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Heatwole C, Johnson N, Bode R, Dekdebrun J, Dilek N, Hilbert JE, Luebbe E, Martens W, McDermott MP, Quinn C, Rothrock N, Thornton C, Vickrey BG, Victorson D, Moxley RT. Patient-Reported Impact of Symptoms in Myotonic Dystrophy Type 2 (PRISM-2). Neurology 2015; 85:2136-46. [PMID: 26581301 DOI: 10.1212/wnl.0000000000002225] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 08/24/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the frequency and relative importance of the most life-affecting symptoms in myotonic dystrophy type 2 (DM2) and to identify the factors that have the strongest association with these symptoms. METHODS We conducted a cross-sectional study of adult patients with DM2 from a National Registry of DM2 Patients to assess the prevalence and relative importance of 310 symptoms and 21 symptomatic themes. Participant responses were compared by age categories, sex, educational attainment, employment status, and duration of symptoms. RESULTS The symptomatic themes with the highest prevalence in DM2 were the inability to do activities (94.4%), limitations with mobility or walking (89.2%), hip, thigh, or knee weakness (89.2%), fatigue (89.2%), and myotonia (82.6%). Participants identified the inability to do activities and fatigue as the symptomatic themes that have the greatest overall effect on their lives. Unemployment, a longer duration of symptoms, and less education were associated with a higher average prevalence of all symptomatic themes (p < 0.01). Unemployment, a longer duration of symptoms, sex, and increased age were associated with a higher average effect of all symptomatic themes among patients with DM2 (p < 0.01). CONCLUSIONS The lives of patients with DM2 are affected by a variety of symptoms. These symptoms have different levels of significance and prevalence in this population and vary across DM2 subgroups in different demographic categories.
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Affiliation(s)
- Chad Heatwole
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA.
| | - Nicholas Johnson
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Rita Bode
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Jeanne Dekdebrun
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Nuran Dilek
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - James E Hilbert
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Elizabeth Luebbe
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - William Martens
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Michael P McDermott
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Christine Quinn
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Nan Rothrock
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Charles Thornton
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Barbara G Vickrey
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - David Victorson
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
| | - Richard T Moxley
- From the Departments of Neurology (C.H., J.D., N.D., J.E.H., E.L., W.M., M.P.M., C.T., R.T.M.) and Biostatistics and Computational Biology (M.P.M.), and James P. Wilmot Cancer Institute (C.Q.), University of Rochester Medical Center, Rochester, NY; University of Utah (N.J.), Salt Lake City; Northwestern University Feinberg School of Medicine (R.B., N.R., D.V.), Chicago, IL; David Geffen School of Medicine (B.G.V.), UCLA Medical Center, Los Angeles; and Greater Los Angeles VA HealthCare System (B.G.V.), CA
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Funk GD, Rajani V, Alvares TS, Revill AL, Zhang Y, Chu NY, Biancardi V, Linhares-Taxini C, Katzell A, Reklow R. Neuroglia and their roles in central respiratory control; an overview. Comp Biochem Physiol A Mol Integr Physiol 2015; 186:83-95. [PMID: 25634606 DOI: 10.1016/j.cbpa.2015.01.010] [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: 08/17/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 01/12/2023]
Abstract
While once viewed as mere housekeepers, providing structural and metabolic support for neurons, it is now clear that neuroglia do much more. Phylogenetically, they have undergone enormous proliferation and diversification as central nervous systems grew in their complexity. In addition, they: i) are morphologically and functionally diverse; ii) play numerous, vital roles in maintaining CNS homeostasis; iii) are key players in brain development and responses to injury; and, iv) via gliotransmission, are likely participants in information processing. In this review, we discuss the diverse roles of neuroglia in maintaining homeostasis in the CNS, their evolutionary origins, the different types of neuroglia and their functional significance for respiratory control, and finally consider evidence that they contribute to the processing of chemosensory information in the respiratory network and the homeostatic control of blood gases.
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Affiliation(s)
- Gregory D Funk
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Vishaal Rajani
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Tucaauê S Alvares
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ann L Revill
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Yong Zhang
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Nathan Y Chu
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Vivian Biancardi
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Department of Animal Morphology and Physiology, Fac. de Ciências Agrárias e Veterinárias/UNESP, Via de Acesso Paulo Donato Castellane km 05, Jaboticabal, SP 14884-900, Brazil
| | - Camila Linhares-Taxini
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Department of Animal Morphology and Physiology, Fac. de Ciências Agrárias e Veterinárias/UNESP, Via de Acesso Paulo Donato Castellane km 05, Jaboticabal, SP 14884-900, Brazil
| | - Alexis Katzell
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Robert Reklow
- Department of Physiology, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute (WCHRI), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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