-phenotype correlations with nine progressive measures of skeletal muscle power and respiratory function. We have built statistical models that include confounding factors such as sex, age, height and weight to further explain variation in muscle power. Our analysis reveals a strong correlation between DM1 genotype and respiratory function and skeletal muscle power, as part of a complex model that includes additional modulators such as sex, age, height, weight and the presence or absence of interrupting variant repeats. Distal skeletal muscle measurements, such as hand pinch and grip strength, show the strongest correlation with disease genotype. Detailed analysis of CTG repeat length, and incorporation of confounding factors, greatly improves the predictive ability of these models. They reveal a greater genetic influence on individual progressive phenotypes than on age at symptom onset and for clinical trials will help optimize stratification and explain patient variability. They will also help practitioners prioritize assessment of the muscular power measurements that correlate best with disease severity.
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Affiliation(s)
- Gayle Overend
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Cécilia Légaré
- Department of Biochemistry, Université de Sherbrooke, Sherbrooke, Québec, Canada.,ECOGENE Biocluster, Chicoutimi, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, rue de l'Hôpital, Saguenay, Québec, Canada
| | - Jean Mathieu
- École de réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, rue de l'Hôpital, Saguenay, Québec, Canada
| | - Luigi Bouchard
- Department of Biochemistry, Université de Sherbrooke, Sherbrooke, Québec, Canada.,ECOGENE Biocluster, Chicoutimi, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, rue de l'Hôpital, Saguenay, Québec, Canada
| | - Cynthia Gagnon
- École de réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, rue de l'Hôpital, Saguenay, Québec, Canada
| | - Darren G Monckton
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Heskamp L, van Nimwegen M, Ploegmakers MJ, Bassez G, Deux JF, Cumming SA, Monckton DG, van Engelen BGM, Heerschap A. Lower extremity muscle pathology in myotonic dystrophy type 1 assessed by quantitative MRI. Neurology 2019; 92:e2803-e2814. [PMID: 31118244 PMCID: PMC6598795 DOI: 10.1212/wnl.0000000000007648] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/07/2019] [Indexed: 01/08/2023] Open
Abstract
Objective To determine the value of quantitative MRI in providing imaging biomarkers for disease in 20 different upper and lower leg muscles of patients with myotonic dystrophy type 1 (DM1). Methods We acquired images covering these muscles in 33 genetically and clinically well-characterized patients with DM1 and 10 unaffected controls. MRIs were recorded with a Dixon method to determine muscle fat fraction, muscle volume, and contractile muscle volume, and a multi-echo spin-echo sequence was used to determine T2 water relaxation time (T2water), reflecting putative edema. Results Muscles in patients with DM1 had higher fat fractions than muscles of controls (15.6 ± 11.1% vs 3.7 ± 1.5%). In addition, patients had smaller muscle volumes (902 ± 232 vs 1,097 ± 251 cm3), smaller contractile muscle volumes (779 ± 247 vs 1,054 ± 246 cm3), and increased T2water (33.4 ± 1.0 vs 31.9 ± 0.6 milliseconds), indicating atrophy and edema, respectively. Lower leg muscles were affected most frequently, especially the gastrocnemius medialis and soleus. Distribution of fat content per muscle indicated gradual fat infiltration in DM1. Between-patient variation in fat fraction was explained by age (≈45%), and another ≈14% was explained by estimated progenitor CTG repeat length (r2 = 0.485) and somatic instability (r2 = 0.590). Fat fraction correlated with the 6-minute walk test (r = −0.553) and muscular impairment rating scale (r = 0.537) and revealed subclinical muscle involvement. Conclusion This cross-sectional quantitative MRI study of 20 different lower extremity muscles in patients with DM1 revealed abnormal values for muscle fat fraction, volume, and T2water, which therefore may serve as objective biomarkers to assess disease state of skeletal muscles in these patients. ClinicalTrials.gov identifier NCT02118779.
