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Labella B, Cotti Piccinelli S, Risi B, Caria F, Damioli S, Bertella E, Poli L, Padovani A, Filosto M. A Comprehensive Update on Late-Onset Pompe Disease. Biomolecules 2023; 13:1279. [PMID: 37759679 PMCID: PMC10526932 DOI: 10.3390/biom13091279] [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: 06/17/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Pompe disease (PD) is an autosomal recessive disorder caused by mutations in the GAA gene that lead to a deficiency in the acid alpha-glucosidase enzyme. Two clinical presentations are usually considered, named infantile-onset Pompe disease (IOPD) and late-onset Pompe disease (LOPD), which differ in age of onset, organ involvement, and severity of disease. Assessment of acid alpha-glucosidase activity on a dried blood spot is the first-line screening test, which needs to be confirmed by genetic analysis in case of suspected deficiency. LOPD is a multi-system disease, thus requiring a multidisciplinary approach for efficacious management. Enzyme replacement therapy (ERT), which was introduced over 15 years ago, changes the natural progression of the disease. However, it has limitations, including a reduction in efficacy over time and heterogeneous therapeutic responses among patients. Novel therapeutic approaches, such as gene therapy, are currently under study. We provide a comprehensive review of diagnostic advances in LOPD and a critical discussion about the advantages and limitations of current and future treatments.
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Affiliation(s)
- Beatrice Labella
- Department of Clinical and Experimental Sciences, University of Brescia, 25100 Brescia, Italy; (B.L.); (S.C.P.); (A.P.)
- Unit of Neurology, ASST Spedali Civili, 25100 Brescia, Italy;
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia, 25100 Brescia, Italy; (B.L.); (S.C.P.); (A.P.)
- NeMO-Brescia Clinical Center for Neuromuscular Diseases, 25064 Brescia, Italy; (B.R.); (F.C.); (S.D.); (E.B.)
| | - Barbara Risi
- NeMO-Brescia Clinical Center for Neuromuscular Diseases, 25064 Brescia, Italy; (B.R.); (F.C.); (S.D.); (E.B.)
| | - Filomena Caria
- NeMO-Brescia Clinical Center for Neuromuscular Diseases, 25064 Brescia, Italy; (B.R.); (F.C.); (S.D.); (E.B.)
| | - Simona Damioli
- NeMO-Brescia Clinical Center for Neuromuscular Diseases, 25064 Brescia, Italy; (B.R.); (F.C.); (S.D.); (E.B.)
| | - Enrica Bertella
- NeMO-Brescia Clinical Center for Neuromuscular Diseases, 25064 Brescia, Italy; (B.R.); (F.C.); (S.D.); (E.B.)
| | - Loris Poli
- Unit of Neurology, ASST Spedali Civili, 25100 Brescia, Italy;
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, 25100 Brescia, Italy; (B.L.); (S.C.P.); (A.P.)
- Unit of Neurology, ASST Spedali Civili, 25100 Brescia, Italy;
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, 25100 Brescia, Italy; (B.L.); (S.C.P.); (A.P.)
- NeMO-Brescia Clinical Center for Neuromuscular Diseases, 25064 Brescia, Italy; (B.R.); (F.C.); (S.D.); (E.B.)
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2
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Álvarez-Velasco R, Nuñez-Peralta CA, Alonso-Pérez J, Gallardo E, Collet-Vidiella R, Reyes-Leiva D, Pascual-Goñi E, Martín-Aguilar L, Caballero-Ávila M, Carbayo-Viejo A, Llauger-Roselló J, Díaz-Manera J, Olivé M. HIGH PREVALENCE OF PARASPINAL MUSCLE INVOLVEMENT IN ADULTS WITH McARDLE DISEASE. Muscle Nerve 2022; 65:568-573. [PMID: 35174518 DOI: 10.1002/mus.27523] [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: 08/06/2021] [Revised: 02/08/2022] [Accepted: 02/12/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION/AIMS Very few studies analyzing the pattern of muscle involvement in magnetic resonance imaging (MRI) of patients with McArdle disease have been reported to date. We aimed to examine the pattern of muscle fat replacement in patients with McArdle disease. METHODS We performed a retrospective study including all patients with genetically confirmed McArdle disease followed in our center from January 2010 to March 2021. Clinical data were collected from the medical record. Whole-body MRI was performed as part of the diagnostic evaluation. The distribution of muscle fat replacement and its severity were analyzed. RESULTS Nine patients were included. Median age at onset was 7 years (range:5-58) and median age at the time when MRI was performed was 57.3 years (range 37.2-72.8). At physical examination 4 patients had permanent weakness: in 3 the weakness was limited to paraspinal muscles whereas in one the weakness involved the paraspinal and proximal upper limb muscles. Muscle MRI showed abnormalities in 6 of the 7 studied patients. In all of them fat replacement of paravertebral muscles was found. Other muscles frequently affected were the tongue in 3, subscapularis in 3, and long head of biceps femoris and semimembranosus in 2. DISCUSSION Our findings suggest that paraspinal muscle involvement is common in McArdle disease and support the need to include this disease in the differential diagnosis of the causes of paraspinal muscle weakness. Involvement of the tongue and subscapularis are also frequent in McArdle disease. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- R Álvarez-Velasco
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - C A Nuñez-Peralta
- Department of Radiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Alonso-Pérez
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - E Gallardo
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - R Collet-Vidiella
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - D Reyes-Leiva
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - E Pascual-Goñi
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - L Martín-Aguilar
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - M Caballero-Ávila
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - A Carbayo-Viejo
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Llauger-Roselló
- Department of Radiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Díaz-Manera
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,John Walton Muscular Dystrophy Research Centre, Newcastle University, International Centre for Life, Newcastle upon Tyne, UK
| | - M Olivé
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
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3
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Bordoli C, Murphy E, Varley I, Sharpe G, Hennis P. A Systematic Review investigating the Effectiveness of Exercise training in Glycogen Storage Diseases. THERAPEUTIC ADVANCES IN RARE DISEASE 2022; 3:26330040221076497. [PMID: 37180413 PMCID: PMC10032442 DOI: 10.1177/26330040221076497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/04/2022] [Indexed: 05/16/2023]
Abstract
Introduction Glycogen storage diseases (GSDs) are rare inborn errors of carbohydrate metabolism typically with skeletal muscle and liver involvement. In those with skeletal muscle involvement, the majority display symptoms of exercise intolerance which can cause profound exercise limitation and impair everyday living and quality of life (QoL). There are no curative treatments for GSDs, thus therapeutic options, such as exercise training, are aimed at improving QoL by alleviating signs and symptoms. In order to investigate the effectiveness of exercise training in adults with GSDs, we systematically reviewed the literature. Methods In this review we conducted searches within SCOPUS and MEDLINE to identify potential papers for inclusion. These papers were independently assessed for inclusion and quality by two authors. We identified 23 studies which included aerobic training, strength training or respiratory muscle training in patients with McArdles (n = 41) and Pompe disease (n = 139). Results In McArdle disease, aerobic exercise training improved aerobic capacity (VO2 peak) by 14-111% with further benefits to functional capacity and well-being. Meanwhile, strength training increased muscle peak power by 100-151% and reduced disease severity. In Pompe disease, a combination of aerobic and strength training improved VO2 peak by 9-10%, muscle peak power by 64%, functional capacity and well-being. Furthermore, respiratory muscle training (RMT) improved respiratory muscular strength [maximum inspiratory pressure (MIP) increased by up to 65% and maximum expiratory pressure (MEP) by up to 70%], with additional benefits shown in aerobic capacity, functional capacity and well-being. Conclusion This adds to the growing body of evidence which suggests that supervised exercise training is safe and effective in improving aerobic capacity and muscle function in adults with McArdle or Pompe disease. However, the literature base is limited in quality and quantity with a dearth of literature regarding exercise training in other GSD subtypes.
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Affiliation(s)
- Claire Bordoli
- Sport, Health and Performance Enhancement
(SHAPE) Research Centre, Nottingham Trent University, Clifton Lane, Clifton,
Nottingham NG11 8NS, UK
| | - Elaine Murphy
- Charles Dent Metabolic Unit, The National
Hospital for Neurology and Neurosurgery, London, UK
| | - Ian Varley
- Sport, Health and Performance Enhancement
(SHAPE) Research Centre, Nottingham Trent University, Nottingham, UK
| | - Graham Sharpe
- Sport, Health and Performance Enhancement
(SHAPE) Research Centre, Nottingham Trent University, Nottingham, UK
| | - Philip Hennis
- Sport, Health and Performance Enhancement
(SHAPE) Research Centre, Nottingham Trent University, Nottingham, UK
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4
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Ravaglia S, Barbarito N, Malovini A, Cirio S, Pichiecchio A, De Filippi P, Danesino C, Carlucci A. Late-onset Pompe disease (LOPD): May axial myopathy influence respiratory dysfunction? Pulmonology 2021; 27:566-568. [PMID: 34253492 DOI: 10.1016/j.pulmoe.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
| | - Nicola Barbarito
- U.O. Pneumologia, Istituto Palazzolo, Fondazione Don Gnocchi, Milano, Italy
| | - Alberto Malovini
- Laboratorio di Informatica e Sistemistica per la Ricerca Clinica, IRCCS Istituti Clinici Scientifici Salvatore Maugeri, Pavia, Italy
| | - Serena Cirio
- U.O. di Pneumologia Riabilitativa, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | | | | | | | - Annalisa Carlucci
- U.O. di Pneumologia Riabilitativa, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy; Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria, Varese - Como, Italy
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5
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Vaeggemose M, Mencagli RA, Hansen JS, Dräger B, Ringgaard S, Vissing J, Andersen H. Function, structure and quality of striated muscles in the lower extremities in patients with late onset Pompe Disease-an MRI study. PeerJ 2021; 9:e10928. [PMID: 33996274 PMCID: PMC8106912 DOI: 10.7717/peerj.10928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/20/2021] [Indexed: 11/20/2022] Open
Abstract
Background Pompe Disease (PD) is a rare inherited metabolic myopathy, caused by lysosomal-α-glucosidase (GAA) deficiency, which leads to glycogen accumulation within the lysosomes, resulting in cellular and tissue damage. Due to the emergence of a disease modifying treatment with recombinant GAA there has been a large increase in studies of late onset Pompe Disease (LOPD) during the last decade. Methods The present study evaluates muscle quality in 10 patients with LOPD receiving treatment with enzyme replacement therapy and in 10 age and gender matched healthy controls applying T1-weighted Dixon MR imaging and isokinetic dynamometry. Muscle quality was determined by muscle strength in relation to muscle size (contractile cross-sectional area, CSA) and to muscle quality (fat fraction). A follow-up evaluation of the patients was performed after 8–12 months. Patient evaluations also included: six-minute walking test (6MWT), forced vital capacity, manual muscle testing and SF-36 questionnaire. Results Fat fraction of knee flexors (0.15 vs 0.07, p < 0.05) and hip muscles (0.11 vs 0.07, p < 0.05) were higher in patients than controls. In patients, contractile CSA correlated with muscle strength (knee flexors: r = 0.86, knee extensors: r = 0.88, hip extensors: r = 0.83, p < 0.05). No correlation was found between fat fraction and muscle strength. The fat fraction of thigh muscles did not correlate with scores from the clinical tests nor did it correlate with the 6MWT. During follow-up, the contractile CSA of the knee extensors increased by 2%. No other statistically significant change was observed. Quantitative MRI reflects muscle function in patients with LOPD, but larger long-term studies are needed to evaluate its utility in detecting changes over time.
