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Zerbinati P, Mazzoli D, Galletti M, Basini G, Rambelli C, Mascioli F, Bò MC, Delia C, Petroselli L, Vulpiani MC, Prati P, Bemporad J, Merlo A. A survey on the short to medium-term satisfaction of neurological patients treated by functional surgery for the correction of limb deformities. Curr Med Res Opin 2024:1-10. [PMID: 38756086 DOI: 10.1080/03007995.2024.2352855] [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] [Received: 01/16/2024] [Accepted: 05/05/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES Functional surgery (FS) is often used to correct congenital or acquired deformities in neurological patients. Along with functional results, short- and medium-term patient satisfaction should always be considered a key goal of surgery and rehabilitation. The aim of this study is to assess the short to medium-term satisfaction of patients who underwent FS and its correlation with perceived improvements. METHODS Invitation to an anonymous online survey was sent via e-mail to all neurological adult patients or caregivers of children who underwent lower or upper limb FS over the 2018-2020 period. The survey investigated patients' satisfaction with the surgery and the variation in pain, ADLs, level of independence, body image, self-esteem, social interaction skills, participation in social events, leisure activities and sports, and use of orthoses or walking aids. Descriptive data analysis was performed. Correlations were assessed using Kendall's tau. RESULTS 122 out of 324 adults and 53 out of 163 children's caregivers filled out the questionnaire, with a response rate approaching 40%. Eighty-three percent of adult respondents and 87% of the children's caregivers were satisfied or very satisfied in the short and medium terms and reported their expectations had been met. Satisfaction was significantly correlated (p < 0.01) with improvements in functional abilities, social participation, self-esteem, and pain reduction. Half of the adults and 40% of children stopped using their orthoses or replaced them with lighter ones. Dissatisfaction and worsened conditions were reported by <10% of the respondents. CONCLUSION According to patients and caregivers, FS was satisfactory in the short and medium terms, following improvements in all the ICF domains for most patients.
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Affiliation(s)
- Paolo Zerbinati
- Neuro-Orthopedic Surgery Unit, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Davide Mazzoli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Martina Galletti
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Giacomo Basini
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Chiara Rambelli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Francesca Mascioli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Maria Chiara Bò
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Caterina Delia
- Azienda Ospedaliero-Universitaria Sant'Andrea, Roma, Italy
| | | | | | - Paolo Prati
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Jonathan Bemporad
- Neurologic Rehabilitation Unit, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Andrea Merlo
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
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Sivera Mascaró R, García Sobrino T, Horga Hernández A, Pelayo Negro AL, Alonso Jiménez A, Antelo Pose A, Calabria Gallego MD, Casasnovas C, Cemillán Fernández CA, Esteban Pérez J, Fenollar Cortés M, Frasquet Carrera M, Gallano Petit MP, Giménez Muñoz A, Gutiérrez Gutiérrez G, Gutiérrez Martínez A, Juntas Morales R, Ciano-Petersen NL, Martínez Ulloa PL, Mederer Hengstl S, Millet Sancho E, Navacerrada Barrero FJ, Navarrete Faubel FE, Pardo Fernández J, Pascual Pascual SI, Pérez Lucas J, Pino Mínguez J, Rabasa Pérez M, Sánchez González M, Sotoca J, Rodríguez Santiago B, Rojas García R, Turon-Sans J, Vicent Carsí V, Sevilla Mantecón T. Clinical practice guidelines for the diagnosis and management of Charcot-Marie-Tooth disease. Neurologia 2024:S2173-5808(24)00047-6. [PMID: 38431252 DOI: 10.1016/j.nrleng.2024.02.008] [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: 09/12/2023] [Accepted: 11/03/2023] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Charcot-Marie-Tooth (CMT) disease is classified considering the neurophysiological and histological findings, the inheritance pattern and the underlying genetic defect. In recent years, with the advent of next generation sequencing, genetic complexity has increased exponentially, expanding the knowledge about disease pathways, and having an impact in clinical management. The aim of this guide is to offer recommendations for the diagnosis, prognosis, monitoring and treatment of this disease in Spain. MATERIAL AND METHODS This consensus guideline has been developed by a multidisciplinary panel encompassing a broad group of professionals including neurologists, neuropediatricians, geneticists, rehabilitators, and orthopaedic surgeons. RECOMMENDATIONS The diagnosis is based in the clinical characterization, usually presenting with a common phenotype. It should be followed by an appropriate neurophysiological study that allows for a correct classification, specific recommendations are established for the parameters that should be included. Genetic diagnosis must be approached in sequentially, once the PMP22 duplication has been ruled out if appropriate, a next generation sequencing should be considered taking into account the limitations of the available techniques. To date, there is no pharmacological treatment that modifies the course of the disease, but symptomatic management is important, as are the rehabilitation and orthopaedic considerations. The latter should be initiated early to identify and improve the patient's functional impairments, including individualised exercise guidelines, orthotic adaptation, and assessment of conservative surgeries such as tendon transpositions. The follow-up of patients with CMT is exclusively clinical, ancillary testing are not necessary in routine clinical practice.
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Affiliation(s)
- R Sivera Mascaró
- Servicio de Neurología, Hospital Universitari i Politécnic La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
| | - T García Sobrino
- Servicio de Neurología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain.
| | - A Horga Hernández
- Servicio de Neurología, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - A L Pelayo Negro
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, Spain; Center for Biomedical Research in the Neurodegenerative Diseases (CIBERNED) Network, Madrid, Spain
| | - A Alonso Jiménez
- Neuromuscular Reference Center, Neurology Department, University Hospital of Antwerp, Amberes, Belgium
| | - A Antelo Pose
- Servicio de Rehabilitación, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | | | - C Casasnovas
- Unitat de Neuromuscular, Servicio de Neurología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | - J Esteban Pérez
- Servicio de Neurología, Unidad de ELA y Enfermedades Neuromusculares, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Fenollar Cortés
- Genética Clínica, Servicio de Análisis Clínicos, Instituto de Medicina del Laboratorio, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - M Frasquet Carrera
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurología, Hospital Universitari Dr. Peset, Valencia, Spain
| | - M P Gallano Petit
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Genética, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Giménez Muñoz
- Servicio de Neurología, Hospital Royo Villanova, Zaragoza, Spain
| | - G Gutiérrez Gutiérrez
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain; Facultad de Medicina, Universidad Europea de Madrid, Madrid, Spain
| | - A Gutiérrez Martínez
- Servicio de Neurología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - R Juntas Morales
- Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - N L Ciano-Petersen
- Servicio de Neurología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - P L Martínez Ulloa
- Servicio de Neurología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Mederer Hengstl
- Servicio de Neurología, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - E Millet Sancho
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurofisiología, Hospital Universitari i Politécnic La Fe, Instituto de Investigación Sanitaria la Fe, Valencia, Spain
| | - F J Navacerrada Barrero
- Servicio de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - F E Navarrete Faubel
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - J Pardo Fernández
- Servicio de Neurología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | | | - J Pérez Lucas
- Servicio de Neurología, Hospital del Tajo, Aranjuez, Madrid, Spain
| | - J Pino Mínguez
- Servicio de Cirugía Ortopédica y Traumatología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - M Rabasa Pérez
- Servicio de Neurología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - M Sánchez González
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - J Sotoca
- Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - R Rojas García
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Departamento de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - J Turon-Sans
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurofisiología, Hospital de la Santa Creu i Sant Pau, Departamento de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - V Vicent Carsí
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - T Sevilla Mantecón
- Servicio de Neurología, Hospital Universitari i Politécnic La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Universidad de Valencia, Valencia, Spain
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Silva SF, Magalhães HLD, Deus FAD, Andrade KKS, Lima VP, Gaiad TP. Rehabilitation interventions targeting the activity and participation of patient with neuromuscular diseases: what do we know? A systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-12. [PMID: 38395419 PMCID: PMC10890920 DOI: 10.1055/s-0044-1779295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/07/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND To be objective and achievable, the rehabilitation goals must be focused on the functional expectations of patients with neuromuscular disease (NMD). OBJECTIVE Investigate rehabilitation programs that are able to modify the activity/participation of patients with NMD. Data search: Embase, BVS/Lilacs, Physiotherapy Evidence Database (PEDro), CINAHL/EBSCO, and Medline were searched in June 2021. It was last updated in March 2023. METHODS Randomized controlled trials investigating any rehabilitation therapy for patients with NMD with an outcome encompassing the activity/participation components of the International Classification of Functioning, Disability and Health (ICF) were included. Pharmacological therapy studies were excluded. The results were synthesized according to the ICF core sets for NMD. The methodological quality and level of evidence were assessed using PEDro criteria and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). This systematic review followed the PRISMA 2020 guideline and was registered at PROSPERO (CRD42020209359). RESULTS Of a total of 1943 identified studies, 12 were included in this review with a methodological quality between regular and good. Light to moderate-intensity aerobic exercise was the most studied intervention. The mobility was assessed in all included studies. CONCLUSION The variability of the types of NMD and the small sample size of the included studies demonstrates that there is very limited evidence of interventions focused on the activity/participation of individuals with NMD. Light to moderate-intensity aerobic exercise seems to improve the mobility, self-care, and social participation of patients with NMD, especially those with slow progression.