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Affiliation(s)
- Linda Heskamp
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.
| | - Marlies van Nimwegen
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Marieke J Ploegmakers
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Guillaume Bassez
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Jean-Francois Deux
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Sarah A Cumming
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Darren G Monckton
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Baziel G M van Engelen
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Arend Heerschap
- From the Department of Radiology and Nuclear Medicine (L.H., M.J.P., A.H.) and Department of Neurology (M.v.N., B.G.M.v.E.), Radboud University Medical Center, Nijmegen, the Netherlands; Neuromuscular Reference Center (G.B.), Sorbonne University, INSERM UMRS 974, AP-HP, Pitié-Salpêtrière Hospital; Department of Radiology (J.-F.D.), Henri Mondor University Hospital, Paris, France; and Institute of Molecular, Cell and Systems Biology (S.A.C., D.G.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
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Wenninger S, Montagnese F, Schoser B. Core Clinical Phenotypes in Myotonic Dystrophies. Front Neurol 2018; 9:303. [PMID: 29770119 PMCID: PMC5941986 DOI: 10.3389/fneur.2018.00303] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/18/2018] [Indexed: 12/22/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) and type 2 (DM2) represent the most frequent multisystemic muscular dystrophies in adulthood. They are progressive, autosomal dominant diseases caused by an abnormal expansion of an unstable nucleotide repeat located in the non-coding region of their respective genes DMPK for DM1 and CNBP in DM2. Clinically, these multisystemic disorders are characterized by a high variability of muscular and extramuscular symptoms, often causing a delay in diagnosis. For both subtypes, many symptoms overlap, but some differences allow their clinical distinction. This article highlights the clinical core features of myotonic dystrophies, thus facilitating their early recognition and diagnosis. Particular attention will be given to signs and symptoms of muscular involvement, to issues related to respiratory impairment, and to the multiorgan involvement. This article is part of a Special Issue entitled “Beyond Borders: Myotonic Dystrophies—A European Perception.”
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Affiliation(s)
- Stephan Wenninger
- Friedrich-Baur-Institute, Klinikum der Universität München, Munich, Germany
| | | | - Benedikt Schoser
- Friedrich-Baur-Institute, Klinikum der Universität München, Munich, Germany
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7
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Hogrel JY, Ollivier G, Ledoux I, Hébert LJ, Eymard B, Puymirat J, Bassez G. Relationships between grip strength, myotonia, and CTG expansion in myotonic dystrophy type 1. Ann Clin Transl Neurol 2017; 4:921-925. [PMID: 29296622 PMCID: PMC5740258 DOI: 10.1002/acn3.496] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 02/01/2023] Open
Abstract
In myotonic dystrophy type 1, several studies have suggested causal relationships between CTG repeat length and the severity of symptoms, such as weakness or myotonia. We aimed to explore these relationships in a large population of 144 DM1 patients. All patients underwent clinical and functional assessments using a standardized test for grip strength and myotonia assessment. Myotonia was assessed using a fully automatic software based on mathematical modeling of relaxation force curve. CTG repeat length was statistically correlated with both myotonia and grip strength, which are two major primary neuromuscular symptoms of DM1 patients. However, these relationships are not clinically meaningful and not predictive at the individual level.
