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Stroeks SLVM, Hellebrekers D, Claes GRF, Krapels IPC, Henkens MHTM, Sikking M, Vanhoutte EK, Helderman-van den Enden A, Brunner HG, van den Wijngaard A, Verdonschot JAJ. Diagnostic and prognostic relevance of using large gene panels in the genetic testing of patients with dilated cardiomyopathy. Eur J Hum Genet 2023; 31:776-783. [PMID: 37198425 PMCID: PMC10325988 DOI: 10.1038/s41431-023-01384-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 05/19/2023] Open
Abstract
It was previously suggested that increasing the number of genes on diagnostic gene panels could increase the genetic yield in patient with dilated cardiomyopathy (DCM). We explored the diagnostic and prognostic relevance of testing DCM patients with an expanded gene panel. The current study included 225 consecutive DCM patients who had no genetic diagnosis after a 48-gene cardiomyopathy-panel. These were then evaluated using an expanded gene panel of 299 cardiac-associated genes. A likely pathogenic/pathogenic (P/LP) variant was detected in 13 patients. Five variants were reclassifications of variants found in genes which were already detected using the 48 gene panel. Only one of the other eight variants could explain the phenotype of the patient (KCNJ2). The panel detected 186 VUSs in 127 patients (of which 6 also had a P/LP variant). The presence of a VUS was significantly associated with the combined end-point of mortality, heart failure hospitalization, heart transplantation or life-threatening arrhythmias(HR, 2.04 [95% CI, 1.15 to 3.65]; p = 0.02). The association of a VUS with prognosis remained when we only included VUSs in robust DCM-associated genes (high suspicious VUSs), but disappeared when we only included VUSs in non-robust DCM-associated genes (low suspicious VUSs), highlighting the importance of weighing of VUSs. Overall, the use of large gene panels for genetic testing in DCM does not increase the diagnostic yield, although a VUS in a robust DCM-associated gene is associated with an adverse prognosis. Altogether, current diagnostic gene panels should be limited to the robust DCM-associated genes.
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Affiliation(s)
- Sophie L V M Stroeks
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
| | - Debby Hellebrekers
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Godelieve R F Claes
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ingrid P C Krapels
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michiel H T M Henkens
- Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands
- Netherlands Heart Institute (NLHI), Utrecht, The Netherlands
| | - Maurits Sikking
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
| | - Els K Vanhoutte
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Apollonia Helderman-van den Enden
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Han G Brunner
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW Institute for Developmental Biology and Cancer, Maastricht University, Maastricht, The Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arthur van den Wijngaard
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Job A J Verdonschot
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart, (ERN GUARD-Heart), Amsterdam, The Netherlands.
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands.
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2
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Stroeks SLVM, Lunde IG, Hellebrekers DMEI, Claes GRF, Wakimoto H, Gorham J, Krapels IPC, Vanhoutte EK, van den Wijngaard A, Henkens MTHM, Raafs AG, Sikking MA, Broers JLV, Nabben M, Jones EAV, Heymans SRB, Brunner HG, Verdonschot JAJ. Prevalence and Clinical Consequences of Multiple Pathogenic Variants in Dilated Cardiomyopathy. Circ Genom Precis Med 2023; 16:e003788. [PMID: 36971006 DOI: 10.1161/circgen.122.003788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Background:
Dilated cardiomyopathy (DCM) was considered a monogenetic disease that can be caused by over 60 genes. Evidence suggests that the combination of multiple pathogenic variants leads to greater disease severity and earlier onset. So far, not much is known about the prevalence and disease course of multiple pathogenic variants in patients with DCM. To gain insight into these knowledge gaps, we (1) systematically collected clinical information from a well-characterized DCM cohort and (2) created a mouse model.
Methods:
Complete cardiac phenotyping and genotyping was performed in 685 patients with consecutive DCM. Compound heterozygous digenic (LMNA [lamin]/titin deletion A-band) with monogenic (LMNA/wild-type) and wild-type/wild-type mice were created and phenotypically followed over time.
Results:
One hundred thirty-one likely pathogenic/pathogenic (LP/P) variants in robust DCM-associated genes were found in 685 patients with DCM (19.1%) genotyped for the robust genes. Three of the 131 patients had a second LP/P variant (2.3%). These 3 patients had a comparable disease onset, disease severity, and clinical course to patients with DCM with one LP/P. The LMNA/Titin deletion A-band mice had no functional differences compared with the LMNA/wild-type mice after 40 weeks of follow-up, although RNA-sequencing suggests increased cardiac stress and sarcomere insufficiency in the LMNA/Titin deletion A-band mice.
Conclusions:
In this study population, 2.3% of patients with DCM with one LP/P also have a second LP/P in a different gene. Although the second LP/P does not seem to influence the disease course of DCM in patients and mice, the finding of a second LP/P can be of importance to their relatives.
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Affiliation(s)
- Sophie L V M Stroeks
- Cardiovascular Research Institute Maastricht (CARIM); S.L.V.M.S., T.H.M.H., A.G.R., M.A.S., E.A.V.J., S.R.B.H., J.A.J.V.), Maastricht University, Maastricht, Netherlands
- KU Leuven, Cardiovascular Sciences, Belgium (S.L.V.M.S., E.A.V.J., S.R.B.H.)
| | - Ida G Lunde
- Genetics, Harvard Medical School, Boston, MA (I.G.L., H.W., J.G.)
- Diagnostics and Technology, Akershus University Hospital, Oslo, Norway (I.G.L.)
| | - Debby M E I Hellebrekers
- Clinical Genetics, Maastricht University Medical Center, the Netherlands (D.M.E.I.H., G.R.F.C., I.P.C.K., E.P.K., A.v.d.W., H.G.B., J.A.J.V.)
| | - Godelieve R F Claes
- Clinical Genetics, Maastricht University Medical Center, the Netherlands (D.M.E.I.H., G.R.F.C., I.P.C.K., E.P.K., A.v.d.W., H.G.B., J.A.J.V.)
| | - Hiroko Wakimoto
- Genetics, Harvard Medical School, Boston, MA (I.G.L., H.W., J.G.)
| | - Joshua Gorham
- Genetics, Harvard Medical School, Boston, MA (I.G.L., H.W., J.G.)
| | - Ingrid P C Krapels
- Clinical Genetics, Maastricht University Medical Center, the Netherlands (D.M.E.I.H., G.R.F.C., I.P.C.K., E.P.K., A.v.d.W., H.G.B., J.A.J.V.)
| | | | - Arthur van den Wijngaard
- Clinical Genetics, Maastricht University Medical Center, the Netherlands (D.M.E.I.H., G.R.F.C., I.P.C.K., E.P.K., A.v.d.W., H.G.B., J.A.J.V.)
| | | | - Anne G Raafs
- Cardiovascular Research Institute Maastricht (CARIM); S.L.V.M.S., T.H.M.H., A.G.R., M.A.S., E.A.V.J., S.R.B.H., J.A.J.V.), Maastricht University, Maastricht, Netherlands
| | - Maurits A Sikking
- Cardiovascular Research Institute Maastricht (CARIM); S.L.V.M.S., T.H.M.H., A.G.R., M.A.S., E.A.V.J., S.R.B.H., J.A.J.V.), Maastricht University, Maastricht, Netherlands
| | - Jos L V Broers
- Genetics and Cell Biology (J.L.V.B., M.N.), Maastricht University, Maastricht, Netherlands
| | - Miranda Nabben
- Genetics and Cell Biology (J.L.V.B., M.N.), Maastricht University, Maastricht, Netherlands
| | - Elizabeth A V Jones
- Cardiovascular Research Institute Maastricht (CARIM); S.L.V.M.S., T.H.M.H., A.G.R., M.A.S., E.A.V.J., S.R.B.H., J.A.J.V.), Maastricht University, Maastricht, Netherlands
- KU Leuven, Cardiovascular Sciences, Belgium (S.L.V.M.S., E.A.V.J., S.R.B.H.)
| | | | - Han G Brunner
- Clinical Genetics, Maastricht University Medical Center, the Netherlands (D.M.E.I.H., G.R.F.C., I.P.C.K., E.P.K., A.v.d.W., H.G.B., J.A.J.V.)
