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Nabatame S, Tanigawa J, Tominaga K, Kagitani-Shimono K, Yanagihara K, Imai K, Ando T, Tsuyusaki Y, Araya N, Matsufuji M, Natsume J, Yuge K, Bratkovic D, Arai H, Okinaga T, Matsushige T, Azuma Y, Ishihara N, Miyatake S, Kato M, Matsumoto N, Okamoto N, Takahashi S, Hattori S, Ozono K. Association between cerebrospinal fluid parameters and developmental and neurological status in glucose transporter 1 deficiency syndrome. J Neurol Sci 2023; 447:120597. [PMID: 36965413 DOI: 10.1016/j.jns.2023.120597] [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: 08/28/2022] [Revised: 01/30/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE In glucose transporter 1 deficiency syndrome (Glut1DS), cerebrospinal fluid glucose (CSFG) and CSFG to blood glucose ratio (CBGR) show significant differences among groups classified by phenotype or genotype. The purpose of this study was to investigate the association between these biochemical parameters and Glut1DS severity. METHODS The medical records of 45 patients who visited Osaka University Hospital between March 2004 and December 2021 were retrospectively examined. Neurological status was determined using the developmental quotient (DQ), assessed using the Kyoto Scale of Psychological Development 2001, and the Scale for the Assessment and Rating of Ataxia (SARA). CSF parameters included CSFG, CBGR, and CSF lactate (CSFL). RESULTS CSF was collected from 41 patients, and DQ and SARA were assessed in 24 and 27 patients, respectively. Simple regression analysis showed moderate associations between neurological status and biochemical parameters. CSFG resulted in a higher R2 than CBGR in these analyses. CSF parameters acquired during the first year of life were not comparable to those acquired later. CSFL was measured in 16 patients (DQ and SARA in 11 and 14 patients, respectively). Although simple regression analysis also showed moderate associations between neurological status and CSFG and CSFL, the multiple regression analysis for DQ and SARA resulted in strong associations through the use of a combination of CSFG and CSFL as explanatory variables. CONCLUSION The severity of Glut1DS can be predicted from CSF parameters. Glucose and lactate are independent contributors to the developmental and neurological status in Glut1DS.
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Affiliation(s)
- Shin Nabatame
- Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Junpei Tanigawa
- Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Koji Tominaga
- Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Kuriko Kagitani-Shimono
- Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Keiko Yanagihara
- Department of Pediatric Neurology, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, Osaka 594-1101, Japan.
| | - Katsumi Imai
- Department of Clinical Research, National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi, Shizuoka, Shizuoka 420-8688, Japan.
| | - Toru Ando
- Department of Pediatric Medicine, Municipal Tsuruga Hospital, 1-6-60, Mishimacho, Tsuruga, Fukui 914-8502, Japan.
| | - Yu Tsuyusaki
- Division of Neurology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami, Yokohama, Kanagawa 232-8555, Japan.
| | - Nami Araya
- Department of Pediatrics, School of Medicine, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Shiwa, Iwate 028-3695, Japan; Epilepsy Clinic Bethel Satellite Sendai-Station, Comfort Hotel Sendai-Higashiguchi #1F, 205-5 Nakakecho, Miyagino, Sendai, Miyagi 983-0864, Japan.
| | - Mayumi Matsufuji
- Department of Pediatrics, Kagoshima City Hospital, 37-1 Uearatacho, Kagoshima, Kagoshima 890-8760, Japan.
| | - Jun Natsume
- Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa, Nagoya, Aichi 466-8550, Japan.
| | - Kotaro Yuge
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
| | - Drago Bratkovic
- Metabolic Clinic, Women's and Children's Hospital, 72 King William Rd, North Adelaide 5006, SA, Australia.
| | - Hiroshi Arai
- Department of Pediatric Neurology, Bobath Memorial Hospital, 1-6-5 Higashinakahama, Joto, Osaka, Osaka 536-0023, Japan.
| | - Takeshi Okinaga
- Department of Pediatrics, Bell Land General Hospital, 500-3 Higashiyama, Naka, Sakai, Osaka, 599-8247, Japan.
| | - Takeshi Matsushige
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
| | - Yoshiteru Azuma
- Department of Pediatrics, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Human Genetics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Naoko Ishihara
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoake, Aichi 470-1192, Japan.
| | - Satoko Miyatake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan; Clinical Genetics Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Mitsuhiro Kato
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8555, Japan.
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, Osaka 594-1101, Japan.
| | - Satoru Takahashi
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
| | - Satoshi Hattori
- Department of Biomedical Statistics, Graduate School of Medicine and Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Alves CM, Rezende AR, Marques IA, Martins Naves EL. SpES: A new portable device for objective assessment of hypertonia in clinical practice. Comput Biol Med 2021; 134:104486. [PMID: 33991858 DOI: 10.1016/j.compbiomed.2021.104486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/30/2022]
Abstract
Spasticity is a motor disorder that affects millions around the world. It is a particular type of hypertonia characterized by the speed-dependent increase of the muscle stretch reflex, where its correct evaluation is essential for rehabilitation. The preferred method for this assessment is the Modified Ashworth Scale (MAS), a rank derived from clinical observations. Currently, few methods can quantify this disorder objectively. Tonic Stretch Reflex Threshold (TSRT) is a parameter speed-dependent obtained from electromyographic (EMG) measurements and angular signals. Therefore, the objective was to develop portable equipment for quantitative assessments of hypertonia based on TSRT. To this end, we designed an instrument composed of single-channel EMG, flexible optical goniometer, and software for the online computing of TSRT from acquired signals. The new equipment named SpES (Spasticity Evaluation System) was applied to measuring hypertonia of the biceps brachii in twenty-two participants. The experiment was performed during manual passive stretching of the affected limb at predefined speeds. The results provided by SpES presented a satisfactory coefficient of determination (0.70) and a strong correlation with MAS (0.79). In summary, while MAS depends on precise clinical observations, SpES has the TSRT quantitative method embedded for reaching an objective assessment of hypertonia in clinical practice.
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Affiliation(s)
- Camille Marques Alves
- Assistive Technology Lab, Faculty of Electrical Engineering, Federal University of Uberlandia, Brazil.
| | - Andressa Rastrelo Rezende
- Assistive Technology Lab, Faculty of Electrical Engineering, Federal University of Uberlandia, Brazil
| | - Isabela Alves Marques
- Assistive Technology Lab, Faculty of Electrical Engineering, Federal University of Uberlandia, Brazil
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