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Tamura S, Nakamoto Y, Sozu Y, Tamura Y. Positioning head tilt observed in two cats with myasthenia gravis. JFMS Open Rep 2024; 10:20551169231224534. [PMID: 38357272 PMCID: PMC10865950 DOI: 10.1177/20551169231224534] [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] [Indexed: 02/16/2024] Open
Abstract
Case series summary A 1-year-old castrated male domestic shorthair cat was suspected with myasthenia gravis (MG) based on neurological examination, complete blood count (CBC), serum biochemistry, radiography and electrophysiological examination. In addition, a 9-year-old spayed female domestic shorthair cat was diagnosed with MG based on neurological examination, CBC, serum biochemistry, radiography, ultrasonography and increased acetylcholine receptor antibody titre. Positioning head tilt (PHT) was observed at the time of diagnosis in both cats. Relevance and novel information Although the pathophysiology of PHT in cats is not fully understood, the mechanism for PHT in cats with MG may be similar to that of cats with hypokalaemic myopathy, supporting our hypothesis that muscle spindle dysfunction causes PHT.
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Affiliation(s)
| | - Yuya Nakamoto
- Neuro Vets Animal Neurology Clinic, Kyoto, Japan
- Veterinary Surgery, Graduate School of Life and Environmental Science, Osaka Metropolitan University, Sakai, Japan
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Gözaçan Karabulut D, Maden Ç, Yiğit S. Comparison of hand dexterity and hand laterality task in duchenne muscular dystrophy patients with typically developing peers. NeuroRehabilitation 2024; 55:95-102. [PMID: 39213100 DOI: 10.3233/nre-240125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Hand dexterity is important with Duchenne muscular dystrophy (DMD). OBJECTIVE The aim of this study was to compare hand dexterity and hand laterality task assessments in patients with DMD with typically-developing peers. METHODS The study included 25 DMD with a mean age of 10.2±2.38 and 21 typically-developing peers with a mean age of 10.33±2.26. Functional levels of DMD patients were determined by Brooke Upper Extremity Functional Classification Scale and Brooke Lower Extremity Functional Scale. The ABILHAND-Kids and 9-hole peg test were used to assess the hand dexterity of all participants, and assess the hand laterality task. RESULTS Patients with DMD had lower ABILHAND-Kids scores than their typically-developing peers (p < 0.001). Patients with DMD had higher 9-hole peg test duration on the dominant and non-dominant extremity compared to typically-developing peers (p < 0.001). Patients with DMD were found to be different from their typically-developing peers (p < 0.001) in lateralization response time and accuracy. CONCLUSION Patients with DMD were found to have lower manual dexterity and hand laterality task skills compared to their typically-developing peers. It is recommended that hand dexterity and upper extremity recognition capacities should be considered in assessment and intervention programs for physiotherapists and clinicians working in this field.
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Affiliation(s)
- Demet Gözaçan Karabulut
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
| | - Çağtay Maden
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
| | - Sedat Yiğit
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey
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Wu KW, Yu CH, Huang TH, Lu SH, Tsai YL, Wang TM, Lu TW. Children with Duchenne muscular dystrophy display specific kinematic strategies during obstacle-crossing. Sci Rep 2023; 13:17094. [PMID: 37816796 PMCID: PMC10564917 DOI: 10.1038/s41598-023-44270-9] [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: 01/22/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023] Open
Abstract
Duchenne muscular dystrophy (DMD) is a genetic disease characterized by progressive muscle weakness with increased neuromechanical challenge and fall risks, especially during obstructed locomotion. This study aimed to identify the kinematic strategies for obstacle-crossing in DMD via synthesizing the changes in the joint kinematics and associated end-point control. Fourteen boys with DMD (age: 9.0 ± 2.5 years) and fourteen typically developed controls (age: 9.0 ± 2.8 years) each crossed obstacles of three different heights (10%, 20% and 30% of leg length) while the angular motions of the trunk-pelvis-leg apparatus and foot-obstacle clearances were measured. Two-way analyses of variance were used to analyze group and obstacle height effects. Compared to the controls, the DMD group crossed obstacles with significantly increased step width, but decreased crossing speed, crossing step length, trailing toe-obstacle clearance and leading heel-obstacle horizontal distance (p < 0.05). When the leading toe was above the obstacle, the patients showed significantly increased pelvic hiking, pelvic and trunk anterior tilt and ankle plantarflexion, but decreased hip flexion in both limbs (p < 0.05). Similar kinematic changes were found during trailing-limb crossing, except for an additional increase in swing-hip abduction and decrease in contralateral trunk side-bending and stance-knee flexion. Patients with DMD crossed obstacles via a specific kinematic strategy with altered end-point control, predisposing them to a greater risk of tripping during trailing-limb crossing. These results suggest that crossing kinematics in DMD should be monitored-especially in the proximal segments of the pelvis-leg apparatus-that may lead to an increased risk of falling.
