1
|
Vill K, Sehri M, Müller C, Hannibal I, Huf V, Idriess M, Gerstl L, Bonfert MV, Tacke M, Schroeder AS, Landgraf MN, Müller-Felber W, Blaschek A. Qualitative and quantitative muscle ultrasound in patients with Duchenne muscular dystrophy: Where do sonographic changes begin? Eur J Paediatr Neurol 2020; 28:142-150. [PMID: 32758414 DOI: 10.1016/j.ejpn.2020.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 05/19/2020] [Accepted: 06/04/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The number of studies investigating and understanding the disease mechanisms of Duchenne muscular dystrophy (DMD) in human clinical trials have increased substantially over the last decade. Suitable clinical instruments for the measurement of disease progress and drug efficiency are mandatory, but currently not available, especially in the youngest patients. The aim of this study was to detect a reproducible pattern of muscle involvement in early stages potentially preceding evidence of motor regression. MATERIAL AND METHODS A cohort of 25 DMD patients aged 1-6 years at the first presentation were examined at multiple timepoints and compared with age-matched healthy controls. Muscle ultrasound was quantified using computer-analyzed gray scale levels (GSL) and blinded visual rating, using a modified Heckmatt scale. RESULTS Changes in muscle echogenicity in DMD patients occurred very early, clearly preceding motor regression and in some cases, even before the motor plateau phase was reached. Visual rating and GSL identified the earliest changes in the proximal adductor magnus muscle. CONCLUSION Muscle ultrasound can be used as an additional method to assess the disease progression and for decision-making in paucisymptomatic DMD patients. Sonographic changes in the ad-ductor magnus muscle seem to be the first detectable changes with a recognisable pattern.
Collapse
Affiliation(s)
- K Vill
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany.
| | - M Sehri
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - C Müller
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - I Hannibal
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - V Huf
- Department of Radiology, University Medical Center Regensburg, Germany.
| | - M Idriess
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - L Gerstl
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - M V Bonfert
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - M Tacke
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - A S Schroeder
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - M N Landgraf
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - W Müller-Felber
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - A Blaschek
- LMU Munich, University Hospital, Dr. von Hauner Children's Hospital, Department of Pediatrics, Disvision of Pediatric Neurology and Developmental Medicine, Munich, Germany
| |
Collapse
|
2
|
Landgraf MN, König H, Hannibal I, Langhagen T, Bonfert MV, Klose B, Rahmsdorf B, Giese RM, Straube A, von Kries R, Albers L, Ebinger F, Ertl-Wagner B, Kammer B, Körte I, Sollmann N, Krieg S, Heinen F. Migräne im Kindes- und Jugendalter – Gehirn und Muskel? Nervenarzt 2017; 88:1402-1410. [DOI: 10.1007/s00115-017-0428-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|