- Radboud University Medical Center, Human Genetics, Nijmegen, the Netherlands (H.G.B.)
| | - Job A J Verdonschot
- Cardiovascular Research Institute Maastricht (CARIM); S.L.V.M.S., T.H.M.H., A.G.R., M.A.S., E.A.V.J., S.R.B.H., J.A.J.V.), Maastricht University, Maastricht, Netherlands
- Clinical Genetics, Maastricht University Medical Center, the Netherlands (D.M.E.I.H., G.R.F.C., I.P.C.K., E.P.K., A.v.d.W., H.G.B., J.A.J.V.)
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3
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Stroeks SLVM, Verdonschot JAJ, Lunde IG, Henkens MTHM, Willemars M, Schianchi F, Luiken JFP, Wang P, Derks K, Krapels IPC, Vanhoutte EK, Jones EAV, Brunner HG, Nabben M, Heymans SRB. Titin truncating variant cardiomyopathy and related sarcomere insufficiency causes high energy demand resulting in mitochondrial dysfunction, autophagosome formation, and apoptosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Objectives
Titin truncating variants (TTNtv) are the most prevalent genetic cause of dilated cardiomyopathy (DCM), resulting in upregulation of cardiac transcripts of oxidative phosphorylation (1,2). However, the underlying molecular mechanism(s) and cellular consequences of these findings remain unknown.
Methods and results
To gain insight into the metabolic changes and cellular consequences of a TTNtv, metabolic, mitochondrial, and survival pathways were studied in human TTNtv DCM hearts and isolated cardiomyocytes of TTNtv mice. TTNtv resulted in a significant increase of cardiac transcripts of glycolysis, citric acid cycle, mitochondrial fission, autophagy, and apoptosis when comparing RNAseq in 24 TTNtv and 27 mutation-negative DCM cardiac biopsies. Furthermore, a decrease in the area of myofibrils in human TTNtv hearts (TTNtv vs. mutation-negative DCM: 46%, and 62%, P=0.001), and an increase of mitochondrial (49% and 31%, P=0,001) and autophagosome areas (4% and 2%, P=0.002) was observed using transmission electron microscopy (TEM). Similar patterns of cardiomyocyte disorganization and stress could be seen in TTNtv hearts of mice even without a phenotype. Additionally, observed swollen mitochondria by TEM and decreased quantity of OXPHOS proteins by immunoblotting in murine TTNtv hearts indicate mitochondrial stress. Mitochondrial oxygen consumption at baseline and the maximum respiration in TTNtv cardiomyocytes of mice increased by a factor of 1.8 and 1.5 respectively (both P≤0.05), compared to WT. Furthermore, palmitate oxidation in TTNtv cardiomyocytes increased by 1.3 fold (P=0.005) compared to WT mice, suggestive of increased energy demand in TTNtv.
Conclusion
Myofibrillar insufficiency in human TTNtv DCM augments the cardiac oxygen and energy consumption, leading to pronounced morphological and functional mitochondrial decompensation. Swelling, damage and fission of mitochondria is further characterized by autophagosome formation and increased apoptosis pathways in TTNtv hearts.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Double-Dose consortium by Dutch Cardiovascular Alliance (DCVA)
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Affiliation(s)
- S L V M Stroeks
- Cardiovascular Research Institute Maastricht (CARIM), Cardiology , Maastricht , The Netherlands
| | - J A J Verdonschot
- Academic Hospital Maastricht, Clinical Genetics , Maastricht , The Netherlands
| | - I G Lunde
- Harvard Medical School , Boston , United States of America
| | - M T H M Henkens
- Cardiovascular Research Institute Maastricht (CARIM) , Maastricht , The Netherlands
| | - M Willemars
- Cardiovascular Research Institute Maastricht (CARIM), Genetics and Cell Biology , Maastricht , The Netherlands
| | - F Schianchi
- Cardiovascular Research Institute Maastricht (CARIM), Genetics and Cell Biology , Maastricht , The Netherlands
| | - J F P Luiken
- Cardiovascular Research Institute Maastricht (CARIM), Genetics and Cell Biology , Maastricht , The Netherlands
| | - P Wang
- Academic Hospital Maastricht, Clinical Genetics , Maastricht , The Netherlands
| | - K Derks
- Academic Hospital Maastricht, Clinical Genetics , Maastricht , The Netherlands
| | - I P C Krapels
- Academic Hospital Maastricht, Clinical Genetics , Maastricht , The Netherlands
| | - E K Vanhoutte
- Academic Hospital Maastricht, Clinical Genetics , Maastricht , The Netherlands
| | | | - H G Brunner
- Academic Hospital Maastricht, Clinical Genetics , Maastricht , The Netherlands
| | - M Nabben
- Cardiovascular Research Institute Maastricht (CARIM), Genetics and Cell Biology , Maastricht , The Netherlands
| | - S R B Heymans
- Cardiovascular Research Institute Maastricht (CARIM), Cardiology , Maastricht , The Netherlands
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4
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Verdonschot JAJ, Hazebroek MR, Krapels IPC, Henkens MTHM, Raafs A, Wang P, Merken JJ, Claes GRF, Vanhoutte EK, van den Wijngaard A, Heymans SRB, Brunner HG. Implications of Genetic Testing in Dilated Cardiomyopathy. Circ Genom Precis Med 2020; 13:476-487. [PMID: 32880476 DOI: 10.1161/circgen.120.003031] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Genetic analysis is a first-tier test in dilated cardiomyopathy (DCM). Electrical phenotypes are common in genetic DCM, but their exact contribution to the clinical course and outcome is unknown. We determined the prevalence of pathogenic gene variants in a large unselected DCM population and determined the role of electrical phenotypes in association with outcome. METHODS This study included 689 patients with DCM from the Maastricht Cardiomyopathy Registry, undergoing genetic evaluation using a 48 cardiomyopathy-associated gene-panel, echocardiography, endomyocardial biopsies, and Holter monitoring. Upon detection of a pathogenic variant in a patient with DCM, familial segregation was performed. Outcome was defined as cardiovascular death, heart transplantation, heart failure hospitalization, and/or occurrence of life-threatening arrhythmias. RESULTS A (likely) pathogenic gene variant was found in 19% of patients, varying from 36% in familial to 13% in nonfamilial DCM. Family segregation analysis showed familial disease in 46% of patients with DCM who were initially deemed nonfamilial by history. Overall, 18% of patients with a nongenetic risk factor had a pathogenic gene variant. Almost all pathogenic gene variants occurred in just 12 genes previously shown to have robust disease association with DCM. Genetic DCM was independently associated with electrical phenotypes such as atrial fibrillation, nonsustained ventricular tachycardia, and atrioventricular block and inversely correlated with the presence of a left bundle branch block (P<0.01). After a median follow-up of 4 years, event-free survival was reduced in genetic versus patients with nongenetic DCM (P=0.01). This effect on outcome was mediated by the associated electrical phenotypes of genetic DCM (P<0.001). CONCLUSIONS One in 5 patients with an established nongenetic risk factor or a nonfamilial disease still carries a pathogenic gene variant. Genetic DCM is characterized by a profile of electrical phenotypes (atrial fibrillation, nonsustained ventricular tachycardia, and atrioventricular block), which carries increased risk for adverse outcomes. Based on these findings, we envisage a broader role for genetic testing in DCM.
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Affiliation(s)
- Job A J Verdonschot
- Department of Cardiology (J.A.J.V., M.R.H., M.T.H.M.H., A.R., J.J.M., S.R.B.H.)