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Affiliation(s)
- Kuan-Wen Wu
- Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei, Taiwan, ROC
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Cheng-Hao Yu
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ROC
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan, ROC
| | - Tse-Hua Huang
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan, ROC
| | - Shiuan-Huei Lu
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ROC
| | - Yu-Lin Tsai
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Ting-Ming Wang
- Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei, Taiwan, ROC
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Tung-Wu Lu
- Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei, Taiwan, ROC.
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ROC.
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Tamura S, Nakamoto Y, Tamura Y. Reversible positioning head tilt observed in 14 cats with hypokalaemic myopathy. J Feline Med Surg 2023; 25:1098612X231175761. [PMID: 37318332 PMCID: PMC10811976 DOI: 10.1177/1098612x231175761] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
CASE SERIES SUMMARY Positioning head tilt (PHT) is a dynamic neurological sign in which the head tilts to the opposite side to which it is moving. This sign is triggered in response to head movement and is thought to be due to the lack of inhibition of vestibular nuclei by the cerebellar nodulus and uvula (NU). The occurrence of PHT in animals has been suggested to be an indicator of NU dysfunction. Here, we describe the acute onset of PHT in 14 cats. All the cats were diagnosed with hypokalaemic myopathy caused by a range of pathologies. The PHT resolved along with other signs related to myopathy, such as cervical flexion and generalised weakness, after electrolyte correction in all cats. RELEVANCE AND NOVEL INFORMATION Hypokalaemic myopathy was the likely cause of PHT in the present feline cases.
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Affiliation(s)
| | - Yuya Nakamoto
- Neuro Vets Animal Neurology Clinic, Kyoto, Japan
- Veterinary Surgery, Graduate School of Life and Environmental Science, Osaka Metropolitan University, Sakai, Japan
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Qu N, Tian H, De Martino E, Zhang B. Neck Pain: Do We Know Enough About the Sensorimotor Control System? Front Comput Neurosci 2022; 16:946514. [PMID: 35910451 PMCID: PMC9337601 DOI: 10.3389/fncom.2022.946514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Neck pain is a worldwide health problem. Clarifying the etiology and providing effective interventions are challenging for the multifactorial nature of neck pain. As an essential component of cervical spine function, the sensorimotor control system has been extensively studied in both healthy and pathological conditions. Proprioceptive signals generated from cervical structures are crucial to normal cervical functions, and abnormal proprioception caused by neck pain leads to alterations in neural plasticity, cervical muscle recruitment and cervical kinematics. The long-term sensorimotor disturbance and maladaptive neural plasticity are supposed to contribute to the recurrence and chronicity of neck pain. Therefore, multiple clinical evaluations and treatments aiming at restoring the sensorimotor control system and neural plasticity have been proposed. This paper provides a short review on neck pain from perspectives of proprioception, sensorimotor control system, neural plasticity and potential interventions. Future research may need to clarify the molecular mechanism underlying proprioception and pain. The existing assessment methods of cervical proprioceptive impairment and corresponding treatments may need to be systematically reevaluated and standardized. Additionally, new precise motor parameters reflecting sensorimotor deficit and more effective interventions targeting the sensorimotor control system or neural plasticity are encouraged to be proposed.