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Affiliation(s)
- Sionara Ferreira Silva
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina MG, Brazil.
| | - Hugo Leonardo de Magalhães
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Performance Funcional, Diamantina MG, Brazil.
| | - Franciele Angelo de Deus
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Performance Funcional, Diamantina MG, Brazil.
| | - Keysy Karoline Souza Andrade
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Performance Funcional, Diamantina MG, Brazil.
| | - Vanessa Pereira Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina MG, Brazil.
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Performance Funcional, Diamantina MG, Brazil.
| | - Thaís Peixoto Gaiad
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina MG, Brazil.
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Performance Funcional, Diamantina MG, Brazil.
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Ferraro F, Calafiore D, Curci C, Fortunato F, Carantini I, Genovese F, Lucchini G, Merlo A, Ammendolia A, de Sire A. Effects of intensive rehabilitation on functioning in patients with mild and moderate Charcot-Marie-Tooth disease: a real-practice retrospective study. Neurol Sci 2024; 45:289-297. [PMID: 37552411 PMCID: PMC10761523 DOI: 10.1007/s10072-023-06998-0] [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: 01/20/2023] [Accepted: 07/14/2023] [Indexed: 08/09/2023]
Abstract
Charcot-Marie-Tooth (CMT) disease is one of the most common inherited neuropathies and can lead to progressive muscular weakness, pes cavus, loss of deep tendon reflexes, distal sensory loss, and gait impairment. There are still no effective drugs or surgical therapies for CMT, and supportive treatment is limited to rehabilitative therapy and surgical treatment of skeletal deformities. Many rehabilitative therapeutic approaches have been proposed, but timing and cadence of rehabilitative intervention are not clearly defined, and long-term follow-up is lacking in literature. The aim of this real-practice retrospective study was to assess the effectiveness of an intensive neurorehabilitation protocol on muscle strength and functioning in CMT patients. We analyzed data of patients with diagnosis of mild to moderate CMT. The rehabilitation program lasted 2-4 h a day, 5 days a week, for 3 weeks and consisted of manual treatments, strengthening exercises, stretching, core stability, balance and resistance training, aerobic exercises, and tailored self-care training. Data were collected at baseline (T0), after treatment (T1), and at the 12-month mark (T2) in terms of the following outcome measures: muscle strength, pain, fatigue, cramps, balance, walking speed, and ability. We included 37 CMT patients with a median age of 50.72 ± 13.31 years, with different forms: demyelinating (n = 28), axonal (n = 8), and mixed (n = 1). After intensive rehabilitation treatment, all outcomes significantly improved. This improvement was lost at the 1-year mark. Taken together, these findings suggest that an intensive rehabilitation program improves short-term symptoms and functional outcomes in a cohort of inpatients affected by mild to moderate CMT.
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Affiliation(s)
- Francesco Ferraro
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100, Mantova, Italy
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100, Mantova, Italy
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100, Mantova, Italy
| | - Francesco Fortunato
- Institute of Neurology, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100, Catanzaro, Italy
| | - Irene Carantini
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100, Mantova, Italy
- ACMT-Rete per la malattia di Charcot-Marie-Tooth OdV Association, Rome, Italy
| | - Filippo Genovese
- ACMT-Rete per la malattia di Charcot-Marie-Tooth OdV Association, Rome, Italy
| | | | - Andrea Merlo
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University Hospital "Mater Domini", University of Catanzaro Magna Graecia, Via Campanella, 115-88100, Catanzaro, Italy
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University Hospital "Mater Domini", University of Catanzaro Magna Graecia, Via Campanella, 115-88100, Catanzaro, Italy.
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Shen Z, Li M, He F, Huang C, Zheng Y, Wang Z, Ma S, Chen L, Liu Z, Zheng H, Xiong F. Intravenous Administration of an AAV9 Vector Ubiquitously Expressing C1orf194 Gene Improved CMT-Like Neuropathy in C1orf194 -/- Mice. Neurotherapeutics 2023; 20:1835-1846. [PMID: 37843769 PMCID: PMC10684460 DOI: 10.1007/s13311-023-01429-6] [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] [Accepted: 08/19/2023] [Indexed: 10/17/2023] Open
Abstract
Charcot-Marie-Tooth (CMT) disease, also known as hereditary motor sensory neuropathy, is a group of rare genetically heterogenous diseases characterized by progressive muscle weakness and atrophy, along with sensory deficits. Despite extensive pre-clinical and clinical research, no FDA-approved therapy is available for any CMT type. We previously identified C1ORF194, a novel causative gene for CMT, and found that both C1orf194 knock-in (I121N) and knockout mice developed clinical phenotypes similar to those in patients with CMT. Encouraging results of adeno-associated virus (AAV)-mediated gene therapy for spinal muscular atrophy have stimulated the use of AAVs as vehicles for CMT gene therapy. Here, we present a gene therapy approach to restore C1orf194 expression in a knockout background. We used C1orf194-/- mice treated with AAV serotype 9 (AAV9) vector carrying a codon-optimized WT human C1ORF194 cDNA whose expression was driven by a ubiquitously expressed chicken β-actin promoter with a CMV enhancer. Our preclinical evaluation demonstrated the efficacy of AAV-mediated gene therapy in improving sensory and motor abilities, thus achieving largely normal gross motor performance and minimal signs of neuropathy, on the basis of neurophysiological and histopathological evaluation in C1orf194-/- mice administered AAV gene therapy. Our findings advance the techniques for delivering therapeutic interventions to individuals with CMT.
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Affiliation(s)
- Zongrui Shen
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Meiyi Li
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Fei He
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Cheng Huang
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yingchun Zheng
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zhikui Wang
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Shunfei Ma
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Li Chen
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zhengshan Liu
- Division of Translational Neuroscience in Schizophrenia, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Hui Zheng
- Department of Neurology, The First School of Clinical Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Fu Xiong
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Guangzhou, Guangdong, China.
- Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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Pedersen BS, Kodal LS, Kaalund AB, Holm-Yildiz S, Pedersen MM, Dysgaard T. Effect of strength training on functional outcomes and strength in patients with polyneuropathy: A scoping review. Front Physiol 2023; 14:1158039. [PMID: 37089431 PMCID: PMC10116572 DOI: 10.3389/fphys.2023.1158039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction: Polyneuropathy (PNP) is a chronic progressive disease that over time can lead to damage of sensory, motor and/or autonomic peripheral nerves. Symptoms vary from predominantly sensory to severe sensorimotor affection both proximally and distally. This can result in considerable functional impairments that affect activities of daily living. In other neurological patients, strength training has shown to improve strength and functional outcomes. Since medical treatment only exists for very few percentages of the underlying causes it is obvious to consider if strength training could be a potential treatment for functional impairments. To date little is known on the effect of strength training in patients with PNP.Aim: The aim of this scoping review was to summarize research on strength training and outcomes on physical function in patients with PNP.Methods: We systematically searched five data bases; Pubmed, Embase, Cinahl, Cochrane library and Web of science. Studies on strength training (load ≥70% of 1RM) in patients with PNP were included. The search was carried out in November 2022.Results: 362 articles were screened by title and abstract, 101 articles were full text screened. Eight studies were included. Patients with Charcot-Marie-Tooth (CMT), chronic inflammatory polyneuropathy (CIDP) and diabetic polyneuropathy (DPN) were represented in the studies (five RCTs, two case-series, and one cross-over trial). The methodological quality ranged from fair-poor in seven studies, one study reached good quality. Results from the studies indicated that strength training in CMT, CIDP and DPN may improve strength. However, various outcomes were used to evaluate strength training, so direct comparisons were difficult.Discussion: In this scoping review we summarized research on strength training and outcomes evaluated in interventions in patients with PNP. Eight studies were included, they indicated that strength training may be beneficial for patients with PNP. However, due to low methodological strength of most studies a recommendation for patients with PNP cannot be made. Thus, the low number of studies with relatively low quality, where various functional outcomes were used, underscores the importance of future studies to evaluate the effect of strength training on relevant functional outcomes and strength in patients with PNP.
