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Pascual-Morena C, Martínez-Vizcaíno V, Cavero-Redondo I, Álvarez-Bueno C, Lucerón-Lucas-Torres M, Saz-Lara A, Martínez-García I. A meta-analysis of the prevalence of neuropsychiatric disorders and their association with disease onset in myotonic dystrophy. Acta Neuropsychiatr 2024:1-12. [PMID: 39376198 DOI: 10.1017/neu.2024.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/09/2024]
Abstract
There is a high prevalence of neuropsychiatric disorders in myotonic dystrophy types 1 and 2 (DM1 and DM2), including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in DM1, and depression and anxiety in both DMs. The aim of this systematic review and meta-analysis was to estimate the prevalence of ASD, ADHD, depression and anxiety in the population with DM, and their association with disease onset. A systematic search of Medline, Scopus, Web of Science, and the Cochrane Library was conducted from inception to November 2023. Observational studies estimating the prevalence of these disorders in DM1 or DM2 were included. A meta-analysis of the prevalence of these disorders and an association study with disease onset by prevalence ratio meta-analysis were performed. Thirty-eight studies were included. In DM1, the prevalence of ASD was 14%, with congenital onset being 79% more common than juvenile onset, while the prevalence of ADHD was 21%, with no difference between congenital and juvenile onset, and the prevalence of depression and anxiety were 14% and 16%. Depression was more common in the adult onset. Finally, the prevalence of depression in DM2 was 16%. A higher prevalence of neuropsychiatric disorders is observed in individuals with DM1 and DM2 than in the general population. Therefore, actively screening for congenital and juvenile neurodevelopmental disorders in DM1 and emotional disorders in DM1 and DM2 may improve the quality of life of those affected.
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Affiliation(s)
- Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Iván Cavero-Redondo
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
- CarVasCare Research Group, Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | - Alicia Saz-Lara
- CarVasCare Research Group, Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Irene Martínez-García
- CarVasCare Research Group, Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
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Trucco F, Lizio A, Roma E, di Bari A, Salmin F, Albamonte E, Casiraghi J, Pozzi S, Becchiati S, Antonaci L, Salvalaggio A, Catteruccia M, Tosi M, Marinella G, Danti FR, Bruschi F, Veneruso M, Parravicini S, Fiorillo C, Berardinelli A, Pini A, Moroni I, Astrea G, Battini R, D’Amico A, Ricci F, Pane M, Mercuri EM, Johnson NE, Sansone VA. Association between Reported Sleep Disorders and Behavioral Issues in Children with Myotonic Dystrophy Type 1-Results from a Retrospective Analysis in Italy. J Clin Med 2024; 13:5459. [PMID: 39336946 PMCID: PMC11432637 DOI: 10.3390/jcm13185459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Sleep disorders have been poorly described in congenital (CDM) and childhood (ChDM) myotonic dystrophy despite being highly burdensome. The aims of this study were to explore sleep disorders in a cohort of Italian CDM and ChDM and to assess their association with motor and respiratory function and disease-specific cognitive and behavioral assessments. Methods: This was an observational multicenter study. Reported sleep quality was assessed using the Pediatric Daytime Sleepiness Scale (PDSS) and Pediatric Sleep Questionnaire (PSQ). Sleep quality was correlated to motor function (6 min walk test, 6MWT and grip strength; pulmonary function (predicted Forced Vital Capacity%, FVC% pred.); executive function assessed by BRIEF-2; autism traits assessed by Autism Spectrum Screening Questionnaire (ASSQ) and Repetitive Behavior Scale-revised (RBS-R); Quality of life (PedsQL) and disease burden (Congenital Childhood Myotonic Dystrophy Health Index, CCMDHI). Results: Forty-six patients were included, 33 CDM and 13 ChDM, at a median age of 10.4 and 15.1 years. Daytime sleepiness and disrupted sleep were reported by 30% children, in both subgroups of CDM and ChDM. Daytime sleepiness correlated with autism traits in CDM (p < 0.05). Disrupted sleep correlated with poorer executive function (p = 0.04) and higher disease burden (p = 0.03). Conclusions: Sleep issues are a feature of both CDM and ChDM. They correlate with behavioral issues and impact on disease burden.
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Affiliation(s)
- Federica Trucco
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
- Department of Neurorehabilitation, University of Milan, 20122 Milan, Italy
- Paediatric Neurology and Muscular Diseases Unit, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, 16132 Genoa, Italy
| | - Andrea Lizio
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
| | - Elisabetta Roma
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
| | - Alessandra di Bari
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
| | - Francesca Salmin
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
| | - Emilio Albamonte
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
| | - Jacopo Casiraghi
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
| | - Susanna Pozzi
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
| | - Stefano Becchiati
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
| | - Laura Antonaci
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS Università Cattolica del Sacro Cuore, 00136 Roma, Italy; (L.A.); (M.P.); (E.M.M.)
| | - Anna Salvalaggio
- Department of Sciences of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy; (A.S.); (F.R.)