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Affiliation(s)
| | | | | | - Bianca Dräger
- Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Münster, Germany
| | | | - John Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Henning Andersen
- Department of Neurology, Aarhus University Hospital, Aarhus N, Denmark
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6
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Aivazoglou LU, Guimarães JB, Link TM, Costa MAF, Cardoso FN, de Mattos Lombardi Badia B, Farias IB, de Rezende Pinto WBV, de Souza PVS, Oliveira ASB, de Siqueira Carvalho AA, Aihara AY, da Rocha Corrêa Fernandes A. MR imaging of inherited myopathies: a review and proposal of imaging algorithms. Eur Radiol 2021; 31:8498-8512. [PMID: 33881569 DOI: 10.1007/s00330-021-07931-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/05/2021] [Accepted: 03/23/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW The aims of this review are to discuss the imaging modalities used to assess muscle changes in myopathies, to provide an overview of the inherited myopathies focusing on their patterns of muscle involvement in magnetic resonance imaging (MR), and to propose up-to-date imaging-based diagnostic algorithms that can help in the diagnostic workup. CONCLUSION Familiarization with the most common and specific patterns of muscular involvement in inherited myopathies is very important for radiologists and neurologists, as imaging plays a significant role in diagnosis and follow-up of these patients. KEY POINTS • Imaging is an increasingly important tool for diagnosis and follow-up in the setting of inherited myopathies. • Knowledge of the most common imaging patterns of muscle involvement in inherited myopathies is valuable for both radiologists and neurologists. • In this review, we present imaging-based algorithms that can help in the diagnostic workup of myopathies.
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Affiliation(s)
- Laís Uyeda Aivazoglou
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil.,Laboratório Delboni Auriemo - Grupo DASA, Av Juruá, 434, Barueri, SP, 06455-010, Brazil
| | - Julio Brandão Guimarães
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil. .,Musculoskeletal and Quantitative Imaging Research Group (MQIR), Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, USA.
| | - Thomas M Link
- Musculoskeletal and Quantitative Imaging Research Group (MQIR), Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Maria Alice Freitas Costa
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil.,Laboratório Delboni Auriemo - Grupo DASA, Av Juruá, 434, Barueri, SP, 06455-010, Brazil
| | - Fabiano Nassar Cardoso
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil
| | - Bruno de Mattos Lombardi Badia
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Igor Braga Farias
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Wladimir Bocca Vieira de Rezende Pinto
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Paulo Victor Sgobbi de Souza
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Acary Souza Bulle Oliveira
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Alzira Alves de Siqueira Carvalho
- Laboratório de Doenças Neuromusculares da Faculdade de Medicina do ABC - Departamento de Neurociências, Av. Lauro Gomes, 2000, Santo André, SP, 09060-870, Brazil
| | - André Yui Aihara
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil.,Laboratório Delboni Auriemo - Grupo DASA, Av Juruá, 434, Barueri, SP, 06455-010, Brazil
| | - Artur da Rocha Corrêa Fernandes
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil
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7
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van Doorn JLM, Pennati F, Hansen HHG, van Engelen BGM, Aliverti A, Doorduin J. Respiratory muscle imaging by ultrasound and MRI in neuromuscular disorders. Eur Respir J 2021; 58:13993003.00137-2021. [PMID: 33863737 DOI: 10.1183/13993003.00137-2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/26/2021] [Indexed: 11/05/2022]
Abstract
Respiratory muscle weakness is common in neuromuscular disorders and leads to significant respiratory difficulties. Therefore, reliable and easy assessment of respiratory muscle structure and function in neuromuscular disorders is crucial. In the last decade, ultrasound and MRI emerged as promising imaging techniques to assess respiratory muscle structure and function. Respiratory muscle imaging directly measures the respiratory muscles and, in contrast to pulmonary function testing, is independent of patient effort. This makes respiratory muscle imaging suitable to use as tool in clinical respiratory management and as outcome parameter in upcoming drug trials for neuromuscular disorders, particularly in children. In this narrative review, we discuss the latest studies and technological developments in imaging of the respiratory muscles by US and MR, and its clinical application and limitations. We aim to increase understanding of respiratory muscle imaging and facilitate its use as outcome measure in daily practice and clinical trials.
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Affiliation(s)
- Jeroen L M van Doorn
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Francesca Pennati
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Hendrik H G Hansen
- Department of Medical Imaging, Medical Ultrasound Imaging Center (MUSIC), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Jonne Doorduin
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
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8
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Starbuck C, Reay J, Silk E, Roberts M, Hendriksz C, Jones R. Are there common walking gait characteristics in patients diagnosed with late-onset Pompe disease? Hum Mov Sci 2021; 77:102777. [PMID: 33730657 DOI: 10.1016/j.humov.2021.102777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/07/2020] [Accepted: 02/28/2021] [Indexed: 11/26/2022]
Abstract
Late-onset Pompe disease (LOPD) is a rare disease, defined as a progressive accumulation of lysosomal glycogen resulting in muscle weakness and respiratory problems. Anecdotally, individuals often have difficulties walking, yet, there is no three-dimensional data supporting these claims. We aimed to assess walking patterns in individuals with LOPD and compare with healthy individuals. Kinematic, kinetic and spatiotemporal data were compared during walking at a self-selected speed between individuals with LOPD (n = 12) and healthy controls (n = 12). Gait profile scores and movement analysis profiles were also determined to indicate gait quality. In comparison with healthy individuals, the LOPD group demonstrated greater thoracic sway (96%), hip adduction angles (56%) and pelvic range of motion (77%) and reduced hip extensor moments (36%). Greater group variance for the LOPD group were also observed. Individuals with LOPD had a slower (15%) walking speed and reduced cadence (7%). Gait profile scores were 37% greater in the LOPD group compared to the healthy group. Proximal muscular weakness associated with LOPD disease is likely to have resulted in a myopathic gait pattern, slower selected walking speeds and deviations in gait patterns. Although individuals with LOPD presented with some common characteristics, greater variability in gait patterns is likely to be a result of wide variability in phenotype spectrum observed with LOPD. This is the first study to examine walking in individuals with LOPD using instrumented gait analysis and provides an understanding of LOPD on walking function which can help orientate physiotherapy treatment for individuals with LOPD.
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Affiliation(s)
- Chelsea Starbuck
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK.
| | - Julie Reay
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK
| | - Edward Silk
- The Mark Holland Metabolic Unit, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK
| | - Mark Roberts
- The Mark Holland Metabolic Unit, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK
| | - Christian Hendriksz
- The Mark Holland Metabolic Unit, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK
| | - Richard Jones
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK
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9
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Díaz-Manera J, Walter G, Straub V. Skeletal muscle magnetic resonance imaging in Pompe disease. Muscle Nerve 2020; 63:640-650. [PMID: 33155691 DOI: 10.1002/mus.27099] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/11/2020] [Accepted: 10/18/2020] [Indexed: 12/12/2022]
Abstract
Pompe disease is characterized by a deficiency of acid alpha-glucosidase that results in muscle weakness and a variable degree of disability. There is an approved therapy based on enzymatic replacement that has modified disease progression. Several reports describing muscle magnetic resonance imaging (MRI) features of Pompe patients have been published. Most of the studies have focused on late-onset Pompe disease (LOPD) and identified a characteristic pattern of muscle involvement useful for the diagnosis. In addition, quantitative MRI studies have shown a progressive increase in fat in skeletal muscles of LOPD over time and they are increasingly considered a good tool to monitor progression of the disease. The studies performed in infantile-onset Pompe disease patients have shown less consistent changes. Other more sophisticated muscle MRI sequences, such as diffusion tensor imaging or glycogen spectroscopy, have also been used in Pompe patients and have shown promising results.