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Affiliation(s)
| | | | | | | | - Bruno Eymard
- Institut de Myologie GH Pitié-Salpêtrière Paris France
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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
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9
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Symonds T, Campbell P, Randall JA. A review of muscle- and performance-based assessment instruments in DM1. Muscle Nerve 2017; 56:78-85. [DOI: 10.1002/mus.25468] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Tara Symonds
- Clinical Outcomes Solutions; Folkestone Kent United Kingdom
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10
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Mazzotti AL, Coletti D. The Need for a Consensus on the Locution "Central Nuclei" in Striated Muscle Myopathies. Front Physiol 2016; 7:577. [PMID: 27932999 PMCID: PMC5120524 DOI: 10.3389/fphys.2016.00577] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/10/2016] [Indexed: 01/08/2023] Open
Affiliation(s)
- Anna L Mazzotti
- Assointerpreti, Italian Association of Conference InterpretersRome, Italy; MPS Public SpeakingRome, Italy
| | - Dario Coletti
- Biology of Adaptation and Aging, CNRS, UMR 8256, INSERM ERL U1164, Institut de Biologie Paris-Seine, Université Pierre et Marie CurieParis, France; Department of Anatomical, Histological, Forensic Sciences and Orthopedics, Sapienza University of RomeRome, Italy; Interuniversity Institute of MyologyRome, Italy
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11
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Tan SV, Z'graggen WJ, Boërio D, Turner C, Hanna MG, Bostock H. In vivo assessment of muscle membrane properties in myotonic dystrophy. Muscle Nerve 2016; 54:249-57. [PMID: 26789642 DOI: 10.1002/mus.25025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 12/16/2015] [Accepted: 12/28/2015] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Myotonia in myotonic dystrophy types 1 (DM1) and 2 (DM2) is generally attributed to reduced chloride-channel conductance. We used muscle velocity recovery cycles (MVRCs) to investigate muscle membrane properties in DM1 and DM2, using comparisons with myotonia congenita (MC). METHODS MVRCs and responses to repetitive stimulation were compared between patients with DM1 (n = 18), DM2 (n = 5), MC (n = 18), and normal controls (n = 20). RESULTS Both DM1 and DM2 showed enhanced late supernormality after multiple conditioning stimuli, indicating delayed repolarization as in MC. Contrary to MC, however, DM1 showed reduced early supernormality after multiple conditioning stimuli, and weak DM1 patients also showed abnormally slow latency recovery after repetitive stimulation. CONCLUSIONS These findings support the presence of impaired chloride conductance in both DM1 and DM2. The early supernormality changes indicate that sodium currents were reduced in DM1, whereas the weakness-associated slow recovery after repetitive stimulation may provide an indication of reduced Na(+) /K(+) -ATPase activation. Muscle Nerve 54: 249-257, 2016.
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Affiliation(s)
- S Veronica Tan
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, The National, Queen Square, London, WC1N 3BG, UK.,Institute of Neurology, University College London, Queen Square, London, UK.,Department of Neurology and Neurophysiology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Academic Neurosciences, Kings College, London, UK
| | - Werner J Z'graggen
- Department of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Delphine Boërio
- Department of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Christopher Turner
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, The National, Queen Square, London, WC1N 3BG, UK.,Institute of Neurology, University College London, Queen Square, London, UK
| | - Michael G Hanna
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, The National, Queen Square, London, WC1N 3BG, UK.,Institute of Neurology, University College London, Queen Square, London, UK
| | - Hugh Bostock
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, The National, Queen Square, London, WC1N 3BG, UK.,Institute of Neurology, University College London, Queen Square, London, UK.,Department of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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Willemse H, Theodoratos A, Smith PN, Dulhunty AF. Unexpected dependence of RyR1 splice variant expression in human lower limb muscles on fiber-type composition. Pflugers Arch 2015; 468:269-78. [PMID: 26438192 DOI: 10.1007/s00424-015-1738-9] [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: 07/09/2015] [Revised: 09/14/2015] [Accepted: 09/29/2015] [Indexed: 10/23/2022]
Abstract
The skeletal muscle ryanodine receptor Ca(2+) release channel (RyR1), essential for excitation-contraction (EC) coupling, demonstrates a known developmentally regulated alternative splicing in the ASI region. We now find unexpectedly that the expression of the splice variants is closely related to fiber type in adult human lower limb muscles. We examined the distribution of myosin heavy chain isoforms and ASI splice variants in gluteus minimus, gluteus medius and vastus medialis from patients aged 45 to 85 years. There was a strong positive correlation between ASI(+)RyR1 and the percentage of type 2 fibers in the muscles (r = 0.725), and a correspondingly strong negative correlation between the percentages of ASI(+)RyR1 and percentage of type 1 fibers. When the type 2 fiber data were separated into type 2X and type 2A, the correlation with ASI(+)RyR1 was stronger in type 2X fibers (r = 0.781) than in type 2A fibers (r = 0.461). There was no significant correlation between age and either fiber-type composition or ASI(+)RyR1/ASI(-)RyR1 ratio. The results suggest that the reduced expression of ASI(-)RyR1 during development may reflect a reduction in type 1 fibers during development. Preferential expression of ASI(-) RyR1, having a higher gain of in Ca(2+) release during EC coupling than ASI(+)RyR1, may compensate for the reduced terminal cisternae volume, fewer junctional contacts and reduced charge movement in type 1 fibers.