- Department of Clinical Genetics (J.A.J.V., I.P.C.K., P.W., G.R.F.C., E.K.V., A.v.d.W., H.G.B.)
| | - Mark R Hazebroek
- Department of Cardiology (J.A.J.V., M.R.H., M.T.H.M.H., A.R., J.J.M., S.R.B.H.)
| | - Ingrid P C Krapels
- Department of Clinical Genetics (J.A.J.V., I.P.C.K., P.W., G.R.F.C., E.K.V., A.v.d.W., H.G.B.)
| | | | - Anne Raafs
- Department of Cardiology (J.A.J.V., M.R.H., M.T.H.M.H., A.R., J.J.M., S.R.B.H.)
| | - Ping Wang
- Department of Clinical Genetics (J.A.J.V., I.P.C.K., P.W., G.R.F.C., E.K.V., A.v.d.W., H.G.B.)
| | - Jort J Merken
- Department of Cardiology (J.A.J.V., M.R.H., M.T.H.M.H., A.R., J.J.M., S.R.B.H.)
| | - Godelieve R F Claes
- Department of Clinical Genetics (J.A.J.V., I.P.C.K., P.W., G.R.F.C., E.K.V., A.v.d.W., H.G.B.)
| | - Els K Vanhoutte
- Department of Clinical Genetics (J.A.J.V., I.P.C.K., P.W., G.R.F.C., E.K.V., A.v.d.W., H.G.B.)
| | | | - Stephane R B Heymans
- Department of Cardiology (J.A.J.V., M.R.H., M.T.H.M.H., A.R., J.J.M., S.R.B.H.)
- Department of Cardiovascular Research, University of Leuven, Belgium (S.R.B.H.)
- Netherlands Heart Institute (ICIN), Utrecht (S.R.B.H.)
| | - Han G Brunner
- Department of Clinical Genetics (J.A.J.V., I.P.C.K., P.W., G.R.F.C., E.K.V., A.v.d.W., H.G.B.)
- GROW Institute for Developmental Biology and Cancer, Maastricht University Medical Center (H.G.B.)
- Department of Human Genetics and Donders Center for Neuroscience, Radboudumc Nijmegen, the Netherlands (H.G.B.)
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5
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Verdonschot JAJ, Vanhoutte EK, Claes GRF, Helderman-van den Enden ATJM, Hoeijmakers JGJ, Hellebrekers DMEI, de Haan A, Christiaans I, Lekanne Deprez RH, Boen HM, van Craenenbroeck EM, Loeys BL, Hoedemaekers YM, Marcelis C, Kempers M, Brusse E, van Waning JI, Baas AF, Dooijes D, Asselbergs FW, Barge-Schaapveld DQCM, Koopman P, van den Wijngaard A, Heymans SRB, Krapels IPC, Brunner HG. A mutation update for the FLNC gene in myopathies and cardiomyopathies. Hum Mutat 2020; 41:1091-1111. [PMID: 32112656 PMCID: PMC7318287 DOI: 10.1002/humu.24004] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/12/2020] [Accepted: 02/25/2020] [Indexed: 12/11/2022]
Abstract
Filamin C (FLNC) variants are associated with cardiac and muscular phenotypes. Originally, FLNC variants were described in myofibrillar myopathy (MFM) patients. Later, high‐throughput screening in cardiomyopathy cohorts determined a prominent role for FLNC in isolated hypertrophic and dilated cardiomyopathies (HCM and DCM). FLNC variants are now among the more prevalent causes of genetic DCM. FLNC‐associated DCM is associated with a malignant clinical course and a high risk of sudden cardiac death. The clinical spectrum of FLNC suggests different pathomechanisms related to variant types and their location in the gene. The appropriate functioning of FLNC is crucial for structural integrity and cell signaling of the sarcomere. The secondary protein structure of FLNC is critical to ensure this function. Truncating variants with subsequent haploinsufficiency are associated with DCM and cardiac arrhythmias. Interference with the dimerization and folding of the protein leads to aggregate formation detrimental for muscle function, as found in HCM and MFM. Variants associated with HCM are predominantly missense variants, which cluster in the ROD2 domain. This domain is important for binding to the sarcomere and to ensure appropriate cell signaling. We here review FLNC genotype–phenotype correlations based on available evidence.
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Affiliation(s)
- Job A J Verdonschot
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Cardiology, Cardiovascular Research Institute (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Els K Vanhoutte
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Godelieve R F Claes
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | | | - Debby M E I Hellebrekers
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Amber de Haan
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Imke Christiaans
- Department of Clinical Genetics, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Clinical Genetics, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ronald H Lekanne Deprez
- Department of Clinical Genetics, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Hanne M Boen
- Department of Cardiology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | | | - Bart L Loeys
- Department of Medical Genetics, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Yvonne M Hoedemaekers
- Department of Clinical Genetics, University Medical Centre Groningen, Groningen, The Netherlands.,Department of Clinical Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carlo Marcelis
- Department of Clinical Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Marlies Kempers
- Department of Clinical Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Esther Brusse
- Department of Neurology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Jaap I van Waning
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Annette F Baas
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dennis Dooijes
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Arthur van den Wijngaard
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Stephane R B Heymans
- Department of Cardiology, Cardiovascular Research Institute (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium.,The Netherlands Heart Institute, Utrecht, The Netherlands
| | - Ingrid P C Krapels
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Han G Brunner
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Clinical Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Genetics and Cell Biology, GROW Institute for Developmental Biology and Cancer, Maastricht University Medical Centre, Maastricht, The Netherlands
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6
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Verdonschot JAJ, Robinson EL, James KN, Mohamed MW, Claes GRF, Casas K, Vanhoutte EK, Hazebroek MR, Kringlen G, Pasierb MM, van den Wijngaard A, Glatz JFC, Heymans SRB, Krapels IPC, Nahas S, Brunner HG, Szklarczyk R. Mutations in PDLIM5 are rare in dilated cardiomyopathy but are emerging as potential disease modifiers. Mol Genet Genomic Med 2019; 8:e1049. [PMID: 31880413 PMCID: PMC7005607 DOI: 10.1002/mgg3.1049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/23/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND A causal genetic mutation is found in 40% of families with dilated cardiomyopathy (DCM), leaving a large percentage of families genetically unsolved. This prevents adequate counseling and clear recommendations in these families. We aim to identify novel genes or modifiers associated with DCM. METHODS We performed computational ranking of human genes based on coexpression with a predefined set of genes known to be associated with DCM, which allowed us to prioritize gene candidates for their likelihood of being involved in DCM. Top candidates will be checked for variants in the available whole-exome sequencing data of 142 DCM patients. RNA was isolated from cardiac biopsies to investigate gene expression. RESULTS PDLIM5 was classified as the top candidate. An interesting heterozygous variant (189_190delinsGG) was found in a DCM patient with a known pathogenic truncating TTN-variant. The PDLIM5 loss-of-function (LoF) variant affected all cardiac-specific isoforms of PDLIM5 and no LoF variants were detected in the same region in a control cohort of 26,000 individuals. RNA expression of PDLIM5 and its direct interactors (MYOT, LDB3, and MYOZ2) was increased in cardiac tissue of this patient, indicating a possible compensatory mechanism. The PDLIM5 variant cosegregated with the TTN-variant and the phenotype, leading to a high disease penetrance in this family. A second patient was an infant with a homozygous 10 kb-deletion of exon 2 in PDLIM5 resulting in early-onset cardiac disease, showing the importance of PDLIM5 in cardiac function. CONCLUSIONS Heterozygous PDLIM5 variants are rare and therefore will not have a major contribution in DCM. Although they likely play a role in disease development as this gene plays a major role in contracting cardiomyocytes and homozygous variants lead to early-onset cardiac disease. Other environmental and/or genetic factors are probably necessary to unveil the cardiac phenotype in PDLIM5 mutation carriers.