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Affiliation(s)
- Jordi Díaz-Manera
- John Walton Muscular Dystrophy Research Center, Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK.,Neuromuscular Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Enfermedades Raras, Barcelona, Spain
| | - Glenn Walter
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, Florida, USA
| | - Volker Straub
- John Walton Muscular Dystrophy Research Center, Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
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10
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Peculiar muscle imaging findings in a patient with alphaB-crystallinopathy and axial myopathy. J Neurol Sci 2020; 416:116999. [PMID: 32619840 DOI: 10.1016/j.jns.2020.116999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/28/2020] [Accepted: 06/15/2020] [Indexed: 11/21/2022]
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11
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Hofste A, Soer R, Hermens HJ, Wagner H, Oosterveld FGJ, Wolff AP, Groen GJ. Inconsistent descriptions of lumbar multifidus morphology: A scoping review. BMC Musculoskelet Disord 2020; 21:312. [PMID: 32429944 PMCID: PMC7236939 DOI: 10.1186/s12891-020-03257-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/31/2020] [Indexed: 12/18/2022] Open
Abstract
Background Lumbar multifidus (LM) is regarded as the major stabilizing muscle of the spine. The effects of exercise therapy in low back pain (LBP) are attributed to this muscle. A current literature review is warranted, however, given the complexity of LM morphology and the inconsistency of anatomical descriptions in the literature. Methods Scoping review of studies on LM morphology including major anatomy atlases. All relevant studies were searched in PubMed (Medline) and EMBASE until June 2019. Anatomy atlases were retrieved from multiple university libraries and online. All studies and atlases were screened for the following LM parameters: location, imaging methods, spine levels, muscle trajectory, muscle thickness, cross-sectional area, and diameter. The quality of the studies and atlases was also assessed using a five-item evaluation system. Results In all, 303 studies and 19 anatomy atlases were included in this review. In most studies, LM morphology was determined by MRI, ultrasound imaging, or drawings – particularly for levels L4–S1. In 153 studies, LM is described as a superficial muscle only, in 72 studies as a deep muscle only, and in 35 studies as both superficial and deep. Anatomy atlases predominantly depict LM as a deep muscle covered by the erector spinae and thoracolumbar fascia. About 42% of the studies had high quality scores, with 39% having moderate scores and 19% having low scores. The quality of figures in anatomy atlases was ranked as high in one atlas, moderate in 15 atlases, and low in 3 atlases. Discussion Anatomical studies of LM exhibit inconsistent findings, describing its location as superficial (50%), deep (25%), or both (12%). This is in sharp contrast to anatomy atlases, which depict LM predominantly as deep muscle. Within the limitations of the self-developed quality-assessment tool, high-quality scores were identified in a majority of studies (42%), but in only one anatomy atlas. Conclusions We identified a lack of standardization in the depiction and description of LM morphology. This could affect the precise understanding of its role in background and therapy in LBP patients. Standardization of research methodology on LM morphology is recommended. Anatomy atlases should be updated on LM morphology.
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Affiliation(s)
- Anke Hofste
- Anesthesiology Pain Center, University of Groningen, University Medical Center Groningen, Location Beatrixoord, Dilgtweg 5, Haren, the Netherlands. .,Faculty of Physical Activity and Health, Saxion University of Applied Sciences, Enschede, the Netherlands.
| | - Remko Soer
- Anesthesiology Pain Center, University of Groningen, University Medical Center Groningen, Location Beatrixoord, Dilgtweg 5, Haren, the Netherlands.,Faculty of Physical Activity and Health, Saxion University of Applied Sciences, Enschede, the Netherlands
| | - Hermie J Hermens
- Department of Biomedical Signals & Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, the Netherlands.,Telemedicine Group, Roessingh Research and Development, Enschede, the Netherlands
| | - Heiko Wagner
- Department of Movement Science, Institute of Sport and Exercise Sciences, Münster, Germany
| | - Frits G J Oosterveld
- Faculty of Physical Activity and Health, Saxion University of Applied Sciences, Enschede, the Netherlands
| | - André P Wolff
- Anesthesiology Pain Center, University of Groningen, University Medical Center Groningen, Location Beatrixoord, Dilgtweg 5, Haren, the Netherlands
| | - Gerbrand J Groen
- Anesthesiology Pain Center, University of Groningen, University Medical Center Groningen, Location Beatrixoord, Dilgtweg 5, Haren, the Netherlands
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12
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Iolascon G, Vitacca M, Carraro E, Chisari C, Fiore P, Messina S, Mongini T, Moretti A, Sansone VA, Toscano A, Siciliano G. Adapted physical activity and therapeutic exercise in late-onset Pompe disease (LOPD): a two-step rehabilitative approach. Neurol Sci 2020; 41:859-868. [PMID: 31811531 DOI: 10.1007/s10072-019-04178-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/25/2019] [Indexed: 02/08/2023]
Abstract
Aerobic exercise, training to sustain motor ability, and respiratory rehabilitation may improve general functioning and quality of life (QoL) in neuromuscular disorders. Patients with late-onset Pompe disease (LOPD) typically show progressive muscle weakness, respiratory dysfunction and minor cardiac involvement. Characteristics and modalities of motor and respiratory rehabilitation in LOPD are not well defined and specific guidelines are lacking. Therefore, we evaluated the role of physical activity, therapeutic exercise, and pulmonary rehabilitation programs in order to promote an appropriate management of motor and respiratory dysfunctions and improve QoL in patients with LOPD. We propose two operational protocols: one for an adapted physical activity (APA) plan and the other for an individual rehabilitation plan, particularly focused on therapeutic exercise (TE) and respiratory rehabilitation.
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Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy.
| | - Michele Vitacca
- FERS Respiratory Rehabilitation Unit, ICS S. Maugeri IRCCS, Lumezzane, BS, Italy
| | - Elena Carraro
- NeuroMuscular Omnicentre, Fondazione Serena Onlus, Neurorehabilitation Unit, University of Milan, Milan, Italy
| | - Carmelo Chisari
- Unit of Neurorehabilitation, Department of Medical Specialties, University Hospital of Pisa, Pisa, Italy
| | - Pietro Fiore
- Department of Basic Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Sonia Messina
- Neurology and Neuromuscular Unit, University of Messina, Messina, Italy
| | - Tiziana Mongini
- Neuromuscular Unit, Department of Neurosciences, University of Turin, Turin, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Valeria A Sansone
- NeuroMuscular Omnicentre, Fondazione Serena Onlus, Neurorehabilitation Unit, University of Milan, Milan, Italy
| | - Antonio Toscano
- Neurology and Neuromuscular Unit, University of Messina, Messina, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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13
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Diamanti L, Paoletti M, Di Vita U, Muzic SI, Cereda C, Ballante E, Pichiecchio A. MRI study of paraspinal muscles in patients with Amyotrophic Lateral Sclerosis (ALS). J Clin Med 2020; 9:jcm9040934. [PMID: 32231147 PMCID: PMC7230865 DOI: 10.3390/jcm9040934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/18/2020] [Accepted: 03/21/2020] [Indexed: 01/16/2023] Open
Abstract
Background: the study of paraspinal muscles is pivotal for the diagnosis and staging of Amyotrophic Lateral Sclerosis (ALS), and is usually performed by electromyography. Objective: to evaluate the role of paraspinal muscle MRI as a diagnostic biomarker in ALS. Methods: we evaluated T1-w images of newly diagnosed ALS patients (n = 14), age-matched healthy controls (n = 11), patients affected by inflammatory myopathy (n = 10), and lumbar radiculopathy (n = 19), and compared them semiquantitatively by using the Mercuri Scale. Results: a significant difference in the appearance of the psoas muscle was observed between ALS patients and patients with radiculopathy (p = 0.003); after stratifying ALS patients into spinal and bulbar onsets, we found a significant difference in the appearance of the longissimus dorsi muscle between the spinal onset ALS subgroup and bulbar onset ALS subgroup (p = 0.0245), while no difference was found for multifidus (p = 0.1441), iliocostal (p = 0.0655), and psoas muscles (p = 0.0813) between the cohort subgroups. Conclusions: paraspinal T1-w MRI could help to distinguish spinal ALS patients from healthy and pathological controls. Specifically, the study of longissimus dorsi could play the role of a diagnostic ALS biomarker.
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Affiliation(s)
- Luca Diamanti
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.P.); (C.C.); (E.B.); (A.P.)
- Correspondence: ; Tel.: +39-382-3801
| | - Matteo Paoletti
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.P.); (C.C.); (E.B.); (A.P.)
| | - Umberto Di Vita
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (U.D.V.); (S.I.M.)
| | - Shaun Ivan Muzic
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (U.D.V.); (S.I.M.)
| | - Cristina Cereda
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.P.); (C.C.); (E.B.); (A.P.)
| | - Elena Ballante
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.P.); (C.C.); (E.B.); (A.P.)
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (U.D.V.); (S.I.M.)
| | - Anna Pichiecchio
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.P.); (C.C.); (E.B.); (A.P.)
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (U.D.V.); (S.I.M.)
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14
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Pena LD, Barohn RJ, Byrne BJ, Desnuelle C, Goker-Alpan O, Ladha S, Laforêt P, Mengel KE, Pestronk A, Pouget J, Schoser B, Straub V, Trivedi J, Van Damme P, Vissing J, Young P, Kacena K, Shafi R, Thurberg BL, Culm-Merdek K, van der Ploeg AT. Safety, tolerability, pharmacokinetics, pharmacodynamics, and exploratory efficacy of the novel enzyme replacement therapy avalglucosidase alfa (neoGAA) in treatment-naïve and alglucosidase alfa-treated patients with late-onset Pompe disease: A phase 1, open-label, multicenter, multinational, ascending dose study. Neuromuscul Disord 2019; 29:167-186. [DOI: 10.1016/j.nmd.2018.12.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 01/10/2023]
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15
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Fernández-Simón E, Carrasco-Rozas A, Gallardo E, Figueroa-Bonaparte S, Belmonte I, Pedrosa I, Montiel E, Suárez-Calvet X, Alonso-Pérez J, Segovia S, Nuñez-Peralta C, Llauger J, Mayos M, Illa I, Díaz-Manera J. PDGF-BB serum levels are decreased in adult onset Pompe patients. Sci Rep 2019; 9:2139. [PMID: 30765719 PMCID: PMC6375999 DOI: 10.1038/s41598-018-38025-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/19/2018] [Indexed: 12/19/2022] Open
Abstract
Adult onset Pompe disease is a genetic disorder characterized by slowly progressive skeletal and respiratory muscle weakness. Symptomatic patients are treated with enzymatic replacement therapy with human recombinant alfa glucosidase. Motor functional tests and spirometry are commonly used to follow patients up. However, a serological biomarker that correlates with the progression of the disease could improve follow-up. We studied serum concentrations of TGFβ, PDGF-BB, PDGF-AA and CTGF growth factors in 37 adult onset Pompe patients and 45 controls. Moreover, all patients performed several muscle function tests, conventional spirometry, and quantitative muscle MRI using 3-point Dixon. We observed a statistically significant change in the serum concentration of each growth factor in patients compared to controls. However, only PDGF-BB levels were able to differentiate between asymptomatic and symptomatic patients, suggesting its potential role in the follow-up of asymptomatic patients. Moreover, our results point to a dysregulation of muscle regeneration as an additional pathomechanism of Pompe disease.
