1
|
Shida T, Hatanaka S, Ohta T, Osuka Y, Kojima N, Motokawa K, Iwasaki M, Miyamae F, Okamura T, Hirano H, Awata S, Sasai H. Proposal and validation of an equation to identify sarcopenia using bioelectrical impedance analysis-derived parameters. Nutrition 2024; 124:112453. [PMID: 38669830 DOI: 10.1016/j.nut.2024.112453] [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] [Received: 01/21/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE This study aimed to develop a simpler approach for diagnosing sarcopenia by using only bioelectrical impedance vector analysis parameters. METHODS The study design was a cross-sectional study. The research was conducted based on the Itabashi Longitudinal Study on Aging, a community-based cohort study, with data collected from the 2022 and 2023 surveys in Itabashi Ward, Tokyo, Japan. The development cohort consisted of 1146 participants from the 2022 survey, and the validation cohort included 656 participants from the 2023 survey. Both cohorts were comprised of community-dwelling older adults with similar inclusion criteria. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. The logistic model utilized height divided by impedance at 50 kHz and phase angle to establish a new regression equation to identify sarcopenia. Regression equations were generated for the development cohort and validated for the validation cohort. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC) for men and women. RESULTS The prevalence of sarcopenia was 20.7% and 14.8% in the development and validation cohort, respectively. The AUC (95% confidence interval) of the logistic model in discriminating sarcopenia was 0.92 (0.88, 0.95) for men and 0.82 (0.78, 0.86) for women in the development cohort and 0.85 (0.78, 0.91) for men and 0.90 (0.86, 0.95) for women in the validation cohort. CONCLUSION The study demonstrated that a simple formula using bioelectrical parameters at 50 kHz proved useful in identifying sarcopenia in the older adult population.
Collapse
Affiliation(s)
- Takashi Shida
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
| | - Sho Hatanaka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Takahisa Ohta
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yosuke Osuka
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan; Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| |
Collapse
|
2
|
Gopalakrishnan B, Galili U, Saenger M, Burket NJ, Koss W, Lokender MS, Wolfe KM, Husak SJ, Stark CJ, Solorio L, Cox A, Dunbar A, Shi R, Li J. α-Gal Nanoparticles in CNS Trauma: II. Immunomodulation Following Spinal Cord Injury (SCI) Improves Functional Outcomes. Tissue Eng Regen Med 2024; 21:437-453. [PMID: 38308742 PMCID: PMC10987462 DOI: 10.1007/s13770-023-00616-y] [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: 07/06/2023] [Revised: 08/30/2023] [Accepted: 09/03/2023] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Previous investigations have shown that local application of nanoparticles presenting the carbohydrate moiety galactose-α-1,3-galactose (α-gal epitopes) enhance wound healing by activating the complement system and recruiting pro-healing macrophages to the injury site. Our companion in vitro paper suggest α-gal epitopes can similarly recruit and polarize human microglia toward a pro-healing phenotype. In this continuation study, we investigate the in vivo implications of α-gal nanoparticle administration directly to the injured spinal cord. METHODS α-Gal knock-out (KO) mice subjected to spinal cord crush were injected either with saline (control) or with α-gal nanoparticles immediately following injury. Animals were assessed longitudinally with neurobehavioral and histological endpoints. RESULTS Mice injected with α-gal nanoparticles showed increased recruitment of anti-inflammatory macrophages to the injection site in conjunction with increased production of anti-inflammatory markers and a reduction in apoptosis. Further, the treated group showed increased axonal infiltration into the lesion, a reduction in reactive astrocyte populations and increased angiogenesis. These results translated into improved sensorimotor metrics versus the control group. CONCLUSIONS Application of α-gal nanoparticles after spinal cord injury (SCI) induces a pro-healing inflammatory response resulting in neuroprotection, improved axonal ingrowth into the lesion and enhanced sensorimotor recovery. The data shows α-gal nanoparticles may be a promising avenue for further study in CNS trauma.
Collapse
Affiliation(s)
- Bhavani Gopalakrishnan
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Uri Galili
- Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Megan Saenger
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
| | - Noah J Burket
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
| | - Wendy Koss
- Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, 47907, USA
| | - Manjari S Lokender
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
| | - Kaitlyn M Wolfe
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
| | - Samantha J Husak
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
| | - Collin J Stark
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
| | - Luis Solorio
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Abigail Cox
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, 47907, USA
| | - August Dunbar
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
| | - Riyi Shi
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Jianming Li
- Center for Paralysis Research, Purdue University, West Lafayette, IN, 47907, USA.
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, 47907, USA.
| |
Collapse
|
3
|
Rebollo P, García-López S, Povedano M, Cattinari MG, Martínez-Moreno M, Terrancle Á, Cabello-Moruno R, Vázquez-Costa JF. Design and Validation of a Clinical Outcome Measure for Adolescents and Adult Patients with Spinal Muscular Atrophy: SMA Life Study Protocol. Neurol Ther 2024; 13:233-249. [PMID: 38180726 PMCID: PMC10787721 DOI: 10.1007/s40120-023-00571-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION The objective of this study is to develop a clinical tool for the evaluation and follow-up of adolescent and adult patients with 5q spinal muscular atrophy (SMA) and to design its validation. METHODS This prospective, non-interventional study will be carried out at five centres in Spain and will include patients aged 16 years or older with a confirmed diagnosis of 5q SMA (biallelic mutation of the survival motor neuron 1 [SMN1] gene). A panel of experts made up of neurologists, physiatrists and Spanish patients' association (FundAME), participated in the design of the clinical tool. Physicians will administer the tool at three time points (baseline, 12 months and 24 months). Additionally, data from other questionnaires and scales will be collected. Once recruitment is achieved, an interim statistical analysis will be performed to assess its psychometric properties by applying Rasch analysis and classical statistical tests. RESULTS The tool will consist of up to 53 items to assess functional status from a clinical perspective in seven key dimensions (bulbar, respiratory, axial, lower, upper, fatigability and other symptoms), which will be collected together with objective clinical measures (body mass index, forced vital capacity, pinch strength and 6-minute walk test). CONCLUSIONS The validation of this tool will facilitate the clinical evaluation of adult and adolescent patients with SMA and the quantification of their response to new treatments in both clinical practice and research.
Collapse
Affiliation(s)
| | | | - Mónica Povedano
- Unidad Funcional de Motoneurona (UFMN), Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Mercedes Martínez-Moreno
- Sección de Rehabilitación Infantil, Servicio de Medicina Física y Rehabilitación, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Juan F Vázquez-Costa
- Department of Medicine, University of Valencia, Valencia, Spain.
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Avenida Fernando Abril Martorell 106, 46026, Valencia, Spain.
