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Brisson JD, Brais B, Mathieu J, Lessard I, Gagné-Ouellet V, Côté I, Gagnon C. Characterization of muscle strength and mobility in oculopharyngeal muscular dystrophy. Muscle Nerve 2023; 68:841-849. [PMID: 37849345 DOI: 10.1002/mus.27984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION/AIMS Muscle weakness, and its association with mobility limitations, has received little study in oculopharyngeal muscular dystrophy (OPMD) using quantitative and standardized assessments. The objectives of this study were to (1) document upper and lower limb muscle strength, upper limb functions, fatigue, and mobility capacities; (2) compare them with reference values and across participant age groups; and (3) explore associations between muscle strength, fatigue, and mobility capacities among adults with OPMD. METHODS Thirty-four participants were included in this cross-sectional study. The following variables were assessed: quantitative maximal isometric muscle strength, grip and pinch strength, fatigue, walking speed, walking endurance, sit-to-stand, and stair ascent and descent capacities. RESULTS Muscle strength was lower for older than younger participants for five muscle groups (P < .05). Walking endurance, sit-to-stand, stairs (ascent and descent), and strength of hip flexion, grip, and pinch were below 80% of reference values in participants ≥56 y old (55.3%-78.2%). Moderate to strong correlations were found between muscle strength and mobility capacities (ρ = 0.42-0.80, P < .05), and between fatigue and either muscle strength or mobility capacities (ρ = 0.42-0.75, P < .05). DISCUSSION This study highlights the impact of OPMD on strength, endurance, and functional capacity, among others, with patients being well below reference values even before the age of 65 y. In addition to helping health professionals to offer better clinical guidance, these results will improve clinical trial readiness. The next steps will be to assess the metrological properties of outcome measures and continue to document the disease progression rate.
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Affiliation(s)
- Jean-Denis Brisson
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Quebec, Canada
- Centre de recherche du Centre intégré universitaire du Saguenay-Lac-St-Jean, Clinique des maladies neuromusculaires, Saguenay, Quebec, Canada
| | - Bernard Brais
- Department of Neurology, McGill University, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Jean Mathieu
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Quebec, Canada
- Centre de recherche du Centre intégré universitaire du Saguenay-Lac-St-Jean, Clinique des maladies neuromusculaires, Saguenay, Quebec, Canada
| | - Isabelle Lessard
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Quebec, Canada
| | - Valérie Gagné-Ouellet
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Quebec, Canada
| | - Isabelle Côté
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Quebec, Canada
| | - Cynthia Gagnon
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Quebec, Canada
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2
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Conte TC, Duran-Bishop G, Orfi Z, Mokhtari I, Deprez A, Côté I, Molina T, Kim TY, Tellier L, Roussel MP, Maggiorani D, Benabdallah B, Leclerc S, Feulner L, Pellerito O, Mathieu J, Andelfinger G, Gagnon C, Beauséjour C, McGraw S, Duchesne E, Dumont NA. Clearance of defective muscle stem cells by senolytics restores myogenesis in myotonic dystrophy type 1. Nat Commun 2023; 14:4033. [PMID: 37468473 PMCID: PMC10356779 DOI: 10.1038/s41467-023-39663-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/22/2023] [Indexed: 07/21/2023] Open
Abstract
Muscle stem cells, the engine of muscle repair, are affected in myotonic dystrophy type 1 (DM1); however, the underlying molecular mechanism and the impact on the disease severity are still elusive. Here, we show using patients' samples that muscle stem cells/myoblasts exhibit signs of cellular senescence in vitro and in situ. Single cell RNAseq uncovers a subset of senescent myoblasts expressing high levels of genes related to the senescence-associated secretory phenotype (SASP). We show that the levels of interleukin-6, a prominent SASP cytokine, in the serum of DM1 patients correlate with muscle weakness and functional capacity limitations. Drug screening revealed that the senolytic BCL-XL inhibitor (A1155463) can specifically remove senescent DM1 myoblasts by inducing their apoptosis. Clearance of senescent cells reduced the expression of SASP, which rescued the proliferation and differentiation capacity of DM1 myoblasts in vitro and enhanced their engraftment following transplantation in vivo. Altogether, this study identifies the pathogenic mechanism associated with muscle stem cell defects in DM1 and opens a therapeutic avenue that targets these defective cells to restore myogenesis.
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Affiliation(s)
- Talita C Conte
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of pharmacology and physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Gilberto Duran-Bishop
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of obstetrics and gynecology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Zakaria Orfi
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of pharmacology and physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Inès Mokhtari
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Health Sciences, Université du Québec à Chicoutimi, Saguenay, QC, Canada
- Neuromuscular diseases interdisciplinary research group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, QC, Canada
| | - Alyson Deprez
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of pharmacology and physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Isabelle Côté
- Neuromuscular diseases interdisciplinary research group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, QC, Canada
| | - Thomas Molina
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of pharmacology and physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Tae-Yeon Kim
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of microbiology, infectiology and immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Lydia Tellier
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- School of rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Marie-Pier Roussel
- Neuromuscular diseases interdisciplinary research group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, QC, Canada
- Department of Fundamental Sciences, Université du Québec à Chicoutimi, Saguenay, QC, Canada
| | - Damien Maggiorani
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of pharmacology and physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | | | | | - Lara Feulner
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | | | - Jean Mathieu
- Neuromuscular diseases interdisciplinary research group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, QC, Canada
- CHU Sherbrooke Research Center, and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Gregor Andelfinger
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Cynthia Gagnon
- Neuromuscular diseases interdisciplinary research group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, QC, Canada
- CHU Sherbrooke Research Center, and Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Christian Beauséjour
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of pharmacology and physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Serge McGraw
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of obstetrics and gynecology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Elise Duchesne
- Department of Health Sciences, Université du Québec à Chicoutimi, Saguenay, QC, Canada.
- Neuromuscular diseases interdisciplinary research group (GRIMN), Saguenay-Lac-St-Jean Integrated University Health and Social Services Center, Saguenay, QC, Canada.
| | - Nicolas A Dumont
- CHU Sainte-Justine Research Center, Montreal, QC, Canada.
