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Friedman LS, Farmer JM, Perlman S, Wilmot G, Gomez C, Bushara KO, Mathews KD, Subramony SH, Ashizawa T, Balcer LJ, Wilson RB, Lynch DR. Measuring the rate of progression in Friedreich ataxia: implications for clinical trial design. Mov Disord 2010; 25:426-32. [PMID: 20063431 PMCID: PMC2954653 DOI: 10.1002/mds.22912] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Friedreich ataxia is an autosomal recessive neurodegenerative disorder characterized by ataxia of all four limbs, dysarthria, and arreflexia. A variety of measures are currently used to quantify disease progression, including the Friedreich Ataxia Rating Scale, examiner-rated functional disability scales, self-reported activities of daily living and performance measures such as the timed 25-foot walk, 9-hole pegboard test, PATA speech test, and low-contrast letter acuity vision charts. This study examines the rate of disease progression over one and two years in a cohort of 236 Friedreich ataxia patients using these scales and performance measure composites. The Friedreich Ataxia Rating Scale and performance-measure composites captured disease progression, with a greater sensitivity to change over 2 years than over 1 year. The measures differed in their sensitivity to change and in possible bias. These results help to establish norms for progression in FRDA that can be useful in measuring the long-term success of therapeutic agents and defining sample-size calculations for double-blind clinical trials.
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Affiliation(s)
- Lisa S Friedman
- Department of Neurology, University of Pennsylvania School of Medicine, United States
- Department of Pediatrics, University of Pennsylvania School of Medicine, United States
- Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - Jennifer M Farmer
- Department of Neurology, University of Pennsylvania School of Medicine, United States
- Department of Pediatrics, University of Pennsylvania School of Medicine, United States
- Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - Susan Perlman
- University of California Los Angeles, Los Angeles, CA, United States
| | | | - Christopher Gomez
- University of Minnesota, Minneapolis, MN, United States
- University of Chicago, Chicago, IL, United States
| | | | | | - S. H Subramony
- University of Texas Medical Branch, Galveston, TX, United States
- University of Mississippi, Jackson, MS, United States
| | - Tetsuo Ashizawa
- University of Texas Medical Branch, Galveston, TX, United States
- University of Florida, Gainesville, FL, United States
| | - Laura J Balcer
- Department of Neurology, University of Pennsylvania School of Medicine, United States
| | - Robert B Wilson
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, United States
| | - David R Lynch
- Department of Neurology, University of Pennsylvania School of Medicine, United States
- Department of Pediatrics, University of Pennsylvania School of Medicine, United States
- Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, United States
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