| | - Michela Catteruccia
- UOS Malattie Muscolari e Neurodegenerative—Ospedale Pediatrico Bambino Gesù, 00165 Roma, Italy; (M.C.); (M.T.); (A.D.)
| | - Michele Tosi
- UOS Malattie Muscolari e Neurodegenerative—Ospedale Pediatrico Bambino Gesù, 00165 Roma, Italy; (M.C.); (M.T.); (A.D.)
| | - Gemma Marinella
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone Pisa, Italy; (G.M.); (G.A.); (R.B.)
| | - Federica R. Danti
- Department of Pediatric Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (F.R.D.); (I.M.)
| | - Fabio Bruschi
- Department of Pediatric Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (F.R.D.); (I.M.)
| | - Marco Veneruso
- Unit of Child Neuropsychiatry, IRCCS Istituto Giannina Gaslini and DINOGMI, University of Genova, 16132 Genova, Italy; (M.V.); (C.F.)
| | - Stefano Parravicini
- Child and Adolescent Neuromuscular Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy; (S.P.); (A.B.)
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Chiara Fiorillo
- Unit of Child Neuropsychiatry, IRCCS Istituto Giannina Gaslini and DINOGMI, University of Genova, 16132 Genova, Italy; (M.V.); (C.F.)
| | - Angela Berardinelli
- Child and Adolescent Neuromuscular Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy; (S.P.); (A.B.)
| | - Antonella Pini
- Pediatric Neuromuscular Unit, UOC Neuropsichiatria dell’età Pediatrica, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy;
| | - Isabella Moroni
- Department of Pediatric Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (F.R.D.); (I.M.)
| | - Guja Astrea
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone Pisa, Italy; (G.M.); (G.A.); (R.B.)
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone Pisa, Italy; (G.M.); (G.A.); (R.B.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Adele D’Amico
- UOS Malattie Muscolari e Neurodegenerative—Ospedale Pediatrico Bambino Gesù, 00165 Roma, Italy; (M.C.); (M.T.); (A.D.)
| | - Federica Ricci
- Department of Sciences of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy; (A.S.); (F.R.)
| | - Marika Pane
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS Università Cattolica del Sacro Cuore, 00136 Roma, Italy; (L.A.); (M.P.); (E.M.M.)
| | - Eugenio M. Mercuri
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS Università Cattolica del Sacro Cuore, 00136 Roma, Italy; (L.A.); (M.P.); (E.M.M.)
| | - Nicholas E. Johnson
- Department of Neurology, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | - Valeria A. Sansone
- The NeMO Clinical Center in Milan, 20162 Milan, Italy; (F.T.); (A.L.); (E.R.); (A.d.B.); (F.S.); (E.A.); (J.C.); (S.P.); (S.B.)
- Department of Neurorehabilitation, University of Milan, 20122 Milan, Italy
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García I, Martínez O, Amayra I, Salgueiro M, Rodríguez AA, López-Paz JF. Effects of a neuropsychosocial teleassistance intervention on social cognition and health-related quality of life of pediatric patients with neuromuscular diseases. J Pediatr Psychol 2024; 49:525-535. [PMID: 38452290 DOI: 10.1093/jpepsy/jsae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE This study aimed to determine the effects of a neuropsychosocial teleassistance group-based intervention on improving social cognitive functioning and health-related quality of life (HRQoL) in pediatric neuromuscular diseases (NMD). METHODS Thirty-five pediatric patients with NMD were assigned to the neuropsychosocial intervention program (n = 20) or waiting list control condition (n = 15). The intervention group received an integrative approach that combines training in social cognition with cognitive behavioral therapy. All participants completed a neuropsychological and clinical assessment at baseline and follow-up, which included tests of social cognition, both for emotion recognition and theory of mind, and HRQoL. Repeated-measures multivariate analysis of covariance was used to determine the effects of the teleassistance program. RESULTS Group × Time interactions revealed significant improvements in the intervention group as compared with the control group for different social cognition's indicators (AR NEPSY-II: p = .003, η2p = .24; TM NEPSY: p < .001, η2p = .35; Verbal task: p < .001, η2p = .35; Happé's Strange Stories: p = .049, η2p = .11) and HRQoL (Psychosocial health: p = .012, η2p = .18; Emotional functioning: p = .037, η2p = 0.13; Social functioning: p = .006, η2p = .21; Total: p = .013, η2p = .17), showing medium to large effects. CONCLUSIONS Patients receiving the neuropsychosocial intervention showed improvements in their social cognition performance and psychosocial HRQoL, providing evidence about the positive effects of the program in pediatric patients with NMD. This should be considered in further research and interventions in this field.