- School of rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
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Aoussim A, Légaré C, Roussel MP, Madore AM, Morissette MC, Laprise C, Duchesne E. Towards the Identification of Biomarkers for Muscle Function Improvement in Myotonic Dystrophy Type 1. J Neuromuscul Dis 2023; 10:1041-1053. [PMID: 37694373 PMCID: PMC10657677 DOI: 10.3233/jnd-221645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Myotonic dystrophy type 1 (DM1) is the most common muscular dystrophy in adults. In DM1 patients, skeletal muscle is severely impaired, even atrophied and patients experience a progressive decrease in maximum strength. Strength training for these individuals can improve their muscle function and mass, however, the biological processes involved in these improvements remain unknown. OBJECTIVE This exploratory study aims at identifying the proteomic biomarkers and variables associated with the muscle proteome changes induced by training in DM1 individuals. METHODS An ion library was developed from liquid chromatography-tandem mass spectrometry proteomic analyses of Vastus Lateralis muscle biopsies collected in 11 individuals with DM1 pre-and post-training. RESULTS The proteomic analysis showed that the levels of 44 proteins were significantly modulated. A literature review (PubMed, UniProt, PANTHER, REACTOME) classified these proteins into biological sub-classes linked to training-induced response, including immunity, energy metabolism, apoptosis, insulin signaling, myogenesis and muscle contraction. Linear models identified key variables explaining the proteome modulation, including atrophy and hypertrophy factors. Finally, six proteins of interest involved in myogenesis, muscle contraction and insulin signaling were identified: calpain-3 (CAN3; Muscle development, positive regulation of satellite cell activation), 14-3-3 protein epsilon (1433E; Insulin/Insulin-like growth factor, PI3K/Akt signaling), myosin-binding protein H (MYBPH; Regulation of striated muscle contraction), four and a half LIM domains protein 3 (FHL3; Muscle organ development), filamin-C (FLNC; Muscle fiber development) and Cysteine and glycine-rich protein 3 (CSRP3). CONCLUSION These findings may lead to the identification for DM1 individuals of novel muscle biomarkers for clinical improvement induced by rehabilitation, which could eventually be used in combination with a targeted pharmaceutical approach to improving muscle function, but further studies are needed to confirm those results.
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Affiliation(s)
- Amira Aoussim
- Département des sciences de la santé, Université du Québec à Chicoutimi, Québec, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay– Lac-Saint-Jean, Hôpital de Jonquière, Québec, Canada
- Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Québec, Canada
| | - Cécilia Légaré
- Département des sciences de la santé, Université du Québec à Chicoutimi, Québec, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay– Lac-Saint-Jean, Hôpital de Jonquière, Québec, Canada
- Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Québec, Canada
- RNA Institute, College of Arts and Sciences, University at Albany-SUNY, Albany, USA
| | - Marie-Pier Roussel
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay– Lac-Saint-Jean, Hôpital de Jonquière, Québec, Canada
- Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Québec, Canada
- Département des sciences fondamentales, Université du Québec à Chicoutimi, Québec, Canada
| | - Anne-Marie Madore
- Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Québec, Canada
- Département des sciences fondamentales, Université du Québec à Chicoutimi, Québec, Canada
| | - Mathieu C. Morissette
- Department of Medicine, Université Laval, Québec, Canada
- Quebec Heart and Lung Institute – Université Laval, Québec, Canada
| | - Catherine Laprise
- Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Québec, Canada
- Département des sciences fondamentales, Université du Québec à Chicoutimi, Québec, Canada
| | - Elise Duchesne
- Département des sciences de la santé, Université du Québec à Chicoutimi, Québec, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay– Lac-Saint-Jean, Hôpital de Jonquière, Québec, Canada
- Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Québec, Canada
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Bélair N, Côté I, Gagnon C, Mathieu J, Duchesne E. Explanatory factors of dynamic balance impairment in myotonic dystrophy type 1. Muscle Nerve 2022; 65:683-687. [PMID: 35212003 DOI: 10.1002/mus.27527] [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: 06/11/2021] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION/AIMS Myotonic dystrophy type 1 (DM1) is a neuromuscular disease affecting many systems and for which muscle weakness is one of the cardinal symptoms. People with DM1 also present with balance-related impairments and high fall risk. The aim of this study was to explore explanatory factors of dynamic balance impairment in the DM1 population. METHODS A secondary analysis of data collected as part of a larger study was performed. The Mini Balance Evaluation System Test (Mini-BESTest) was used to assess dynamic balance. Age, sex, and CTG repeat length in blood were retrieved from medical records and research files. The maximal isometric muscle strength of five lower limb muscle groups (hip flexors and extensors, knee flexors and extensors, and ankle dorsiflexors) was quantitatively assessed as well as fatigue. Standard multiple regression analysis was used. RESULTS Fifty-two individuals (31 men) aged between 24 and 81 years were included. The final model explains 65.9% of the balance score; ankle dorsiflexor muscle strength was the strongest explanatory factor, followed by CTG repeat length, age and fatigue to a lesser extent. DISCUSSION Dynamic balance is impaired in people with DM1. Results of this study suggest that rehabilitation interventions aimed at improving strength of the ankle dorsiflexors and managing fatigue could help to improve dynamic balance in this specific population.