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Affiliation(s)
- Esther Fernández-Simón
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Carrasco-Rozas
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eduard Gallardo
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Sebastián Figueroa-Bonaparte
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Izaskun Belmonte
- Rehabilitation and physiotherapy department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Irene Pedrosa
- Rehabilitation and physiotherapy department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Montiel
- Rehabilitation and physiotherapy department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Suárez-Calvet
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Jorge Alonso-Pérez
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sonia Segovia
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Claudia Nuñez-Peralta
- Radiology department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaume Llauger
- Radiology department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mercedes Mayos
- Respiratory department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Illa
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | | | - Jordi Díaz-Manera
- Neuromuscular Disorders Unit. Neurology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Barcelona, Spain.
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16
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Paoletti M, Pichiecchio A, Cotti Piccinelli S, Tasca G, Berardinelli AL, Padovani A, Filosto M. Advances in Quantitative Imaging of Genetic and Acquired Myopathies: Clinical Applications and Perspectives. Front Neurol 2019; 10:78. [PMID: 30804884 PMCID: PMC6378279 DOI: 10.3389/fneur.2019.00078] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022] Open
Abstract
In the last years, magnetic resonance imaging (MRI) has become fundamental for the diagnosis and monitoring of myopathies given its ability to show the severity and distribution of pathology, to identify specific patterns of damage distribution and to properly interpret a number of genetic variants. The advances in MR techniques and post-processing software solutions have greatly expanded the potential to assess pathological changes in muscle diseases, and more specifically of myopathies; a number of features can be studied and quantified, ranging from composition, architecture, mechanical properties, perfusion, and function, leading to what is known as quantitative MRI (qMRI). Such techniques can effectively provide a variety of information beyond what can be seen and assessed by conventional MR imaging; their development and application in clinical practice can play an important role in the diagnostic process and in assessing disease course and treatment response. In this review, we briefly discuss the current role of muscle MRI in diagnosing muscle diseases and describe in detail the potential and perspectives of the application of advanced qMRI techniques in this field.
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Affiliation(s)
- Matteo Paoletti
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Anna Pichiecchio
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Stefano Cotti Piccinelli
- Unit of Neurology, Center for Neuromuscular Diseases, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Giorgio Tasca
- Neurology Department, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Alessandro Padovani
- Unit of Neurology, Center for Neuromuscular Diseases, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Massimiliano Filosto
- Unit of Neurology, Center for Neuromuscular Diseases, ASST Spedali Civili and University of Brescia, Brescia, Italy
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17
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Plöckinger U, Prasad V, Ziagaki A, Tiling N, Poellinger A. 2-deoxy-2-[18]fluoro-D-glucose PET/CT (18FDG PET/CT) may not be a viable biomarker in Pompe disease. Hum Genomics 2018. [PMID: 29523196 PMCID: PMC5845361 DOI: 10.1186/s40246-018-0145-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Pompe disease (PD) is an autosomal recessive, lysosomal storage disease due to a mutation of the acid α-glucosidase (GAA) gene. In adult patients, PD is characterized by slowly progressive limb-girdle and trunk myopathy and restrictive respiratory insufficiency. Enzyme replacement therapy (ERT) is available, improving or stabilizing muscle-function in some and slowing deterioration in other patients. Unfortunately, there is no biomarker available to indicate therapeutic efficacy and/or disease activity. Whole body MRI depicts all skeletal muscles demonstrating foci of atrophic muscles, i.e., late and irreversible pathological changes. Any method indicating the localizations of increased muscle glycogen storage, muscle inflammation and/or degradation could possibly help identifying newly afflicted tissue and may be of prognostic value. We therefore investigated 2-deoxy-2-[18]fluoro-D-glucose (FDG) PET, a biomarker for glucose-metabolism, as a tool to evaluate disease activity and prognosis in PD. Methods In a pilot study, we investigated four patients by FDG dynamic PET/CT while on ERT. One patient had FDG-PET/CT twice, before and after 12 months on ERT. Dynamic FDG-PET/CT quantifies the metabolic rate of glucose utilisation in mg/ml/min. MRI was performed in parallel with pelvic and thigh muscles semi-quantitatively scored for atrophy and disease-activity. Results None of the muscles analysed showed a focally increased FDG-uptake. Thus, quantification of muscle glucose metabolism could not be calculated. However, increased FDG-uptake, i.e., increased glucose utilisation, was observed in the respiratory muscles of one patient with severe, restrictive respiratory failure. In contrast, specific MRI sequences showed oedematous as well as atrophic muscle areas in PD. Conclusions Our pilot study demonstrates that FDG-uptake does not correlate with glycogen storage in vivo. In contrast, MRI is an excellent tool to demonstrate the extent of muscle involvement. Specific MRI sequences may even demonstrate early changes possibly allowing prognostic predictions or localization of early stages of PD.
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Affiliation(s)
- U Plöckinger
- Kompetenzzentrum Seltene Stoffwechselkrankheiten, Interdisziplinäres Stoffwechsel-Centrum: Endokrinologie, Diabetes und Stoffwechsel, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, Campus Virchow-Klinikum, 13352, Berlin, Germany.
| | - V Prasad
- Department of Nuclear Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Nuclear Medicine Universitätsklinik Ulm, Ulm, Germany
| | - A Ziagaki
- Kompetenzzentrum Seltene Stoffwechselkrankheiten, Interdisziplinäres Stoffwechsel-Centrum: Endokrinologie, Diabetes und Stoffwechsel, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, Campus Virchow-Klinikum, 13352, Berlin, Germany
| | - N Tiling
- Kompetenzzentrum Seltene Stoffwechselkrankheiten, Interdisziplinäres Stoffwechsel-Centrum: Endokrinologie, Diabetes und Stoffwechsel, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, Campus Virchow-Klinikum, 13352, Berlin, Germany
| | - A Poellinger
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
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18
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Lollert A, Stihl C, Hötker AM, Mengel E, König J, Laudemann K, Gökce S, Düber C, Staatz G. Quantification of intramuscular fat in patients with late-onset Pompe disease by conventional magnetic resonance imaging for the long-term follow-up of enzyme replacement therapy. PLoS One 2018; 13:e0190784. [PMID: 29315315 PMCID: PMC5760036 DOI: 10.1371/journal.pone.0190784] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/20/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate a quantitative method based on conventional T1-weighted magnetic resonance (MR) imaging to assess fatty muscular degeneration in patients with late-onset Pompe disease and to compare it with semi-quantitative visual evaluation (the Mercuri score). In addition, a long-term retrospective data analysis was performed to evaluate treatment response to enzyme replacement therapy with alglucosidase alfa. METHODS MR images of the lumbar spine were acquired in 41 patients diagnosed with late-onset Pompe disease from 2006 through 2015. Two independent readers retrospectively evaluated fatty degeneration of the psoas and paraspinal muscles by applying the Mercuri score. Quantitative semi-automated muscle and fat tissue separation was performed, and inter-observer agreement and correlations with clinical parameters were assessed. Follow-up examinations were performed in 13 patients treated with alglucosidase alfa after a median of 39 months; in 7/13 patients, an additional follow-up examination was completed after a median of 63 months. RESULTS Inter-observer agreement was high. Measurements derived from the quantitative method correlated well with Medical Research Council scores of muscle strength, with moderate correlations found for the 6-minute walk test, the 4-step stair climb test, and spirometry in the supine position. A significant increase in the MR-derived fat fraction of the psoas muscle was found between baseline and follow-up 1 (P = 0.016), as was a significant decrease in the performance on the 6-minute walk test (P = 0.006) and 4-step stair climb test (P = 0.034), as well as plasma creatine kinase (P = 0.016). No statistically significant difference in clinical or MR-derived parameters was found between follow-up 1 and follow-up 2. CONCLUSIONS Quantification of fatty muscle degeneration using the semi-automated method can provide a more detailed overview of disease progression than semi-quantitative Mercuri scoring. MR-derived data correlated with clinical symptoms and patient exercise capacity. After an initial worsening, the fat fraction of the psoas muscle and performance on the 6-minute walk test stayed constant during long-term follow-up under enzyme replacement therapy.