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Affiliation(s)
- Irune García
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Spain
| | - Oscar Martínez
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Spain
| | - Imanol Amayra
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Spain
| | - Monika Salgueiro
- Department of Clinical and Health Psychology and Research Methodology, Faculty of Psychology, University of the Basque Country UPV/EHU, Spain
| | - Alicia Aurora Rodríguez
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Spain
| | - Juan Francisco López-Paz
- Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Spain
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Ostojić S, Kovačević G, Meola G, Pešović J, Savić-Pavićević D, Brkušanin M, Kravljanac R, Perić M, Martić J, Pejić K, Ristić S, Perić S. Main features and disease outcome of congenital myotonic dystrophy - experience from a single tertiary center. Neuromuscul Disord 2024; 40:16-23. [PMID: 38810326 DOI: 10.1016/j.nmd.2024.05.002] [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: 02/11/2024] [Revised: 04/05/2024] [Accepted: 05/08/2024] [Indexed: 05/31/2024]
Abstract
Congenital myotonic dystrophy type 1 (CDM1) is a rare neuromuscular disease. The aim of our study was to evaluate clinical variability of CDM1 and factors that may influence survival in CDM1. Research included 24 pediatric patients with CDM1. Most of our patients had some form of hypoxic ischemic encephalopathy (HIE) (74 %), from mild to severe. Prolonged and complicated deliveries (75 %), high percentage of children resuscitated at birth (57 %) and respiratory insufficiency (46 %) with consequent hypoxia were the main reasons that could explain high percentage of HIE. Therapeutic hypothermia was applied in three children with poor outcome. Median survival of all CDM1 was 14.2 ± 1.5 years. Six patients had a fatal outcome (25 %). Their mean age of death was 3.0 ± 2.8 years. Poor prognostic factors for the survival of our CDM1 patients were: preterm delivery, resuscitation at birth, severe HIE, hypothermia treatment and permanent mechanical ventilation. Respiratory insufficiency was the main life-threatening factor. Our data clearly indicates the need to develop natural history studies in CDM1 in order to enhance the standards of care and to develop clinical trials investigating causative therapies in pediatric patients with CDM1.
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Affiliation(s)
- Slavica Ostojić
- Neurology Department, Institute for Mother and Child Health Care of Serbia "Dr. Vukan Cupic", Faculty of Medicine, University of Belgrade, Serbia.
| | - Gordana Kovačević
- Neurology Department, Institute for Mother and Child Health Care of Serbia "Dr. Vukan Cupic", Faculty of Medicine, University of Belgrade, Serbia
| | - Giovanni Meola
- Department of Neurorehabilitation Sciences, Casa Di Cura Igea, Department of Biomedical Sciences for Health, University of Milan, Fondazione Malattie Miotoniche-FMM, Milan Italy
| | - Jovan Pešović
- University of Belgrade-Faculty of Biology, Center for Human Molecular Genetics, Belgrade, Serbia
| | - Dušanka Savić-Pavićević
- University of Belgrade-Faculty of Biology, Center for Human Molecular Genetics, Belgrade, Serbia
| | - Miloš Brkušanin
- University of Belgrade-Faculty of Biology, Center for Human Molecular Genetics, Belgrade, Serbia
| | - Ružica Kravljanac
- Neurology Department, Institute for Mother and Child Health Care of Serbia "Dr. Vukan Cupic", Faculty of Medicine, University of Belgrade, Serbia
| | - Marina Perić
- Nephrology Department, Institute for Mother and Child Health Care of Serbia "Dr. Vukan Cupic", Faculty of Medicine, University of Belgrade, Serbia
| | - Jelena Martić
- Intensive Care Unit, Institute for Mother and Child Health Care of Serbia "Dr. Vukan Cupic", Faculty of Medicine, University of Belgrade, Serbia
| | - Katarina Pejić
- Intensive Care Unit, Institute for Mother and Child Health Care of Serbia "Dr. Vukan Cupic", Faculty of Medicine, University of Belgrade, Serbia
| | - Snežana Ristić
- Intensive Care Unit, Institute for Mother and Child Health Care of Serbia "Dr. Vukan Cupic", Faculty of Medicine, University of Belgrade, Serbia
| | - Stojan Perić
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbia
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5
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Pater R, Garmendia J, Gallais B, Graham C, Voet N. 267th ENMC International workshop: psychological interventions for improving quality of life in slowly progressive neuromuscular disorders. Neuromuscul Disord 2023; 33:562-569. [PMID: 37331200 DOI: 10.1016/j.nmd.2023.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023]
Abstract
This workshop aimed to develop recommendations for psychological interventions to support people living with slowly progressive neuromuscular disorders (NMD). The workshop comprised clinicians, researchers, people living with NMD and their relatives. First, participants considered the key psychological challenges presented by NMD and the impact of NMD on relationships and mental health. Later, several psychological approaches for enhancing well-being in NMD were described. The results of randomised controlled trials of Cognitive Behaviour Therapy and Acceptance and Commitment Therapy for improving fatigue, quality of life, and mood in adults with NMD were examined. Then the group considered ways to adapt therapies for cognitive impairments or neurodevelopmental differences that occur in some NMD, alongside ways to support children and adolescents with NMD and their family members. Based on the evidence from randomised controlled trials, carefully conducted observational studies, and the coherence of these data with the experience of those living with NMD, the group recommends that psychological interventions should be embedded in the routine clinical care offered to people living with NMD.