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Affiliation(s)
- Britt Stævnsbo Pedersen
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- *Correspondence: Britt Stævnsbo Pedersen,
| | - Louise Sloth Kodal
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anna Bundgaard Kaalund
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sonja Holm-Yildiz
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette Merete Pedersen
- Department of Clinical Research and Physical Medicine and Rehabilitation Research Copenhagen (PMR-C), Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Dysgaard
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Newman L, Fornusek C, Hackett D. An exploratory study of exercise behaviours and barriers to participation in people with Charcot-Marie-Tooth disease: a focus on resistance training. J Exerc Rehabil 2023; 19:35-44. [PMID: 36910678 PMCID: PMC9993004 DOI: 10.12965/jer.2346020.010] [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: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
The aim of this study was to explore and describe the exercise behaviours and barriers in people with Charcot-Marie-Tooth disease (CMT), with a particular focus on resistance training (RT). Ninety-four Australian adults with a diagnosis of CMT completed an online survey. Fifty-seven percent of respondents reported performing some form of RT each week. Those performing RT engaged in more aerobic activity (P≤0.01) and were involved in longer periods of structured exercise (P<0.01) compared to those not performing RT. The RT group was more likely to perceive their exercise levels as acceptable (P<0.01), that following a program was important (P=0.02), and that exercise is beneficial (P=0.04). The RT group were more likely to have been advised to exercise (P=0.02). Common barriers to exercise were fatigue (64.9%), pain (57.4%), motivation (51.1%), and time (46.8%). RT status did not influence the type of barriers experienced. Weekly RT time was positively associated with exercise satisfaction (r=0.43, P<0.01) and walking distance prior to resting (r=0.29, P=0.04). The findings suggest that positive exercise experiences, advice, assistance from a trainer, and potentially greater resources may influence participation in RT for people with CMT.
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Affiliation(s)
- Laura Newman
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Che Fornusek
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Daniel Hackett
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Playing Disability Rugby League with Charcot-Marie-Tooth Disease: A Case Study. Sports (Basel) 2023; 11:sports11020021. [PMID: 36828306 PMCID: PMC9964179 DOI: 10.3390/sports11020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Charcot-Marie-Tooth (CMT) disease is a common inherited neurological disorder that causes damage to peripheral nerves. Reports of CMT patients participating in team-based sports such as disability rugby league are scarce. The objective of this case report was to evaluate the benefits of participation in disability rugby league in a 50-year-old male with CMT. Leg muscle mass and strength was worse for the case subject compared to two age-matched CMT participants with an exercise history; however, evidence of greater function in the case subject was observed through better 6-min walk test performance. Performance in a series of sport specific tests was noticeably worse for the case subject compared to a fellow rugby league player (age matched) with cerebral palsy. Inferior in-game performance was observed for the case subject compared to his fellow rugby league player in terms of distance covered, top running speed, and intensity. However, the case subject may have assumed a different role when playing as evident by the different behaviours he displayed during the games (i.e., less player contacts, tackles, or touches, but more passes of the ball). This case study provides information concerning disability rugby league as an adjunctive mode of treatment for CMT populations.
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Beloribi-Djefaflia S, Attarian S. Treatment of Charcot-Marie-Tooth neuropathies. Rev Neurol (Paris) 2023; 179:35-48. [PMID: 36588067 DOI: 10.1016/j.neurol.2022.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 12/31/2022]
Abstract
Charcot-Marie-Tooth (CMT) is a heterogeneous group of inherited neuropathies that affect the peripheral nerves and slowly cause progressive disability. Currently, there is no effective therapy. Patients' management is based on rehabilitation and occupational therapy, fatigue, and pain treatment with regular follow-up according to the severity of the disease. In the last three decades, much progress has been made to identify mutations involved in the different types of CMT, decipher the pathophysiology of the disease, and identify key genes and pathways that could be targeted to propose new therapeutic strategies. Genetic therapy is one of the fields of interest to silence genes such as PMP22 in CMT1A or to express GJB1 in CMT1X. Among the most promising molecules, inhibitors of the NRG-1 axis and modulators of UPR or the HDACs enzyme family could be used in different types of CMT.
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Affiliation(s)
- S Beloribi-Djefaflia
- Reference center for neuromuscular disorders and ALS, AP-HM, CHU La Timone, Marseille, France
| | - S Attarian
- Reference center for neuromuscular disorders and ALS, AP-HM, CHU La Timone, Marseille, France; FILNEMUS, European Reference Network for Rare Diseases (ERN), Marseille, France; Medical Genetics, Aix Marseille Université-Inserm UMR_1251, 13005 Marseille, France.
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Irisin and Bone in Sickness and in Health: A Narrative Review of the Literature. J Clin Med 2022; 11:jcm11226863. [PMID: 36431340 PMCID: PMC9699623 DOI: 10.3390/jcm11226863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 11/24/2022] Open
Abstract
Irisin is a hormone-like myokine produced by the skeletal muscle in response to exercise. Upon its release into the circulation, it is involved in the browning process and thermogenesis, but recent evidence indicates that this myokine could also regulate the functions of osteoblasts, osteoclasts, and osteocytes. Most human studies have reported that serum irisin levels decrease with age and in conditions involving bone diseases, including both primary and secondary osteoporosis. However, it should be emphasized that recent findings have called into question the importance of circulating irisin, as well as the validity and reproducibility of current methods of irisin measurement. In this review, we summarize data pertaining to the role of irisin in the bone homeostasis of healthy children and adults, as well as in the context of primary and secondary osteoporosis. Additional research is required to address methodological issues, and functional studies are required to clarify whether muscle and bone damage per se affect circulating levels of irisin or whether the modulation of this myokine is caused by the inherent mechanisms of underlying diseases, such as genetic or inflammatory causes. These investigations would shed further light on the effects of irisin on bone homeostasis and bone disease.
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Thomas FP, Brannagan TH, Butterfield RJ, Desai U, Habib AA, Herrmann DN, Eichinger KJ, Johnson NE, Karam C, Pestronk A, Quinn C, Shy ME, Statland JM, Subramony SH, Walk D, Stevens-Favorite K, Miller B, Leneus A, Fowler M, van de Rijn M, Attie KM. Randomized Phase 2 Study of ACE-083 in Patients With Charcot-Marie-Tooth Disease. Neurology 2022; 98:e2356-e2367. [PMID: 35545446 PMCID: PMC9202530 DOI: 10.1212/wnl.0000000000200325] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 02/17/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The goal of this work was to determine whether locally acting ACE-083 is safe and well tolerated and increases muscle volume, motor function, and quality of life (QoL) in adults with Charcot-Marie-Tooth disease (CMT) type 1. METHODS This phase 2 study enrolled adults with CMT1 or CMTX (N = 63). Part 1 was open label and evaluated the safety and tolerability of different dose levels of ACE-083 for use in part 2. Part 2 was a randomized, placebo-controlled, 6-month study of 240 mg/muscle ACE-083 injected bilaterally into the tibialis anterior muscle, followed by a 6-month, open-label extension in which all patients received ACE-083. Pharmacodynamic endpoints included total muscle volume (TMV; primary endpoint), contractile muscle volume (CMV), and fat fraction. Additional secondary endpoints included 6-minute walk test, 10-m walk/run, muscle strength, and QoL. Safety was assessed with treatment-emergent adverse events (TEAEs) and clinical laboratory tests. RESULTS In part 1 (n = 18), ACE-083 was generally safe and well tolerated at all dose levels, with no serious adverse events, TEAEs of grade 3 or greater, or death reported. In part 2 (n = 45 enrolled, n = 44 treated), there was significantly greater change in TMV with ACE-083 compared with placebo (least-squares mean difference 13.5%; p = 0.0096). There was significant difference between ACE-083 and placebo for CMV and change in ankle dorsiflexion strength. Fat fraction and all other functional outcomes were not significantly improved by ACE-083. Moderate to mild injection-site reactions were the most common TEAEs. DISCUSSION Despite significantly increased TMV and CMV, patients with CMT receiving ACE-083 in tibialis anterior muscles did not demonstrate greater functional improvement compared with those receiving placebo. TRIAL REGISTRATION INFORMATION Clinical Trials Registration: NCT03124459. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that intramuscular ACE-083 is safe and well tolerated and increases total muscle volume after 6 months of treatment in adults with CMT1 or CMTX.