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Affiliation(s)
- Hermia Willemse
- John Curtin School of Medical Research, Australian National University, Acton, ACT, 2600, Australia.
| | - Angelo Theodoratos
- John Curtin School of Medical Research, Australian National University, Acton, ACT, 2600, Australia.
| | - Paul N Smith
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Building 6, Level 1, P.O. Box 11, Woden, ACT, 2606, Australia.
| | - Angela F Dulhunty
- John Curtin School of Medical Research, Australian National University, Acton, ACT, 2600, Australia.
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Characteristic MRI Findings of upper Limb Muscle Involvement in Myotonic Dystrophy Type 1. PLoS One 2015; 10:e0125051. [PMID: 25919300 PMCID: PMC4412668 DOI: 10.1371/journal.pone.0125051] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 03/13/2015] [Indexed: 11/19/2022] Open
Abstract
The objective of our study was to evaluate the relation between muscle MRI findings and upper limb weakness with grip myotonia in patients with myotonic dystrophy type 1 (DM1). Seventeen patients with DM1 were evaluated by manual muscle strength testing and muscle MRI of the upper limbs. Many DM1 patients presenting with decreased grasping power frequently showed high intensity signals in the flexor digitorum profundus (FDP) muscles on T1-weighted imaging. Patients presenting with upper limb weakness frequently also showed high intensity signals in the flexor pollicis longus, abductor pollicis longus, and extensor pollicis muscles. Disturbances of the distal muscles of the upper limbs were predominant in all DM1 patients. Some DM1 patients with a prolonged disease duration showed involvement of not only distal muscles but also proximal muscles in the upper limbs. Muscle involvement of the upper limbs on MRI strongly correlated positively with the disease duration or the numbers of CTG repeats. To our knowledge, this is the first study to provide a detailed description of the distribution and severity of affected muscles of the upper limbs on MRI in patients with DM1. We conclude that muscle MRI findings are very useful for identifying affected muscles and predicting the risk of muscle weakness in the upper limbs of DM1 patients.
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Bouchard JP, Cossette L, Bassez G, Puymirat J. Natural history of skeletal muscle involvement in myotonic dystrophy type 1: a retrospective study in 204 cases. J Neurol 2014; 262:285-93. [PMID: 25380585 DOI: 10.1007/s00415-014-7570-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 01/28/2023]
Abstract
Myotonic dystrophy type 1 (DM1) is the most frequent muscular dystrophy in adult. The aim of this study was to investigate the natural history of skeletal muscle weakness in adults, in a cross-sectional, retrospective study. In a cohort of 204 adult DM1 patients, we quantified muscle impairment, handgrip force and physical disability. Muscle strength was similarly affected in the legs and in the arms, the right and left side, and distally more than proximally in patients. The earliest and the most affected skeletal muscles were the digit flexors, foot dorsiflexors and neck flexors; whereas the elbow and knee extensors and flexors were the least affected muscle groups. The rate of decline of the muscle strength was -0.111 units/year. The handgrip values were lower in DM1 patients than the normative values and the rate of decline in handgrip force per year was -0.24 kg. Limitation in mobility or walking is observed in 84 % of DM1 patients but requirement of wheelchair is infrequent (3 %). The decrease in muscle strength, handgrip force and the increase in physical disability were highly correlated with duration of the disease and the number of CTG repeats in the blood. Significant association was found between decline in muscle strength and the age at onset, physical disability and the age of patients at evaluation, handgrip force and gender. Decline in muscle weakness is very slow and although limitation when walking is a common manifestation of DM1 in patients, the requirement of wheelchair is infrequent.
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Affiliation(s)
- Jean-Pierre Bouchard
- Department of Neurological Sciences, CHU de Quebec, Enfant-Jesus Hospital, Quebec, Canada
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