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Affiliation(s)
- André Lollert
- Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- * E-mail:
| | - Clemens Stihl
- Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Andreas M. Hötker
- Department of Diagnostic and Interventional Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Eugen Mengel
- Villa Metabolica, Center of Pediatric and Adolescent Medicine, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jochem König
- Institute for Medical Biostatistics, Epidemiology and Informatics, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Katharina Laudemann
- Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Seyfullah Gökce
- Villa Metabolica, Center of Pediatric and Adolescent Medicine, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Gundula Staatz
- Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
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19
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Garibaldi M, Tasca G, Diaz-Manera J, Ottaviani P, Laschena F, Pantoli D, Gerevini S, Fiorillo C, Maggi L, Tasca E, D'Amico A, Musumeci O, Toscano A, Bruno C, Massa R, Angelini C, Bertini E, Antonini G, Pennisi EM. Muscle MRI in neutral lipid storage disease (NLSD). J Neurol 2017; 264:1334-1342. [PMID: 28503705 PMCID: PMC5502068 DOI: 10.1007/s00415-017-8498-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 04/23/2017] [Accepted: 04/25/2017] [Indexed: 01/28/2023]
Abstract
Neutral lipid storage disease (NLSD) is a rare inherited disorder of lipid metabolism resulting in lipid droplets accumulation in different tissues. Skeletal muscle could be affected in both two different form of disease: NLSD with myopathy (NLSD-M) and NLSD with ichthyosis (NLSD-I). We present the muscle imaging data of 12 patients from the Italian Network for NLSD: ten patients presenting NLSD-M and two patients with NLSD-I. In NLSD-M gluteus minimus, semimembranosus, soleus and gastrocnemius medialis in the lower limbs and infraspinatus in the upper limbs were the most affected muscles. Gracilis, sartorius, subscapularis, pectoralis, triceps brachii and sternocleidomastoid were spared. Muscle involvement was not homogenous and characteristic “patchy” replacement was observed in at least one muscle in all the patients. Half of the patients showed one or more STIR positive muscles. In both NLSD-I cases muscle involvement was not observed by T1-TSE sequences, but one of them showed positive STIR images in more than one muscle in the leg. Our data provides evidence that muscle imaging can identify characteristic alterations in NLSD-M, characterized by a specific pattern of muscle involvement with “patchy” areas of fatty replacement. Larger cohorts are needed to assess if a distinct pattern of muscle involvement exists also for NLSD-I.
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Affiliation(s)
- Matteo Garibaldi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy.
| | - Giorgio Tasca
- Institute of Neurology, Policlinico "A.Gemelli" Foundation University Hospital, Rome, Italy
| | - Jordi Diaz-Manera
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | | | - Francesco Laschena
- Department of Radiology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy
| | - Donatella Pantoli
- Neuroradiology Unit, Department of Radiology, San Filippo Neri Hospital, Rome, Italy
| | | | - Chiara Fiorillo
- Pediatric Neurology and Muscular Disorders, Istituto Giannina Gaslini, Genoa, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Adele D'Amico
- Unit of Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - Olimpia Musumeci
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Claudio Bruno
- Pediatric Neurology and Muscular Disorders, Istituto Giannina Gaslini, Genoa, Italy
| | - Roberto Massa
- Department of Systems Medicine (Neurology), University of Rome Tor Vergata, Rome, Italy
| | | | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
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Chéraud C, Froissart R, Lannes B, Echaniz-Laguna A. Novel variant in the PYGM gene causing late-onset limb-girdle myopathy, ptosis, and camptocormia. Muscle Nerve 2017; 57:157-160. [PMID: 28120463 DOI: 10.1002/mus.25588] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 11/09/2022]
Abstract
INTRODUCTION McArdle disease is a glycogen storage disease caused by mutations in the PYGM gene encoding myophosphorylase. It manifests classically with childhood-onset exercise-induced pain. METHODS We report the characteristics of 2 unrelated patients with a new homozygous mutation of the PYGM gene. RESULTS Two patients, aged 76 and 79 years, presented with severe upper and lower limb atrophy and weakness. Additionally, 1 patient presented with bilateral ptosis, and the other with camptocormia. In both patients, symptoms had developed progressively in the 2 preceding years, and there was no history of exercise intolerance. Both patients demonstrated myogenic abnormalities on electromyography, multiple glycogen-containing vacuoles and undetectable muscle myophosphorylase activity on muscle biopsy, and a novel homozygous frameshift p.Lys42Profs*48 PYGM mutation. CONCLUSIONS This report expands the phenotype and genotype of McArdle disease and suggests that PYGM mutations should be looked for in patients with very late-onset myopathy with no previous history of exercise intolerance. Muscle Nerve 57: 157-160, 2018.
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Affiliation(s)
- Chrystel Chéraud
- Département de Neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67098, Strasbourg, France.,Centre de Référence Neuromusculaire du Grand Est (CERNEST), Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Roseline Froissart
- Service des Maladies Héréditaires du Métabolisme, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France
| | - Béatrice Lannes
- Service de Pathologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Andoni Echaniz-Laguna
- Département de Neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67098, Strasbourg, France.,Centre de Référence Neuromusculaire du Grand Est (CERNEST), Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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21
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Sechi A, Salvadego D, Da Ponte A, Bertin N, Dardis A, Cattarossi S, Devigili G, Reccardini F, Bembi B, Grassi B. Investigation on acute effects of enzyme replacement therapy and influence of clinical severity on physiological variables related to exercise tolerance in patients with late onset Pompe disease. Neuromuscul Disord 2017; 27:542-549. [PMID: 28433478 DOI: 10.1016/j.nmd.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 02/10/2017] [Accepted: 03/05/2017] [Indexed: 11/19/2022]
Abstract
Exercise intolerance is one of the clinical hallmarks of late-onset Pompe disease (LOPD). We studied the acute effects of ERT on the physiological variables associated with exercise tolerance in patients chronically ERT treated. Moreover, we assessed the influence of clinical severity on the investigated variables. The day before (B) and the day after (A) ERT injection, 11 LOPD patients performed on a cycle-ergometer an exercise tolerance test to voluntary exhaustion; VO2, HR, RPE, and GAA activity were determined in B and A. The disease severity was characterized by Walton scale, 6MWT, and pulmonary function tests. No significant differences in the variables related to exercise tolerance were found in A vs B, despite a significant increase in GAA activity in peripheral lymphocytes. No differences in VO2 peak were observed between patients with only skeletal muscle impairment and patients with both skeletal and respiratory muscle impairment. Distance walked at 6MWT was significantly higher than VO2 peak expressed as percentage of normal values. In conclusion, in LOPD patients the exercise tolerance test is not acutely affected by ERT administration; the peripheral muscle component seems more prominent in determining the VO2 peak decrease than the respiratory component; VO2 peak might be more sensitive than 6MWT in estimating exercise tolerance in LOPD.
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Affiliation(s)
- Annalisa Sechi
- Regional Coordinator Center for Rare Diseases, Academic Hospital of Udine, Udine, Italy.
| | - Desy Salvadego
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Alessandro Da Ponte
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Nicole Bertin
- Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - Andrea Dardis
- Regional Coordinator Center for Rare Diseases, Academic Hospital of Udine, Udine, Italy
| | - Silvia Cattarossi
- Regional Coordinator Center for Rare Diseases, Academic Hospital of Udine, Udine, Italy
| | | | | | - Bruno Bembi
- Regional Coordinator Center for Rare Diseases, Academic Hospital of Udine, Udine, Italy
| | - Bruno Grassi
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
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22
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Pichiecchio A, Rossi M, Cinnante C, Colafati GS, Icco R, Parini R, Menni F, Furlan F, Burlina A, Sacchini M, Donati MA, Fecarotta S, Casa RD, Deodato F, Taurisano R, Rocco M. Muscle MRI of classic infantile pompe patients: Fatty substitution and edema‐like changes. Muscle Nerve 2017; 55:841-848. [DOI: 10.1002/mus.25417] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 07/18/2016] [Accepted: 09/23/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Anna Pichiecchio
- Neuroradiology DepartmentC. Mondino National Neurological InstituteVia Mondino2 ‐ 27100Pavia Italy
| | - Marta Rossi
- Child Neuropsychiatry UnitDepartment of Brain and Behavioral Sciences, University of PaviaPavia Italy
| | - Claudia Cinnante
- Unit of NeuroradiologyDepartment of Neuroscience, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of MilanMilan Italy
| | | | - Roberto Icco
- Neurology UnitDepartment of Brain and Behavioral Sciences, University of PaviaPavia Italy
| | - Rossella Parini
- Unit of Rare Metabolic Diseases, San Gerardo HospitalMonza Italy
| | - Francesca Menni
- Pediatric Highly Intensive Care UnitDepartment of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilano Italy
| | - Francesca Furlan
- Unit of Metabolic DiseasesAzienda Ospedaliera UniversitariaPadua Italy
| | - Alberto Burlina
- Unit of Metabolic DiseasesAzienda Ospedaliera UniversitariaPadua Italy
| | - Michele Sacchini
- Metabolic and Neuromuscular UnitAOU Meyer HospitalFlorence Italy
| | | | - Simona Fecarotta
- Department of Translational Medicine‐Section of PediatricsFederico II UniversityNaples Italy
| | - Roberto Della Casa
- Department of Translational Medicine‐Section of PediatricsFederico II UniversityNaples Italy
| | | | | | - Maja Rocco
- Unit of Rare DiseasesDepartment of Pediatrics, Giannina Gaslini InstituteGenoa Italy
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23
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Figueroa-Bonaparte S, Segovia S, Llauger J, Belmonte I, Pedrosa I, Alejaldre A, Mayos M, Suárez-Cuartín G, Gallardo E, Illa I, Díaz-Manera J. Muscle MRI Findings in Childhood/Adult Onset Pompe Disease Correlate with Muscle Function. PLoS One 2016; 11:e0163493. [PMID: 27711114 PMCID: PMC5053479 DOI: 10.1371/journal.pone.0163493] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 09/09/2016] [Indexed: 11/18/2022] Open
Abstract
Objectives Enzyme replacement therapy has shown to be effective for childhood/adult onset Pompe disease (AOPD). The discovery of biomarkers useful for monitoring disease progression is one of the priority research topics in Pompe disease. Muscle MRI could be one possible test but the correlation between muscle MRI and muscle strength and function has been only partially addressed so far. Methods We studied 34 AOPD patients using functional scales (Manual Research Council scale, hand held myometry, 6 minutes walking test, timed to up and go test, time to climb up and down 4 steps, time to walk 10 meters and Motor Function Measure 20 Scale), respiratory tests (Forced Vital Capacity seated and lying, Maximun Inspiratory Pressure and Maximum Expiratory Pressure), daily live activities scales (Activlim) and quality of life scales (Short Form-36 and Individualized Neuromuscular Quality of Life questionnaire). We performed a whole body muscle MRI using T1w and 3-point Dixon imaging centered on thighs and lower trunk region. Results T1w whole body muscle MRI showed a homogeneous pattern of muscle involvement that could also be found in pre-symptomatic individuals. We found a strong correlation between muscle strength, muscle functional scales and the degree of muscle fatty replacement in muscle MRI analyzed using T1w and 3-point Dixon imaging studies. Moreover, muscle MRI detected mild degree of fatty replacement in paraspinal muscles in pre-symptomatic patients. Conclusion Based on our findings, we consider that muscle MRI correlates with muscle function in patients with AOPD and could be useful for diagnosis and follow-up in pre-symptomatic and symptomatic patients under treatment. Take home message Muscle MRI correlates with muscle function in patients with AOPD and could be useful to follow-up patients in daily clinic.