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Affiliation(s)
- Nicolas Bélair
- Unité d'enseignement en physiothérapie, Département des sciences de la santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Isabelle Côté
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Jonquière, Jonquière, Québec, Canada
| | - Cynthia Gagnon
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Jonquière, Jonquière, Québec, Canada.,Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CR-CHUS), Sherbrooke, Québec, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Jean Mathieu
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Jonquière, Jonquière, Québec, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Elise Duchesne
- Unité d'enseignement en physiothérapie, Département des sciences de la santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Jonquière, Jonquière, Québec, Canada.,Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada.,Centre de recherche Charles-Le Moyne (CRCLM), Sherbrooke, Québec, Canada
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Parent A, Ballaz L, Samadi B, Vocos Pht M, Comtois AS, Pouliot-Laforte A. Static Postural Control Deficits in Adults with Myotonic Dystrophy Type 1, Steinert Disease. J Neuromuscul Dis 2022; 9:311-320. [PMID: 35001896 DOI: 10.3233/jnd-210639] [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: 11/15/2022]
Abstract
BACKGROUND Myotonic dystrophy type 1 (DM1) is characterized by progressive and predominantly distal muscle atrophy and myotonia. Gait and balance impairments, resulting in falls, are frequently reported in this population. However, the extent to which individuals with DM1 rely more on a specific sensory system for balance than asymptomatic individuals (AI) is unknown. OBJECTIVE Evaluate postural control performance in individuals with DM1 and its dependence on vision compared to AI. METHODS 20 participants with DM1, divided into two groups based on their diagnosis, i.e. adult and congenital phenotype, and 12 AI participants were recruited. Quiet standing postural control was assessed in two visual conditions: eyes-open and eyes-closed. The outcomes measures were center of pressure (CoP) mean velocity, CoP range of displacement in anteroposterior and mediolateral axis, and the 95% confidence ellipse's surface. Friedman and Kruskal-Wallis analysis of variance were used to compare outcomes between conditions and groups, respectively. RESULTS Significant group effect and condition effect were observed on postural control performance. No significant difference was observed between the two DM1 groups. The significant differences observed between the AI group and the two DM1 groups in the eyes-open condition were also observed in the eyes-closed condition. CONCLUSIONS The result revealed poorer postural control performance in people with DM1 compared to AI. The DM1 group also showed similar decrease in performance than AI in eyes-closed condition, suggesting no excessive visual dependency.
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Affiliation(s)
- Audrey Parent
- Sainte-Justine UHC Research Center, Centre de Réadaptation Marie Enfant, 5200 rue Bélanger, Montreal (Qc), H1T 1C9, Canada.,Department of Physical Activity Sciences, Université du Québec à Montréal (UQAM), 141 Avenue du Président-Kennedy, Local SB-4290, Montreal (Qc), H2X 1Y4, Canada
| | - Laurent Ballaz
- Sainte-Justine UHC Research Center, Centre de Réadaptation Marie Enfant, 5200 rue Bélanger, Montreal (Qc), H1T 1C9, Canada.,Department of Physical Activity Sciences, Université du Québec à Montréal (UQAM), 141 Avenue du Président-Kennedy, Local SB-4290, Montreal (Qc), H2X 1Y4, Canada
| | - Bahare Samadi
- Sainte-Justine UHC Research Center, Centre de Réadaptation Marie Enfant, 5200 rue Bélanger, Montreal (Qc), H1T 1C9, Canada.,Department of MechanicalEngineering, École Polytechnique de Montréal, 2900 Boulevard Edouard-Montpetit, Montreal (Qc) H3T 1J4, Canada
| | - Maria Vocos Pht
- Centre de réadaptation Lucie-Bruneau du Centreintégré universitaire de santé et services sociaux(CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, 2275 AvenueLaurier E, Montréal (Qc), H2H 2N8, Canada
| | - Alain Steve Comtois
- Department of Physical Activity Sciences, Université du Québec à Montréal (UQAM), 141 Avenue du Président-Kennedy, Local SB-4290, Montreal (Qc), H2X 1Y4, Canada
| | - Annie Pouliot-Laforte
- Sainte-Justine UHC Research Center, Centre de Réadaptation Marie Enfant, 5200 rue Bélanger, Montreal (Qc), H1T 1C9, Canada.,Department of Physical Activity Sciences, Université du Québec à Montréal (UQAM), 141 Avenue du Président-Kennedy, Local SB-4290, Montreal (Qc), H2X 1Y4, Canada
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Morin M, Duchesne E, Bernier J, Blanchette P, Langlois D, Hébert LJ. What is Known About Muscle Strength Reference Values for Adults Measured by Hand-Held Dynamometry: A Scoping Review. Arch Rehabil Res Clin Transl 2021; 4:100172. [PMID: 35282144 PMCID: PMC8904874 DOI: 10.1016/j.arrct.2021.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Existing literature regarding handheld dynamometer (HHD) strength reference values is scarce. The current literature includes gaps relating to strength units used and well-described protocols. There is a critical need to develop HHD reference values in adults. Considering the increased availability of high quality HHD, this issue is urgent.
Objective Data Sources Study Selection Data Extraction Data Synthesis Conclusion
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Mateus T, Costa A, Viegas D, Marques A, Herdeiro MT, Rebelo S. Outcome measures frequently used to assess muscle strength in patients with myotonic dystrophy type 1: a systematic review. Neuromuscul Disord 2021; 32:99-115. [PMID: 35031191 DOI: 10.1016/j.nmd.2021.09.014] [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: 01/30/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
Measurement of muscle strength is fundamental for the management of patients with myotonic dystrophy type 1 (DM1). Nevertheless, guidance on this topic is somewhat limited due to heterogeneous outcome measures used. This systematic literature review aimed to summarize the most frequent outcome measures to assess muscle strength in patients with DM1. We searched on Pubmed, Web of Science and Embase databases. Observational studies using measures of muscle strength assessment in adult patients with DM1 were included. From a total of 80 included studies, 24 measured cardiac, 45 skeletal and 23 respiratory muscle strength. The most common method and outcome measures used to assess cardiac muscle strength were echocardiography and ejection fraction, for skeletal muscle strength were quantitative muscle test, manual muscle test and maximum isometric torque and medical research council and for respiratory muscle strength were manometry and maximal inspiratory and expiratory pressure. We successfully gathered the more consensual methods and measures to evaluate muscle strength in future clinical studies, particularly to test muscle strength response to treatments in patients with DM1. Future consensus on a set of measures to evaluate muscle strength (core outcome set), is important for these patients.
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Affiliation(s)
- Tiago Mateus
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Adriana Costa
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Diana Viegas
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory - Lab3R, Institute of Biomedicine (iBiMED), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Sandra Rebelo
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal.