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Affiliation(s)
- Florian P Thomas
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA.
| | - Thomas H Brannagan
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Russell J Butterfield
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Urvi Desai
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Ali A Habib
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - David N Herrmann
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Katy J Eichinger
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Nicholas E Johnson
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Chafic Karam
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Alan Pestronk
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Colin Quinn
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Michael E Shy
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Jeffrey M Statland
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Sub H Subramony
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - David Walk
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Katherine Stevens-Favorite
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Barry Miller
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Ashley Leneus
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Marcie Fowler
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Marc van de Rijn
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Kenneth M Attie
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
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Colaianni G, Oranger A, Dicarlo M, Lovero R, Storlino G, Pignataro P, Fontana A, Di Serio F, Ingravallo A, Caputo G, Di Leo A, Barone M, Grano M. Irisin Serum Levels and Skeletal Muscle Assessment in a Cohort of Charcot-Marie-Tooth Patients. Front Endocrinol (Lausanne) 2022; 13:886243. [PMID: 35634506 PMCID: PMC9134857 DOI: 10.3389/fendo.2022.886243] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Charcot-Marie-Tooth (CMT) indicates a group of inherited polyneuropathies whose clinical phenotypes primarily include progressive distal weakness and muscle atrophy. Compelling evidence showed that the exercise-mimetic myokine irisin protects against muscle wasting in an autocrine manner, thus possibly preventing the onset of musculoskeletal atrophy. Therefore, we sought to determine if irisin serum levels correlate with biochemical and muscle parameters in a cohort of CMT patients. METHODS This cohort study included individuals (N=20) diagnosed with CMT disease. Irisin and biochemical markers were quantified in sera. Skeletal muscle mass (SMM) was evaluated by bioelectric impedance analysis, muscle strength by handgrip, and muscle quality was derived from muscle strength and muscle mass ratio. RESULTS CMT patients (m/f, 12/8) had lower irisin levels than age and sex matched healthy subjects (N=20) (6.51 ± 2.26 vs 9.34 ± 3.23 μg/ml; p=0.003). SMM in CMT patients was always lower compared to SMM reference values reported in healthy Caucasian population matched for age and sex. Almost the totality of CMT patients (19/20) showed low muscle quality and therefore patients were evaluated on the basis of muscle strength. Irisin was lower in presence of pathological compared to normal muscle strength (5.56 ± 1.26 vs 7.67 ± 2.72 μg/ml; p=0.03), and directly correlated with the marker of bone formation P1PN (r= 0.669; 95%CI 0.295 to 0.865; p=0.002), but inversely correlated with Vitamin D (r=-0.526; 95%CI -0,791 to -0,095; p=0.017). Surprisingly, in women, irisin levels were higher than in men (7.31 ± 2.53 vs 5.31 ± 1.02 μg/ml, p=0.05), and correlated with both muscle strength (r=0.759; 95%CI 0.329 to 0.929; p=0.004) and muscle quality (r=0.797; 95%CI 0.337 to 0.950; p=0.006). CONCLUSION Our data demonstrate lower irisin levels in CMT patients compared to healthy subjects. Moreover, among patients, we observed, significantly higher irisin levels in women than in men, despite the higher SMM in the latter. Future studies are necessary to establish whether, in this clinical contest, irisin could represent a marker of the loss of muscle mass and strength and/or bone loss.
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Affiliation(s)
- Graziana Colaianni
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Angela Oranger
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Manuela Dicarlo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Roberto Lovero
- Clinical Pathology Unit, Polyclinic of Bari, Bari, Italy
| | - Giuseppina Storlino
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Patrizia Pignataro
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | | | | | - Angelica Ingravallo
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Giuseppe Caputo
- Territorial Neurology Service of Parkinson Disease and Movement Disorders Network - Apulia - Azienda Sanitaria Locale (ASL) Bari, Bari, Italy
| | - Alfredo Di Leo
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Michele Barone
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Maria Grano
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
- *Correspondence: Maria Grano,
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Pisciotta C, Saveri P, Pareyson D. Challenges in Treating Charcot-Marie-Tooth Disease and Related Neuropathies: Current Management and Future Perspectives. Brain Sci 2021; 11:1447. [PMID: 34827446 PMCID: PMC8615778 DOI: 10.3390/brainsci11111447] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 02/06/2023] Open
Abstract
There is still no effective drug treatment available for Charcot-Marie-Tooth neuropathies (CMT). Current management relies on rehabilitation therapy, surgery for skeletal deformities, and symptomatic treatment of pain; fatigue and cramps are frequent complaints that are difficult to treat. The challenge is to find disease-modifying therapies. Several approaches, including gene silencing, to counteract the PMP22 gene overexpression in the most frequent CMT1A type are under investigation. PXT3003 is the compound in the most advanced phase for CMT1A, as a second-phase III trial is ongoing. Gene therapy to substitute defective genes or insert novel ones and compounds acting on pathways important for different CMT types are being developed and tested in animal models. Modulation of the Neuregulin pathway determining myelin thickness is promising for both hypo-demyelinating and hypermyelinating neuropathies; intervention on Unfolded Protein Response seems effective for rescuing misfolded myelin proteins such as P0 in CMT1B. HDAC6 inhibitors improved axonal transport and ameliorated phenotypes in different CMT models. Other potential therapeutic strategies include targeting macrophages, lipid metabolism, and Nav1.8 sodium channel in demyelinating CMT and the P2X7 receptor, which regulates calcium influx into Schwann cells, in CMT1A. Further approaches are aimed at correcting metabolic abnormalities, including the accumulation of sorbitol caused by biallelic mutations in the sorbitol dehydrogenase (SORD) gene and of neurotoxic glycosphingolipids in HSN1.
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Affiliation(s)
| | | | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy; (C.P.); (P.S.)
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14
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Ramdharry G, Buscemi V, Boaz A, Dawes H, Jaki T, Jones F, Marsden J, Paul L, Playle R, Randell E, Robling M, Rochester L, Busse M. Proposing a Core Outcome Set for Physical Activity and Exercise Interventions in People With Rare Neurological Conditions. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:705474. [PMID: 36188845 PMCID: PMC9397985 DOI: 10.3389/fresc.2021.705474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/23/2021] [Indexed: 12/21/2022]
Abstract
Rare neurological conditions (RNCs) encompass a variety of diseases that differ in progression and symptoms but typically include muscle weakness, sensory and balance impairment and difficulty with coordinating voluntary movement. This can limit overall physical activity, so interventions to address this are recommended. The aim of this study was to agree a core outcome measurement set for physical activity interventions in people living with RNCs. We followed established guidelines to develop core outcome sets. Broad ranging discussions in a series of stakeholder workshops led to the consensus that (1) physical well-being; (2) psychological well-being and (3) participation in day-to-day activities should be evaluated in interventions. Recommendations were further informed by a scoping review of physical activity interventions for people living with RNCs. Nearly 200 outcome measures were identified from the review with a specific focus on activities or functions (e.g, on lower limb function, ability to perform daily tasks) but limited consideration of participation based outcomes (e.g., social interaction, work and leisure). Follow on searches identified two instruments that matched the priority areas: the Oxford Participation and Activities Questionnaire and the Sources of Self-Efficacy for Physical Activity. We propose these scales as measures to assess outcomes that are particularly relevant to assess when evaluating physical activity interventions mong people with RNCs. Validation work across rare neurological conditions is now required to inform application of this core outcome set in future clinical trials to facilitate syntheses of results and meta-analyses.
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Affiliation(s)
- Gita Ramdharry
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, United Kingdom
- Institute of Neurology, University College London, London, United Kingdom
| | - Valentina Buscemi
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, United Kingdom
- Institute of Neurology, University College London, London, United Kingdom
| | - Annette Boaz
- Faculty of Health, Social Care and Education, St. George's, University of London, London, United Kingdom
| | - Helen Dawes
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Thomas Jaki
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Mathematics and Statistics, University of Lancaster, Lancaster, United Kingdom
| | - Fiona Jones
- Faculty of Health, Social Care and Education, St. George's, University of London, London, United Kingdom
- Faculty of Health, Social Care and Education, Kingston University, Surrey, United Kingdom
| | - Jonathan Marsden
- Faculty of Health, Plymouth University, Plymouth, United Kingdom
| | - Lorna Paul
- Department of Physiotherapy and Paramedicine, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Rebecca Playle
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Elizabeth Randell
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Michael Robling
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Lynn Rochester
- Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
- *Correspondence: Monica Busse
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Chitapure T, Jethwani D, Zubair Ahmed S, Panigrahy C. Impact of Customized and Sustained Physiotherapy in Charcot-Marie-Tooth Disease. Cureus 2021; 13:e17201. [PMID: 34540429 PMCID: PMC8439527 DOI: 10.7759/cureus.17201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 11/07/2022] Open
Abstract
Charcot-Marie-Tooth (CMT) disease is the most inherited form of peripheral neuropathy. This condition is also known as hereditary motor and sensory neuropathy (HMSN), which is a slowly progressive neuropathy affecting peripheral nerves and causes sensory loss, weakness and muscle wasting. This primarily involves distal muscles of feet, lower legs, hands and forearm. CMT is the most frequently inherited peripheral neuropathy known to affect 1 in 2500 individuals. There are four types: CMT1, CMT2, CMT3 and CMT4, depending upon the involvement of specific gene deficit, inheritance pattern, age of onset and whether the primary defect results in an abnormality of the myelin or axon of the nerve. Diagnosis of CMT is done based on physical examination, genetic testing, and electromyography (EMG) and nerve conduction velocity (NCV) test results. Symptoms of weakness progress from distal to proximal, i.e., it begins from feet and ankles. CMT is a known length dependent neuropathy which results in foot drop and later weakness of hands and forearm becomes evident. Due to the involvement of sensory nerve fibres, sensations like heat, touch, pain and most prominently vibration is also present distally. Long standing effects of CMT leads to the development of deformity and/or contractures which may involve forefoot, hindfoot, toes and/or long finger flexors. As physiotherapy is a means to maintain and/or gain maximum possible functional independence, consistency of the treatment becomes the most important factor. This case report intends to show that consistency in performing physiotherapeutic exercises helps in gaining maximum possible functional independence. This case report is a discussion of a 25-year-old male patient referred to the physiotherapy department with the polyneuropathy type symptoms with his history and investigation reports being consistent with that of Charcot-Marie-Tooth disease.