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Affiliation(s)
- Sebastián Figueroa-Bonaparte
- Neuromuscular Disorders Unit. Neurology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
- Centro de Investigación en Red en Enfermedades Raras (CIBERER)
| | - Sonia Segovia
- Neuromuscular Disorders Unit. Neurology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
- Centro de Investigación en Red en Enfermedades Raras (CIBERER)
| | - Jaume Llauger
- Radiology department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
| | - Izaskun Belmonte
- Rehabilitation and physiotherapy department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
| | - Irene Pedrosa
- Rehabilitation and physiotherapy department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
| | - Aída Alejaldre
- Neuromuscular Disorders Unit. Neurology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
- Centro de Investigación en Red en Enfermedades Raras (CIBERER)
| | - Mercè Mayos
- Respiratory diseases department. Hospital de la Santa Creu i Sant Pau. Barcelona. Universitat Autònoma de Barcelona, Spain
| | - Guillermo Suárez-Cuartín
- Respiratory diseases department. Hospital de la Santa Creu i Sant Pau. Barcelona. Universitat Autònoma de Barcelona, Spain
| | - Eduard Gallardo
- Neuromuscular Disorders Unit. Neurology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
- Centro de Investigación en Red en Enfermedades Raras (CIBERER)
| | - Isabel Illa
- Neuromuscular Disorders Unit. Neurology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
- Centro de Investigación en Red en Enfermedades Raras (CIBERER)
| | - Jordi Díaz-Manera
- Neuromuscular Disorders Unit. Neurology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona, Spain
- Centro de Investigación en Red en Enfermedades Raras (CIBERER)
- * E-mail:
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24
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van der Ploeg A, Carlier PG, Carlier RY, Kissel JT, Schoser B, Wenninger S, Pestronk A, Barohn RJ, Dimachkie MM, Goker-Alpan O, Mozaffar T, Pena LDM, Simmons Z, Straub V, Guglieri M, Young P, Boentert M, Baudin PY, Wens S, Shafi R, Bjartmar C, Thurberg BL. Prospective exploratory muscle biopsy, imaging, and functional assessment in patients with late-onset Pompe disease treated with alglucosidase alfa: The EMBASSY Study. Mol Genet Metab 2016; 119:115-23. [PMID: 27473031 DOI: 10.1016/j.ymgme.2016.05.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Late-onset Pompe disease is characterized by progressive skeletal myopathy followed by respiratory muscle weakness, typically leading to loss of ambulation and respiratory failure. In this population, enzyme replacement therapy (ERT) with alglucosidase alfa has been shown to stabilize respiratory function and improve mobility and muscle strength. Muscle pathology and glycogen clearance from skeletal muscle in treatment-naïve adults after ERT have not been extensively examined. METHODS This exploratory, open-label, multicenter study evaluated glycogen clearance in muscle tissue samples collected pre- and post- alglucosidase alfa treatment in treatment-naïve adults with late-onset Pompe disease. The primary endpoint was the quantitative reduction in percent tissue area occupied by glycogen in muscle biopsies from baseline to 6months. Secondary endpoints included qualitative histologic assessment of tissue glycogen distribution, secondary pathology changes, assessment of magnetic resonance images (MRIs) for intact muscle and fatty replacement, and functional assessments. RESULTS Sixteen patients completed the study. After 6months of ERT, the percent tissue area occupied by glycogen in quadriceps and deltoid muscles decreased in 10 and 8 patients, respectively. No changes were detected on MRI from baseline to 6months. A majority of patients showed improvements on functional assessments after 6months of treatment. All treatment-related adverse events were mild or moderate. CONCLUSIONS This exploratory study provides novel insights into the histopathologic effects of ERT in late-onset Pompe disease patients. Ultrastructural examination of muscle biopsies demonstrated reduced lysosomal glycogen after ERT. Findings are consistent with stabilization of disease by ERT in treatment-naïve patients with late-onset Pompe disease.
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Affiliation(s)
- Ans van der Ploeg
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Pierre G Carlier
- Institut de Myologie, AIM and CEA NMR Laboratory - Spectroscopy Laboratory, Université Pierre et Marie Curie, Paris, France
| | - Robert-Yves Carlier
- Medical Imaging Department, Raymond Poincare University Hospital, Garches, France
| | - John T Kissel
- Department of Neurology, Division of Neuromuscular Medicine, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Benedikt Schoser
- Friedrich-Baur-Institut, Neurologische Klinik, Klinikum der Universität München, München, Germany
| | - Stephan Wenninger
- Friedrich-Baur-Institut, Neurologische Klinik, Klinikum der Universität München, München, Germany
| | - Alan Pestronk
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Richard J Barohn
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mazen M Dimachkie
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ozlem Goker-Alpan
- Lysosomal Disorders Unit and Center for Clinical Trials, O&O Alpan LLC, Fairfax, VA, USA
| | - Tahseen Mozaffar
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
| | - Loren D M Pena
- Division of Pediatric Medical Genetics, Duke University Medical Center, Durham, NC, USA
| | | | - Volker Straub
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Michela Guglieri
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Peter Young
- Department of Sleep Medicine and Neuromuscular Disorders, University Hospital of Münster, Münster, Germany
| | - Matthias Boentert
- Department of Sleep Medicine and Neuromuscular Disorders, University Hospital of Münster, Münster, Germany
| | | | - Stephan Wens
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
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25
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Mogalle K, Perez-Rovira A, Ciet P, Wens SCA, van Doorn PA, Tiddens HAWM, van der Ploeg AT, de Bruijne M. Quantification of Diaphragm Mechanics in Pompe Disease Using Dynamic 3D MRI. PLoS One 2016; 11:e0158912. [PMID: 27391236 PMCID: PMC4938606 DOI: 10.1371/journal.pone.0158912] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/23/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diaphragm weakness is the main reason for respiratory dysfunction in patients with Pompe disease, a progressive metabolic myopathy affecting respiratory and limb-girdle muscles. Since respiratory failure is the major cause of death among adult patients, early identification of respiratory muscle involvement is necessary to initiate treatment in time and possibly prevent irreversible damage. In this paper we investigate the suitability of dynamic MR imaging in combination with state-of-the-art image analysis methods to assess respiratory muscle weakness. METHODS The proposed methodology relies on image registration and lung surface extraction to quantify lung kinematics during breathing. This allows for the extraction of geometry and motion features of the lung that characterize the independent contribution of the diaphragm and the thoracic muscles to the respiratory cycle. RESULTS Results in 16 3D+t MRI scans (10 Pompe patients and 6 controls) of a slow expiratory maneuver show that kinematic analysis from dynamic 3D images reveals important additional information about diaphragm mechanics and respiratory muscle involvement when compared to conventional pulmonary function tests. Pompe patients with severely reduced pulmonary function showed severe diaphragm weakness presented by minimal motion of the diaphragm. In patients with moderately reduced pulmonary function, cranial displacement of posterior diaphragm parts was reduced and the diaphragm dome was oriented more horizontally at full inspiration compared to healthy controls. CONCLUSION Dynamic 3D MRI provides data for analyzing the contribution of both diaphragm and thoracic muscles independently. The proposed image analysis method has the potential to detect less severe diaphragm weakness and could thus be used to determine the optimal start of treatment in adult patients with Pompe disease in prospect of increased treatment response.
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Affiliation(s)
- Katja Mogalle
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics & Radiology, Erasmus MC, Rotterdam, the Netherlands
- * E-mail: (KM); (MdB)
| | - Adria Perez-Rovira
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics & Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Pediatric Pulmonology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Pierluigi Ciet
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Pediatrics, Respiratory Medicine and Allergology, Erasmus MC-Sophia, Rotterdam, the Netherlands
| | - Stephan C. A. Wens
- Department of Neurology, Erasmus MC, Rotterdam, the Netherlands
- Centre for Lysosomal and Metabolic Diseases, Erasmus MC-Sophia, Rotterdam, the Netherlands
| | - Pieter A. van Doorn
- Department of Neurology, Erasmus MC, Rotterdam, the Netherlands
- Centre for Lysosomal and Metabolic Diseases, Erasmus MC-Sophia, Rotterdam, the Netherlands
| | - Harm A. W. M. Tiddens
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Pediatrics, Respiratory Medicine and Allergology, Erasmus MC-Sophia, Rotterdam, the Netherlands
| | - Ans T. van der Ploeg
- Centre for Lysosomal and Metabolic Diseases, Erasmus MC-Sophia, Rotterdam, the Netherlands
- Department of Pediatrics, Division of Metabolic Diseases and Genetics, Erasmus MC-Sophia, Rotterdam, the Netherlands
| | - Marleen de Bruijne
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics & Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
- * E-mail: (KM); (MdB)
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26
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Pompe Disease: Diagnosis and Management. Evidence-Based Guidelines from a Canadian Expert Panel. Can J Neurol Sci 2016; 43:472-85. [DOI: 10.1017/cjn.2016.37] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractPompe disease is a lysosomal storage disorder caused by a deficiency of the enzyme acid alpha-glucosidase. Patients have skeletal muscle and respiratory weakness with or without cardiomyopathy. The objective of our review was to systematically evaluate the quality of evidence from the literature to formulate evidence-based guidelines for the diagnosis and management of patients with Pompe disease. The literature review was conducted using published literature, clinical trials, cohort studies and systematic reviews. Cardinal treatment decisions produced seven management guidelines and were assigned a GRADE classification based on the quality of evidence in the published literature. In addition, six recommendations were made based on best clinical practices but with insufficient data to form a guideline. Studying outcomes in rare diseases is challenging due to the small number of patients, but this is in particular the reason why we believe that informed treatment decisions need to consider the quality of the evidence.