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain.
| |
Collapse
|
4
|
Wang F, Zhang F, Song J, Zou S, Li J, Huang Y, Zhang L, Wang Q. Acute Toxic Effects of Tetrodotoxin in Mice via Intramuscular Injection and Oral Gavage. Toxins (Basel) 2023; 15:toxins15050334. [PMID: 37235368 DOI: 10.3390/toxins15050334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Tetrodotoxin (TTX) is a highly fatal marine biotoxin. Constantly increasing intoxications and the lack of specific antitoxic drugs in clinical applications highlight the need for further research into the toxic effects of TTX. Current reports on poisoning cases and the TTX toxicity mechanism suggest that the blocking of voltage-gated sodium channels (VGSCs) by TTX is probably reversible, but direct evidence of this is lacking, as far as we are aware. This study explored the acute toxic effects of TTX at sub-lethal doses via different routes, analyzing variations in muscle strength and TTX concentration in the blood in mice. We found that the loss of muscle strength in mice caused by TTX was dose-dependent and reversible, and the death time and muscle strength variations after oral gavage with TTX appeared to occur later and were more variable than those after intramuscular injection. In conclusion, we systematically compared the acute toxic effects of TTX for two different administration routes at sub-lethal doses, directly verifying the reversible reaction of TTX blocking VGSCs and speculating that averting a complete block of VGSCs by TTX could be an effective strategy for preventing death from TTX poisoning. This work may provide data for the diagnosis and treatment of TTX poisoning.
Collapse
Affiliation(s)
- Fan Wang
- Department of Marine Biomedicine and Polar Medicine, Naval Special Medical Center, Naval Medical University, Shanghai 200433, China
| | - Fuhai Zhang
- Department of Marine Biomedicine and Polar Medicine, Naval Special Medical Center, Naval Medical University, Shanghai 200433, China
| | - Juxingsi Song
- Department of Marine Biomedicine and Polar Medicine, Naval Special Medical Center, Naval Medical University, Shanghai 200433, China
| | - Shuaijun Zou
- Department of Marine Biomedicine and Polar Medicine, Naval Special Medical Center, Naval Medical University, Shanghai 200433, China
| | - Jie Li
- Department of Marine Biomedicine and Polar Medicine, Naval Special Medical Center, Naval Medical University, Shanghai 200433, China
| | - Yichao Huang
- Department of Marine Biomedicine and Polar Medicine, Naval Special Medical Center, Naval Medical University, Shanghai 200433, China
| | - Liming Zhang
- Department of Marine Biomedicine and Polar Medicine, Naval Special Medical Center, Naval Medical University, Shanghai 200433, China
| | - Qianqian Wang
- Department of Marine Biomedicine and Polar Medicine, Naval Special Medical Center, Naval Medical University, Shanghai 200433, China
| |
Collapse
|
5
|
Vázquez‐Costa JF, Povedano M, Nascimiento‐Osorio AE, Moreno Escribano A, Kapetanovic Garcia S, Dominguez R, Exposito JM, González L, Marco C, Medina Castillo J, Muelas N, Natera de Benito D, Ñungo Garzón NC, Pitarch Castellano I, Sevilla T, Hervás D. Validation of motor and functional scales for the evaluation of adult patients with 5q spinal muscular atrophy. Eur J Neurol 2022; 29:3666-3675. [PMID: 36047967 PMCID: PMC9826246 DOI: 10.1111/ene.15542] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/04/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE Mos scales currently used to evaluate spinal muscular atrophy (SMA) patients have only been validated in children. The aim of this study was to assess the construct validity and responsiveness of several outcome measures in adult SMA patients. METHODS Patients older than 15 years and followed up in five referral centres for at least 6 months, between October 2015 and August 2020, with a motor function scale score (Hammersmith Functional Motor Scale Expanded [HFMSE], Revised Upper Limb module [RULM]) were included. Bedside functional scales (Egen Klassification [EK2], Revised Amyotrophic Lateral Sclerosis Functional Rating Scale [ALSFRS-R]) were also collected when available. Spearman's rho correlations (rs) and Bangdiwala's concordance test (B) were used to evaluate the scales' construct validity. Monthly slopes of change were used to calculate their responsiveness of the scales. RESULTS The study included 79 SMA patients, followed up for a mean of 16 months. All scales showed strong correlations with each other (rs > 0.70). A floor effect in motor function scales was found in the weakest patients (HFMSE < 5 and RULM < 10), and a ceiling effect was found in stronger patients (HFMSE > 60 and RULM > 35). The ALSFRS-R (B = 0.72) showed a strong ability to discriminate between walkers, sitters and non-sitters, and the HFMSE (B = 0.86) between walkers and sitters. The responsiveness was low overall, although in treated patients a moderate responsiveness was found for the ALSFRS-R and HFMSE in walkers (0.69 and 0.61, respectively) and for EK2 in sitters (0.65) and non-sitters (0.60). CONCLUSIONS This study shows the validity and limitations of the scales most frequently used to assess adult SMA patients. Overall, bedside functional scales showed some advantages over motor scales, although all showed limited responsiveness.
Collapse
Affiliation(s)
- Juan F. Vázquez‐Costa
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain,Department of MedicineUniversitat de ValènciaValenciaSpain
| | - Mónica Povedano
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Andrés E. Nascimiento‐Osorio
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain,Center for the Biomedical Research on Rare Diseases (CIBERER), ISCIIIBarcelonaSpain
| | - Antonio Moreno Escribano
- Neuromuscular Unit, Neurology DepartmentHospital Clínico Universitario Virgen de la ArrixacaMurciaSpain
| | | | - Raul Dominguez
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Jessica M. Exposito
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain
| | - Laura González
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Carla Marco
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | | | - Nuria Muelas
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Daniel Natera de Benito
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain
| | - Nancy Carolina Ñungo Garzón
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Inmaculada Pitarch Castellano
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Teresa Sevilla
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain,Department of MedicineUniversitat de ValènciaValenciaSpain
| | - David Hervás
- Department of Applied Statistics and Operational Research and QualityUniversitat Politècnica de ValènciaValenciaSpain
| |
Collapse
|
6
|
Zhang H, Luo W, Li C, Zhao J, Zhang Q, Gu R. Description of Clinical Features and Diagnoses of 444 Cases with Neck-Shoulder-Upper Extremity Pain: A Single-Center Retrospective Review. J Pain Res 2022; 15:3483-3492. [PMID: 36348743 PMCID: PMC9637346 DOI: 10.2147/jpr.s376205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Neck-shoulder-upper extremity pain (NSUEP) is a frequently occurring clinical constellation of syndromes. However, its etiology is complicated, and the diagnosis is challenging. We aimed to present detailed clinical characteristics and diagnoses of NSUEP from a single center and heighten clinicians' understanding of this condition. PATIENTS AND METHODS Prospectively collected databases were used to retrospectively evaluate patients with NSUEP who underwent treatment at the multidisciplinary consultation center for neck, shoulder, and upper extremity pain at the China-Japan Union Hospital of Jilin University between April 2014 and July 2021. We performed descriptive statistics regarding demographic data, symptoms, findings of physical and radiographic examinations, and each patient's diagnosis. RESULTS Development of NSUEP was primarily observed in individuals aged between 51 and 60 years (n = 157, 35.4%). Patients were most commonly referred for upper extremity pain (n = 306, 68.9%). Patients with upper extremity pain presented with hypoesthesia (n = 139, 45.4%), muscle weakness (n = 93, 30.4%), muscle atrophy (n = 90, 29.4%), hyperesthesia (n = 39, 12.7%), and turgidity (n = 18, 5.9%). Among the 22 patients with upper extremity swelling, 8 (36.4%) were diagnosed with autoimmune rheumatic diseases. Among the 352 patients with a single diagnosis, 51 (14.5%) presented with thoracic outlet syndrome, 49 (13.9%) with cervical radiculopathy, 16 (4.5%) with carpal tunnel syndrome, and 16 (4.5%) with brachial plexus injury. Further, among the 92 patients with compound diagnosis, 18 patients (19.6%) were diagnosed with cervical radiculopathy. CONCLUSION Among the NSUEP patients in this study, older individuals were the largest group. Pain, numbness, weakness, and mobility limitation are common complaints accompanying NSUEP. The common etiologies of NSUEP include cervical spondylosis, thoracic outlet syndrome, carpal tunnel syndrome, and brachial plexus injury. In addition, autoimmune rheumatic diseases should be considered in patients with NSUEP and swelling.