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Affiliation(s)
- Job A J Verdonschot
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Emma L Robinson
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kiely N James
- Rady Children's Institute for Genomic Medicine, San Diego, CA, USA
| | - Mohamed W Mohamed
- Sanford Children's Hospital, Fargo, ND, USA.,North Dakota University, Fargo, ND, USA
| | - Godelieve R F Claes
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kari Casas
- Sanford Children's Hospital, Fargo, ND, USA.,North Dakota University, Fargo, ND, USA
| | - Els K Vanhoutte
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Mark R Hazebroek
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | - Arthur van den Wijngaard
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan F C Glatz
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Stephane R B Heymans
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Cardiovascular Research, University of Leuven, Leuven, Belgium.,Netherlands Heart Institute (ICIN), Utrecht, The Netherlands
| | - Ingrid P C Krapels
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Shareef Nahas
- Rady Children's Institute for Genomic Medicine, San Diego, CA, USA
| | - Han G Brunner
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Human Genetics, Donders Center for Neuroscience, Radboudumc, Nijmegen, The Netherlands.,GROW Institute for Developmental Biology and Cancer, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Radek Szklarczyk
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
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7
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Cavaletti G, Cornblath DR, Merkies IS, Postma TJ, Rossi E, Alberti P, Bruna J, Argyriou AA, Briani C, Velasco R, Kalofonos HP, Psimaras D, Ricard D, Pace A, Faber CG, Lalisang RI, Brandsma D, Koeppen S, Kerrigan S, Schenone A, Grisold W, Mazzeo A, Padua L, Dorsey SG, Penas‐Prado M, Valsecchi MG, Cavaletti G, Cornblath DR, Merkies IS, Postma TJ, Rossi E, Alberti P, Bruna J, Argyriou AA, Briani C, Velasco R, Kalofonos HP, Psimaras D, Ricard D, Pace A, Faber CG, Lalisang RI, Brandsma D, Koeppen S, Kerrigan S, Schenone A, Grisold W, Mazzeo A, Padua L, Dorsey SG, Penas‐Prado M, Valsecchi MG, Frigeni B, Lanzani F, Mattavelli L, Piatti ML, Binda D, Bidoli P, Cazzaniga M, Cortinovis D, Galiè E, Campagnolo M, Salvalaggio A, Ruiz M, Vanhoutte EK, Boogerd W, Hense J, Grant R, Storey D, Reni L, Demichelis C, Pessino A, Granata G, Leandri M, Ghigliotti I, Plasmati R, Pastorelli F, Heimans J, Eurelings M, Meijer RJ, Pozza EL, Toscano A, Gentile L, Santarpia M, Gonzalez CD. Patients' and physicians' interpretation of chemotherapy‐induced peripheral neurotoxicity. J Peripher Nerv Syst 2019; 24:111-119. [DOI: 10.1111/jns.12306] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/13/2018] [Accepted: 01/15/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and SurgeryUniversity of Milano‐Bicocca Monza Italy
| | - David R. Cornblath
- Department of NeurologyJohns Hopkins University School of Medicine Baltimore Maryland USA
| | - Ingemar S.J. Merkies
- Department of Neurology, Spaarne HospitalHoofddorp/Maastricht University Medical Center Maastricht The Netherlands
- Department of NeurologySt. Elisabeth Hospital Willemstad Curaçao
| | - Tjeerd J. Postma
- Department of Neurology, Amsterdam UMCVrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Emanela Rossi
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and SurgeryUniversity of Milano‐Bicocca Monza Italy
| | - Paola Alberti
- Experimental Neurology Unit, School of Medicine and SurgeryUniversity of Milano‐Bicocca Monza Italy
| | - Jordi Bruna
- Unit of Neuro‐Oncology, Department of NeurologyUniversity Hospital of Bellvitge‐IDIBELL (Bellvitge Biomedical Research Institute) Hospitalet, Spain
| | - Andreas A. Argyriou
- Division of Clinical Oncology‐Department of MedicineUniversity Hospital of Patras Patras Greece
| | - Chiara Briani
- Department of NeurosciencesUniversity of Padova Padova Italy
| | - Roser Velasco
- Unit of Neuro‐Oncology, Department of NeurologyUniversity Hospital of Bellvitge‐IDIBELL (Bellvitge Biomedical Research Institute) Hospitalet, Spain
| | - Haralabos P. Kalofonos
- Division of Clinical Oncology‐Department of MedicineUniversity Hospital of Patras Patras Greece
| | - Dimitri Psimaras
- Hôpital de la Pitié‐Salpêtrière, AP‐HPService de Neurologie Mazarin Paris France
| | - Damien Ricard
- Service de Neurologie de l'HIE PercyService de Santé des Armées Clamart France
| | - Andrea Pace
- Neuroncology UnitIRCCS Regina Elena National Cancer Institute Rome Italy
| | - Catharina G. Faber
- Department of Neurology, Spaarne HospitalHoofddorp/Maastricht University Medical Center Maastricht The Netherlands
| | - Roy I. Lalisang
- Division of Medical Oncology, Department of Internal MedicineGROW‐School of Oncology and Developmental Biology, Maastricht University Medical Center Maastricht The Netherlands
| | - Dieta Brandsma
- Department of Neuro‐oncologyNetherlands Cancer Institute Amsterdam The Netherlands
| | - Susanne Koeppen
- Department of Neurology and West German Cancer CenterUniversity of Essen Essen Germany
| | - Simon Kerrigan
- Edinburgh Centre for Neuro‐Oncology and Edinburgh Cancer Research CentreWestern General Hospital Edinburgh UK
| | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, OphthalmologyGenetic and Maternal Infantile Sciences, University of Genova and Ospedale Policlinico San Martino Genoa Italy
- Dipartimento di NeuroscienzeIRCCS Ospedale Policlinico San Martino Genoa Italy
| | - Wolfgang Grisold
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology Vienna Austria
| | - Anna Mazzeo
- Department of Clinical and Experimental MedicineUniversity of Messina Messina Italy
| | - Luca Padua
- Department of Neurosciences Cattolica UniversityRome and IRCCS Don Carlo Gnocchi Milan Italy
| | - Susan G. Dorsey
- Department of Pain & Translational Symptom ScienceUniversity of Maryland School of Nursing and the Marlene and Stewart Greenebaum Cancer Center Baltimore Maryland USA
| | - Marta Penas‐Prado
- Department of Neuro‐OncologyThe UT MD Anderson Cancer Center Houston Texas USA
| | - Maria G. Valsecchi
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and SurgeryUniversity of Milano‐Bicocca Monza Italy
| | | | | | | | | | | | | | - Jordi Bruna
- University Hospital of Bellvitge‐IDIBELL (Bellvitge Biomedical Research Institute) Hospitalet
| | | | | | | | | | | | | | | | | | | | | | | | | | - Angelo Schenone
- University of Genova and Ospedale Policlinico San Martino Genoa
| | - Wolfgang Grisold
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology Vienna
| | | | | | - Susan G. Dorsey
- University of Maryland School of Nursing and the Marlene and Stewart Greenebaum Cancer Center Baltimore
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8
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Vanhoutte EK, Hermans MCE, Faber CG, Gorson KC, Merkies ISJ, Thonnard JL. Rasch-ionale for neurologists. J Peripher Nerv Syst 2016; 20:260-8. [PMID: 26115370 DOI: 10.1111/jns.12122] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 04/24/2015] [Accepted: 06/11/2015] [Indexed: 01/14/2023]
Abstract
Outcome measures are considered the most important tools to monitor patients' outcome in both clinical and research settings. Measuring the clinical state of patients is a fundamental part of our daily clinical practice and research that sometimes is taken for granted. In peripheral neuropathies, there are many scales available, but most of these are at the ordinal level. This paper will systematically address the types of scales available (being nominal, ordinal, interval, or ratio data-based) in terms of their strengths and weaknesses. The differences between classical test theory-based and modern test method-based outcome measures will be addressed with emphasis on Rasch methodology. Various steps will be highlighted as part of the evaluation and construction of outcome measures using the Rasch method, with the aim to increase the knowledge and utility of this technique. We argue that Rasch-built outcome measures should be used for future studies in neuromuscular disorders and their method of construction could be easily extrapolated to other neurological illnesses.