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Roussel MP, Fiset MM, Gauthier L, Lavoie C, McNicoll É, Pouliot L, Gagnon C, Duchesne E. Assessment of muscular strength and functional capacity in the juvenile and adult myotonic dystrophy type 1 population: a 3-year follow-up study. J Neurol 2021; 268:4221-4237. [PMID: 33907889 DOI: 10.1007/s00415-021-10533-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Myotonic dystrophy type 1 (DM1) is a progressive, multisystemic, and autosomal dominant disease. Muscle wasting and weakness have been associated with impaired functional capacity and restricted social participation in affected individuals. The disease's presentation is very heterogenous and its progression is still under-documented. OBJECTIVE The aim of the study was to document the progression of muscular strength and functional capacity in the DM1 population over a 3-year period. METHODS Twenty-three individuals with juvenile or adult phenotypes of DM1 were recruited to complete clinical assessments in 2016 and 2019. Maximal isometric muscle strength (MIMS) was evaluated with quantified muscle testing and functional capacity was evaluated with the Mini-BESTest, the 10-m walk test at comfortable and maximal speeds, the Timed Up and Go and the 6-min walk test. Participants also completed three questionnaires: DM1-Activ, Upper Extremity Functional Index and Lower Extremity Functional Scale (LEFS). Subgroup analyses were evaluated for sex, phenotype, and type of physical activity practiced during the 3-year period. RESULTS For the whole group, there was a significant decline in the scores of the Mini-BESTest and the LEFS. Also, MIMS significantly declined for prehension, lateral pinch as well as for hip abductors, knee extensors and ankle dorsiflexors muscle groups. Subgroups analyses revealed that men lost more MIMS than women, and that adult phenotype lost more MIMS than juvenile phenotype. CONCLUSION Quantified muscle testing is a better indicator of disease progression over a 3-year period than functional tests. Phenotype and sex are important factors that influence the progression of DM1.
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Affiliation(s)
- Marie-Pier Roussel
- Département des sciences fondamentales, Université du Québec à Chicoutimi, Québec, Canada
- Groupe de Recherche Interdisciplinaire sur les Maladies Neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Jonquière, Québec, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, Québec, Canada
- Centre Intersectoriel en Santé Durable (CISD), Université du Québec à Chicoutimi, Québec, Canada
| | - Marie-Michèle Fiset
- Unité d'enseignement en physiothérapie, Département des sciences de la santé, Université du Québec à Chicoutimi, 555, boul. de l'Université, Chicoutimi, Québec, G7H 2B1, Canada
| | - Laurie Gauthier
- Unité d'enseignement en physiothérapie, Département des sciences de la santé, Université du Québec à Chicoutimi, 555, boul. de l'Université, Chicoutimi, Québec, G7H 2B1, Canada
| | - Claudia Lavoie
- Unité d'enseignement en physiothérapie, Département des sciences de la santé, Université du Québec à Chicoutimi, 555, boul. de l'Université, Chicoutimi, Québec, G7H 2B1, Canada
| | - Émilie McNicoll
- Unité d'enseignement en physiothérapie, Département des sciences de la santé, Université du Québec à Chicoutimi, 555, boul. de l'Université, Chicoutimi, Québec, G7H 2B1, Canada
| | - Laurie Pouliot
- Unité d'enseignement en physiothérapie, Département des sciences de la santé, Université du Québec à Chicoutimi, 555, boul. de l'Université, Chicoutimi, Québec, G7H 2B1, Canada
| | - Cynthia Gagnon
- Groupe de Recherche Interdisciplinaire sur les Maladies Neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Jonquière, Québec, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, Québec, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada
| | - Elise Duchesne
- Groupe de Recherche Interdisciplinaire sur les Maladies Neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Jonquière, Québec, Canada.
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, Québec, Canada.
- Centre Intersectoriel en Santé Durable (CISD), Université du Québec à Chicoutimi, Québec, Canada.
- Unité d'enseignement en physiothérapie, Département des sciences de la santé, Université du Québec à Chicoutimi, 555, boul. de l'Université, Chicoutimi, Québec, G7H 2B1, Canada.
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Tremblay M, Muslemani S, Côté I, Gagnon C, Fortin J, Gallais B. Accomplishment of instrumental activities of daily living and its relationship with cognitive functions in adults with myotonic dystrophy type 1 childhood phenotype: an exploratory study. BMC Psychol 2021; 9:56. [PMID: 33865455 PMCID: PMC8052658 DOI: 10.1186/s40359-021-00562-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/06/2021] [Indexed: 11/14/2022] Open
Abstract
Background The childhood phenotype of myotonic dystrophy type 1 (DM1) involves impaired cognitive functioning starting in infancy, which may compromise later on their ability to carry out instrumental activities of daily living (IADLs) necessary for living independently. The current study aims to document the ability to perform IADLs among adults with the childhood phenotype of DM1 and to explore its links to cognitive functioning. Methods This cross-sectional exploratory study was conducted among 11 individuals living with DM1. IADLs related to money management, home management & transportation and health & safety activities were assessed by the Independent Living Scale (ILS). Neuropsychological tests assessed participants’ intellectual abilities and executive functioning. Associations were investigated using Spearman’s rho correlation. Results Important difficulties were found in all three categories of IADLs, mostly in money management in which only 2/11 participants were scored as independent. 8/11 participants showed low to very low intellectual functioning and limit to impaired executive functioning. Apathy was also a common feature as 5/11 participants showed clinical level of apathy. A lower IQ was associated with greater difficulty in the home management & transportation subtest of the ILS. Conclusions Adults with the childhood phenotype of DM1 demonstrate relative dependence in regard to the following IADLs: money management and home management & transportation. Level of dependence is, at least partially, associated with cognitive impairments. The work relates to results from an exploratory study; thus, studies must be pursued to describe in more details difficulties experienced by this population.
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Affiliation(s)
- Marjolaine Tremblay
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada.,Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Université de Sherbrooke, Québec, Canada
| | - Samar Muslemani
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada.,Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Université de Sherbrooke, Québec, Canada
| | - Isabelle Côté
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada
| | - Cynthia Gagnon
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada.,Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Université de Sherbrooke, Québec, Canada
| | - Julie Fortin
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada
| | - Benjamin Gallais
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada. .,Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Université de Sherbrooke, Québec, Canada. .,ÉCOBES - Recherche Et Transfert, Cégep de Jonquière, 2505 rue Saint-Hubert, Jonquière, QC, G7X 7X2, Canada.