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Jones HN, Crisp KD, Robey RR, Case LE, Kravitz RM, Kishnani PS. Respiratory muscle training (RMT) in late-onset Pompe disease (LOPD): Effects of training and detraining. Mol Genet Metab 2016; 117:120-8. [PMID: 26381077 DOI: 10.1016/j.ymgme.2015.09.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Determine the effects of a 12-week respiratory muscle training (RMT) program in late-onset Pompe disease (LOPD). METHODS We investigated the effects of 12-weeks of RMT followed by 3-months detraining using a single-subject A-B-A experimental design replicated across 8 adults with LOPD. To assess maximal volitional respiratory strength, our primary outcomes were maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Effect sizes for changes in MIP and MEP were determined using Cohen's d statistic. Exploratory outcomes targeted motor function, and peak cough flow (PCF) was measured in the last 5 subjects. RESULTS From pretest to posttest, all 8 subjects exhibited increases in MIP, and 7 of 8 showed increases in MEP. Effect size data reveal the magnitude of increases in MIP to be large in 4 (d≥1.0) and very large in 4 (d≥2.0), and effect sizes for increases in MEP were large in 1 (d≥1.0) and very large in 6 (d≥2.0). Across participants, pretest to posttest MIP and MEP increased by a mean of 19.6% (sd=9.9) and 16.1% (sd=17.3), respectively. Respiratory strength increases, particularly for the inspiratory muscles, were generally durable to 3-months detraining. CONCLUSIONS These data suggest our 12-week RMT program results in large to very large increases in inspiratory and expiratory muscle strength in adults with LOPD. Additionally, increases in respiratory strength appeared to be relatively durable following 3-months detraining. Although additional research is needed, RMT appears to offer promise as an adjunctive treatment for respiratory weakness in LOPD.
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Affiliation(s)
- Harrison N Jones
- Department of Surgery, Division of Head and Neck Surgery & Communication Sciences, Duke University, Durham, NC, USA.
| | - Kelly D Crisp
- Department of Speech Pathology & Audiology, Duke University, Durham, NC, USA.
| | - Randall R Robey
- Communication Disorders, University of Virginia, Charlottesville, VA, USA.
| | - Laura E Case
- Physical Therapy Division, Duke University, Durham, NC, USA.
| | - Richard M Kravitz
- Division of Pediatric Pulmonary and Sleep Medicine, Duke University, Durham, NC, USA.
| | - Priya S Kishnani
- Department of Pediatrics, Division of Medical Genetics, Duke University, Durham, NC, USA.
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Abstract
A 72-year-old, seemingly healthy, Japanese man suddenly lost consciousness. At the emergency room, the patient's Glasgow coma scale score was 10 and a thoracic breathing pattern was observed. An arterial blood gas analysis indicated acute hypercarbic respiratory failure. He was placed on non-invasive positive pressure ventilation. The next day he was alert. Manual muscle testing revealed that his face, neck and limb muscle strength were normal. He could walk, and Gowers' sign was not observed. Computed tomography showed atrophy of the paravertebral, abdominal wall and diaphragm crura muscles, without apparent limb muscle involvement. Pompe's disease was diagnosed based on the results of biochemical and genetic tests for acid alpha-glucosidase.
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Affiliation(s)
- Hiroki Takano
- Neurology Service, Tachikawa General Hospital, Japan
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Llerena Junior JC, Nascimento OJM, Oliveira ASB, Dourado Junior MET, Marrone CD, Siqueira HH, Sobreira CFR, Dias-Tosta E, Werneck LC. Guidelines for the diagnosis, treatment and clinical monitoring of patients with juvenile and adult Pompe disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 74:166-76. [DOI: 10.1590/0004-282x20150194] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/25/2015] [Indexed: 01/30/2023]
Abstract
ABSTRACT Pompe disease (PD) is a potentially lethal illness involving irreversible muscle damage resulting from glycogen storage in muscle fiber and activation of autophagic pathways. A promising therapeutic perspective for PD is enzyme replacement therapy (ERT) with the human recombinant enzyme acid alpha-glucosidase (Myozyme®). The need to organize a diagnostic flowchart, systematize clinical follow-up, and establish new therapeutic recommendations has become vital, as ERT ensures greater patient longevity. A task force of experienced clinicians outlined a protocol for diagnosis, monitoring, treatment, genetic counseling, and rehabilitation for PD patients. The study was conducted under the coordination of REBREPOM, the Brazilian Network for Studies of PD. The meeting of these experts took place in October 2013, at L’Hotel Port Bay in São Paulo, Brazil. In August 2014, the text was reassessed and updated. Given the rarity of PD and limited high-impact publications, experts submitted their views.
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30
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Díaz-Manera J, Alejaldre A, González L, Olivé M, Gómez-Andrés D, Muelas N, Vílchez JJ, Llauger J, Carbonell P, Márquez-Infante C, Fernández-Torrón R, Poza JJ, López de Munáin A, González-Quereda L, Mirabet S, Clarimon J, Gallano P, Rojas-García R, Gallardo E, Illa I. Muscle imaging in muscle dystrophies produced by mutations in the EMD and LMNA genes. Neuromuscul Disord 2015; 26:33-40. [PMID: 26573435 DOI: 10.1016/j.nmd.2015.10.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/23/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
Abstract
Identifying the mutated gene that produces a particular muscle dystrophy is difficult because different genotypes may share a phenotype and vice versa. Muscle MRI is a useful tool to recognize patterns of muscle involvement in patients with muscle dystrophies and to guide the diagnosis process. The radiologic pattern of muscle involvement in patients with mutations in the EMD and LMNA genes has not been completely established. Our objective is to describe the pattern of muscle fatty infiltration in patients with mutations in the EMD and in the LMNA genes and to search for differences between the two genotypes that could be helpful to guide the genetic tests. We conducted a national multicenter study in 42 patients, 10 with mutations in the EMD gene and 32 with mutations in the LMNA gene. MRI or CT was used to study the muscles from trunk to legs. Patients had a similar pattern of fatty infiltration regardless of whether they had the mutation in the EMD or LMNA gene. The main muscles involved were the paravertebral, glutei, quadriceps, biceps, semitendinosus, semimembranosus, adductor major, soleus, and gastrocnemius. Involvement of peroneus muscle, which was more frequently affected in patients with mutations in the EMD gene, was useful to differentiate between the two genotypes. Muscle MRI/CT identifies a similar pattern of muscle fatty infiltration in patients with mutations in the EMD or the LMNA genes. The involvement of peroneus muscles could be useful to conduct genetic analysis in patients with an EDMD phenotype.
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Affiliation(s)
- Jordi Díaz-Manera
- Neuromuscular Disorders Unit, Neurology Department, Universitat Autónoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain.
| | - Aida Alejaldre
- Neuromuscular Disorders Unit, Neurology Department, Universitat Autónoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain
| | - Laura González
- Institute of Neuropathology, Department of Pathology, IDIBELL-Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain; Neuromuscular Unit, Department of Neurology, IDIBELL-Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain; Department of Neurology, Hospital de Viladecans, Barcelona, Spain
| | - Montse Olivé
- Institute of Neuropathology, Department of Pathology, IDIBELL-Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain; Neuromuscular Unit, Department of Neurology, IDIBELL-Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - David Gómez-Andrés
- Pediatric Department, Hospital Universitario Infanta Sofía, TRADESMA IdiPaz-UAM, Madrid, Spain
| | - Nuria Muelas
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain; Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Juan José Vílchez
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain; Department of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Jaume Llauger
- Radiology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pilar Carbonell
- Neuromuscular Disorders Unit, Department of Neurology and Neurophysiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Celedonio Márquez-Infante
- Neuromuscular Disorders Unit, Department of Neurology and Neurophysiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Roberto Fernández-Torrón
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Neurology, Hospital Universitario Donostia, Donostia-San Sebastián, Spain; Neurosciences Area, Biodonostia Institute, Donostia-San Sebastián, Spain
| | - Juan José Poza
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Spain; Neuromuscular Disorders Unit, Department of Neurology and Neurophysiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Adolfo López de Munáin
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Neurology, Hospital Universitario Donostia, Donostia-San Sebastián, Spain; Neurosciences Area, Biodonostia Institute, Donostia-San Sebastián, Spain
| | - Lidia González-Quereda
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain; Department of Neurology, Hospital Universitario Donostia, Donostia-San Sebastián, Spain; Neurosciences Area, Biodonostia Institute, Donostia-San Sebastián, Spain
| | - Sonia Mirabet
- Cardiology Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jordi Clarimon
- Neuromuscular Disorders Unit, Neurology Department, Universitat Autónoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Pía Gallano
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain; Genetic Department, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ricard Rojas-García
- Neuromuscular Disorders Unit, Neurology Department, Universitat Autónoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain
| | - Eduard Gallardo
- Neuromuscular Disorders Unit, Neurology Department, Universitat Autónoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain
| | - Isabel Illa
- Neuromuscular Disorders Unit, Neurology Department, Universitat Autónoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain
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Bioimpedance Analysis as a Method to Evaluate the Proportion of Fatty and Muscle Tissues in Progressive Myopathy in Pompe Disease. JIMD Rep 2015; 26:45-51. [PMID: 26253708 DOI: 10.1007/8904_2015_473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 06/08/2015] [Accepted: 06/10/2015] [Indexed: 12/04/2022] Open
Abstract
During progressive myopathy, the space of atrophic muscle tissue is gradually filled by fatty tissue. The proportion of these two tissue types relative to body mass provides an indication of the extent of muscle tissue destruction, i.e., the progression and severity of the disease.In this study we use Pompe disease as an example to report the new possibility of using bioimpedance analysis (BIA) to assess the relative proportion of fatty and muscle tissue in diseases associated with muscle atrophy, thus enabling the assessment of disease progression and the effectiveness of treatment. Results from BIA analysis were compared with magnetic resonance images.The results of muscle magnetic resonance images and BIA analysis were similar, which suggests that BIA may provide valuable diagnostic guidance for the assessment of the progression of the disorder.