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Affiliation(s)
- Ronne Pater
- Klimmendaal, Rehabilitation Center, Arnhem, The Netherlands; Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Joana Garmendia
- Department of Clinical and Health Psychology and Research Methodology; Psychology Faculty, University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Gipuzkoa, Spain
| | - Benjamin Gallais
- ÉCOBES - Research and Transfer, Cegep de Jonquière, Jonquière, Canada
| | | | - Nicoline Voet
- Klimmendaal, Rehabilitation Center, Arnhem, The Netherlands; Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
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Aden P, Skarbø AB, Wallace S, Ørstavik K, Rasmussen M. Cognitive function, behaviour and quality of life in children with myotonic dystrophy type 1 in South - Eastern Norway. Eur J Paediatr Neurol 2023; 45:1-6. [PMID: 37209486 DOI: 10.1016/j.ejpn.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/22/2023] [Accepted: 05/07/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Cognitive and behavioural problems may be predominant in the clinical picture of myotonic dystrophy (DM1) in childhood. This can lead to a diagnostic delay and thus prevent optimal therapeutic measures. OBJECTIVE To obtain an overview of children with DM1 in our health region and study their cognitive and behavioural function, quality of life and neurological status. METHODS Patients diagnosed with DM1 were recruited to this cross-sectional study through local habilitation teams of our health region. Neuropsychological testing and physical examination were performed for the majority. For some patients information was retrieved from medical records and through telephone interviews. A questionnaire was administered regarding quality of life. RESULTS 27 subjects <18 years diagnosed with DM1 were identified, giving a frequency of DM1 of 4.3/100 000 in this age group. Twenty consented to participate. Five had congenital DM1. Most of the participants had only mild neurological deficits. Two with congenital type had hydrocephalus requiring a shunt. Ten, whereof none with congenital DM1, had a cognitive function within normal range. Three were diagnosed with an autism spectrum disorder, and additional three were reported with autistic traits. Many parents reported social and school problems for their child. CONCLUSIONS Intellectual disability and varying degrees of autistic behaviour were quite common. Motor deficits were most often mild. A strong focus regarding support at school and in social communication is needed for children growing up with DM1.
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Affiliation(s)
- Petra Aden
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.
| | - Anne-Britt Skarbø
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.
| | - Sean Wallace
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway; Department of Neurology, Section for Rare Neuromuscular Disorders and EMAN, Oslo University Hospital, Oslo, Norway.
| | - Kristin Ørstavik
- Department of Neurology, Section for Rare Neuromuscular Disorders and EMAN, Oslo University Hospital, Oslo, Norway.
| | - Magnhild Rasmussen
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway; Department of Neurology, Section for Rare Neuromuscular Disorders and EMAN, Oslo University Hospital, Oslo, Norway.
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7
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Sweere DJJ, Moelands SVL, Klinkenberg S, Leenen L, Hendriksen JGM, Braakman HMH. Cognitive phenotype of childhood myotonic dystrophy type 1: A multicenter pooled analysis. Muscle Nerve 2023. [PMID: 37129457 DOI: 10.1002/mus.27836] [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: 07/26/2022] [Revised: 03/31/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION/AIMS There is clear evidence for brain involvement in childhood myotonic dystrophy type 1 (DM1) from imaging studies and the prevalence of intellectual impairment and neurodevelopmental disorders. The cognitive profile of children with DM1 however is poorly understood. The aim of this study was to assess the cognitive profile of children with DM1. METHODS Neuropsychological examination reports of 45 children aged 2-17 y were analyzed. All cognitive subtests used in this cohort were pooled in 10 cognitive domains. For every patient a composite z-score was calculated for every assessed domain. Composite scores were classified as average (z > -1), mild cognitive impairment (-1 ≥ z > -2), or major cognitive impairment (z ≤ -2). RESULTS The nature and extent of neuropsychological examinations differed between centers and patients. The domains with the highest frequency of major cognitive impairment were social cognition (4/9 children tested; 44%), attention (13/32; 41%), and fine motor skills (3/10; 30%). Combining mild and major cognitive impairment, working memory (20/28; 71%), attention (21/32; 66%), and visuospatial functions (16/28; 57%) were the most frequently affected domains. Long-term memory was least affected, with mild impairment only in 5/29 (17%). DISCUSSION Children with DM1 may have specific cognitive deficits, most frequently affecting working memory, attention, and visuospatial functions, in addition to the previously described global intellectual impairments. We recommend including a standardized neuropsychological examination in the standards of care for DM1 children. Early recognition of cognitive deficits and behavioral disorders in children with DM1 can improve their management.