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Affiliation(s)
- Ning Qu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - HaoChun Tian
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Enrico De Martino
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Aerospace Medicine and Rehabilitation Laboratory, Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bin Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Bin Zhang,
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de Souza MA, Martinez EZ, da Silva Lizzi EA, Cezarani A, de Queiroz Davoli GB, Bená MI, da Rosa Sobreira CF, Mattiello-Sverzut AC. Alternative instrument for the evaluation of handgrip strength in Duchenne muscular dystrophy. BMC Pediatr 2022; 22:334. [PMID: 35689212 PMCID: PMC9185969 DOI: 10.1186/s12887-022-03388-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background The commonly used dynamometers can be ineffective in evaluating handgrip in patients with Duchenne muscular dystrophy (DMD), especially children with generalized muscle weakness. The aim of this study was to analyze whether the modified sphygmomanometer is an effective instrument for handgrip strength evaluation in patients with DMD, during different stages of the disease. Method The handgrip strength of 33 patients was evaluated by the Jamar dynamometer and the modified sphygmomanometer. Motor function was evaluated by the Motor Function Measurement (MFM) scale. Four evaluations, with a six-month interval between each, were performed: Evaluation 1 (N = 33), Evaluation 2 (N = 24), Evaluation 3 (N = 15), and Evaluation 4 (N = 8). A linear regression model with mixed effects was used for the longitudinal data and descriptive analysis of strength for all four evaluations. Result The first evaluation data presented very high correlations between the dynamometer and the modified sphygmomanometer (r = 0.977; p < 0.001). The longitudinal analysis showed a significant difference between Evaluation 1 and the other handgrip strength evaluations obtained using the dynamometer (p < 0.05) but not the modified sphygmomanometer (p > 0.05). Null values were obtained only when using the dynamometer device. Conclusion The modified sphygmomanometer seems to be more suitable than the dynamometer for measuring handgrip strength in all stages of DMD.
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Affiliation(s)
- Mariana Angélica de Souza
- Department of Health Science, Ribeirao Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Campus, Ribeirão Preto, SP, 14049-900, Brazil
| | - Edson Zangiacomi Martinez
- Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Ananda Cezarani
- Department of Health Science, Ribeirao Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Campus, Ribeirão Preto, SP, 14049-900, Brazil
| | - Gabriela Barroso de Queiroz Davoli
- Department of Health Science, Ribeirao Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Campus, Ribeirão Preto, SP, 14049-900, Brazil
| | - Marjory Irineu Bená
- Department of Neurosciences of the Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Ana Claudia Mattiello-Sverzut
- Department of Health Science, Ribeirao Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Campus, Ribeirão Preto, SP, 14049-900, Brazil.
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Kröger S, Watkins B. Muscle spindle function in healthy and diseased muscle. Skelet Muscle 2021; 11:3. [PMID: 33407830 PMCID: PMC7788844 DOI: 10.1186/s13395-020-00258-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/20/2020] [Indexed: 12/16/2022] Open
Abstract
Almost every muscle contains muscle spindles. These delicate sensory receptors inform the central nervous system (CNS) about changes in the length of individual muscles and the speed of stretching. With this information, the CNS computes the position and movement of our extremities in space, which is a requirement for motor control, for maintaining posture and for a stable gait. Many neuromuscular diseases affect muscle spindle function contributing, among others, to an unstable gait, frequent falls and ataxic behavior in the affected patients. Nevertheless, muscle spindles are usually ignored during examination and analysis of muscle function and when designing therapeutic strategies for neuromuscular diseases. This review summarizes the development and function of muscle spindles and the changes observed under pathological conditions, in particular in the various forms of muscular dystrophies.