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Gutiérrez-Rivas E, Bautista J, Vílchez J, Muelas N, Díaz-Manera J, Illa I, Martínez-Arroyo A, Olivé M, Sanz I, Arpa J, Fernández-Torrón R, López de Munáin A, Jiménez L, Solera J, Lukacs Z. Targeted screening for the detection of Pompe disease in patients with unclassified limb-girdle muscular dystrophy or asymptomatic hyperCKemia using dried blood: A Spanish cohort. Neuromuscul Disord 2015; 25:548-53. [DOI: 10.1016/j.nmd.2015.04.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 04/10/2015] [Accepted: 04/20/2015] [Indexed: 11/26/2022]
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Crescimanno G, Modica R, Lo Mauro R, Musumeci O, Toscano A, Marrone O. Role of the cardio-pulmonary exercise test and six-minute walking test in the evaluation of exercise performance in patients with late-onset Pompe disease. Neuromuscul Disord 2015; 25:542-7. [PMID: 25908581 DOI: 10.1016/j.nmd.2015.03.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 02/16/2015] [Accepted: 03/15/2015] [Indexed: 12/19/2022]
Abstract
In patients with late-onset Pompe disease, we explored the role of the Cardiopulmonary Exercise Test (CPET) and the Six-Minute Walking Test (6MWT) in the assessment of exercise capacity and in the evaluation of the effects of enzyme replacement therapy (ERT). Eight patients affected by late-onset Pompe disease, followed up at the Centre for Neuromuscular Diseases and treated with ERT, underwent a baseline evaluation with a spirometry, a CPET and a 6MWT. Four of them were restudied after 36 months of treatment. Three patients showed a reduction in exercise capacity as evaluated by peak oxygen uptake (VO2) measured at the CPET and Distance Walked (DW) measured at the 6MWT (median % predicted: 67.1 [range 54.3-99.6] and 67.3 [56.6-82.6], respectively). Cardiac and respiratory limitations revealed by the CPET were correlated to peak VO2, but not to the DW. Nevertheless, percent of predicted values of peak VO2 and DW were strongly correlated (rho = 0.85, p = 0.006), and close to identity. In the longitudinal evaluation forced vital capacity decreased, while peak VO2 and DW showed a trend to a parallel improvement. We concluded that although only the CPET revealed causes of exercise limitation, which partially differed among patients, CPET and 6MWT showed a similar overall degree of exercise impairment. That held true in the longitudinal assessment during ERT, where both tests demonstrated similar small improvements, occurring despite deterioration in forced vital capacity.
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Affiliation(s)
- G Crescimanno
- Italian National Research Council, Institute of Biomedicine and Molecular Immunology, Palermo, Italy; Department of Pneumology, Villa Sofia - Cervello Hospital, Palermo, Italy.
| | - R Modica
- Department of Pneumology, Villa Sofia - Cervello Hospital, Palermo, Italy
| | - R Lo Mauro
- Department of Cardiology, Villa Sofia - Cervello Hospital, Palermo, Italy
| | - O Musumeci
- Department of Neurosciences, Reference Centre for Rare Neuromuscular Disorders, University of Messina, Italy
| | - A Toscano
- Department of Neurosciences, Reference Centre for Rare Neuromuscular Disorders, University of Messina, Italy
| | - O Marrone
- Italian National Research Council, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
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Muscle imaging data in late-onset Pompe disease reveal a correlation between the pre-existing degree of lipomatous muscle alterations and the efficacy of long-term enzyme replacement therapy. Mol Genet Metab Rep 2015; 3:58-64. [PMID: 26937398 PMCID: PMC4750633 DOI: 10.1016/j.ymgmr.2015.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Late-onset Pompe disease (LOPD) is a metabolic myopathy caused by mutations in GAA and characterized by proximal muscle weakness and respiratory insufficiency. There is evidence from clinical studies that enzyme replacement therapy (ERT) with human recombinant alpha-glucosidase improves motor performance and respiratory function in LOPD. Objective We analyzed quantitative muscle MRI data of lower limbs to evaluate the effects of long-term ERT on muscle parameters. Methods Three symptomatic LOPD patients who received ERT for five years and four untreated presymptomatic LOPD patients were included in the study. T1-weighted MRI images were used to determine volumes of thigh and lower leg muscles. In addition, mean gray values of eight individual thigh muscles were calculated to assess the degree of lipomatous muscle alterations. Results We detected a decrease in thigh muscle volume of 6.7% (p < 0.001) and an increase in lower leg muscle volume of 8.2% (p = 0.049) after five years of ERT. Analysis of individual thigh muscles revealed a positive correlation between the degree of lipomatous muscle alterations at baseline and the increase of gray values after five years of ERT (R2 = 0.68, p < 0.001). Muscle imaging in presymptomatic patients showed in one case pronounced lipomatous alteration of the adductor magnus muscle and mild to moderate changes in further thigh muscles. Conclusions The results demonstrate that fatty muscle degeneration can occur before clinical manifestation of muscle weakness and suggest that mildly affected muscles may respond better to ERT treatment than severely involved muscles. If these findings can be validated by further studies, it should be discussed if muscle alterations detected by muscle MRI may be an objective sign of disease manifestation justifying an early start of ERT in clinically asymptomatic patients in order to improve the long-term outcome.
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Nikitin SS, Kurbatov SA, Bredelev VA, Kovalchuk MO. Alarming signs and symptoms in the early diagnostics of late onset Pompe disease: super omnia clinica. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:19-24. [DOI: 10.17116/jnevro201511511219-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tasca G, Monforte M, Iannaccone E, Laschena F, Ottaviani P, Leoncini E, Boccia S, Galluzzi G, Pelliccioni M, Masciullo M, Frusciante R, Mercuri E, Ricci E. Upper girdle imaging in facioscapulohumeral muscular dystrophy. PLoS One 2014; 9:e100292. [PMID: 24932477 PMCID: PMC4059711 DOI: 10.1371/journal.pone.0100292] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/22/2014] [Indexed: 11/19/2022] Open
Abstract
Background In Facioscapulohumeral muscular dystrophy (FSHD), the upper girdle is early involved and often difficult to assess only relying on physical examination. Our aim was to evaluate the pattern and degree of involvement of upper girdle muscles in FSHD compared with other muscle diseases with scapular girdle impairment. Methods We propose an MRI protocol evaluating neck and upper girdle muscles. One hundred-eight consecutive symptomatic FSHD patients and 45 patients affected by muscular dystrophies and myopathies with prominent upper girdle involvement underwent this protocol. Acquired scans were retrospectively analyzed. Results The trapezius (100% of the patients) and serratus anterior (85% of the patients) were the most and earliest affected muscles in FSHD, followed by the latissimus dorsi and pectoralis major, whilst spinati and subscapularis (involved in less than 4% of the patients) were consistently spared even in late disease stages. Asymmetry and hyperintensities on short-tau inversion recovery (STIR) sequences were common features, and STIR hyperintensities could also be found in muscles not showing signs of fatty replacement. The overall involvement appears to be disease-specific in FSHD as it significantly differed from that encountered in the other myopathies. Conclusions The detailed knowledge of single muscle involvement provides useful information for correctly evaluating patients' motor function and to set a baseline for natural history studies. Upper girdle imaging can also be used as an additional tool helpful in supporting the diagnosis of FSHD in unclear situations, and may contribute with hints on the currently largely unknown molecular pathogenesis of this disease.
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Affiliation(s)
| | - Mauro Monforte
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
| | | | - Francesco Laschena
- Department of Radiology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy
| | | | - Emanuele Leoncini
- Institute of Hygiene-Department of Public Health, Catholic University School of Medicine, Rome, Italy
| | - Stefania Boccia
- Institute of Hygiene-Department of Public Health, Catholic University School of Medicine, Rome, Italy
| | | | - Marco Pelliccioni
- Unione Italiana Lotta Distrofia Muscolare (UILDM) Rome Section, Rome, Italy
| | | | - Roberto Frusciante
- Neurophysiopathology Unit, Columbus Hospital, Catholic University School of Medicine, Rome, Italy
| | - Eugenio Mercuri
- Pediatric Neurology Unit, Catholic University School of Medicine, Rome, Italy
| | - Enzo Ricci
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
- * E-mail:
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Dubrovsky A, Fulgenzi E, Amartino H, Carlés D, Corderi J, de Vito E, Fainboim A, Ferradás N, Guelbert N, Lubieniecki F, Mazia C, Mesa L, Monges S, Pesquero J, Reisin R, Rugiero M, Schenone A, Szlago M, Taratuto AL, Zgaga M. Consenso argentino para el diagnóstico, seguimiento y tratamiento de la enfermedad de Pompe. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.neuarg.2014.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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