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Affiliation(s)
- Dirk J J Sweere
- Center for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Suzanne V L Moelands
- Department of Paediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Sylvia Klinkenberg
- Center for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Loes Leenen
- Center for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
| | - Jos G M Hendriksen
- Center for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Hilde M H Braakman
- Department of Paediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
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8
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Unexpected diagnosis of myotonic dystrophy type 2 repeat expansion by genome sequencing. Eur J Hum Genet 2023; 31:122-124. [PMID: 35945246 PMCID: PMC9823003 DOI: 10.1038/s41431-022-01166-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/29/2022] [Accepted: 07/21/2022] [Indexed: 02/08/2023] Open
Abstract
Several neurological disorders, such as myotonic dystrophy are caused by expansions of short tandem repeats (STRs) which can be difficult to detect by molecular tools. Methodological advances have made repeat expansion (RE) detection with whole genome sequencing (WGS) feasible. We recruited a multi-generational family (family A) ascertained for genetic studies of autism spectrum disorder. WGS was performed on seven children from four nuclear families from family A and analyzed for REs of STRs known to cause neurological disorders. We detected an expansion of a heterozygous intronic CCTG STR in CNBP in two siblings. This STR causes myotonic dystrophy type 2 (DM2). The expansion did not segregate with the ASD phenotype. Repeat-primed PCR showed that the DM2 CCTG motif was expanded above the pathogenic threshold in both children and their mother. On subsequent examination, the mother had mild features of DM2. We show that screening of STRs in WGS datasets has diagnostic utility, both in the clinical and research domain, with potential management and genetic counseling implications.
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Rosado Bartolomé A, Puertas Martín V, Domínguez González C, Ramos Miranda M. Alteración cognitiva en la distrofia miotónica tipo 1 (enfermedad de Steinert). Semergen 2022; 48:208-213. [DOI: 10.1016/j.semerg.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 01/27/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022]
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10
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Specht S, Straub V. Intellectual disability in paediatric patients with genetic muscle diseases. Neuromuscul Disord 2021; 31:988-997. [PMID: 34736636 DOI: 10.1016/j.nmd.2021.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/19/2022]
Abstract
The differential diagnosis of genetic muscle disease has become increasingly difficult due to the rapid progress in genetic medicine in recent years. Where classifications based on the clinical picture were attributed to one gene only a few years ago, today we know that a variety of clinical presentations can result from the same mutation and, conversely, various genes are associated with a similar phenotype. A significant consideration in assessing a patient with muscle weakness is the presence or absence of intellectual disability, thus narrowing the differential diagnostic approach in any child with an as yet undiagnosed muscle disease. Intellectual disability in neuromuscular diseases is often associated with behavioural disorders and may be correlated with abnormal brain imaging. Conversely, brain involvement can sometimes be seen without intellectual disability, but may be associated with an epilepsy risk and is helpful for the differential diagnosis. This review focuses on the three most common causes of paediatric muscle diseases with intellectual disability, dystrophinopathies, myotonic dystrophy type 1 and dystroglycanopathies. It also summarises differential diagnostic considerations when assessing a child with a genetic muscle disease and intellectual disability. The recent scientific literature on this topic is reviewed, the frequency of intellectual disability assessed, and specific clinical features are described. Where available, data on disease onset, progression and serum creatine kinase levels are presented and the pattern of muscle involvement described in an algorithm. Central nervous involvement and brain imaging analysis was reviewed and included.
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Affiliation(s)
- Sabine Specht
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle, UK
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle, UK.
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11
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De Serres-Bérard T, Pierre M, Chahine M, Puymirat J. Deciphering the mechanisms underlying brain alterations and cognitive impairment in congenital myotonic dystrophy. Neurobiol Dis 2021; 160:105532. [PMID: 34655747 DOI: 10.1016/j.nbd.2021.105532] [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: 08/12/2021] [Revised: 09/24/2021] [Accepted: 10/11/2021] [Indexed: 12/13/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is a multisystemic and heterogeneous disorder caused by the expansion of CTG repeats in the 3' UTR of the myotonic dystrophy protein kinase (DMPK) gene. There is a congenital form (CDM1) of the disease characterized by severe hypotonia, respiratory insufficiency as well as developmental delays and intellectual disabilities. CDM1 infants manifest important brain structure abnormalities present from birth while, in contrast, older patients with adult-onset DM1 often present neurodegenerative features and milder progressive cognitive deficits. Promising therapies targeting central molecular mechanisms contributing to the symptoms of adult-onset DM1 are currently in development, but their relevance for treating cognitive impairment in CDM1, which seems to be a partially distinct neurodevelopmental disorder, remain to be elucidated. Here, we provide an update on the clinical presentation of CDM1 and review recent in vitro and in vivo models that have provided meaningful insights on its consequences in development, with a particular focus on the brain. We discuss how enhanced toxic gain-of-function of the mutated DMPK transcripts with larger CUG repeats and the resulting dysregulation of RNA-binding proteins may affect the developing cortex in utero. Because the methylation of CpG islets flanking the trinucleotide repeats has emerged as a strong biomarker of CDM1, we highlight the need to investigate the tissue-specific impacts of these chromatin modifications in the brain. Finally, we outline promising potential therapeutic treatments for CDM1 and propose future in vitro and in vivo models with great potential to shed light on this disease.