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Affiliation(s)
- Tajuddin Chitapure
- Assistant Professor, MGM School of Physiotherapy, Aurangabad, a constituent unit of MGMIHS, Navi Mumbai, IND
| | - Divya Jethwani
- Associate Professor, Department of Physiotherapy, Tilak Maharashtra Vidyapeeth Jayantrao Tilak College of Physiotherapy, Pune, IND
| | | | - Chinmoyee Panigrahy
- Musculoskeletal Physiotherapy, Tilak Maharashtra Vidyapeeth Jayantrao Tilak College of Physiotherapy, Pune, IND
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Sommese M, Corrado B. A Comprehensive Approach to Rehabilitation Interventions in Patients with Angelman Syndrome: A Systematic Review of the Literature. Neurol Int 2021; 13:359-370. [PMID: 34449677 PMCID: PMC8395863 DOI: 10.3390/neurolint13030036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/24/2022] Open
Abstract
Angelman syndrome is a rare genetic disease affecting the central nervous system and neurobehavioral development causing severe mental, linguistic, and physical disabilities. The purpose of this review was to analyze the most recent evidence regarding the rehabilitation of subjects affected by this syndrome. The review was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses. A total of 3661 studies were identified in the databases. Once the inclusion/exclusion criteria were applied, 15 studies were considered for the paper's preparation. The level of evidence of the studies was established according to the criteria of the Oxford Center for Evidence-Based Medicine-Levels of Evidence. From the selected studies, five rehabilitative approaches emerged: physiotherapy, applied behavioral analysis, toilet training, microswitch-cluster technology, and augmentative and alternative communication. Although the studies did not have a high level of evidence, the reported results appear to be encouraging and pave the way for further studies. It seems that individualized and multidisciplinary rehabilitation interventions help to improve patients' autonomy and quality of life. In some studies, the caregivers' role was fundamental to identify preferences and long-term improvements. Further studies on larger populations and with better methodological quality are needed to confirm the results.
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Affiliation(s)
| | - Bruno Corrado
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
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17
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Pisciotta C, Saveri P, Pareyson D. Updated review of therapeutic strategies for Charcot-Marie-Tooth disease and related neuropathies. Expert Rev Neurother 2021; 21:701-713. [PMID: 34033725 DOI: 10.1080/14737175.2021.1935242] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction: Charcot-Marie-Tooth disease (CMT) and related neuropathies represent the most prevalent inherited neuromuscular disorders. Nonetheless, there is still no pharmacological treatment available for any CMT type. However, the landscape is rapidly evolving and several novel approaches are providing encouraging results in preclinical studies and leading to clinical trials.Areas covered: The authors review the most promising therapies under study and the ongoing/planned clinical trials. Several approaches to address PMP22 overexpression underlying CMT1A, the most frequent subtype, are being tested. Gene silencing, targeting PMP22, and gene therapy, to introduce specific genes or to substitute or modulate defective ones, are being experimented in animal models. Compounds acting on ER stress, unfolded protein response, neuregulin pathways, phosphoinositides metabolism, axonal transport and degeneration, inflammation, polyol pathway, deoxysphingolipid metabolism, purine nucleotide pool are potential therapeutic candidates for different forms of CMT and related neuropathies.Expert opinion: We are getting closer to find effective therapies for CMT, but are far behind the exciting examples of other genetic neuromuscular disorders. The authors analyze the possible reasons for this gap and the way to fill it. Preclinical and clinical research is ongoing with coordinated efforts and they are confident that in the next few years we will see the first effective treatments.
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Affiliation(s)
- Chiara Pisciotta
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Paola Saveri
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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18
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Hackett D, Roberts-Clarke D, Halaki M, Burns J, Singh MF, Fornusek C. High intensity power training in middle-aged women with Charcot–Marie–Tooth disease: a case series. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims High-intensity power training has been shown to be effective in improving muscular capabilities, functional performance and health-related quality of life in populations with physical impairments. However, the effectiveness of high-intensity power training in people with Charcot–Marie–Tooth disease remains uncertain. This case series investigated the effects of high-intensity power training on muscle performance, function and health-related quality of life in middle-aged women with Charcot-Marie-Tooth disease. Methods Four women (age 51–58 years) with Charcot–Marie–Tooth disease type 1A participated in 8 weeks of supervised high-intensity power training. Results All participants improved strength of the right hip abductors (46.7–109.7%) and left hip abductors (27.3–128.6%), maximal gait speed (2.3–9.1%), static balance (0.7–4.9%), tandem walk (−3.3 to −58.5%), and mental component scores on the Short Form 36 Health Status Survey (0.8–27.6%). Adherence to high-intensity power training was 100% and only one minor adverse event related to the intervention was reported. Conclusions Although promising, larger controlled studies are indicated to confirm the safety and efficacy of high-intensity progressive resistance and power training in this cohort.
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Affiliation(s)
- Daniel Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Daniel Roberts-Clarke
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Mark Halaki
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Joshua Burns
- The University of Sydney & The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Maria Fiatarone Singh
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA
| | - Che Fornusek
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Han L, Huang Y, Nie Y, Li J, Chen G, Tu S, Shen P, Chen C. A novel PMP22 insertion mutation causing Charcot-Marie-Tooth disease type 3: A case report. Medicine (Baltimore) 2021; 100:e25163. [PMID: 33726003 PMCID: PMC7982204 DOI: 10.1097/md.0000000000025163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Charcot-Marie-Tooth disease (CMT) is a group of hereditary neuropathies with clinical features of muscle atrophy, sensory loss, and foot deformities. CMT is related to a number of genes, such as peripheral myelin protein 22 gene (PMP22). Missense mutations, small deletion mutations, and duplications of PMP22 are common in CMT patients, but few insertion mutation cases of PMP22 have been reported. PATIENT CONCERNS A 26-year-old male patient with the complaint of general weakness, peroneal atrophy, and deformities in the extremities visited our hospital. The patient was born with bilateral thumbs and feet dystonia. Additionally, delayed feet arch development and delayed walking was observed when he was a child. DIAGNOSIS Using whole-exome sequencing and electrophysiological test, we identified a novel insertion mutation of PMP22 (NM_153322, c.54_55insGTGCTG, p.(L19delinsVLL)) in a 26-year-old male patient with peroneal atrophy and nerve conduction was not elicited in electromyography (EMG) study. The Protein Variation Effect Analyzer (PROVEAN) program analysis predicted that the variant is likely to be "deleterious." SWISS-MODEL program predicted that alpha helix in original location was disrupted by inserted 6 bases, which may account for the occurrence of CMT3. INTERVENTIONS The patient received symptomatic and supportive treatments, and routine rehabilitation exercises during hospitalization. OUTCOMES The condition of the patient was improved, but the disease could not be cured. At 1- and 3-months follow-up, manifestations of the patient were unchanged, and he could take care of himself. LESSONS Our findings link a novel PMP22 mutation with a clinical diagnosis of CMT3. The link between gene variation and CMT phenotype may help to reveal the structure and function of PMP22 protein and the pathogenesis of CMT. This study adds further support to the heterogeneity of PMP22 related CMT and provides solid functional evidence for the pathogenicity of the p.(L19delinsVLL) PMP22 variant. Moreover, with the development of high-throughput sequencing technology, the combination of next-generation sequencing (NGS) and conventional Sanger sequencing is becoming one of the comprehensive, inexpensive, and convenient tools for genetic diagnosis of CMT.