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Affiliation(s)
- Els K Vanhoutte
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mieke C E Hermans
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Catharina G Faber
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kenneth C Gorson
- Department of Neurology, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Ingemar S J Merkies
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neurology, Erasmus Medical Center Rotterdam, Rotterdam.,Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands
| | - Jean-L Thonnard
- Institute of Neuroscience (IoNS), Université catholique de Louvain.,Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Brussels, Belgium
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9
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Vanhoutte EK, Draak THP, Gorson KC, van Nes SI, Hoeijmakers JGJ, Van der Pol WL, Notermans NC, Lewis RA, Nobile-Orazio E, Léger JM, Van den Bergh PYK, Lauria G, Bril V, Katzberg H, Lunn MPT, Pouget J, van der Kooi AJ, Hahn AF, van Doorn PA, Cornblath DR, van den Berg LH, Faber CG, Merkies ISJ. Impairment measures versus inflammatory RODS in GBS and CIDP: a responsiveness comparison. J Peripher Nerv Syst 2016; 20:289-95. [PMID: 26114893 DOI: 10.1111/jns.12118] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 05/10/2015] [Accepted: 06/10/2015] [Indexed: 01/02/2023]
Abstract
This study aimed to 'define responder' through the concept of minimum clinically important differences using the individually obtained standard errors (MCID-SE) and a heuristic 'external criterion' responsiveness method in patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). One hundred and fourteen newly diagnosed or relapsing patients (GBS: 55, CIDP: 59) were serially examined (1-year follow-up). The inflammatory Rasch-built overall disability scale (I-RODS), Rasch-transformed MRC sum score (RT-MRC), and Rasch-transformed modified-INCAT-sensory scale (RT-mISS) were assessed. Being-a-responder was defined as having a MCID-SE cut-off ≥1.96. Also, the correlations between patients' scores on each scale and the EuroQoL health-status 'thermometer' (external criterion) were determined (higher correlation indicated better responsiveness). In both diseases, the SEs showed a characteristic 'U'-shaped dynamic pattern across each scales' continuum. The number of patients showing a meaningful change were higher for the I-RODS > RT-MRC > RT-mISS and were in GBS higher than CIDP patients. The MCID-SE concept using Rasch-transformed data demonstrated an individual pattern of 'being-a-responder' in patients with immune-mediated neuropathies, and the findings were validated by the external criterion responsiveness method. The I-RODS showed greater responsiveness compared with the MRC and INCAT-sensory scales, and its use is therefore recommended in future trials in GBS and CIDP.
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Affiliation(s)
- Els K Vanhoutte
- Department of Clinical Genetics, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - Thomas H P Draak
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - Kenneth C Gorson
- Department of Neurology, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Sonja I van Nes
- Department of Neurology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | - W-Ludo Van der Pol
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Nicolette C Notermans
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Richard A Lewis
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Eduardo Nobile-Orazio
- Department of Neurological Sciences, Humanitas Clinical Institute, Milan University, Milan, Italy
| | - Jean-Marc Léger
- Department of Neurology, Hôpital de la Salpêtrière, Paris, France
| | | | - Giuseppe Lauria
- Neuromuscular Diseases Unit, National Neurological Institute "Carlo Besta", Milan, Italy
| | - Vera Bril
- Department of Neurology, Toronto General Hospital, Toronto, Canada
| | - Hans Katzberg
- Department of Neurology, Toronto General Hospital, Toronto, Canada
| | - Michael P T Lunn
- Department of Neurology, Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, London, UK
| | - Jean Pouget
- Department of Neurology, Centre de Référence des Maladies Neuromusculaires et de la SLA, Hôpital de La Timone, Marseille, France
| | | | - Angelika F Hahn
- Department of Neurology, London Health Science Center, London, Canada
| | - Pieter A van Doorn
- Department of Neurology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - David R Cornblath
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Leonard H van den Berg
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Catharina G Faber
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - Ingemar S J Merkies
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands.,Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands
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10
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Pruppers MHJ, Draak THP, Vanhoutte EK, Van der Pol WL, Gorson KC, Léger JM, Nobile-Orazio E, Lewis RA, van den Berg LH, Faber CG, Merkies ISJ. Outcome measures in MMN revisited: further improvement needed. J Peripher Nerv Syst 2016; 20:306-18. [PMID: 26115442 DOI: 10.1111/jns.12124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 04/23/2015] [Accepted: 06/10/2015] [Indexed: 11/27/2022]
Abstract
The objectives of this study were to provide an overview of the outcome measures (OMs) applied in clinical trials in multifocal motor neuropathy (MMN) and to determine the responsiveness of a core set of selected OMs as part of the peripheral neuropathy outcome measures standardization (PeriNomS) study. The following OMs were serially applied in 26 patients with newly diagnosed or relapsing MMN, receiving intravenous immunoglobulin (assessments: T0/T3/T12 months): 14 muscle pairs MRC (Medical Research Council) scale, the Neuropathy Impairment Scale motor-subset, a self-evaluation scale, grip strength, and MMN-RODS© (Rasch-built overall disability scale). All data, except the grip strength, were subjected to Rasch analyses before determining responsiveness. For grip strength, responsiveness was examined using a combined anchor- (SF-36 question-2) and distribution-based (½ × SD) minimum clinically important difference (MCID) techniques, determining the proportion of patients exceeding both the identified cut-offs. For the remaining scales, the magnitude of change for each patient on each scale was determined using the MCID related to the individual SE (responder definition: MCID-SE ≥ 1.96). Overall, a great assortment of measures has been used in MMN trials with different responsiveness definitions. For the selected OMs, responsiveness was poor and only seen in one fourth to one third of the patients, the grip strength being more responsive. Despite the efforts taken to standardize outcome assessment, further clinimetric responsiveness studies are needed in MMN.
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Affiliation(s)
- Mariëlle H J Pruppers
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Thomas H P Draak
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Els K Vanhoutte
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - W-Ludo Van der Pol
- Department of Neurology, Rudolf Magnus Institute of Neuroscience University Medical Center, Utrecht, The Netherlands
| | - Kenneth C Gorson
- Department of Neurology, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Jean-Marc Léger
- Department of Neurology, Hôpital de la Salpêtrière, Paris, France
| | - Eduardo Nobile-Orazio
- Department of Neurological Sciences, Milan University, Humanitas Clinical Institute, Rozzano, Milan, Italy
| | - Richard A Lewis
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Leonard H van den Berg
- Department of Neurology, Rudolf Magnus Institute of Neuroscience University Medical Center, Utrecht, The Netherlands
| | - Catharina G Faber
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ingemar S J Merkies
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands
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11
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Draak THP, Pruppers MHJ, van Nes SI, Vanhoutte EK, Bakkers M, Gorson KC, Van der Pol WL, Lewis RA, Notermans NC, Nobile-Orazio E, Léger JM, Van den Bergh PYK, Lauria G, Bril V, Katzberg H, Lunn MPT, Pouget J, van der Kooi AJ, van den Berg LH, van Doorn PA, Cornblath DR, Hahn AF, Faber CG, Merkies ISJ. Grip strength comparison in immune-mediated neuropathies: Vigorimeter vs. Jamar. J Peripher Nerv Syst 2016; 20:269-76. [PMID: 26115516 DOI: 10.1111/jns.12126] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 04/21/2015] [Accepted: 06/11/2015] [Indexed: 01/06/2023]
Abstract
The Jamar dynamometer and Vigorimeter have been used to assess grip strength in immune-mediated neuropathies, but have never been compared to each other. Therefore, we performed a comparison study between these two devices in patients with immune-mediated neuropathies. Grip strength data were collected in 102 cross-sectional stable and 163 longitudinal (new diagnoses or changing condition) patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), gammopathy-related polyneuropathy (MGUSP), and multifocal motor neuropathy (MMN). Stable patients were assessed twice (validity/reliability studies). Longitudinal patients were assessed 3-5 times during 1 year. Responsiveness comparison between the two tools was examined using combined anchor-/distribution-based minimum clinically important difference (MCID) techniques. Patients were asked to indicate their preference for the Jamar or Vigorimeter. Both tools correlated highly with each other (ρ = 0.86, p < 0.0001) and showed good intra-class correlation coefficients (Jamar [Right/Left hands]: ICC 0.997/0.96; Vigori: ICC 0.95/0.98). Meaningful changes were comparable between the two instruments, being higher in GBS compared to CIDP patients. In MGUSP/MMN poor responsiveness was seen. Significant more patients preferred the Vigorimeter. In conclusion, validity, reliability, and responsiveness aspects were comparable between the Jamar dynamometer and Vigorimeter. However, based on patients' preference, the Vigorimeter is recommended in future studies in immune-mediated neuropathies.