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10
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Duchesne E, Hébert LJ, Mathieu J, Côté I, Roussel MP, Gagnon C. Validity of the Mini-BESTest in adults with myotonic dystrophy type 1. Muscle Nerve 2020; 62:95-102. [PMID: 32314404 DOI: 10.1002/mus.26893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Myotonic dystrophy type 1 (DM1) is a multisystemic neuromuscular disease that causes balance problems. The objective of this study was to assess the construct validity of the Mini-BESTest among adults with DM1. METHODS Fifty-nine individuals with late-onset or adult phenotypes of DM1 were recruited. Participants performed the Mini-BESTest, 10-Meter Walk Test (10mWT), 6-Minute Walk Test (6MWT), and Timed Up & Go (TUG) and were questioned on their tendency to lose balance and whether they fell in the past month. RESULTS Scores on the Mini-BESTest were significantly different between phenotypes and CTG repeat numbers (P < .02). Significant correlations were found with the 10mWT, 6MWT, and the TUG (r = 0.77-0.84; P < .001). A cutoff score of 21.5 was found to identify fallers with 90% posttest accuracy. DISCUSSION The Mini-BESTest demonstrates evidence of construct validity when assessing balance in the DM1 population.
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Affiliation(s)
- Elise Duchesne
- Health Sciences Department, Université du Québec à Chicoutimi, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Hôpital de Jonquière, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-St-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, Québec, Canada
| | - Luc J Hébert
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Hôpital de Jonquière, Québec, Canada.,Rehabilitation and Radiology Departments, Faculty of Medicine, Université Laval, Québec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, (CIRRIS), Institut de réadaptation en déficience physique de Québec, Québec, Canada
| | - Jean Mathieu
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Hôpital de Jonquière, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-St-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, Québec, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada
| | - Isabelle Côté
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Hôpital de Jonquière, Québec, Canada
| | - Marie-Pier Roussel
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Hôpital de Jonquière, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-St-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, Québec, Canada.,Department of Fundamental Sciences, Université du Québec à Chicoutimi, Québec, Canada
| | - Cynthia Gagnon
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Hôpital de Jonquière, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-St-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, Québec, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada
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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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12
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Roussel MP, Hébert LJ, Duchesne E. Intra-Rater Reliability and Concurrent Validity of Quantified Muscle Testing for Maximal Knee Extensors Strength in Men with Myotonic Dystrophy Type 1. J Neuromuscul Dis 2019; 6:233-240. [PMID: 31127731 DOI: 10.3233/jnd-190388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Myotonic dystrophy type 1 (DM1) is the most prevalent degenerative neuromuscular disease in adults. Knee extensor (KE) maximal strength loss is a strong indicator of physical limitations in DM1. A reliable, precise and accessible maximal strength evaluation method needs to be validated for this slowly progressive disease. OBJECTIVE This paper aims to assess the intra-rater reliability, the standard error of measurement (SEM), the minimal detectable change (MDC), and the concurrent validity of quantified muscle testing (QMT) using a handheld dynamometer with a gold standard: the Biodex isokinetic device. METHODS Nineteen men with the adult form of DM1 participated in this study by attending 2 visits spaced by one week. The evaluation of KE muscle strength with QMT was completed on the first visit and the same QMT evaluation in addition to the maximal muscle strength evaluation using an isokinetic device were performed on the second visit. RESULTS The intra-rater reliability was excellent with an intraclass correlation coefficient (ICC) of 0.98 (0.96-0.99 : 95% confidence interval). SEM and MDC values were 1.05 Nm and 2.92 Nm, respectively. Concurrent validity of QMT of KE muscle group with the Biodex was also excellent with a Spearman's correlation of ρ= 0.98. CONCLUSIONS The excellent concurrent validity and intra-rater reliability, and the small SEM and MDC of the QMT make this test a method of choice, in either a clinical or research setting, to precisely evaluate muscle strength impairments of the KE in men with DM1.
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Affiliation(s)
- Marie-Pier Roussel
- Département des sciences fondamentales, Université du Québec à Chicoutimi, Saguenay, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, Saguenay, Québec, Canada
| | - Luc J Hébert
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Québec, Canada.,Départements de réadaptation et de radiologie-médecine nucléaire, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Elise Duchesne
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, Saguenay, Québec, Canada.,Département des sciences de la santé, Université du Québec à Chicoutimi, Saguenay, Québec, Canada
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13
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Jimenez-Moreno AC, Nikolenko N, Kierkegaard M, Blain AP, Newman J, Massey C, Moat D, Sodhi J, Atalaia A, Gorman GS, Turner C, Lochmüller H. Analysis of the functional capacity outcome measures for myotonic dystrophy. Ann Clin Transl Neurol 2019; 6:1487-1497. [PMID: 31402614 PMCID: PMC6689676 DOI: 10.1002/acn3.50845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/11/2019] [Accepted: 06/26/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives Defining clinically relevant outcome measures for myotonic dystrophy type 1 (DM1) that can be valid and feasible for different phenotypes has proven problematic. The Outcome Measures for Myotonic Dystrophy (OMMYD) group proposed a battery of functional outcomes: 6‐minute walk test, 30 seconds sit and stand test, timed 10 m walk test, timed 10 m walk/run test, and nine‐hole peg test. This, however, required a large‐scale investigation, Methods A cohort of 213 patients enrolled in the natural history study, PhenoDM1, was analyzed in cross‐sectional analysis and subsequently 98 patients were followed for longitudinal analysis. We aimed to assess: (1) feasibility and best practice; (2) intra‐session reliability; (3) validity; and (4) behavior over time, of these tests. Results OMMYD outcomes proved feasible as 96% of the participants completed at least one trial for all tests and more than half (n = 113) performed all three trials of each test. Body mass index and disease severity associate with functional capacity. There was a significant difference between the first and second trials of each test. There was a moderate to strong correlation between these functional outcomes and muscle strength, disease severity and patient‐reported outcomes. All outcomes after 1 year detected a change in functional capacity except the nine‐hole peg test. Conclusions These tests can be used as a battery of outcomes or independently based on the shown overlapping psychometric features and strong cross‐correlations. Due to the large and heterogeneous sample of this study, these results can serve as reference values for future studies.