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Affiliation(s)
- Liang Han
- Department of Integrated Traditional Chinese and Western Medicine, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan
| | - Yanjing Huang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan
| | - Yuan Nie
- Rehabilitation Center, Qijiang District Hospital of Traditional Chinese Medicine, 50 Dashi Road of Wenlong Avenue, Chongqing
| | - Jing Li
- Department of Integrated Traditional Chinese and Western Medicine, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan
| | - Gang Chen
- Department of Integrated Traditional Chinese and Western Medicine, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan
| | - Shenghao Tu
- Department of Integrated Traditional Chinese and Western Medicine, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan
| | - Pan Shen
- Department of Integrated Traditional Chinese and Western Medicine, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan
| | - Chao Chen
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, China
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Boutary S, Echaniz-Laguna A, Adams D, Loisel-Duwattez J, Schumacher M, Massaad C, Massaad-Massade L. Treating PMP22 gene duplication-related Charcot-Marie-Tooth disease: the past, the present and the future. Transl Res 2021; 227:100-111. [PMID: 32693030 DOI: 10.1016/j.trsl.2020.07.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/02/2020] [Accepted: 07/15/2020] [Indexed: 12/30/2022]
Abstract
Charcot-Marie-Tooth (CMT) disease is the most frequent inherited neuropathy, affecting 1/1500 to 1/10000. CMT1A represents 60%-70% of all CMT and is caused by a duplication on chromosome 17p11.2 leading to an overexpression of the Peripheral Myelin Protein 22 (PMP22). PMP22 gene is under tight regulation and small changes in its expression influences myelination and affect motor and sensory functions. To date, CMT1A treatment is symptomatic and classic pharmacological options have been disappointing. Here, we review the past, present, and future treatment options for CMT1A, with a special emphasis on the highly promising potential of PMP22-targeted small interfering RNA and antisense oligonucleotides.
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Affiliation(s)
- Suzan Boutary
- U 1195, INSERM and Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Andoni Echaniz-Laguna
- U 1195, INSERM and Paris-Saclay University, Le Kremlin-Bicêtre, France; Neurology Department, AP-HP, Paris-Saclay Universityand French Referent Center for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies (CRMR-NNERF), Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - David Adams
- U 1195, INSERM and Paris-Saclay University, Le Kremlin-Bicêtre, France; Neurology Department, AP-HP, Paris-Saclay Universityand French Referent Center for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies (CRMR-NNERF), Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Julien Loisel-Duwattez
- U 1195, INSERM and Paris-Saclay University, Le Kremlin-Bicêtre, France; Neurology Department, AP-HP, Paris-Saclay Universityand French Referent Center for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies (CRMR-NNERF), Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | | | - Charbel Massaad
- Faculty of Basic and Biomedical Sciences, Paris Descartes University, INSERM UMRS 1124, Paris, France
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Corrado B, Di Luise C, Servodio Iammarrone C. Management of Muscle Spasticity in Children with Cerebral Palsy by Means of Extracorporeal Shockwave Therapy: A Systematic Review of the Literature. Dev Neurorehabil 2021; 24:1-7. [PMID: 31674272 DOI: 10.1080/17518423.2019.1683908] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The purpose of this systematic review was to investigate the effectiveness of extracorporeal shockwave therapy for the management of muscle spasticity in children with cerebral palsy. An electronic database search was performed to identify studies relevant to the research question. Assessment of the quality of evidence in all relevant studies was performed with the help of the Oxford Center for Evidence-based Medicine guide. Four studies met our inclusion criteria for review: one was a low-quality randomized controlled clinical trial, two were individual case-control studies and one was a case series study. Reduction in muscle stiffness and improvement in joint range of motion were the outcomes in all of the selected studies that used extracorporeal shockwave therapy. However, considering the limited evidence provided by these studies, further research is needed to support the use of extracorporeal shockwave therapy in the management of muscle spasticity in children with cerebral palsy.
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Supervised Physical Therapy and Polymyositis/Dermatomyositis-A Systematic Review of the Literature. Neurol Int 2020; 12:77-88. [PMID: 33255200 PMCID: PMC7768488 DOI: 10.3390/neurolint12030015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/28/2020] [Indexed: 11/23/2022] Open
Abstract
Objective: to find the most up-to-date evidence of the effectiveness and safety of supervised physical therapy in polymyositis/dermatomyositis patients. Methods: a systematic review of the literature in the main scientific databases was carried out. We searched for randomized controlled trials concerning supervised physical therapy and polymyositis/dermatomyositis. The PICOS method was used for the formulation of the clinical query. Methodological quality and the level of evidence of the included studies were assessed using the modified Jadad scale and the Oxford Centre for Evidence-Based Medicine Levels of Evidence guide, respectively. Results: a total of 2591 articles were found. By applying the inclusion/exclusion criteria, six randomized controlled clinical trials were admitted to the final phase of the review. The compared approaches concerned supervised exercise programs based on strategies of muscle strengthening or aerobic work. Following these exercises, an increase in the maximum rate of oxygen consumption, a decrease in creatine phosphokinase levels, an enhancement in the patient’s aerobic performance and an improvement in the quality of life indexes were registered. The methodological quality of the included studies ranged from 3 to 4.5. All the studies were classified as presenting an evidence level of 2b. Conclusions: supervised physical therapy in polymyositis/dermatomyositis is an effective, safe and free-of-contraindications tool to be used both in the acute and in the established phases of the pathology. However, further and higher-quality studies are necessary to confirm those findings, to clarify the timing of exercise delivery and to guide the choice towards different types of muscle contraction exercises.
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Abstract
PURPOSE OF REVIEW This article provides an overview of Charcot-Marie-Tooth disease (CMT) and other inherited neuropathies. These disorders encompass a broad spectrum with variable motor, sensory, autonomic, and other organ system involvement. Considerable overlap exists, both phenotypically and genetically, among these separate categories, all eventually exhibiting axonal injury and neurologic impairment. Depending on the specific neural and non-neural localizations, patients experience varying morbidity and mortality. Neurologic evaluations, including neurophysiologic testing, can help diagnose and predict patient disabilities. Diagnosis is often complex, especially when genetic and acquired components overlap. RECENT FINDINGS Next-generation sequencing has greatly improved genetic diagnosis, with many third-party reimbursement parties now embracing phenotype-based panel evaluations. Through the advent of comprehensive gene panels, symptoms previously labeled as idiopathic or atypical now have a better chance to receive a specific diagnosis. A definitive molecular diagnosis affords patients improved care and counsel. The new classification scheme for inherited neuropathies emphasizes the causal gene names. A specific genetic diagnosis is important as considerable advances are being made in gene-specific therapeutics. Emerging therapeutic approaches include small molecule chaperones, antisense oligonucleotides, RNA interference, and viral gene delivery therapies. New therapies for hereditary transthyretin amyloidosis and Fabry disease are discussed. SUMMARY Comprehensive genetic testing through a next-generation sequencing approach is simplifying diagnostic algorithms and affords significantly improved decision-making processes in neuropathy care. Genetic diagnosis is essential for pathogenic understanding and for gene therapy development. Gene-targeted therapies have begun entering the clinic. Currently, for most inherited neuropathy categories, specific symptomatic management and family counseling remain the mainstays of therapy.
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Corrado B, Giardulli B, Costa M. Evidence-Based Practice in Rehabilitation of Myasthenia Gravis. A Systematic Review of the Literature. J Funct Morphol Kinesiol 2020; 5:jfmk5040071. [PMID: 33467286 PMCID: PMC7739309 DOI: 10.3390/jfmk5040071] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 12/28/2022] Open
Abstract
Myasthenia gravis is a rare neuromuscular disorder characterized by muscle weakness and fatigue. This review analyzes the most recent evidence regarding the effectiveness and safety of different rehabilitative approaches to the disease. The review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 365 articles were found in the main scientific databases. Applying the inclusion/exclusion criteria, 11 studies were admitted to the final phase of the review. Three different rehabilitative approaches were identified: physical training, respiratory training, and balance training. All rehabilitative modalities contributed to enhancing functional outcomes, reducing fatigue, and improving quality of life, but currently none can be recommended over another for the lack of cross-comparative studies. The included studies showed methodological quality from low to fair. Despite the range of rehabilitative interventions available, there is a lack of high-quality evidence. However, this review suggests that a multidisciplinary rehabilitation approach should be recommended to people with myasthenia gravis, and above all, for those with mild to moderate symptomatology.
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Affiliation(s)
- Bruno Corrado
- Department of Public Health, University Federico II of Naples, Via S. Pansini n.5, 80131 Naples, Italy;
- Correspondence: ; Tel.: +39-0817462796; Fax: +39-0817462881
| | - Benedetto Giardulli
- Department of Public Health, University Federico II of Naples, Via S. Pansini n.5, 80131 Naples, Italy;
| | - Massimo Costa
- Department of Polyspecialistic Medicine, Cardarelli Hospital, Via A. Cardarelli, 80131 Naples, Italy;
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Evidence-Based Physical Therapy for Individuals with Rett Syndrome: A Systematic Review. Brain Sci 2020; 10:brainsci10070410. [PMID: 32630125 PMCID: PMC7407501 DOI: 10.3390/brainsci10070410] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 06/25/2020] [Accepted: 06/29/2020] [Indexed: 12/12/2022] Open
Abstract
Rett syndrome is a rare genetic disorder that affects brain development and causes severe mental and physical disability. This systematic review analyzes the most recent evidence concerning the role of physical therapy in the management of individuals with Rett syndrome. The review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A total of 17319 studies were found in the main scientific databases. Applying the inclusion/exclusion criteria, 22 studies were admitted to the final phase of the review. Level of evidence of the included studies was assessed using the Oxford Centre for Evidence-Based Medicine—Levels of Evidence guide. Nine approaches to physical therapy for patients with Rett syndrome were identified: applied behavior analysis, conductive education, environmental enrichment, traditional physiotherapy with or without aids, hydrotherapy, treadmill, music therapy, computerized systems, and sensory-based treatment. It has been reported that patients had clinically benefited from the analysed approaches despite the fact that they did not have strong research evidence. According to the results, a multimodal individualized physical therapy program should be regularly recommended to patients with Rett syndrome in order to preserve autonomy and to improve quality of life. However, more high-quality studies are needed to confirm these findings.