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Affiliation(s)
- Thomas H P Draak
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mariëlle H J Pruppers
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sonja I van Nes
- Department of Neurology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Els K Vanhoutte
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mayienne Bakkers
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kenneth C Gorson
- Department of Neurology, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - W-Ludo Van der Pol
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre, Utrecht, The Netherlands
| | - Richard A Lewis
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nicolette C Notermans
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre, Utrecht, The Netherlands
| | - Eduardo Nobile-Orazio
- Department of Neurological Sciences, Milan University, Humanitas Clinical Institute, Milan, Italy
| | - Jean-Marc Léger
- Department of Neurology, Hôpital de la Salpêtrière, Paris, France
| | | | - Giuseppe Lauria
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Milan, Italy
| | - Vera Bril
- Department of Neurology, Toronto General Hospital, Toronto, Canada
| | - Hans Katzberg
- Department of Neurology, Toronto General Hospital, Toronto, Canada
| | - Michael P T Lunn
- Department of Neurology, Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, London, UK
| | - Jean Pouget
- Department of Neurology, Centre de Référence des Maladies Neuromusculaires et de la SLA, Hôpital de La Timone, Marseille, France
| | | | - Leonard H van den Berg
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre, Utrecht, The Netherlands
| | - Pieter A van Doorn
- Department of Neurology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - David R Cornblath
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Angelika F Hahn
- Department of Neurology, London Health Science Center, London, Canada
| | - Catharina G Faber
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ingemar S J Merkies
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands
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12
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Draak THP, Gorson KC, Vanhoutte EK, van Nes SI, van Doorn PA, Cornblath DR, van den Berg LH, Faber CG, Merkies ISJ. Does ability to walk reflect general functionality in inflammatory neuropathies? J Peripher Nerv Syst 2016; 21:74-81. [DOI: 10.1111/jns.12167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 02/28/2016] [Accepted: 03/04/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Thomas H. P. Draak
- Department of Neurology; University Medical Centre Maastricht; Maastricht The Netherlands
| | - Kenneth C. Gorson
- Department of Neurology; St. Elizabeth's Medical Centre, Tufts University School of Medicine; Boston MA USA
| | - Els K. Vanhoutte
- Department of Clinical Genetics; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Sonja I. van Nes
- Department of Neurology, Havenziekenhuis; Rotterdam The Netherlands
| | - Pieter A. van Doorn
- Department of Neurology; Erasmus Medical Centre Rotterdam; Rotterdam The Netherlands
| | - David R. Cornblath
- Department of Neurology; Johns Hopkins School of Medicine; Baltimore MD USA
| | - Leonard H. van den Berg
- Department of Neurology; Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht; Utrecht The Netherlands
| | - Catharina G. Faber
- Department of Neurology; University Medical Centre Maastricht; Maastricht The Netherlands
| | - Ingemar S. J. Merkies
- Department of Neurology; University Medical Centre Maastricht; Maastricht The Netherlands
- Department of Neurology; Spaarne Hospital; Hoofddorp The Netherlands
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Draak THP, Gorson KC, Vanhoutte EK, van Nes SI, van Doorn PA, Cornblath DR, van den Berg LH, Faber CG, Merkies ISJ. Correlation of the patient's reported outcome Inflammatory-RODS with an objective metric in immune-mediated neuropathies. Eur J Neurol 2016; 23:1248-53. [PMID: 27129110 DOI: 10.1111/ene.13025] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 03/22/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE There is increasing interest in using patient-reported outcome measures (PROMs) in clinical studies to capture individual changes over time. However, PROMs have also been criticized because they are entirely subjective. Our objective was to examine the relationship between a subjective PROM and an objective outcome tool in patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and gammopathy-related polyneuropathy (MGUSP). METHODS The Inflammatory Rasch-built Overall Disability Scale (I-RODS©, a multi-item scale that examines functionality) was completed by 137 patients with newly diagnosed (or relapsing) GBS (55), CIDP (59) and MGUSP (23) who were serially examined (GBS/CIDP, T0/T1/T3/T6/T12 months; MGUSP, T0/T3/T12). Possible association between the I-RODS findings and the vigorimeter scores, an objective linear instrument to assess grip strength, was examined. RESULTS A significant correlating trend was found between the I-RODS and grip strength scores for the overall group and in each illness, independently. CONCLUSION The objectivity of patients' subjective report on their functional state based on a strong correlation between the I-RODS and grip strength in patients with GBS, CIDP and MGUSP has been demonstrated. These findings provide further support to use the I-RODS and grip strength in future clinical studies in these conditions.
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Affiliation(s)
- T H P Draak
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - K C Gorson
- Department of Neurology, St Elizabeth's Medical Centre, Tufts University School of Medicine, Boston, MA, USA
| | - E K Vanhoutte
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - S I van Nes
- Department of Neurology, Havenziekenhuis, Rotterdam, The Netherlands
| | - P A van Doorn
- Department of Neurology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - D R Cornblath
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - L H van den Berg
- Department of Neurology, Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht, Utrecht, The Netherlands
| | - C G Faber
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - I S J Merkies
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands.,Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands
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Draak THP, Vanhoutte EK, van Nes SI, Gorson KC, Van der Pol WL, Notermans NC, Nobile-Orazio E, Lewis RA, Léger JM, Van den Bergh PYK, Lauria G, Bril V, Katzberg H, Lunn MPT, Pouget J, van der Kooi AJ, Hahn AF, van den Berg LH, van Doorn PA, Cornblath DR, Faber CG, Merkies ISJ. Comparing the NIS vs. MRC and INCAT sensory scale through Rasch analyses. J Peripher Nerv Syst 2015; 20:277-88. [DOI: 10.1111/jns.12127] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 04/21/2015] [Accepted: 06/11/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Thomas H. P. Draak
- Department of Neurology; Maastricht University Medical Center; Maastricht The Netherlands
| | - Els K. Vanhoutte
- Department of Clinical Genetics; Maastricht University Medical Center; Maastricht The Netherlands
| | - Sonja I. van Nes
- Department of Neurology; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Kenneth C. Gorson
- Department of Neurology, St. Elizabeth's Medical Center; Tufts University School of Medicine; Boston MA USA
| | - W.-Ludo Van der Pol
- Department of Neurology, Rudolf Magnus Institute of Neuroscience; University Medical Center Utrecht; Utrecht The Netherlands
| | - Nicolette C. Notermans
- Department of Neurology, Rudolf Magnus Institute of Neuroscience; University Medical Center Utrecht; Utrecht The Netherlands
| | - Eduardo Nobile-Orazio
- Department of Neurological Sciences, Milan University; Humanitas Clinical Institute; Rozzano Milan Italy
| | - Richard A. Lewis
- Department of Neurology; Cedars-Sinai Medical Center; Los Angeles, California USA
| | - Jean-Marc Léger
- Department of Neurology; Hôpital de la Salpêtrière; Paris France
| | | | - Giuseppe Lauria
- Department of Clinical Neurosciences; Neuromuscular Diseases Unit National Neurological Institute “Carlo Besta”; 3rd Neurology Unit Milan Italy
| | - Vera Bril
- Department of Neurology; Toronto General Hospital; Toronto ON Canada
| | - Hans Katzberg
- Department of Neurology; Toronto General Hospital; Toronto ON Canada
| | - Michael P. T. Lunn
- Department of Neurology, Centre for Neuromuscular Disease; National Hospital for Neurology and Neurosurgery; Queen Square London UK
| | - Jean Pouget
- Department of Neurology; Centre de Référence des Maladies Neuromusculaires et de la SLA; Hôpital de La Timone Marseille France
| | | | - Angelika F. Hahn
- Department of Neurology; London Health Science Center; London ON Canada
| | - Leonard H. van den Berg
- Department of Neurology, Rudolf Magnus Institute of Neuroscience; University Medical Center Utrecht; Utrecht The Netherlands
| | - Pieter A. van Doorn
- Department of Neurology; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - David R. Cornblath
- Department of Neurology; Johns Hopkins School of Medicine; Baltimore MD USA
| | - Catharina G. Faber
- Department of Neurology; Maastricht University Medical Center; Maastricht The Netherlands
| | - Ingemar S. J. Merkies
- Department of Neurology; Maastricht University Medical Center; Maastricht The Netherlands
- Department of Neurology; Spaarne Hospital; Hoofddorp The Netherlands
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Vanhoutte EK, Faber CG, van Nes SI, Cats EA, Van der Pol WL, Gorson KC, van Doorn PA, Cornblath DR, van den Berg LH, Merkies ISJ. Rasch-built Overall Disability Scale for Multifocal motor neuropathy (MMN-RODS©
). J Peripher Nerv Syst 2015; 20:296-305. [DOI: 10.1111/jns.12141] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 04/24/2015] [Accepted: 08/20/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Els K. Vanhoutte
- Department of Neurology; University Medical Centre Maastricht; Maastricht The Netherlands
| | - Catharina G. Faber
- Department of Neurology; University Medical Centre Maastricht; Maastricht The Netherlands
| | - Sonja I. van Nes
- Department of Neurology; Erasmus Medical Centre Rotterdam; Rotterdam The Netherlands
| | - Elisabeth A. Cats