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Affiliation(s)
- Stephan Kröger
- Department of Physiological Genomics, Biomedical Center, Ludwig-Maximilians-University Munich, Großhaderner Str. 9, 82152, Planegg-Martinsried, Germany.
| | - Bridgette Watkins
- Department of Physiological Genomics, Biomedical Center, Ludwig-Maximilians-University Munich, Großhaderner Str. 9, 82152, Planegg-Martinsried, Germany
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Nobusako S, Tsujimoto T, Sakai A, Shuto T, Furukawa E, Osumi M, Nakai A, Maeda T, Morioka S. Manual Dexterity is not Related to Media Viewing but is Related to Perceptual Bias in School-Age Children. Brain Sci 2020; 10:brainsci10020100. [PMID: 32069947 PMCID: PMC7071373 DOI: 10.3390/brainsci10020100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/12/2020] [Accepted: 02/12/2020] [Indexed: 12/03/2022] Open
Abstract
Although the media can have both negative and positive effects on children’s cognitive and motor functions, its influence on their perceptual bias and manual dexterity is unclear. Thus, we investigated the association between media viewing time, media preference level, perceptual bias, and manual dexterity in 100 school-aged children. Questionnaires completed by children and their parents were used to ascertain media viewing time and preference levels. Perceptual bias and manual dexterity were measured using the visual-tactile temporal order judgment task and Movement Assessment Battery for Children—2nd edition, respectively. There were significant positive correlations between age and media viewing time and between media viewing time and media preference level. There was also a significant negative correlation between visual bias and manual dexterity. Hierarchical multiple regression analysis revealed that increasing visual bias was a significant predictor of decreasing manual dexterity. Further, children with low manual dexterity showed significant visual bias compared to those with high manual dexterity, when matched for age and gender. The present results demonstrated that, in school-aged children, although viewing media was not associated with perceptual bias and manual dexterity, there was a significant association between perceptual bias and manual dexterity.
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Affiliation(s)
- Satoshi Nobusako
- Neurorehabilitation Research Center, Kio University, Nara 635-0832, Japan
- Graduate School of Health Science, Kio University, Nara 635-0832, Japan
- Correspondence: ; Tel.: +81-745-54-1601
| | - Taeko Tsujimoto
- Department of Rehabilitation, Nishide Clinic, Osaka 532-0002, Japan
| | - Ayami Sakai
- Department of Rehabilitation, Higashi Osaka Yamaji Hospital, Osaka 578-0925, Japan
| | - Takashi Shuto
- Department of Home-Visit Rehabilitation, Ishida Clinic, Osaka 592-0002, Japan
| | - Emi Furukawa
- Neurorehabilitation Research Center, Kio University, Nara 635-0832, Japan
| | - Michihiro Osumi
- Neurorehabilitation Research Center, Kio University, Nara 635-0832, Japan
- Graduate School of Health Science, Kio University, Nara 635-0832, Japan
| | - Akio Nakai
- Graduate School of Clinical Education & The Center for the Study of Child Development, Institute for Education, Mukogawa Women’s University, Hyogo 663-8558, Japan
| | - Takaki Maeda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Shu Morioka
- Neurorehabilitation Research Center, Kio University, Nara 635-0832, Japan
- Graduate School of Health Science, Kio University, Nara 635-0832, Japan
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Artilheiro MC, Cardoso de Sá CDS, Fávero FM, Wutzki HC, de Resende MBD, Caromano FA, Voos MC. Hand Function in Muscular Dystrophies. Percept Mot Skills 2017; 124:441-451. [DOI: 10.1177/0031512516688834] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate the relationship between Performance of Upper Limb (PUL) and Jebsen–Taylor Test (JTT) to assess and monitor upper limb function progression in patients with muscular dystrophy. Thirty patients diagnosed with Duchenne muscular dystrophy, limb-girdle muscular dystrophy, Becker muscular dystrophy, myotonic dystrophy Type 1, and fascioscapulohumeral dystrophy were submitted to the shoulder, elbow, and wrist domains of PUL, and to JTT subtests. Spearman tests investigated the relationships between PUL and JTT total scores and domains. Correlations were classified as strong ( r ≥ 0.70), moderate (0.40 ≤ r < 0.70), or weak ( r ≤ 0.40). There were strong correlations between the PUL and JTT total scores ( r = −0.706). Although JTT measures time and PUL provides kinesiologic scores, these measures were related. Therefore, muscle synergies, which control the compensatory movements and motor functions involving mainly shoulder, elbow, wrist, and finger movements, are related to timed performance in patients with muscular dystrophies.