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Paz G. Massage therapy treatment and outcomes in a patient with Charcot-Marie-Tooth disease: A case report. J Bodyw Mov Ther 2020; 24:130-137. [PMID: 32507138 DOI: 10.1016/j.jbmt.2019.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/07/2019] [Accepted: 10/19/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Charcot-Marie-Tooth (CMT) disease, a progressive hereditary peripheral neuropathy, leads to muscle weakness, wasting, and sensory and motor nerve deprivation. The two main types of CMT are CMT1 (demyelinating) and CMT2 (axonal). Initial findings include foot deformities and sensory changes with progression to altered gait, diminished reflexes, and muscle wasting and weakness. Treatment is aimed at reducing symptoms with physiotherapy, orthotics, splints, braces, fatigue and pain management and possible surgical intervention. Research is limited on the effects of massage or other complementary and alternative medicines (CAM) on CMT. OBJECTIVE To determine whether massage therapy would aid in reducing bilateral foot and lumbar pain and increasing lumbar range of motion (ROM) in a CMT patient. METHOD A 44-year-old male with CMT presented with lumbar and bilateral foot pain, and foot deformities. Treatment aims were to decrease lumbar and foot pain and increase lumbar ROM. A tape measure was used to measure lumbar flexion and extension pre- and post-treatment. The Numerical Rating Scale (NRS) was used to evaluate foot and lumbar pain intensity before and after each treatment. Rhythmical superficial touch, myofascial release, and petrissage techniques were applied to the back, legs, and neck. A massage therapy student provided treatments over seven weeks. RESULTS Bilateral foot and lumbar pain decreased and lumbar flexion and extension increased post-treatment, and overall. All other lumbar movements increased overall. CONCLUSION Massage therapy may positively affect pain intensity and ROM associated with CMT. Future studies linking massage therapy and CMT are needed.
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Affiliation(s)
- Galit Paz
- Grant MacEwan University, Massage Therapy Program, Canada.
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Dohrn MF, Auer-Grumbach M, Baron R, Birklein F, Escolano-Lozano F, Geber C, Grether N, Hagenacker T, Hund E, Sachau J, Schilling M, Schmidt J, Schulte-Mattler W, Sommer C, Weiler M, Wunderlich G, Hahn K. Chance or challenge, spoilt for choice? New recommendations on diagnostic and therapeutic considerations in hereditary transthyretin amyloidosis with polyneuropathy: the German/Austrian position and review of the literature. J Neurol 2020; 268:3610-3625. [PMID: 32500375 PMCID: PMC8463516 DOI: 10.1007/s00415-020-09962-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 02/06/2023]
Abstract
Hereditary transthyretin amyloidosis is caused by pathogenic variants (ATTRv) in the TTR gene. Alongside cardiac dysfunction, the disease typically manifests with a severely progressive sensorimotor and autonomic polyneuropathy. Three different drugs, tafamidis, patisiran, and inotersen, are approved in several countries, including the European Union and the United States of America. By stabilizing the TTR protein or degrading its mRNA, all types of treatment aim at preventing amyloid deposition and stopping the otherwise fatal course. Therefore, it is of utmost importance to recognize both onset and progression of neuropathy as early as possible. To establish recommendations for diagnostic and therapeutic procedures in the follow-up of both pre-symptomatic mutation carriers and patients with manifest ATTRv amyloidosis with polyneuropathy, German and Austrian experts elaborated a harmonized position. This paper is further based on a systematic review of the literature. Potential challenges in the early recognition of disease onset and progression are the clinical heterogeneity and the subjectivity of sensory and autonomic symptoms. Progression cannot be defined by a single test or score alone but has to be evaluated considering various disease aspects and their dynamics over time. The first-line therapy should be chosen based on individual symptom constellations and contra-indications. If symptoms worsen, this should promptly implicate to consider optimizing treatment. Due to the rareness and variability of ATTRv amyloidosis, the clinical course is most importantly directive in doubtful cases. Therefore, a systematic follow-up at an experienced center is crucial to identify progression and reassure patients and carriers.
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Affiliation(s)
- Maike F Dohrn
- Neuromuscular Outpatient Clinic, Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Michaela Auer-Grumbach
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Ralf Baron
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Frank Birklein
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Fabiola Escolano-Lozano
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Christian Geber
- Department of Neurology, Red Cross Pain Centre Mainz, Mainz, Germany
| | - Nicolai Grether
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Tim Hagenacker
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Ernst Hund
- Amyloidosis Center Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Juliane Sachau
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Matthias Schilling
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Münster, Germany
| | - Jens Schmidt
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Wilhelm Schulte-Mattler
- Department of Psychiatry and Psychotherapy, University Hospital Regensburg, Regensburg, Germany
| | - Claudia Sommer
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Markus Weiler
- Amyloidosis Center Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gilbert Wunderlich
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Center for Rare Diseases, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Katrin Hahn
- Department of Neurology, Charité University Medicine, Berlin, Germany
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Mori L, Signori A, Prada V, Pareyson D, Piscosquito G, Padua L, Pazzaglia C, Fabrizi GM, Picelli A, Schenone A. Treadmill training in patients affected by Charcot-Marie-Tooth neuropathy: results of a multicenter, prospective, randomized, single-blind, controlled study. Eur J Neurol 2019; 27:280-287. [PMID: 31444929 PMCID: PMC6973058 DOI: 10.1111/ene.14074] [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: 03/06/2019] [Accepted: 08/21/2019] [Indexed: 11/29/2022]
Abstract
Background and purpose Muscle‐strengthening, stretching or proprioceptive treatments may slow symptom progression in Charcot—Marie–Tooth (CMT) neuropathy. The aim of the study was to evaluate safety and efficacy of treadmill training in CMT1A. Methods We planned a multicenter, prospective, randomized, single‐blind, controlled study. We recruited 53 outpatients affected by CMT1A and randomized them into two treatment groups: one underwent stretching and proprioceptive exercise, whereas the other was additionally treated with treadmill training (TreSPE). Primary outcome measures (OMs) were the walking evaluations and secondary OM was the balance assessment. All participants were assessed at baseline and after 3 and 6 months of treatment. Results Most patients showed an improvement in at least one OM after 3 months [42/47 (89.4%)] and 6 months [38/40 (95%)] of treatment. No adverse events were reported in either group. Conclusions The most important finding was that both stretching and proprioceptive exercise and treadmill training had an objective benefit on patients affected by CMT disease, without causing overwork weakness. We had a low rate of drop out and did not find deterioration in motor performance. Our results also confirm that applying evidence‐based medicine methods to rehabilitative research is the correct way to test the efficacy of a treatment.
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Affiliation(s)
- L Mori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Signori
- Department of Health Science, Biostatistics Section, University of Genoa, Genoa, Italy
| | - V Prada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - D Pareyson
- Fondazione IRCCS, Istituto Neurologico Carlo Besta, Milan, Italy
| | - G Piscosquito
- Functional Neuromotor Rehabilitation Unit, IRCCS 'ICS Maugeri Spa - SB' Scientific Institute of Telese Terme, Telese Terme, Italy
| | - L Padua
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of Sacred Heart, Rome, Italy
| | - C Pazzaglia
- Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - G M Fabrizi
- Neurology Section, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Picelli
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Corrado B, Ciardi G, Iammarrone CS. Rehabilitation management of Pompe disease, from childhood trough adulthood: A systematic review of the literature. Neurol Int 2019; 11:7983. [PMID: 31281600 PMCID: PMC6589625 DOI: 10.4081/ni.2019.7983] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 06/11/2019] [Indexed: 12/14/2022] Open
Abstract
Pompe disease (PD) is a rare neuromuscular disorder caused by a deficiency of the enzyme acid alpha-glucosidase. There are three forms of PD depending on the age at onset and clinical severity. PD causes involvement of different organ systems, such as the heart, musculoskeletal system, and respiratory system. As of today, enzyme replacement therapy represents the main therapeutic tool for PD. Rehabilitation is an integral part of a multidisciplinary approach to this pathology. The goal of the present review is to find scientific evidence for the rehabilitative approach to PD, with respect to both the infantile- and adult-onset forms. A systematic literature review was made using the following databases: Pubmed, Pedro, Cochrane Library, EDS Base Index, Trip, and Cinhal. Randomized controlled trials or cohort studies with a sample population of at least six subjects were retrieved. The PICO method was used to formulate the clinical query. The search resulted in 1665 articles. Of these, four cohort studies were subjected to the final phase of the review. Three studies regarded inspiratory muscle training with a threshold, while the fourth study analyzed the effectiveness of therapeutic, aerobic, and reinforcement exercises. Inspiratory muscle training with a threshold increases the pressures generated during inhalation. Aerobic exercise is capable of increasing patients' muscular endurance and performance. To date, however, rehabilitative treatment for patients with PD has no validation in evidencebased medicine. Further studies, possibly with a larger sample size and higher quality are necessary to confirm the effectiveness of rehabilitation in patients with PD.