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Affiliation(s)
- Thiéry De Serres-Bérard
- LOEX, CHU de Québec-Université Laval Research Center, Quebec City, Canada; CERVO Brain Research Center, Institut universitaire en santé mentale de Québec, Quebec City, Canada
| | - Marion Pierre
- CERVO Brain Research Center, Institut universitaire en santé mentale de Québec, Quebec City, Canada
| | - Mohamed Chahine
- CERVO Brain Research Center, Institut universitaire en santé mentale de Québec, Quebec City, Canada; Department of Medicine, Faculty of Medicine, Université Laval, Quebec City, Canada.
| | - Jack Puymirat
- LOEX, CHU de Québec-Université Laval Research Center, Quebec City, Canada; Department of Medicine, Faculty of Medicine, Université Laval, Quebec City, Canada
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12
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Leddy S, Cercignani M, Serra L, Bozzali M. Social cognition in type 1 myotonic dystrophy - A mini review. Cortex 2021; 142:389-399. [PMID: 34154799 DOI: 10.1016/j.cortex.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/13/2021] [Accepted: 05/08/2021] [Indexed: 12/11/2022]
Abstract
Our ability to interact with those around us plays an important role in our relationships, mental well being and ability to successfully navigate the complex social society in which we live. Research in social cognitive neuroscience aims to understand the underlying neurobiology of our social behaviours and interactions with others. Myotonic dystrophy type 1 (DM1) is a genetically inherited neuromuscular disorder characterized by mytonia with systemic manifestations such as cardiac disease, respiratory insufficiency, ophthalmic complications, diabetes and frontal balding among others. Individuals with myotonic dystophy have been found to have widespread changes throughout the brain in both grey and white matter territories. They have been noted to experience difficulty with social cognitive function, and to more frequently display atypical personality traits leading to often unrecognized difficulties with everyday life. In this mini review we explore the anatomical basis of social cognition, current techniques for measuring and investigating this impairment including facial emotion recognition and theory of mind. We examine the evidence for general cognitive dysfunction, autism spectrum and personality disorders in DM1. Throughout the review we discuss neuroimaging highlights relevant to social cognition in DM1. Finally, we discuss practical implications relevant to managing people with myotonic dystrophy and highlight future research needs.
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Affiliation(s)
- Sara Leddy
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom; Brighton and Sussex University Hospital Trust, Brighton, East Sussex, United Kingdom
| | - Mara Cercignani
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom; Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Laura Serra
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marco Bozzali
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom; 'Rita Levi Montalcini' Department of Neuroscience, University of Torino, Turin, Italy.
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13
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Serra L, Bianchi G, Bruschini M, Giulietti G, Domenico CD, Bonarota S, Petrucci A, Silvestri G, Perna A, Meola G, Caltagirone C, Bozzali M. Abnormal Cortical Thickness Is Associated With Deficits in Social Cognition in Patients With Myotonic Dystrophy Type 1. Front Neurol 2020; 11:113. [PMID: 32180756 PMCID: PMC7059122 DOI: 10.3389/fneur.2020.00113] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/31/2020] [Indexed: 12/15/2022] Open
Abstract
Aim: To investigate the cortical thickness in myotonic dystrophy type 1 (DM1) and its potential association with patients' genetic triplet expansion and social cognition deficits. Methods: Thirty patients with DM1 underwent the Social Cognition Battery Test and magnetic resonance imaging (MRI) scanning at 3 T. Twenty-five healthy subjects (HSs) were enrolled in the study to serve as a control group for structural MRI data. To assess changes in cortical thickness in DM1 patients, they were compared to HSs using a t-test model. Correlations were used to assess potential associations between genetic and clinical characteristics and social cognition performances in the patient group. Additionally, multiple regression models were used to explore associations between cortical thickness, CTG triplet expansion size, and scores obtained by DM1 patients on the Social Cognition Battery. Results: DM1 patients showed low performances in several subtests of the Social Cognition Battery. Specifically, they obtained pathological scores at Emotion Attribution Test (i.e., Sadness, Embarrassment, Happiness, and Anger) and at the Social Situations Test (i.e., recognition of normal situation, recognition of aberrant behavior). Significant negative correlations were found between CTG triplet expansion size and Embarrassment, and Severity of Aberrant Behavior. Similarly, a negative correlation was found between patients' MIRS scores and Sadness. DM1 patients compared to HSs showed reduced thickness in the right premotor cortex, angular gyrus, precuneus, and inferior parietal lobule. Significant associations were found between patients' CTG triplet expansion size and thickness in left postcentral gyrus and in the left primary somatosensory cortex, in the posterior cingulate cortex bilaterally, and in the right lingual gyrus. Finally, significant associations were found between cortical thickness and sadness in the superior temporal gyrus, the right precentral gyrus, the right angular gyrus, and the left medial frontal gyrus bilaterally. DM1 patients showed a negative correlation between cortical thickness in the bilateral precuneus and in the left lateral occipital cortex and performance at the Social Situations Test. Finally, DM1 patients showed a negative correlation between cortical thickness in the left precuneus and in the superior frontal gyrus and scores at the Moral Distinction Test. Discussion: The present study shows both cortical thickness changes in DM1 patients compared to controls and significant associations between cortical thickness and patients' social cognition performances. These data confirm the presence of widespread brain damages associated with cognitive impairment in DM1 patients.