Collapse
Affiliation(s)
- Hongchao Zhang
- Department of Orthopedics, The Multidisciplinary Consultation Center of Neck Shoulder Upper Extremity, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
| | - Wenqi Luo
- Department of Orthopedics, The Multidisciplinary Consultation Center of Neck Shoulder Upper Extremity, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
| | - Chaoyuan Li
- Department of Orthopedics, The Multidisciplinary Consultation Center of Neck Shoulder Upper Extremity, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
| | - Jianhui Zhao
- Department of Orthopedics, The Multidisciplinary Consultation Center of Neck Shoulder Upper Extremity, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
| | - Qiao Zhang
- Department of Orthopedics, The Multidisciplinary Consultation Center of Neck Shoulder Upper Extremity, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China,Correspondence: Qiao Zhang; Rui Gu, Department of Orthopedics, The Multidisciplinary Consultation Center of Neck Shoulder Upper Extremity, China-Japan Union Hospital, Jilin University, No. 126 Xiantai Street, Changchun, Jilin Province, 130033, People’s Republic of China, Tel +86 13578793723; +86 13804371075, Fax +86431-89876939, Email ;
| | - Rui Gu
- Department of Orthopedics, The Multidisciplinary Consultation Center of Neck Shoulder Upper Extremity, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
| |
Collapse
|
7
|
De Wel B, Huysmans L, Peeters R, Goosens V, Ghysels S, Byloos K, Putzeys G, D'Hondt A, De Bleecker JL, Dupont P, Maes F, Claeys KG. Prospective Natural History Study in 24 Adult Patients With LGMDR12 Over 2 Years of Follow-up: Quantitative MRI and Clinical Outcome Measures. Neurology 2022; 99:e638-e649. [PMID: 35577579 DOI: 10.1212/wnl.0000000000200708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/24/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Limb-girdle muscular dystrophy autosomal recessive type 12 (LGMDR12) is a rare hereditary muscular dystrophy for which outcome measures are currently lacking. We evaluated quantitative MRI and clinical outcome measures to track disease progression to determine which tests could be useful in future clinical trials to evaluate potential therapies. METHODS We prospectively measured the following outcome measures in all participants at baseline and after 1 and 2 years: 6-minute walk distance (6MWD), 10-meter walk test (10MWT), the Medical Research Council (MRC) sum scores, Biodex isometric dynamometry, serum creatine kinase, and 6-point Dixon MRI of the thighs. RESULTS We included 24 genetically confirmed, adult patients with LGMDR12 and 24 age-matched and sex-matched healthy controls. Patients with intermediate-stage thigh muscle fat replacement at baseline (proton density fat fraction [PDFF] 20%-70%) already showed an increase in PDFF in 8 of the 14 evaluated thigh muscles after 1 year. The standardized response mean demonstrated a high responsiveness to change in PDFF for 6 individual muscles over 2 years in this group. However, in patients with early-stage (<20%) or end-stage (>70%) muscle fat replacement, PDFF did not increase significantly over 2 years of follow-up. Biodex isometric dynamometry showed a significant decrease in muscle strength in all patients in the right and left hamstrings (-6.2 Nm, p < 0.002 and -4.6 Nm, p < 0.009, respectively) and right quadriceps muscles (-9 Nm, p = 0.044) after 1 year of follow-up, whereas the 6MWD, 10MWT, and MRC sum scores were not able to detect a significant decrease in muscle function/strength even after 2 years. There was a moderately strong correlation between total thigh PDFF and clinical outcome measures at baseline. DISCUSSION Thigh muscle PDFF imaging is a sensitive outcome measure to track progressive muscle fat replacement in selected patients with LGMDR12 even after 1 year of follow-up and correlates with clinical outcome measures. Biodex isometric dynamometry can reliably capture the loss of muscle strength over the course of 1 year in patients with LGMDR12 and should be included as an outcome measure in future clinical trials as well.
Collapse
Affiliation(s)
- Bram De Wel
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Lotte Huysmans
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Ronald Peeters
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Veerle Goosens
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Stefan Ghysels
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Kris Byloos
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Guido Putzeys
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Ann D'Hondt
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Jan L De Bleecker
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Patrick Dupont
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Frederik Maes
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium
| | - Kristl G Claeys
- From the Departments of Neurology (B.D.W., A.D.H., K.G.C.) and Radiology (R.P., V.G., S.G., K.B., G.P.), and Medical Imaging Research Centre (L.H., F.M.), University Hospitals Leuven; Laboratories for Muscle Diseases and Neuropathies (B.D.W., K.G.C.) and Cognitive Neurology (P.D.), Department of Neurosciences, and Department ESAT-PSI (L.H., F.M.), KU Leuven; Leuven Brain Institute (LBI) (B.D.W., K.G.C., P.D.); and Department of Neurology (J.L.D.B.), University Hospital Gent, Belgium.