- Department of Neurology; Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht; Utrecht The Netherlands
| | - W.-Ludo Van der Pol
- Department of Neurology; Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht; Utrecht The Netherlands
| | - Kenneth C. Gorson
- Department of Neurology, St. Elizabeth's Medical Center; Tufts University School of Medicine; Boston MA USA
| | - Pieter A. van Doorn
- Department of Neurology; Erasmus Medical Centre Rotterdam; Rotterdam The Netherlands
| | - David R. Cornblath
- Department of Neurology; Johns Hopkins School of Medicine; Baltimore MD USA
| | - Leonard H. van den Berg
- Department of Neurology; Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht; Utrecht The Netherlands
| | - Ingemar S. J. Merkies
- Department of Neurology; University Medical Centre Maastricht; Maastricht The Netherlands
- Department of Neurology; Spaarne Hospital; Hoofddorp The Netherlands
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Bakkers M, Faber CG, Reulen JPH, Hoeijmakers JGJ, Vanhoutte EK, Merkies ISJ. Optimizing temperature threshold testing in small-fiber neuropathy. Muscle Nerve 2015; 51:870-6. [PMID: 25290248 DOI: 10.1002/mus.24473] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2014] [Indexed: 02/04/2023]
Abstract
INTRODUCTION We examined optimization of a temperature threshold testing (TTT) protocol for patients with suspected small-fiber neuropathy (SFN) to lessen the burden for both patients and technicians, without sacrificing accuracy. METHODS Data from 81 patients with SFN (skin biopsy and TTT abnormal) and 81 without SFN (skin biopsy and TTT normal) were used. Warm, cold, and heat pain sensation thresholds were determined bilaterally on the thenar eminence and foot dorsum by methods of limits and levels. Diagnostic accuracy was determined for various sensory modality combinations through comparative corresponding area under the receiver-operator characteristic curves. RESULTS Assessment of warm and cold thresholds in all extremities by the method of levels showed the best discriminatory ability (area under the curve 0.95, sensitivity 84.2%, specificity 93.8%). CONCLUSIONS These assessments are suggested for TTT examination in possible SFN patients. By applying this combination, the time needed for TTT can be reduced, maintaining diagnostic accuracy.
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Affiliation(s)
- Mayienne Bakkers
- Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Catharina G Faber
- Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Jos P H Reulen
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Janneke G J Hoeijmakers
- Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Els K Vanhoutte
- Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
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Vanhoutte EK, Faber CG, Merkies ISJ. 196th ENMC international workshop: Outcome measures in inflammatory peripheral neuropathies 8-10 February 2013, Naarden, The Netherlands. Neuromuscul Disord 2013; 23:924-33. [PMID: 23835324 DOI: 10.1016/j.nmd.2013.06.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Els K Vanhoutte
- Maastricht University Medical Centre, Maastricht, The Netherlands.
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18
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Cavaletti G, Cornblath DR, Merkies ISJ, Postma TJ, Rossi E, Frigeni B, Alberti P, Bruna J, Velasco R, Argyriou AA, Kalofonos HP, Psimaras D, Ricard D, Pace A, Galiè E, Briani C, Dalla Torre C, Faber CG, Lalisang RI, Boogerd W, Brandsma D, Koeppen S, Hense J, Storey D, Kerrigan S, Schenone A, Fabbri S, Valsecchi MG, Mazzeo A, Pace A, Pessino A, Schenone A, Toscano A, Argyriou AA, Brouwer B, Frigeni B, Piras B, Briani C, Dalla Torre C, Dominguez Gonzalez C, Faber CG, Tomasello C, Binda D, Brandsma D, Cortinovis D, Psimaras D, Ricard D, Storey D, Cornblath DR, Galiè E, Lindeck Pozza E, Rossi E, Vanhoutte EK, Lanzani F, Pastorelli F, Altavilla G, Cavaletti G, Granata G, Kalofonos HP, Ghignotti I, Merkies ISJ, Bruna J, Hense J, Heimans JJ, Mattavelli L, Padua L, Reni L, Bakkers M, Boogerd M, Campagnolo M, Cazzaniga M, Eurelings M, Leandri M, Lucchetta M, Penas Prado M, Russo M, Valsecchi MG, Piatti ML, Alberti P, Bidoli P, Grant R, Plasmati R, Velasco R, Lalisang RI, Meijer RJ, Fabbri S, Dorsey SG, Galimberti S, Kerrigan S, Koeppen S, Postma TJ, Boogerd W, Grisold W. The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings. Ann Oncol 2013; 24:454-462. [PMID: 22910842 PMCID: PMC3551481 DOI: 10.1093/annonc/mds329] [Citation(s) in RCA: 208] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 06/05/2012] [Accepted: 07/09/2012] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and dose-limiting complication of cancer treatment. Thus far, the impact of CIPN has not been studied in a systematic clinimetric manner. The objective of the study was to select outcome measures for CIPN evaluation and to establish their validity and reproducibility in a cross-sectional multicenter study. PATIENTS AND METHODS After literature review and a consensus meeting among experts, face/content validity were obtained for the following selected scales: the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), the Total Neuropathy Score clinical version (TNSc), the modified Inflammatory Neuropathy Cause and Treatment (INCAT) group sensory sumscore (mISS), the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and CIPN20 quality-of-life measures. A total of 281 patients with stable CIPN were examined. Validity (correlation) and reliability studies were carried out. RESULTS Good inter-/intra-observer scores were obtained for the TNSc, mISS, and NCI-CTC sensory/motor subscales. Test-retest values were also good for the EORTC QLQ-C30 and CIPN20. Acceptable validity scores were obtained through the correlation among the measures. CONCLUSION Good validity and reliability scores were demonstrated for the set of selected impairment and quality-of-life outcome measures in CIPN. Future studies are planned to investigate the responsiveness aspects of these measures.
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Affiliation(s)
- G Cavaletti
- Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Monza, Italy.
| | - D R Cornblath
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - I S J Merkies
- Department of Neurology, Spaarne Hospital, Hoofddorp/Maastricht, University Medical Center, Maastricht
| | - T J Postma
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - E Rossi
- Center of Biostatistics for Clinical Epidemiology, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Monza, Italy
| | - B Frigeni
- Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Monza, Italy
| | - P Alberti
- Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Monza, Italy
| | - J Bruna
- Unit of Neuro-Oncology, Department of Neurology, University Hospital of Bellvitge, L'Hospitalet, Spain
| | - R Velasco
- Unit of Neuro-Oncology, Department of Neurology, University Hospital of Bellvitge, L'Hospitalet, Spain
| | - A A Argyriou
- Division of Clinical Oncology, Department of Medicine, University Hospital of Patras, Patras, Greece
| | - H P Kalofonos
- Division of Clinical Oncology, Department of Medicine, University Hospital of Patras, Patras, Greece
| | - D Psimaras
- Service de Neurologie Mazarin, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris
| | - D Ricard
- Service de Neurologie, Hôpital du Val-de-Grâce, Service de Santé des Armées, Paris, France
| | - A Pace
- Neurology Unit, National Cancer Institute Regina Elena, Rome
| | - E Galiè
- Neurology Unit, National Cancer Institute Regina Elena, Rome
| | - C Briani
- Department of Neurosciences, University of Padova, Padova, Italy
| | - C Dalla Torre
- Department of Neurosciences, University of Padova, Padova, Italy
| | - C G Faber
- Department of Neurology, Spaarne Hospital, Hoofddorp/Maastricht, University Medical Center, Maastricht
| | - R I Lalisang
- Division of Medical Oncology, Department of Internal Medicine, GROW-School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
| | - W Boogerd
- Department of Neuro-oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D Brandsma
- Department of Neuro-oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Koeppen
- Department of Neurology and West German Cancer Center, University of Essen, Essen, Germany
| | - J Hense
- Department of Neurology and West German Cancer Center, University of Essen, Essen, Germany
| | - D Storey
- Edinburgh Centre for Neuro-Oncology and Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK
| | - S Kerrigan
- Edinburgh Centre for Neuro-Oncology and Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK
| | - A Schenone
- Department of Neurosciences, Ophthalmology and Genetic, Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | - S Fabbri
- Department of Neurosciences, Ophthalmology and Genetic, Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | - M G Valsecchi
- Center of Biostatistics for Clinical Epidemiology, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Monza, Italy
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Peters MJH, van Nes SI, Vanhoutte EK, Bakkers M, van Doorn PA, Merkies ISJ, Faber CG. Revised normative values for grip strength with the Jamar dynamometer. J Peripher Nerv Syst 2011; 16:47-50. [PMID: 21504502 DOI: 10.1111/j.1529-8027.2011.00318.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The Jamar dynamometer has been widely used in various chronic illnesses and has demonstrated its strength as a potential prognostic indicator. Various stratified normative values have been published using different methodologies, leading to conflicting results. No study used statistical techniques considering the non-Gaussian distribution of the obtained grip strength (GS) values. Jamar GS was assessed in 720 healthy participants, subdivided into seven age decade groups consisting of at least 50 men and 50 women each. Normative values (median and fifth values) were calculated using quantile regressions with restricted cubic spline functions on age. Possible confounding personal factors (hand dominance, length, weight, hobby, and job categorization) were examined. Clinically applicable revised normative values for the Jamar dynamometer, stratified for age and gender, are presented. Hand dominance had no influence. Other personal factors only minimally influenced final values. This study provides revised normative GS values for the Jamar dynamometer.