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Affiliation(s)
- Aura Cecilia Jimenez-Moreno
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.,Welcome Trust Mitochondrial Research Centre, Institute of Neurosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Nikoletta Nikolenko
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.,National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Marie Kierkegaard
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
| | - Alasdair P Blain
- Welcome Trust Mitochondrial Research Centre, Institute of Neurosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Jane Newman
- Welcome Trust Mitochondrial Research Centre, Institute of Neurosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Charlotte Massey
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Dionne Moat
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.,The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jas Sodhi
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.,The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Antonio Atalaia
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.,Center of Research in Myology, Sorbonne Université, Paris, France
| | - Grainne S Gorman
- Welcome Trust Mitochondrial Research Centre, Institute of Neurosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Chris Turner
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Hanns Lochmüller
- Department of Neuropediatrics and Muscle Disorders, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Centro Nacional de Análisis Genómico (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain.,Research Institute, The Children's Hospital of Eastern Ontario, Ottawa, Canada.,Division of Neurology, Department of Medicine, Ottawa University, Ottawa, Canada
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Rinninella E, Silvestri G, Cintoni M, Perna A, Martorana GE, De Lorenzo A, Rossini PM, Miggiano GAD, Gasbarrini A, Mele MC. Clinical use of bioelectrical impedance analysis in patients affected by myotonic dystrophy type 1: A cross-sectional study. Nutrition 2019; 67-68:110546. [PMID: 31376676 DOI: 10.1016/j.nut.2019.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/06/2019] [Accepted: 05/10/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Myotonic dystrophy type 1 (DM1) is an inherited muscle disorder characterized by slowly progressive weakness due to muscle degeneration. The Muscular Impairment Rating Scale (MIRS) is validated to assess clinical muscle severity of patients with DM1, although the scale is not sensitive enough to assess disease progression in time intervals fit for clinical trials. The aim of this study was to analyze bioelectrical whole body and arm segmental parameters in patients with DM1 to explore a correlation between bioelectrical impedance analysis (BIA) parameters and disease stage. METHODS Forty patients with DM1 were enrolled in a cross-sectional study. In all patients, MIRS, handgrip strength (HGS), and BIA were assessed. A Kruskal-Wallis test was used to assess the difference in continuous variables according to MIRS. Correlation between BIA values and HGS were made by Pearson's coefficient analysis. A linear regression analysis was performed. RESULTS Eighteen of 40 patients were men (45%). The median age of the cohort was 42 y (30-58 y). Four patients (10%) were classified as MIRS 1; 20 (50%) MIRS 2; 11 (27.5%) MIRS 3; and 5 (12.5%) as MIRS 4. A correlation was observed between phase angle and MIRS (P = 0.0001). MIRS correlated with other BIA values such as resistance, impedance ratio, and capacitance (P = 0.005, P = 0.0001, P = 0.0006, respectively). At linear regression analysis, segmental resistance, phase angle, impedance ratio, and capacitance of both arms significantly correlated with HGS. CONCLUSIONS Results from the study support the use of BIA as a suitable procedure for staging DM1 muscle involvement and as a measure of muscle disease outcome, in clinical practice and in clinical trial design of therapeutic drugs.
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Affiliation(s)
- Emanuele Rinninella
- UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Gabriella Silvestri
- UOC di Neurologia, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo; Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Cintoni
- Scuola di Specializzazione in Scienza dell'Alimentazione, Università di Roma Tor Vergata, Rome, Italy
| | - Alessia Perna
- UOC di Neurologia, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo; Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Ettore Martorana
- UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonino De Lorenzo
- Sezione di Nutrizione Clinica e Nutrigenomica, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Rome, Italy
| | - Paolo Maria Rossini
- UOC di Neurologia, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo; Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacinto Abele Donato Miggiano
- UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Gasbarrini
- Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Rome, Italy; UOC di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Cristina Mele
- UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Rome, Italy
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15
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Légaré C, Overend G, Guay SP, Monckton DG, Mathieu J, Gagnon C, Bouchard L. DMPK gene DNA methylation levels are associated with muscular and respiratory profiles in DM1. NEUROLOGY-GENETICS 2019; 5:e338. [PMID: 31334355 PMCID: PMC6568328 DOI: 10.1212/nxg.0000000000000338] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 12/03/2022]
Abstract
Objective To assess the effects of dystrophia myotonica protein kinase (DMPK) DNA methylation (DNAme) epivariation on muscular and respiratory profiles in patients with myotonic dystrophy type 1 (DM1). Methods Phenotypes were assessed with standardized measures. Pyrosequencing of bisulfite-treated DNA was used to quantify DNAme levels in blood from 90 patients with DM1 (adult form). Modal CTG repeat length was assessed using small-pool PCR. The presence of Acil-sensitive variant repeats was also tested. Results DNAme levels upstream of the CTG expansion (exon and intron 11) were correlated with modal CTG repeat length (rs = −0.224, p = 0.040; rs = −0.317, p = 0.003; and rs = −0.241, p = 0.027), whereas correlations were observed with epivariations downstream of the CTG repeats (rs = 0.227; p = 0.037). The presence of a variant repeat was associated with higher DNAme levels at multiple CpG sites (up to 10% higher; p = 0.001). Stepwise multiple linear regression modeling showed that DNAme contributed significantly and independently to explain phenotypic variability in ankle dorsiflexor (3 CpGs: p = 0.001, 0.013, and 0.001), grip (p = 0.089), and pinch (p = 0.028) strengths and in forced vital capacity (2 CpGs: p = 0.002 and 0.021) and maximal inspiratory pressure (p = 0.012). Conclusions In addition to the CTG repeat length, DMPK epivariations independently explain phenotypic variability in DM1 and could thus improve prognostic accuracy for patients.