| |
Collapse
|
8
|
Lizandra Cortés P, Poveda Verdú D, Albert Férriz A, Ñungo-Garzón NC, Domine MC, Sevilla-Mantecón T, Pitarch-Castellano I, Vázquez-Costa JF. Validation of Neuromyotype: a smart keyboard for the evaluation of spinal muscular atrophy patients. Neurologia 2022:S2173-5808(22)00083-9. [PMID: 35940531 DOI: 10.1016/j.nrleng.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/23/2022] [Indexed: 10/15/2022] Open
Abstract
INTRODUCTION Spinal muscular atrophy 5q (SMA) is a genetic neurodegenerative disease that affects alpha motor neurons producing progressive weakness. New outcome measures are currently required to accurately characterise the disease progression and the efficacy of new available treatments. The objective of this work is to preliminarily validate a new intelligent keyboard (Neuromyotype) measuring typing strength and speed in patients with SMA. MATERIAL AND METHODS Twenty two SMA patients older than 15 years, and 26 healthy controls were included. Three measurements were obtained with the keyboard (maximum strength, execution time of a random typing task, execution time of a sequential typing task) together with the time to complete the Nine-Hole Peg Test (9HPT). Patients were also administered motor (Hammersmith Functional Motor Scale Expanded, HFMSE; Revised Upper Limb module, RULM), and functional scales (Egen Klassification, EK2; and the revised version of Amyotrophic Lateral Sclerosis Functional Rating Scale, ALSFRS-R). The viability and construct validity of the Neuromyotype were analysed, measuring the discriminative power between patients and controls (using ROC curves and the Bangdiwala's B statistic), between the different functional types of SMA (walker, sitter and non-sitter) and their correlation with the rest of motor scales. RESULTS Neuromyotype measurements could be performed in all patients, unlike the rest of the scales. Its administration was quick and easy. The 3 variables on the keyboard discriminated very well between patients and controls, with strength (ROC = 0.963) being the one that best differentiates from the 3, equaling 9HPT (ROC = 0.966). They also showed a good ability to differentiate by functional type (especially non-sitters from sitters and walkers), with sequential time (B = 0.83) being the tool that best discriminates between the three groups above the rest of motor scales. All motor and functional scales showed strong or very strong correlations with each other (rs = 0.71-0.99), with strength correlating better with motor scales and timed variables with functional scales. CONCLUSION This study shows the feasibility and validity of Neuromyotype for the evaluation of adolescent and adult patients with SMA. Data obtained with this tool could be of great clinical relevance, saving time and resources compared to the rest of the scales.
Collapse
Affiliation(s)
- P Lizandra Cortés
- Grupo de Investigación en Enfermedades Neuromusculares y Ataxias, Instituto de Investigación Sanitaria la Fe, Valencia, Spain
| | - D Poveda Verdú
- INESCOP, Centro de Innovación y Tecnología, Elda, Alicante, Spain
| | - A Albert Férriz
- INESCOP, Centro de Innovación y Tecnología, Elda, Alicante, Spain
| | - N C Ñungo-Garzón
- Grupo de Investigación en Enfermedades Neuromusculares y Ataxias, Instituto de Investigación Sanitaria la Fe, Valencia, Spain
| | - M C Domine
- Grupo de Investigación en Enfermedades Neuromusculares y Ataxias, Instituto de Investigación Sanitaria la Fe, Valencia, Spain
| | - T Sevilla-Mantecón
- Grupo de Investigación en Enfermedades Neuromusculares y Ataxias, Instituto de Investigación Sanitaria la Fe, Valencia, Spain; Departamento de Medicina, Universidad de Valencia, Valencia, Spain
| | - I Pitarch-Castellano
- Grupo de Investigación en Enfermedades Neuromusculares y Ataxias, Instituto de Investigación Sanitaria la Fe, Valencia, Spain; Unidad de referencia de Enfermedades Neuromusculares (ERN-NMD), Servicio de Pediatría, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - J F Vázquez-Costa
- Grupo de Investigación en Enfermedades Neuromusculares y Ataxias, Instituto de Investigación Sanitaria la Fe, Valencia, Spain; Unidad de referencia de Enfermedades Neuromusculares (ERN-NMD), Servicio de Neurología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain; Departamento de Medicina, Universidad de Valencia, Valencia, Spain.
| |
Collapse
|
9
|
Validación de Neuromyotype: un teclado inteligente para la evaluación de pacientes con atrofia muscular espinal 5q. Neurologia 2022. [DOI: 10.1016/j.nrl.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
10
|
Sznajder J, Barć K, Kuźma-Kozakiewicz M. Physical activity in patients with amyotrophic lateral sclerosis: Prevalence, patients’ perspectives and relation to the motor performance. NeuroRehabilitation 2022; 50:433-443. [DOI: 10.3233/nre-210312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: There are no recommendations for physical activity in amyotrophic lateral sclerosis (ALS) patients. OBJECTIVE: (i) To describe the prevalence and pattern of physical activity (PA) in ALS patients; (ii) to explore patients’ attitude towards PA; and (iii) to investigate the relationship between PA at home environment and the rate of functional decline. METHODS: 96 ALS patients were followed for 6 months at 3-month intervals and assessed by site of disease onset, disease duration, diagnosis delay, functional status, muscle strength, fatigue and prevalence of PA. RESULTS: Over 70% of patients performed regular exercise and reported a positive effect of PA on functional status and mood. Regularly exercising individuals showed a higher ALSFRS-R bulbar score (11.0 vs 9.0, p = 0.011) and a lower decline of respiratory sub-score of ALSFRS-R compared to non-regularly exercising patients (0 vs 1.0, p = 0.026). Bulbar onset was a negative prognostic factor for regular exercise (odds ratio [OR]: 5.2, p = 0.004). CONCLUSION: The majority of ALS patients perform regular PA and find it positively influence their motor performance and mood. Bulbar disease onset, but not functional status, is a negative prognostic factor for regular exercise in ALS patients. Regular mild PA may result in a slower deterioration of functional status, especially the respiratory function.