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Affiliation(s)
- Laura Serra
- Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | | | | | | | - Sabrina Bonarota
- Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Antonio Petrucci
- UOC Neurologia e Neurofisiopatologia, AO San Camillo Forlanini, Rome, Italy
| | - Gabriella Silvestri
- Department of Geriatrics, Orthopedic and Neuroscience, Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Alessia Perna
- Department of Geriatrics, Orthopedic and Neuroscience, Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Meola
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - Carlo Caltagirone
- Department of Clinical and Behavioral Neurology, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Marco Bozzali
- Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.,Brighton & Sussex Medical School, CISC, University of Sussex, Brighton, United Kingdom
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Gois Beghini D, Iwao Horita S, Monteiro da Fonseca Cardoso L, Anastacio Alves L, Nagaraju K, Henriques-Pons A. A Promising Future for Stem-Cell-Based Therapies in Muscular Dystrophies-In Vitro and In Vivo Treatments to Boost Cellular Engraftment. Int J Mol Sci 2019; 20:ijms20215433. [PMID: 31683627 PMCID: PMC6861917 DOI: 10.3390/ijms20215433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/28/2019] [Accepted: 09/23/2019] [Indexed: 02/06/2023] Open
Abstract
Muscular dystrophies (MD) are a group of genetic diseases that lead to skeletal muscle wasting and may affect many organs (multisystem). Unfortunately, no curative therapies are available at present for MD patients, and current treatments mainly address the symptoms. Thus, stem-cell-based therapies may present hope for improvement of life quality and expectancy. Different stem cell types lead to skeletal muscle regeneration and they have potential to be used for cellular therapies, although with several limitations. In this review, we propose a combination of genetic, biochemical, and cell culture treatments to correct pathogenic genetic alterations and to increase proliferation, dispersion, fusion, and differentiation into new or hybrid myotubes. These boosted stem cells can also be injected into pretreate recipient muscles to improve engraftment. We believe that this combination of treatments targeting the limitations of stem-cell-based therapies may result in safer and more efficient therapies for MD patients. Matricryptins have also discussed.
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Affiliation(s)
- Daniela Gois Beghini
- Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro (RJ) 21040-900, Brazil.
| | - Samuel Iwao Horita
- Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro (RJ) 21040-900, Brazil.
| | | | - Luiz Anastacio Alves
- Laboratório de Comunicação Celular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro (RJ) 21040-900, Brazil.
| | - Kanneboyina Nagaraju
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, Binghamton University, New York, NY 13902, USA.
| | - Andrea Henriques-Pons
- Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro (RJ) 21040-900, Brazil.
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Hunter M, Ekstrom AB, Campbell C, Hung M, Bounsaga J, Bates K, Adams HR, Luebbe E, Moxley RT, Heatwole C, Johnson NE. Patient-reported study of the impact of pediatric-onset myotonic dystrophy. Muscle Nerve 2019; 60:392-399. [PMID: 31298737 PMCID: PMC10970714 DOI: 10.1002/mus.26632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/07/2019] [Accepted: 07/09/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The prevalence and impact of symptoms affecting individuals with pediatric forms of myotonic dystrophy type-1 (DM1) are not well understood. METHODS Patients from the United States, Canada, and Sweden completed a survey that investigated 20 themes associated with pediatric-onset DM1. Participants reported the prevalence and importance of each theme affecting their lives. Surveys from participants were matched with surveys from their caregivers for additional analysis. RESULTS The most prevalent symptomatic themes included problems with hands or fingers (79%) and gastrointestinal issues (75%). Problems with urinary/bowel control and gastrointestinal issues were reported to have the greatest impact on patients' lives. Responses from participants and their caregivers had varying levels of agreement among symptomatic themes. DISCUSSION Many symptoms have meaningful impact on disease burden. The highest levels of agreement between caregivers and individuals with pediatric forms of myotonic dystrophy were found for physical activity themes.