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Affiliation(s)
- Bruno Corrado
- Department of Public Health, ‘Federico II’ University of Naples, Italy
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30
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Genetic neuromuscular disorders: living the era of a therapeutic revolution. Part 1: peripheral neuropathies. Neurol Sci 2019; 40:661-669. [DOI: 10.1007/s10072-019-03778-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/16/2019] [Indexed: 12/17/2022]
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Qin L, Yang C, Lü T, Li L, Zong D, Wu Y. [Analysis of GDAP1 gene mutation in a pedigree with autosomal dominant Charcot-Marie-Tooth disease]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:63-68. [PMID: 30692068 DOI: 10.12122/j.issn.1673-4254.2019.01.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the molecular genetic mechanism of Charcot- Marie-Tooth (CMT) disease in a pedigree. METHODS Genomic DNA was extracted from the peripheral blood of the family members of a pedigree with autosomal dominant CMT disease, and 65 candidate genes of the proband were screened using target exon capture and the next generation sequencing, and the suspicious genes were verified using Sanger sequencing. PolyPhen-2, PROVEAN and SIFT software were used to predict the function of the mutant genes, and PyMOL-1 software was used to simulate the mutant protein structure. RESULTS A heterozygous missense mutation [c.371A>G (p.Y124C)] was detected in exon 3 of GDAP1 gene of the proband. This heterozygous mutation was also detected in both the proband's mother and her brother, but not in her father. Multiple sequence alignment analysis showed that tyrosine at codon 124 of GDAP1 protein was highly conserved. All the 3 prediction software predicted that the mutation was harmful. Molecular structure simulation showed a weakened interaction force between the amino acid residues at codon 124 and the surrounding amino acid residues to affect the overall stability of the protein. CONCLUSIONS The mutation of GDAP1 gene may be related to the pathogenesis of autosomal dominant AD-CMT in this pedigree. The newly discovered c.371A>G mutation (p.Y124C) expands the mutation spectrum of GDAP1 gene, but further study is needed to clarify the underlying pathogenesis.
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Affiliation(s)
- Li Qin
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Canhong Yang
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Tianming Lü
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Lanying Li
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Dandan Zong
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Yueying Wu
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
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Corrado B, Ciardi G, Fortunato L, Servodio Iammarrone C. Burnout syndrome among Italian physiotherapists: a cross-sectional study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2018.1536765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Bruno Corrado
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Gianluca Ciardi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Luciano Fortunato
- Department of Public Health, University of Naples "Federico II", Naples, Italy
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Fontés M. Charcot Marie Tooth Disease. A Single Disorder? Int J Mol Sci 2018; 19:ijms19123807. [PMID: 30501086 PMCID: PMC6321061 DOI: 10.3390/ijms19123807] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Michel Fontés
- C2VN, AIX Marseille Université, INRA 1260-INSERM 1263, 13007 Marseille, France.
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Quadros Santos Monteiro Fonseca AT, Zanoteli E. Charcot-Marie-Tooth disease. REVISTA MÉDICA CLÍNICA LAS CONDES 2018. [DOI: 10.1016/j.rmclc.2018.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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35
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Corrado B, Ciardi G. Hypermobile Ehlers-Danlos syndrome and rehabilitation: taking stock of evidence based medicine: a systematic review of the literature. J Phys Ther Sci 2018; 30:843-847. [PMID: 29950777 PMCID: PMC6016292 DOI: 10.1589/jpts.30.847] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/08/2018] [Indexed: 01/15/2023] Open
Abstract
[Purpose] The aim of the study was to conduct a systematic review about rehabilitation treatment of hypermobile Ehlers-Danlos syndrome, according to Evidence Based Medicine. [Methods] A systematic search has been conducted in following database: PubMed, PEDro, Cochrane, EDS Base Index, TRIP and CINHAL; no time restrictions were adopted. PICO method was employed to formulate the clinical query. Hypermobile Ehlers-Danlos syndrome and physiotherapy were the main keywords of the research. [Results] 1,869 articles emerged from the primary search. After duplicates removal, 1,709 papers have been screened by title and abstracts and then 1,698 were excluded following the inclusion criteria. 11 papers have been admitted to the last stage of the review and have been evaluated in their full-text version. Only one cohort study met the review's final step selection criteria. One cohort study on the efficacy of an integrated physiotherapeutic and cognitive behavioural treatment was evaluated by means of Newcastle-Ottawa Quality Assessment score and resulted of poor evidence. [Conclusion] At the present time, there is no Evidence Based Medicine literature on hypermobile Helers-Danlos syndrome rehabilitation. Clinical studies with high level of evidence are necessary in order to assess the efficacy of physiotherapeutic approaches.
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Affiliation(s)
- Bruno Corrado
- Department of Public Health, Federico II University of Naples: Gianluca Ciardi, Via S. Pansini n.5, 80131 Naples, Italy
| | - Gianluca Ciardi
- Department of Public Health, Federico II University of Naples: Gianluca Ciardi, Via S. Pansini n.5, 80131 Naples, Italy
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Niu HX, Wang RH, Xu HL, Song B, Yang J, Shi CH, Li YS, Zhang BQ, Wang SP, Yong Q, Wang YY, Xu YM. Nine-hole Peg Test and Ten-meter Walk Test for Evaluating Functional Loss in Chinese Charcot-Marie-Tooth Disease. Chin Med J (Engl) 2018; 130:1773-1778. [PMID: 28748848 PMCID: PMC5547827 DOI: 10.4103/0366-6999.211550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: The 9-hole peg test (9-HPT) and 10-meter walk test (10-MWT) are commonly used to test finger motor function and walking ability. The aim of this present study was to investigate the efficacy of these tests for evaluating functional loss in Chinese Charcot-Marie-Tooth (CMT) disease. Methods: Thirty-four Chinese CMT patients (CMT group) from August 2015 to December 2016 were evaluated with 9-HPT, 10-MWT, CMT disease examination score, overall neuropathy limitation scale (ONLS), functional disability score, and Berg Balance Scale (BBS). Thirty-five age- and gender-matched healthy controls (control group) were also included in the study. Student's nonpaired or paired t-test were performed to compare data between two independent or related groups, respectively. The Pearson test was used to examine the correlations between recorded parameters. Results: The mean 9-HPT completion time in the dominant hand of CMT patients was significantly slower than that in the healthy controls (29.60 ± 11.89 s vs. 19.58 ± 3.45 s; t = −4.728, P < 0.001). Women with CMT completed the 9-HPT significantly faster than men with CMT (dominant hand: 24.74 ± 7.93 s vs. 33.01 ± 13.14 s, t = 2.097, P = 0.044). The gait speed of the average self-selected velocity and the average fast-velocity assessed using 10-MWT for CMT patients were significantly slower than those in the control group (1.03 ± 0.18 m/s vs. 1.44 ± 0.17 m/s, t = 9.333, P < 0.001; 1.31 ± 0.30 m/s vs. 1.91 ± 0.25 m/s, t = 8.853, P < 0.001, respectively). There was no difference in gait speed between men and women. Both 9-HPT and 10-MWT were significantly correlated with the ONLS, functional disability score, and BBS (P < 0.05 for all). Conclusion: The 9-HPT and 10-MWT might be useful for functional assessment in Chinese patients with CMT.
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Affiliation(s)
- Hui-Xia Niu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Rui-Hao Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Hong-Liang Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Jing Yang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Chang-He Shi
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Yu-Sheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Bing-Qian Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Shao-Ping Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Quan Yong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Yuan-Yuan Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Yu-Ming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
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Sautreuil P, Delorme D, Baron A, Mane M, Missaoui B, Thoumie P. Maladie de Charcot-Marie-Tooth. Med Sci (Paris) 2017; 33 Hors série n°1:49-54. [DOI: 10.1051/medsci/201733s110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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