Collapse
Affiliation(s)
- Jan Sznajder
- Department of Rehabilitation, Józef Piłsudski University of Physical Education inWarsaw, Warsaw, Poland
- Department of Neurology, University Clinical Centre of Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Barć
- Department of Neurology, University Clinical Centre of Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Kuźma-Kozakiewicz
- Department of Neurology, University Clinical Centre of Medical University of Warsaw, Warsaw, Poland
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
- Neurodegenerative Diseases Research Group, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
11
|
Stotz A, Maghames E, Mason J, Groll A, Zech A. Maximum isometric torque at individually-adjusted joint angles exceeds eccentric and concentric torque in lower extremity joint actions. BMC Sports Sci Med Rehabil 2022; 14:13. [PMID: 35063013 PMCID: PMC8783437 DOI: 10.1186/s13102-022-00401-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 01/10/2022] [Indexed: 11/14/2022]
Abstract
Background Previous research indicates the high relevance of optimal joint angles for individual isometric strength assessment. The objective was to compare lower limb peak isometric muscle strength abilities at the strongest joint angles with those of dynamic contractions in healthy young adults. Methods Eighteen young male adults performed maximum concentric, isometric, and eccentric contractions of the ankle, knee, and hip flexors and extensors, and hip adductors and abductors in a randomized sequence on an isokinetic dynamometer (ISOMED 2000). Angular velocity was set at 60°/s. The peak of concentric contraction torque curves was used to define optimal joint angles best suited to generate maximum torque during isometric contractions. Maximum voluntary contraction torque of all contraction conditions was adjusted for limb weight and analyzed via a generalized linear mixed gamma regression model (GLMM). Results The gamma GLMM revealed strongly significant effects for all three categorical covariates (contraction types, muscle group, and test order) (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$p < 2 \times 10^{ - 16}$$\end{document}p<2×10-16). Eccentric contraction increases the muscle torque (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\hat{\beta }_{k} = 0.147$$\end{document}β^k=0.147) compared to concentric contraction, and isometric contraction even more (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\hat{\beta }_{k} = 0.258$$\end{document}β^k=0.258). A moderate individual-specific variation was found (random effects standard deviation \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\sigma_{b} = 0.093$$\end{document}σb=0.093). Conclusion The results support the importance of optimal joint angles for isometric maximum strength assessment. When such conditions are given, isometric contractions can produce higher muscle torques than eccentric contractions in the lower body.
Collapse
Affiliation(s)
- Andreas Stotz
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany.
| | - Ebrahem Maghames
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany
| | - Joel Mason
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany
| | - Andreas Groll
- Department of Statistics, TU Dortmund University, Vogelpothsweg 87, 44227, Dortmund, Germany
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany
| |
Collapse
|
12
|
Thakore NJ, Drawert BJ, Lapin BR, Pioro EP. Progressive arm muscle weakness in ALS follows the same sequence regardless of onset site: use of TOMS, a novel analytic method to track limb strength. Amyotroph Lateral Scler Frontotemporal Degener 2021; 22:380-387. [PMID: 33620270 PMCID: PMC8292176 DOI: 10.1080/21678421.2021.1889000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/29/2020] [Accepted: 02/07/2021] [Indexed: 10/22/2022]
Abstract
Objective: Examine sequence of weakness in arm muscles from longitudinal hand-held dynamometry (HHD) data in ALS for congruence with contiguous spread of neurodegeneration along spinal cord segments. Methods: Longitudinal HHD data from the Ceftriaxone clinical trial were examined using nonlinear mixed models, assuming a logistic trajectory from normal to zero strength. Unobserved baseline normal strength of weak muscles was assumed using strength of the best-preserved muscle. A novel metric called "time from onset to midway strength" (TOMS) was estimated for each muscle group, and TOMS ratios were examined to identify sequence of weakness, overall and by onset site. Results: Shoulder flexion (SF), elbow flexion (EF), elbow extension (EE), wrist extension (WE), and first dorsal interosseous (FDI) were measured on each side. Over a median of 36 weeks, 513 subjects provided 2589 sets of HHD measures. TOMS increased sequentially in the following order: FDI, WE, SF, EF, and EE. TOMS ratios estimates with 95% CIs (adjusted for multiple comparisons) were: WE/FDI 1.32 (1.24-1.41), SF/WE 1.06 (1.01-1.10), EF/SF 1.06 (1.02-1.10), and EE/EF 1.18 (1.12-1.23). Elbow and shoulder flexors weakened sooner than did elbow extensors. The sequence of arm muscle weakness progression was similar regardless of onset site. Conclusion: Nonsegmental progression of arm muscle weakness that is similar for different onset sites favors cortical influence/network spread over contiguous spread of neurodegeneration in the spinal cord. Furthermore, this study confirms the "split elbow" pattern. TOMS and other proposed methods may have value as outcome measures in clinical research.
Collapse
Affiliation(s)
- Nimish J. Thakore
- Department of Neurology, Neuromuscular Center, Cleveland Clinic, Cleveland, OH, USA
| | - Brian J. Drawert
- Department of Computer Science, University of North Carolina at Asheville, Asheville, NC, USA
| | - Brittany R. Lapin
- Quantitative Health Sciences/Neurological Institute Center for Outcomes Research and Evaluation (NICORE), Cleveland Clinic, Cleveland, OH, USA
| | - Erik P. Pioro
- Department of Neurology, Neuromuscular Center, Cleveland Clinic, Cleveland, OH, USA
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, OH, USA
| |
Collapse
|
13
|
Ranieri F, Mariotto S, Dubbioso R, Di Lazzaro V. Brain Stimulation as a Therapeutic Tool in Amyotrophic Lateral Sclerosis: Current Status and Interaction With Mechanisms of Altered Cortical Excitability. Front Neurol 2021; 11:605335. [PMID: 33613416 PMCID: PMC7892772 DOI: 10.3389/fneur.2020.605335] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/22/2020] [Indexed: 12/14/2022] Open
Abstract
In the last 20 years, several modalities of neuromodulation, mainly based on non-invasive brain stimulation (NIBS) techniques, have been tested as a non-pharmacological therapeutic approach to slow disease progression in amyotrophic lateral sclerosis (ALS). In both sporadic and familial ALS cases, neurophysiological studies point to motor cortical hyperexcitability as a possible priming factor in neurodegeneration, likely related to dysfunction of both excitatory and inhibitory mechanisms. A trans-synaptic anterograde mechanism of excitotoxicity is thus postulated, causing upper and lower motor neuron degeneration. Specifically, motor neuron hyperexcitability and hyperactivity are attributed to intrinsic cell abnormalities related to altered ion homeostasis and to impaired glutamate and gamma aminobutyric acid gamma-aminobutyric acid (GABA) signaling. Several neuropathological mechanisms support excitatory and synaptic dysfunction in ALS; additionally, hyperexcitability seems to drive DNA-binding protein 43-kDA (TDP-43) pathology, through the upregulation of unusual isoforms directly contributing to ASL pathophysiology. Corticospinal excitability can be suppressed or enhanced using NIBS techniques, namely, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), as well as invasive brain and spinal stimulation. Experimental evidence supports the hypothesis that the after-effects of NIBS are mediated by long-term potentiation (LTP)-/long-term depression (LTD)-like mechanisms of modulation of synaptic activity, with different biological and physiological mechanisms underlying the effects of tDCS and rTMS and, possibly, of different rTMS protocols. This potential has led to several small trials testing different stimulation interventions to antagonize excitotoxicity in ALS. Overall, these studies suggest a possible efficacy of neuromodulation in determining a slight reduction of disease progression, related to the type, duration, and frequency of treatment, but current evidence remains preliminary. Main limitations are the small number and heterogeneity of recruited patients, the limited “dosage” of brain stimulation that can be delivered in the hospital setting, the lack of a sufficient knowledge on the excitatory and inhibitory mechanisms targeted by specific stimulation interventions, and the persistent uncertainty on the key pathophysiological processes leading to motor neuron loss. The present review article provides an update on the state of the art of neuromodulation in ALS and a critical appraisal of the rationale for the application/optimization of brain stimulation interventions, in the light of their interaction with ALS pathophysiological mechanisms.