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Affiliation(s)
| | | | - Francis M. Fávero
- Department of Neurology or Neurosurgery, Federal University of São Paulo, Brazil
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Filippini M, Guerra A, Negosanti A, Santi S, Sarajlija J, Musti MA, Gobbi G, Lassonde M, Pini A. Mismatch Negativity Recording in Children With Duchenne Muscular Dystrophy: A Preliminary Study Integrating Neurophysiological and Neuropsychological Results. J Child Neurol 2016; 31:1468-1474. [PMID: 27422795 DOI: 10.1177/0883073816656404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/26/2016] [Indexed: 11/15/2022]
Abstract
Many studies on Duchenne muscular dystrophy children support the hypothesis of a specific neuropsychological phenotype affecting mostly phonological skills. This prospective study aimed to shed light on the role of phonological abilities. Fourteen Duchenne muscular dystrophy children and 7 healthy children underwent mismatch negativity. Moreover, verbal intelligence, visuospatial attention, immediate verbal memory, working memory, grammar, vocabulary, visuomotor skills, reading, text comprehension, writing, and arithmetic were tested in Duchenne muscular dystrophy children. No significant difference between control and Duchenne muscular dystrophy children was found neither for mismatch negativity amplitude (P = .191 and .116, respectively) nor for latency (P = .135). Eight (57.14%) patients showed an impairment of immediate verbal memory and of visuomotor skills, 7 (63.64%) patients had a deficit in writing and arithmetic skills, even with a mean normal intelligence quotient. Taken together, the results put in evidence a heterogeneous neuropsychological profile not explainable on the basis of a phonological deficit.
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Affiliation(s)
- Melissa Filippini
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Angelo Guerra
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | | | - Sara Santi
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Jasenka Sarajlija
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | | | - Giuseppe Gobbi
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Maryse Lassonde
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Antonella Pini
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
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Serum creatinine level: a supplemental index to distinguish Duchenne muscular dystrophy from Becker muscular dystrophy. DISEASE MARKERS 2015; 2015:141856. [PMID: 25852218 PMCID: PMC4380093 DOI: 10.1155/2015/141856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 01/16/2015] [Accepted: 01/18/2015] [Indexed: 02/08/2023]
Abstract
Background. To improve assessment of dystrophinopathy, the aim of this study was to identify whether serum creatinine (Crn) level reflects disease severity. Methods. Biochemical, Vignos score, and genetic data were collected on 212 boys with dystrophinopathy. Results. Serum Crn level had a strong inverse correlation with Vignos score by simple correlation (r = −0.793) and partial correlation analysis after adjustment for age, height, and weight (r = −0.791; both P < 0.01). Serum Crn level was significantly higher in patients with in-frame than out-of-frame mutations (Z = −4.716, P < 0.01) and in Becker muscular dystrophy (BMD) patients than Duchenne muscular dystrophy (DMD) patients at ages 4, 5, 7, and 9 yr (all P < 0.0125). After adjusting for age, height, and weight, BMD patients still had a significantly higher serum Crn level than DMD patients (β = 7.140, t = 6.277, P < 0.01). Conclusions. Serum Crn level reflected disease severity and may serve as a supplemental index to distinguish DMD from BMD in clinical practice.
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