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Affiliation(s)
- Cécilia Légaré
- Department of Biochemistry (C.L., S.-P.G., L.B.), Université de Sherbrooke, Sherbrooke; ECOGENE-21 Biocluster (C.L., S.-P.G., L.B.), Chicoutimi, Québec, Canada; Groupe de Recherche interdisciplinaire sur les maladies neuromusculaires (C.L., J.M., C.G., L.B.), Saguenay, Canada; Institute of Molecular (G.O., D.G.M.), Cell and Systems Biology, University of Glasgow, United Kingdom; and Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-StJean sur les innovations en santé (J.M., C.G.), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Canada
| | - Gayle Overend
- Department of Biochemistry (C.L., S.-P.G., L.B.), Université de Sherbrooke, Sherbrooke; ECOGENE-21 Biocluster (C.L., S.-P.G., L.B.), Chicoutimi, Québec, Canada; Groupe de Recherche interdisciplinaire sur les maladies neuromusculaires (C.L., J.M., C.G., L.B.), Saguenay, Canada; Institute of Molecular (G.O., D.G.M.), Cell and Systems Biology, University of Glasgow, United Kingdom; and Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-StJean sur les innovations en santé (J.M., C.G.), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Canada
| | - Simon-Pierre Guay
- Department of Biochemistry (C.L., S.-P.G., L.B.), Université de Sherbrooke, Sherbrooke; ECOGENE-21 Biocluster (C.L., S.-P.G., L.B.), Chicoutimi, Québec, Canada; Groupe de Recherche interdisciplinaire sur les maladies neuromusculaires (C.L., J.M., C.G., L.B.), Saguenay, Canada; Institute of Molecular (G.O., D.G.M.), Cell and Systems Biology, University of Glasgow, United Kingdom; and Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-StJean sur les innovations en santé (J.M., C.G.), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Canada
| | - Darren G Monckton
- Department of Biochemistry (C.L., S.-P.G., L.B.), Université de Sherbrooke, Sherbrooke; ECOGENE-21 Biocluster (C.L., S.-P.G., L.B.), Chicoutimi, Québec, Canada; Groupe de Recherche interdisciplinaire sur les maladies neuromusculaires (C.L., J.M., C.G., L.B.), Saguenay, Canada; Institute of Molecular (G.O., D.G.M.), Cell and Systems Biology, University of Glasgow, United Kingdom; and Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-StJean sur les innovations en santé (J.M., C.G.), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Canada
| | - Jean Mathieu
- Department of Biochemistry (C.L., S.-P.G., L.B.), Université de Sherbrooke, Sherbrooke; ECOGENE-21 Biocluster (C.L., S.-P.G., L.B.), Chicoutimi, Québec, Canada; Groupe de Recherche interdisciplinaire sur les maladies neuromusculaires (C.L., J.M., C.G., L.B.), Saguenay, Canada; Institute of Molecular (G.O., D.G.M.), Cell and Systems Biology, University of Glasgow, United Kingdom; and Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-StJean sur les innovations en santé (J.M., C.G.), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Canada
| | - Cynthia Gagnon
- Department of Biochemistry (C.L., S.-P.G., L.B.), Université de Sherbrooke, Sherbrooke; ECOGENE-21 Biocluster (C.L., S.-P.G., L.B.), Chicoutimi, Québec, Canada; Groupe de Recherche interdisciplinaire sur les maladies neuromusculaires (C.L., J.M., C.G., L.B.), Saguenay, Canada; Institute of Molecular (G.O., D.G.M.), Cell and Systems Biology, University of Glasgow, United Kingdom; and Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-StJean sur les innovations en santé (J.M., C.G.), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Canada
| | - Luigi Bouchard
- Department of Biochemistry (C.L., S.-P.G., L.B.), Université de Sherbrooke, Sherbrooke; ECOGENE-21 Biocluster (C.L., S.-P.G., L.B.), Chicoutimi, Québec, Canada; Groupe de Recherche interdisciplinaire sur les maladies neuromusculaires (C.L., J.M., C.G., L.B.), Saguenay, Canada; Institute of Molecular (G.O., D.G.M.), Cell and Systems Biology, University of Glasgow, United Kingdom; and Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-StJean sur les innovations en santé (J.M., C.G.), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Canada
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16
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Roussel MP, Morin M, Gagnon C, Duchesne E. What is known about the effects of exercise or training to reduce skeletal muscle impairments of patients with myotonic dystrophy type 1? A scoping review. BMC Musculoskelet Disord 2019; 20:101. [PMID: 30836978 PMCID: PMC6402179 DOI: 10.1186/s12891-019-2458-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myotonic dystrophy type 1 (DM1) is a neuromuscular disease characterized by multisystemic involvements including a progressive loss of maximal muscle strength and muscle wasting. Poor lower-limb strength is an important factor explaining disrupted social participation of affected individuals. This review aims to map what is known about the effects of exercise and training programs undertaken to counteract skeletal muscle impairments in DM1 patients. METHODS Medline, CINAHL and EMBASE databases were searched. Regarding study eligibility, title and abstract of 704 studies followed by 45 full articles were reviewed according to the following eligibility criteria. Inclusion: (1) humans with DM1 and (2) experimental protocol relying on exercise or training. Exclusion: (1) studies that do not evaluate skeletal muscle responses or adaptations, (2) reviews covering articles already included and (3) pharmacological intervention at the same time of exercise or training program. RESULTS Twenty-one papers were selected for in-depth analysis. Different exercise or training protocols were found including: acute exercise, neuromuscular electric stimulation, strength training, aerobic training, balance training and multiple rehabilitation interventions. Seven studies reported clinical measurements only, five physiological parameters only and nine both types. CONCLUSION This scoping review offers a complete summary of the current scientific literature on the effect of exercise and training in DM1 and a framework for future studies based on the concomitant evaluation of the several outcomes in present literature. Although there were a good number of studies focusing on clinical measurements, heterogeneity between studies does not allow to identify what are the adequate training parameters to obtain exercise or training-induced positive impacts on muscle function. Scientific literature is even more scarce regarding physiological parameters, where much more research is needed to understand the underlying mechanisms of exercise response in DM1.
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Affiliation(s)
- Marie-Pier Roussel
- Département des sciences de la santé, physiothérapie, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, Quebec, G7H 2B1, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, 2230 rue de l'Hôpital, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 2230 rue de l'Hôpital, Saguenay, Québec, Canada., Longueuil, Québec, Canada
| | - Marika Morin
- Département des sciences de la santé, physiothérapie, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, Quebec, G7H 2B1, Canada
| | - Cynthia Gagnon
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, 2230 rue de l'Hôpital, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 2230 rue de l'Hôpital, Saguenay, Québec, Canada., Longueuil, Québec, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Québec, Canada
| | - Elise Duchesne
- Département des sciences de la santé, physiothérapie, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, Quebec, G7H 2B1, Canada. .,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, 2230 rue de l'Hôpital, Saguenay, Québec, Canada. .,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 2230 rue de l'Hôpital, Saguenay, Québec, Canada., Longueuil, Québec, Canada.