Collapse
Affiliation(s)
- Federico Ranieri
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sara Mariotto
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| |
Collapse
|
14
|
Ozaki H, Abe T, Dankel SJ, Loenneke JP, Natsume T, Deng P, Naito H. The Measurement of Strength in Children: Is the Peak Value Truly Maximal? CHILDREN (BASEL, SWITZERLAND) 2020; 8:children8010009. [PMID: 33375230 PMCID: PMC7823851 DOI: 10.3390/children8010009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022]
Abstract
It is unclear whether the measurement of maximum muscle strength in younger children can be performed accurately due to factors such as motivation and maturity (i.e., the ability to receive instruction). If there is a large change in a ratio between muscular strength and size from the youngest to the oldest, then this might provide some indication that the youngest may not have been able to voluntarily activate their muscles for reasons mentioned previously. The purpose of this study was to observe the ratio between handgrip strength (HGS) and forearm muscle thickness (MT) across differing ages in younger children. A total of 1133 preschool children (559 boys and 574 girls) between the ages of 4.5 and 6.5 years had MT and HGS measurements and calculated the ratio of HGS/MT (kg/cm). Linear regression was used to assess the impact of age and sex on the dependent variables of MT, HGS, and the HGS/MT ratio. The HGS/MT ratio increases moderately from age 4.5 to 6.5 in both boys and girls. However, the difference in this ratio was small between the age ranges in this sample. Our results indicate children as young as 4.5 may be accurately measured with the handgrip strength test.
Collapse
Affiliation(s)
- Hayao Ozaki
- Department of Sport and Health Science, Tokai Gakuen University, Miyoshi, Aichi 470-0207, Japan;
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science & Recreation Management, The University of Mississippi, Oxford, MS 38677, USA;
- Correspondence:
| | - Scott J. Dankel
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ 08028, USA;
| | - Jeremy P. Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science & Recreation Management, The University of Mississippi, Oxford, MS 38677, USA;
| | - Toshiharu Natsume
- Graduate School of Health and Sports Science, Juntendo University, Inzai, Chiba 270-1695, Japan; (T.N.); (P.D.); (H.N.)
| | - Pengyu Deng
- Graduate School of Health and Sports Science, Juntendo University, Inzai, Chiba 270-1695, Japan; (T.N.); (P.D.); (H.N.)
| | - Hisashi Naito
- Graduate School of Health and Sports Science, Juntendo University, Inzai, Chiba 270-1695, Japan; (T.N.); (P.D.); (H.N.)
| |
Collapse
|
15
|
Asmussen MJ, Mauracher ME, Omu O, Nigg SR, Jarvis SE. Reliability and validity of a novel device for quantifying ankle dorsiflexion force in persons with multiple sclerosis. Mult Scler Relat Disord 2020; 40:101940. [DOI: 10.1016/j.msard.2020.101940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 12/14/2019] [Accepted: 01/08/2020] [Indexed: 10/25/2022]
|
16
|
Vergonjeanne M, Fayemendy P, Marin B, Penoty M, Lautrette G, Sourisseau H, Preux PM, Desport JC, Couratier P, Jésus P. Predictive factors for gastrostomy at time of diagnosis and impact on survival in patients with amyotrophic lateral sclerosis. Clin Nutr 2020; 39:3112-3118. [PMID: 32063408 DOI: 10.1016/j.clnu.2020.01.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/08/2020] [Accepted: 01/22/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Gastrostomy is recommended in patients with Amyotrophic Lateral Sclerosis (ALS) in the presence of weight loss over 10% as compared to usual weight, repeated aspirations or meal time duration longer than 45 min. Currently, the impact of gastrostomy on survival of ALS patients is not clear. AIMS i) to describe diagnosis factors associated with the indication for gastrostomy ii) to evaluate survival of ALS patients with gastrostomy indication according to their acceptance of feeding tube placement. METHODS Patients with ALS were included and followed in the ALS referral centre of Limoges's teaching hospital between 2006 and 2017. Neurological, nutritional and respiratory status was assessed prospectively from diagnosis to death. Statistical analysis was performed using Mann-Whitney test, Chi2 tests, Cox model and multivariate logistic regression. RESULTS Two hundred and eighty-five patients were included. Among the 182 for whom gastrostomy was indicated, 63.7% accepted the placement. The median time was 7.3 months [IQR: 3.2-15.0] and 2.7 months [IQR: 0.9-5.8] respectively from diagnosis to indication and from indication to placement. Weight loss >5% significantly increased the risk of death by 17% (p < 0.0001). At time of diagnosis, bulbar onset, a loss of one point in the body mass index or on the bulbar functional scale were all positively associated with indication for gastrostomy (aOR = 10.0 [95%CI: 1.96-25.0]; p = 0.002, aOR = 1.17 [95%CI: 1.02-1.36]; p = 0.025 and aOR = 1.19 [95%CI: 1.06-1.32]; p = 0.002, respectively). However, gastrostomy placement did not have any impact on survival (aHR = 1.25 [95%CI: 0.88-1.79]; p = 0.22). CONCLUSION Both neurological and nutritional criteria were associated with an indication for gastrostomy at diagnosis. Gastrostomy placement had no impact on survival. The study of earlier gastrostomy placement might be of interest in further prospective studies.
Collapse
Affiliation(s)
- Marion Vergonjeanne
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.
| | - Philippe Fayemendy
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; CHU Limoges, Department of Nutrition, Limoges, France.
| | - Benoit Marin
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; Epidemiology, Biostatistics and Methodological Research Centre, University Hospital of Limoges, France.
| | - Marie Penoty
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; ALS Center, Neurology Department, University Hospital of Limoges, France.
| | | | | | - Pierre-Marie Preux
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; Epidemiology, Biostatistics and Methodological Research Centre, University Hospital of Limoges, France.
| | - Jean-Claude Desport
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; CHU Limoges, Department of Nutrition, Limoges, France.
| | - Philippe Couratier
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; ALS Center, Neurology Department, University Hospital of Limoges, France.
| | - Pierre Jésus
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; CHU Limoges, Department of Nutrition, Limoges, France.