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Affiliation(s)
- Martine J H Peters
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
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20
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Hermans MCE, Faber CG, Vanhoutte EK, Bakkers M, De Baets MH, de Die-Smulders CEM, Merkies ISJ. Peripheral neuropathy in myotonic dystrophy type 1. J Peripher Nerv Syst 2011; 16:24-9. [PMID: 21504499 DOI: 10.1111/j.1529-8027.2011.00313.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Myotonic dystrophy 1 (DM1) is characterized by a wide range of clinical features. We aimed to verify the presence of peripheral nerve involvement in a large cohort of DM1 patients and to determine clinical consequences. A total of 93 patients underwent detailed neurological examination and nerve conduction studies. Additionally, balance impairment was assessed with the Berg Balance Scale and health status was evaluated with the SF-36 health survey. Sensory symptoms were not reported and mild sensory signs were found in six patients. Electrophysiological abnormalities consistent with a diagnosis of neuropathy were found in 16 patients (17%). Peripheral nerve involvement was significantly associated with decreased muscle strength (p = 0.001) and absence of Achilles-tendon reflexes (p = 0.003), but not with age or duration of neuromuscular symptoms. It had no significant effect on balance, mental or physical health. In conclusion, peripheral nerve involvement may be one of the multisystemic manifestations of DM1, but is usually subclinical. Other causes should be excluded when sensory symptoms or signs are severe.
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Affiliation(s)
- Mieke C E Hermans
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands.
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21
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Faber CG, Hoeijmakers JGJ, Ahn HS, Cheng X, Han C, Choi JS, Estacion M, Lauria G, Vanhoutte EK, Gerrits MM, Dib-Hajj S, Drenth JPH, Waxman SG, Merkies ISJ. Gain of function NaV1.7 mutations in idiopathic small fiber neuropathy. Ann Neurol 2011; 71:26-39. [DOI: 10.1002/ana.22485] [Citation(s) in RCA: 394] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 05/10/2011] [Accepted: 05/13/2011] [Indexed: 11/10/2022]
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van Nes SI, Vanhoutte EK, van Doorn PA, Hermans M, Bakkers M, Kuitwaard K, Faber CG, Merkies ISJ. Rasch-built Overall Disability Scale (R-ODS) for immune-mediated peripheral neuropathies. Neurology 2011; 76:337-45. [PMID: 21263135 DOI: 10.1212/wnl.0b013e318208824b] [Citation(s) in RCA: 236] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To develop a patient-based, linearly weighted scale that captures activity and social participation limitations in patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and gammopathy-related polyneuropathy (MGUSP). METHODS A preliminary Rasch-built Overall Disability Scale (R-ODS) containing 146 activity and participation items was constructed, based on the WHO International Classification of Functioning, Disability and Health, literature search, and patient interviews. The preliminary R-ODS was assessed twice (interval: 2-4 weeks; test-retest reliability studies) in 294 patients who experienced GBS in the past (n = 174) or currently have stable CIDP (n = 80) or MGUSP (n = 40). Data were analyzed using the Rasch unidimensional measurement model (RUMM2020). RESULTS The preliminary R-ODS did not meet the Rasch model expectations. Based on disordered thresholds, misfit statistics, item bias, and local dependency, items were systematically removed to improve the model fit, regularly controlling the class intervals and model statistics. Finally, we succeeded in constructing a 24-item scale that fulfilled all Rasch requirements. "Reading a newspaper/book" and "eating" were the 2 easiest items; "standing for hours" and "running" were the most difficult ones. Good validity and reliability were obtained. CONCLUSION The R-ODS is a linearly weighted scale that specifically captures activity and social participation limitations in patients with GBS, CIDP, and MGUSP. Compared to the Overall Disability Sum Score, the R-ODS represents a wider range of item difficulties, thereby better targeting patients with different ability levels. If responsive, the R-ODS will be valuable for future clinical trials and follow-up studies in these conditions.
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Affiliation(s)
- S I van Nes
- Department of Neurology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
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23
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van Nes SI, Vanhoutte EK, Faber CG, Garssen M, van Doorn PA, Merkies ISJ. Improving fatigue assessment in immune-mediated neuropathies: the modified Rasch-built fatigue severity scale. J Peripher Nerv Syst 2010; 14:268-78. [PMID: 20021568 DOI: 10.1111/j.1529-8027.2009.00238.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fatigue is a major disabling complaint in patients with immune-mediated neuropathies (IN). The 9-item fatigue severity scale (FSS) has been used to assess fatigue in these conditions, despite having limitations due to its classic ordinal construct. The aim was to improve fatigue assessment in IN through evaluation of the FSS using a modern clinimetric approach [Rasch unidimensional measurement model (RUMM2020)]. Included were 192 stable patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) or polyneuropathy associated with monoclonal gammopathy of undetermined significance (MGUSP). The obtained FSS data were exposed to RUMM2020 model to investigate whether this scale would meet its expectations. Also, reliability and validity studies were performed. The original FSS did not meet the Rasch model expectations, primarily based on two misfitting items, one of these also showing bias towards the factor 'walking independent.' After removing these two items and collapsing the original 7-point Likert options to 4-point response categories for the remaining items, we succeeded in constructing a 7-item Rasch-built scale that fulfilled all requirements of unidimensionality, linearity, and rating scale model. Good reliability and validity were also obtained for the modified FSS scale. In conclusion, a 7-item linearly weighted Rasch-built modified FSS is presented for more proper assessment of fatigue in future studies in patients with immune-mediated neuropathies.
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Affiliation(s)
- Sonja I van Nes
- Department of Neurology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands.
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24
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Vanhoutte EK, Faber CG, Merkies ISJ. [Statistical significance or clinical relevance?]. Ned Tijdschr Geneeskd 2010; 154:A2516. [PMID: 21176250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This article evaluates the concept of 'minimal clinically important difference' (MCID) through the results of two studies. The first study was a randomised trial in patients with Parkinson's disease claiming a positive effect of treatment with rasagiline over placebo, based on statistical differences in ordinal outcome measures. However, the clinical relevance of the findings according to the concept of MCID was not taken into consideration. In the second study, MCIDs were defined by several methods in a large trial in patients with chronic inflammatory demyelinating polyneuropathy receiving intravenous immunoglobulin (IGIV) or placebo. In that study, the differences in outcomes between the intervention group and the placebo group were not only statistically significant, but also clinically relevant, in favour of the intervention group. This was demonstrated using various MCID cut-off values.
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Affiliation(s)
- Els K Vanhoutte
- Maastricht Universitair Medisch Centrum, afd. Neurologie, Maastricht, the Netherlands.
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