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17
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Petitclerc É, Hébert LJ, Mathieu J, Desrosiers J, Gagnon C. Relationships between Lower Limb Muscle Strength Impairments and Physical Limitations in DM1. J Neuromuscul Dis 2018; 5:215-224. [PMID: 29865087 DOI: 10.3233/jnd-170291] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although adult and late-onset DM1 phenotypes DM1 present distinct lower limb weaknesses portraits, resulting physical limitations have never been described separately for each phenotype. OBJECTIVE To characterize the lower limb weaknesses and physical limitations among the DM1 adult and late-onset phenotypes separately and to document the contribution of weaknesses on mobility to optimize the management of this population. METHODS The strength of four muscle groups among 198 participants was quantified. Participants were categorized according to the severity of their muscular involvement using the Muscular Impairment Rating Scale (MIRS). Physical limitations were assessed using the Timed up-and-go (TUG), Berg Balance Scale (BBS) and 10 meters comfortable walking speed (10MWT). Multiple linear regressions were performed to identify the contribution of each muscle group to the mobility tests scores. RESULTS Late-onset demonstrated less weakness and physical limitations (p < 0.001 - 0.002) than the adult phenotype, but 21.9-47.5% of participants with this phenotype showed mobility scores below reference values. Physical limitations were observed in the first two MIRS grades (37.5-42.1% of the participants) for the TUG and 10MWT. Ankle dorsiflexors and knee extensors were the two muscle groups that showed the strongest relationships with mobility scores. CONCLUSION Although less impaired, the late-onset phenotype shows significant lower limb muscle weakness associated with physical limitations. The surprising presence of quantitative lower limb muscle weakness in the first two MIRS grades needs to be considered when using this scale. Both ankle dorsiflexors and knee extensors appear to be good indicators of physical limitations in DM1.
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Affiliation(s)
- Émilie Petitclerc
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke (Québec), Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, NeuromuscularClinic, Centre intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-St-Jean, site Jonquière, rue de l'Hôpital, Jonquière (Québec), Canada
| | - Luc J Hébert
- Faculty of Medicine, Rehabilitation (Physiotherapy) and Department of Radiology, Université Laval, avenue de la Médecine, Pavillon Ferdinand-Vandry, Québec, QC, Canada
| | - Jean Mathieu
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke (Québec), Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, NeuromuscularClinic, Centre intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-St-Jean, site Jonquière, rue de l'Hôpital, Jonquière (Québec), Canada
| | - Johanne Desrosiers
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke (Québec), Canada
| | - Cynthia Gagnon
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke (Québec), Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, NeuromuscularClinic, Centre intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-St-Jean, site Jonquière, rue de l'Hôpital, Jonquière (Québec), Canada
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18
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Towards clinical outcome measures in myotonic dystrophy type 2: a systematic review. Curr Opin Neurol 2018; 31:599-609. [DOI: 10.1097/wco.0000000000000591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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A 9-year follow-up study of quantitative muscle strength changes in myotonic dystrophy type 1. J Neurol 2018; 265:1698-1705. [PMID: 29785524 DOI: 10.1007/s00415-018-8898-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 10/16/2022]
Abstract
Myotonic dystrophy type 1 (DM1) is a neuromuscular disorder presenting with major muscle impairments. However, few studies have addressed muscle strength progression using quantitative methods. The aims of this study were to document muscle strength changes in eight muscle groups among adults with DM1 over a 9-year period, and to compare this progression between phenotypes (adult and late-onset) and sex. Patients with a genetic diagnosis of DM1 with the late-onset or the adult phenotype were recruited at baseline through the clinical registry of the Saguenay Neuromuscular Clinic. The maximum isometric muscle strength was measured at baseline and 9 years later using a standardized protocol of quantitative muscle testing. Muscle groups included were shoulder abductors, elbow flexors/extensors, wrist extensors, hip flexors, knee flexors/extensors, and ankle dorsiflexors. For the whole group, a mean loss of 24.5-52.8% was observed over the 9-year period for all muscle groups, except for hip flexors which remained stable. Generally, men were stronger and showed a significant greater rate of decline of muscle strength than women. The adult and late-onset phenotypes taken separately also showed a significant and similar decline over the 9-year period, except for the wrist and knee extensors where muscle strength of participants with the adult phenotype decreased faster than in the late-onset phenotype. The similar rate of decline of muscle strength loss observed between phenotypes highlights the need to develop interventions to prevent this decline, even for patients with the late-onset phenotype who are often considered as mildly impaired, and therefore neglected by the rehabilitation services.
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20
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Gagnon C, Tremblay M, CôTé I, Heatwole C. French translation and cross-cultural adaptation of The Myotonic Dystrophy Health Index. Muscle Nerve 2017; 57:686-689. [PMID: 29053894 DOI: 10.1002/mus.25994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2017] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Validation studies of disease-specific instruments for myotonic dystrophy type-1 (DM1) are required prior to their global use in clinical trials involving different cultures and countries. Here we translate and culturally adapt the Myotonic Dystrophy Health Index (MDHI), a disease-specific patient-reported outcome (PRO) measure, for a French DM1 population. METHODS Using the International Society for Pharmacoeconomics and Outcomes Research Task Force method for translation and adaptation of PRO questionnaires, we created a French translation of the MDHI. We subsequently tested this instrument in a cohort of French-speaking patients with DM1. RESULTS The MDHI was forward and back translated and modified by consensus to create the most compatible translation. Cognitive interviews were conducted with 5 patients with DM1 to ensure the usability and understanding of the translation. DISCUSSION The French version of the MDHI is an optimal translation of the original instrument that is acceptable to native patients and ready for clinical trial use. Muscle Nerve 57: 686-689, 2018.
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Affiliation(s)
- Cynthia Gagnon
- Centre de recherche Charles-Le-Moyne, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Marjolaine Tremblay
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Hôpital de Jonquière, Saguenay, Québec, Canada
| | - Isabelle CôTé
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Hôpital de Jonquière, Saguenay, Québec, Canada
| | - Chad Heatwole
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
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