| |
Collapse
|
17
|
Modified behavioural tests to detect white matter injury- induced motor deficits after intracerebral haemorrhage in mice. Sci Rep 2019; 9:16958. [PMID: 31740745 PMCID: PMC6861313 DOI: 10.1038/s41598-019-53263-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 10/26/2019] [Indexed: 01/17/2023] Open
Abstract
Motor function deficit induced by white matter injury (WMI) is one of the most severe complications of intracerebral haemorrhage (ICH). The degree of WMI is closely related to the prognosis of patients after ICH. However, the current behavioural assessment of motor function used in the ICH mouse model is mainly based on that for ischaemic stroke and lacks the behavioural methods that accurately respond to WMI. Here, a series of easy-to-implement behavioural tests were performed to detect motor deficits in mice after ICH. The results showed that the grip strength test and the modified pole test not only can better distinguish the degree of motor dysfunction between different volumes of blood ICH models than the Basso Mouse Scale and the beam walking test but can also accurately reflect the severity of WMI characterized by demyelination, axonal swelling and the latency of motor-evoked potential delay induced by ICH. In addition, after ICH, the results of grip tests and modified pole tests, rather than the Basso Mouse Scale and the beam walking test, were worse than those observed after intraventricular haemorrhage (IVH), which was used as a model of brain haemorrhage in non-white matter areas. These results indicate that the grip strength test and the modified pole test have advantages in detecting the degree of motor deficit induced by white matter injury after ICH in mice.
Collapse
|
18
|
Crook A, Hogden A, Mumford V, Blair IP, Williams KL, Rowe DB. CMS-01 Genetic testing for familial amyotrophic lateral sclerosis (ALS): insights and challenges. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:327-347. [PMID: 31702461 DOI: 10.1080/21678421.2019.1647002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Pathogenic variants in ALS genes are known to be present in up to 70% of familial and 10% of apparently sporadic ALS cases, and can be associated with risks for ALS only, or risks for other neurodegenerative diseases (eg. frontotemporal dementia). While there are no changes to medical management for patients confirmed as pathogenic variant carriers, genetic testing may be important for future drug trials. Confirmation of a pathogenic variant also provides relatives with the opportunity to consider predictive and/or reproductive genetic testing. Genetic counselling is an important aspect of testing decision-making as it enables individuals to make informed decisions about genetic testing while minimising adverse psychological, ethical and legal outcomes. Few studies have explored how individuals decide whether to pursue testing, nor the needs and experiences of familial ALS families.Objective: To identify factors that influence patient and family member decision-making about genetic testing for ALS genes, assess the impact of familial disease on the patient and their family, and identify information and support needs.Methods: In-depth, semi-structured interviews with individuals from Australian ALS families with known pathogenic gene variants explored experiences of familial ALS, and factors that influenced genetic testing decision-making. Interviews were analysed using an inductive approach.Results: Thirty-four individuals from 24 families were interviewed and included patients (n = 4), spouses (n = 4), and asymptomatic at-risk relatives (n = 26). Life stage, experience of disease, costs, research opportunities, and attitudes to familial ALS and/or reproductive options influenced decision-making. Some patients and relatives experienced difficulty gaining accurate information from their health professionals about the costs and implications of genetic counselling or testing, resulting in a reluctance to proceed.Discussion and conclusion: This study provides new insight into the Australian experience of genetic testing and counselling for familial ALS. It highlights the need to work together with other health professionals to ensure the complexities of genetic testing decision-making, and referral pathways are better understood.
Collapse
Affiliation(s)
- Ashley Crook
- Department of Clinical Medicine.,Macquarie University Centre for Motor Neuron Disease Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences; Macquarie University, Sydney, Australia.,Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - Anne Hogden
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.,Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia
| | - Virginia Mumford
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Ian P Blair
- Macquarie University Centre for Motor Neuron Disease Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences; Macquarie University, Sydney, Australia
| | - Kelly L Williams
- Macquarie University Centre for Motor Neuron Disease Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences; Macquarie University, Sydney, Australia
| | - Dominic B Rowe
- Department of Clinical Medicine.,Macquarie University Centre for Motor Neuron Disease Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences; Macquarie University, Sydney, Australia
| |
Collapse
|
19
|
Mauracher ME, Asmussen MJ, Nigg SR, Omu O, Jarvis SE. Portable fixed dynamometry to quantify ankle dorsiflexion force. Muscle Nerve 2019; 60:56-61. [PMID: 30897217 DOI: 10.1002/mus.26476] [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: 01/15/2018] [Revised: 03/17/2019] [Accepted: 03/19/2019] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Quantifying muscle strength is critical in clinical and research settings. A rapid and objective method is ideal. The primary objective of this study was to examine the reliability of a novel device, the rapid objective quantification- tibialis anterior (ROQ-TA), which quantifies the dorsiflexion force of the tibialis anterior, and to assess its validity against isokinetic dynamometry (IKD). METHODS Ankle dorsiflexion of 20 healthy subjects was assessed by 3 modalities, ROQ-TA, manual muscle testing, and isokinetic dynamometry, over 2 testing sessions. RESULTS The intraclass correlation coefficient [ICC(2,1) ] for reliability was 0.872 (0.677-0.949) for the ROQ-TA and 0.892 (0.728-0.957) for IKD. For validity, the ICC(2,1) values for the ROQ-TA and IKD were in good agreement, with 0.672 (0.17-0.87) in the first testing session and 0.769 (0.42-0.91) in the second session. DISCUSSION The ROQ-TA is a valid and reliable device to test ankle dorsiflexion force in a healthy population. Muscle Nerve, 2018.
Collapse
Affiliation(s)
| | - Michael J Asmussen
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Sandro R Nigg
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Onutobor Omu
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Scott E Jarvis
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
20
|
Intraspinal Transplantation of the Adipose Tissue-Derived Regenerative Cells in Amyotrophic Lateral Sclerosis in Accordance with the Current Experts' Recommendations: Choosing Optimal Monitoring Tools. Stem Cells Int 2018; 2018:4392017. [PMID: 30158984 PMCID: PMC6109475 DOI: 10.1155/2018/4392017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/26/2018] [Accepted: 06/14/2018] [Indexed: 12/11/2022] Open
Abstract
Stem cells (SCs) may constitute a perspective alternative to pharmacological treatment in neurodegenerative diseases. Although the safety of SC transplantation has been widely shown, their clinical efficiency in amyotrophic lateral sclerosis (ALS) is still to be proved. It is not only due to a limited number of studies, small treatment groups, and fast but nonlinear disease progression but also due to lack of objective methods able to show subtle clinical changes. Preliminary guidelines for cell therapy have recently been proposed by a group of ALS experts. They combine clinical, neurophysiological, and functional assessment together with monitoring of the cytokine level. Here, we describe a pilot study on transplantation of autologous adipose-derived regenerative cells (ADRC) into the spinal cord of the patients with ALS and monitoring of the results in accordance with the current recommendations. To show early and/or subtle changes within the muscles of interest, a wide range of clinical and functional tests were used and compared in order to choose the most sensitive and optimal set. Additionally, an analysis of transplanted ADRC was provided to develop standards ensuring the derivation and verification of adequate quality of transplanted cells and to correlate ADRC properties with clinical outcome.