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Affiliation(s)
- Michael Hunter
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Anne-Berit Ekstrom
- Regional Pediatric Rehabilitation Center, Queen Silvia Children’s Hospital, Gothenburg, Sweden
| | - Craig Campbell
- Department of Neurology, London Health Science Centre, London, ON, Canada
| | - Man Hung
- Roseman University of Health Sciences College of Dental Medicine, The University of Utah, Salt Lake City, UT, USA
| | - Jerry Bounsaga
- Department of Orthopedics, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Kameron Bates
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Heather R. Adams
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth Luebbe
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - Richard T Moxley
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - Chad Heatwole
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
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Affiliation(s)
- Nathalie Angeard
- Memory, Brain & Cognition Lab (MC2 Lab, EA 7536), Sorbonne Paris Cité, Paris Descartes University, Boulogne-Billancourt, France
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Lee KY, Chang HC, Seah C, Lee LJ. Deprivation of Muscleblind-Like Proteins Causes Deficits in Cortical Neuron Distribution and Morphological Changes in Dendritic Spines and Postsynaptic Densities. Front Neuroanat 2019; 13:75. [PMID: 31417371 PMCID: PMC6682673 DOI: 10.3389/fnana.2019.00075] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/11/2019] [Indexed: 02/06/2023] Open
Abstract
Myotonic dystrophy (Dystrophia Myotonica; DM) is the most common adult-onset muscular dystrophy and its brain symptoms seriously affect patients’ quality of life. It is caused by extended (CTG)n expansions at 3′-UTR of DMPK gene (DM type 1, DM1) or (CCTG)n repeats in the intron 1 of CNBP gene (DM type 2, DM2) and the sequestration of Muscleblind-like (MBNL) family proteins by transcribed (CUG)n RNA hairpin is the main pathogenic mechanism for DM. The MBNL proteins are splicing factors regulating posttranscriptional RNA during development. Previously, Mbnl knockout (KO) mouse lines showed molecular and phenotypic evidence that recapitulate DM brains, however, detailed morphological study has not yet been accomplished. In our studies, control (Mbnl1+/+; Mbnl2cond/cond; Nestin-Cre−/−), Mbnl2 conditional KO (2KO, Mbnl1+/+; Mbnl2cond/cond; Nestin-Cre+/−) and Mbnl1/2 double KO (DKO, Mbnl1ΔE3/ΔE3; Mbnl2cond/cond; Nestin-Cre+/−) mice were generated by crossing three individual lines. Immunohistochemistry for evaluating density and distribution of cortical neurons; Golgi staining for depicting the dendrites/dendritic spines; and electron microscopy for analyzing postsynaptic ultrastructure were performed. We found distributional defects in cortical neurons, reduction in dendritic complexity, immature dendritic spines and alterations of postsynaptic densities (PSDs) in the mutants. In conclusion, loss of function of Mbnl1/2 caused fundamental defects affecting neuronal distribution, dendritic morphology and postsynaptic architectures that are reminiscent of predominantly immature and fetal phenotypes in DM patients.
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Affiliation(s)
- Kuang-Yung Lee
- Department of Neurology, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ho-Ching Chang
- Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Carol Seah
- Department of Neurology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Li-Jen Lee
- Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
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18
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Labayru G, Arenzana I, Aliri J, Zulaica M, López de Munain A, Sistiaga A. A. Social cognition in myotonic dystrophy type 1: Specific or secondary impairment? PLoS One 2018; 13:e0204227. [PMID: 30248121 PMCID: PMC6152965 DOI: 10.1371/journal.pone.0204227] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 09/05/2018] [Indexed: 11/19/2022] Open
Abstract
AIMS The cognitive profile of Myotonic Dystrophy type 1 (DM1) has been described in recent decades. Moreover, DM1 patients show lowered social engagement and difficulties in social-cognitive functions. The aim of the present study is to explore whether social cognition impairment is present in DM1 taking into account the overall cognitive condition. METHOD 38 patients and a control group paired in age and gender participated in the study. All the participants had an IQ within the normal range. Subjects were administered an abbreviated neuropsychological battery which comprised a facial emotion recognition test (POFA) and Faux Pas Test, as well as a self-report questionnaire on cognitive and affective empathy (TECA). RESULTS Statistically significant differences were found only for facial emotion recognition (U = 464.0, p = .006) with a moderate effect size (.31), with the controls obtaining a higher score than the patients. Analyzing each emotion separately, DM1 patients scored significantly lower than controls on the recognition of anger and disgust items. Emotion recognition did not correlate with genetic load, but did correlate negatively with age. No differences were found between patients and controls in any of the other variables related to Theory of Mind (ToM) and empathy. CONCLUSION DM1 does not manifest specific impairments in ToM since difficulties in this area predominantly rely on the cognitive demand of the tasks employed. However, a more basic process such as emotion recognition appears as a core deficit. The role of this deficit as a marker of aging related decline is discussed.
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Affiliation(s)
- Garazi Labayru
- Neuroscience Area, Biodonostia Research Institute, Donostia-San Sebastian, Gipuzkoa, Spain
- Personality, Assessment and Psychological Treatment Department, Psychology Faculty, University of the Basque Country (UPV/EHU), Donostia-San Sebastian, Gipuzkoa, Spain
| | - Irati Arenzana
- Master’s in Child and Adult Neuropsychology, Autonoma University of Barcelona, Spain
| | - Jone Aliri
- Department of Social Psychology and Methodology of Behavioral Sciences, University of the Basque Country (UPV/EHU), Donostia-San Sebastian, Gipuzkoa, Spain
| | - Miren Zulaica
- Neuroscience Area, Biodonostia Research Institute, Donostia-San Sebastian, Gipuzkoa, Spain
| | - Adolfo López de Munain
- Neuroscience Area, Biodonostia Research Institute, Donostia-San Sebastian, Gipuzkoa, Spain
- Neurology Department, Donostia University Hospital, Donostia-San Sebastian, Gipuzkoa, Spain
| | - Andone Sistiaga A.
- Neuroscience Area, Biodonostia Research Institute, Donostia-San Sebastian, Gipuzkoa, Spain
- Personality, Assessment and Psychological Treatment Department, Psychology Faculty, University of the Basque Country (UPV/EHU), Donostia-San Sebastian, Gipuzkoa, Spain
- * E-mail:
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