Collapse
|
21
|
Robinson-Papp J, George MC, Nmashie A, Weisz D, Simpson DM. Lower-extremity Dynamometry as a Novel Outcome Measure in a Double-blind, Placebo-controlled, Feasibility Trial of Intravenous Immunoglobulin (IVIG) for HIV-associated Myelopathy. INNOVATIONS IN CLINICAL NEUROSCIENCE 2018; 15:28-32. [PMID: 29497577 PMCID: PMC5819718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: Open-label data suggest that intravenous immunoglobulin (IVIG) might improve lower-extremity strength in human immunodeficiency virus (HIV)-associated myelopathy (HIVM), a rare but debilitating neurologic complication of HIV. We sought to determine the feasibility of testing the efficacy of IVIG for HIVM more rigorously. Design: We conducted a randomized, double-blind, placebo-controlled feasibility trial of IVIG for HIVM, using dynamometry as an outcome measure (Clinical Trial No. NCT01561755). Setting: The study took place in an academic medical center in New York, New York Participants: Only 12 participants were enrolled in four years; critical impediments to the study were the rarity of patients with new HIVM diagnoses and prior exposure to IVIG in patients with an established diagnosis. Measurements: Dynamometry of hip flexion, knee flexion, and ankle dorsiflexion were measured; the HIV Dementia Motor Score (HDMS); and the two-minute timed walk test were utilized. Results: Recruitment was the major feasibility issue. Dynamometry was generally well-tolerated, had good test-retest reliability (r=0.71-0.86, p<0.02 for all muscle groups), and good inter-item reliability as judged by the correlations between the muscle groups (r=0.76-0.81, p=0.001-0.005). Dynamometry was valid and clinically meaningful based on its correlations with the HDMS and the two-minute timed walk test. Conclusion: We conclude that an adequately powered clinical trial of IVIG for HIVM would likely require a prolonged recruitment period and multiple participating sites. Lower limb dynamometry is a useful outcome measure for HIVM, which might also be useful in other HIV-related gait disorders.
Collapse
Affiliation(s)
- Jessica Robinson-Papp
- Drs. Robinson-Papp, George, Nmashie and Simpson are with the Department of Neurology
- Dr. Weisz is with the Department of Neurosurgery-all from the Icahn School of Medicine at Mount Sinai in New York, New York
| | - Mary Catherine George
- Drs. Robinson-Papp, George, Nmashie and Simpson are with the Department of Neurology
- Dr. Weisz is with the Department of Neurosurgery-all from the Icahn School of Medicine at Mount Sinai in New York, New York
| | - Alexandra Nmashie
- Drs. Robinson-Papp, George, Nmashie and Simpson are with the Department of Neurology
- Dr. Weisz is with the Department of Neurosurgery-all from the Icahn School of Medicine at Mount Sinai in New York, New York
| | - Donald Weisz
- Drs. Robinson-Papp, George, Nmashie and Simpson are with the Department of Neurology
- Dr. Weisz is with the Department of Neurosurgery-all from the Icahn School of Medicine at Mount Sinai in New York, New York
| | - David M Simpson
- Drs. Robinson-Papp, George, Nmashie and Simpson are with the Department of Neurology
- Dr. Weisz is with the Department of Neurosurgery-all from the Icahn School of Medicine at Mount Sinai in New York, New York
| |
Collapse
|
22
|
Omejec G, Podnar S. Neurologic examination and instrument-based measurements in the evaluation of ulnar neuropathy at the elbow. Muscle Nerve 2018; 57:951-957. [DOI: 10.1002/mus.26046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 12/11/2017] [Accepted: 12/15/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Gregor Omejec
- Institute of Clinical Neurophysiology; University Medical Center Ljubljana, Zaloška cesta 7, SI-1525 Ljubljana; Slovenia
| | - Simon Podnar
- Institute of Clinical Neurophysiology; University Medical Center Ljubljana, Zaloška cesta 7, SI-1525 Ljubljana; Slovenia
| |
Collapse
|
23
|
Montes J, Young SD, Mazzone E, Main M. Workshop report. Neuromuscul Disord 2017; 27:S0960-8966(17)30577-1. [PMID: 28917631 DOI: 10.1016/j.nmd.2017.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 11/21/2022]
Affiliation(s)
- Jacqueline Montes
- Departments of Rehabilitation and Regenerative Medicine and Neurology, Columbia University Medical Center, New York, NY, USA.
| | - Sally Dunaway Young
- Departments of Rehabilitation and Regenerative Medicine and Neurology, Columbia University Medical Center, New York, NY, USA
| | - Elena Mazzone
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - Marion Main
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| |
Collapse
|
24
|
Andres PL, Allred MP, Stephens HE, Proffitt Bunnell M, Siener C, Macklin EA, Haines T, English RA, Fetterman KA, Kasarskis EJ, Florence J, Simmons Z, Cudkowicz ME. Fixed dynamometry is more sensitive than vital capacity or ALS rating scale. Muscle Nerve 2017; 56:710-715. [PMID: 28120413 DOI: 10.1002/mus.25586] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/06/2017] [Accepted: 01/19/2017] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Improved outcome measures are essential to efficiently screen the growing number of potential amyotrophic lateral sclerosis (ALS) therapies. METHODS This longitudinal study of 100 (70 male) participants with ALS compared Accurate Test of Limb Isometric Strength (ATLIS), using a fixed, wireless load cell, with ALS Functional Rating Scale-Revised (ALSFRS-R) and vital capacity (VC). RESULTS Participants enrolled at 5 U.S. sites. Data were analyzed from 66 participants with complete ATLIS, ALSFRS-R, and VC data over at least 3 visits. Change in ATLIS was less variable both within- and among-person than change in ALSFRS-R or VC. Additionally, participants who had normal ALSFRS-R arm and leg function averaged 12 to 32% below expected strength values measured by ATLIS. CONCLUSIONS ATLIS was more sensitive to change than ALSFRS-R or VC and could decrease sample size requirements by approximately one-third. The ability of ATLIS to detect prefunctional change has potential value in early trials. Muscle Nerve 56: 710-715, 2017.
Collapse
Affiliation(s)
| | | | | | | | | | - Eric A Macklin
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Travis Haines
- Pennsylvania State University, Hershey, Pennsylvania, USA
| | | | | | | | | | | | | |
Collapse
|
25
|
Shefner JM, Sabbagh MN. An Appraisal of Novel Biomarkers for Evaluating and Monitoring Neurologic Diseases: Editorial Introduction. Neurotherapeutics 2017; 14:1-3. [PMID: 27933486 PMCID: PMC5233637 DOI: 10.1007/s13311-016-0502-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Jeremy M. Shefner
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ USA
| | - Marwan N. Sabbagh
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ USA
| |
Collapse
|