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Okamoto K, Motoki T, Saito I, Urate R, Aibara K, Jogamoto T, Fukuda M, Wakamoto H, Maniwa S, Kondo Y, Toda Y, Goji A, Mori T, Soga T, Konishi Y, Nagai S, Takami Y, Tokorodani C, Nishiuchi R, Usui D, Ando R, Tada S, Yamanishi Y, Nagai M, Arakawa R, Saito K, Nishio H, Ishii E, Eguchi M. Survey of patients with spinal muscular atrophy on the island of Shikoku, Japan. Brain Dev 2020; 42:594-602. [PMID: 32505480 DOI: 10.1016/j.braindev.2020.05.004] [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: 11/12/2019] [Revised: 04/22/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is an inherited neuromuscular disorder associated with spinal motor neuron loss and characterized by generalized muscle weakness. Only a few reports exist on SMA epidemiology in Japan. Additionally, nusinersen recently became available as a treatment for this condition. We estimated the prevalence of each type of SMA on Shikoku, Japan's fourth-largest major island. METHODS We sent a questionnaire to all 131 hospitals in Shikoku that have pediatrics or neurology departments from March to September 2019, asking whether each hospital had SMA patients at that time. If so, we sent a second questionnaire to obtain more detailed information on the clinical data and treatment of each patient. RESULTS A total of 117 hospitals (89.3%) responded to our first questionnaire, and 21 SMA patients were reported, 16 of whom had homozygous deletion of SMN1. Of the 21, nine had SMA type 1, five were type 2, five were type 3, one was type 4, and one was unidentified. The estimated prevalence for all instances of SMA and 5q-SMA was 0.56 and 0.43 per 100,000 people, respectively. Thirteen patients had received nusinersen therapy. Its outcomes varied from no obvious effects and being unable to sit to being able to sit independently. CONCLUSION Our data showed the prevalence of SMA types 2 and 3 was relatively low on Shikoku compared with previous reports from other countries, suggesting delayed diagnosis may affect the results. Remaining motor function may be one predicting factor. Greater awareness of SMA among clinicians and patients seems necessary for more accurate epidemiological studies.
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Affiliation(s)
- Kentaro Okamoto
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Pediatrics, Ehime Prefectural Imabari Hospital, Ehime, Japan.
| | - Takahiro Motoki
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Risako Urate
- Faculty of Medicine, Ehime University, Ehime, Japan
| | - Kaori Aibara
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Toshihiro Jogamoto
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Mitsumasa Fukuda
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Hiroyuki Wakamoto
- Department of Pediatrics, Ehime Rehabilitation Center For Children, Ehime, Japan
| | - Satoshi Maniwa
- Department of Pediatrics, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Yoichi Kondo
- Department of Pediatrics, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Yoshihiro Toda
- Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Aya Goji
- Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Tatsuo Mori
- Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Tomohiro Soga
- Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan
| | - Yukihiko Konishi
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Shigehiro Nagai
- Department of Child Neurology, Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Yoko Takami
- Department of Pediatrics, Takamatsu Red Cross Hospital, Kagawa, Japan
| | - Chiho Tokorodani
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Daisuke Usui
- Department of Pediatrics, Tano Hospital, Kochi, Japan
| | - Rina Ando
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Satoshi Tada
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Yuki Yamanishi
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Masahiro Nagai
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Reiko Arakawa
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Kayoko Saito
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Hisahide Nishio
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Hyogo, Japan; Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Eiichi Ishii
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan; Imabari City Medical Association Hospital, Ehime, Japan
| | - Mariko Eguchi
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
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Okamoto K, Fukuda M, Saito I, Urate R, Maniwa S, Usui D, Motoki T, Jogamoto T, Aibara K, Hosokawa T, Konishi Y, Arakawa R, Mori K, Ishii E, Saito K, Nishio H. Incidence of infantile spinal muscular atrophy on Shikoku Island of Japan. Brain Dev 2019; 41:36-42. [PMID: 30093179 DOI: 10.1016/j.braindev.2018.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 06/08/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is an autosomal recessive disorder caused by homozygous mutations in the SMN1 gene. SMA has long been known to be the most common genetic cause of infant mortality. However, there have been no reports on the epidemiology of infantile SMA (types 1 and 2) based on genetic testing in Japan. In this study, we estimated the incidence of infantile SMA on Shikoku Island, which is a main island of Japan and consists of four prefectures: Ehime, Kagawa, Tokushima and Kochi. METHODS A questionnaire was sent to 91 hospitals on Shikoku Island to investigate the number of SMA infants born from 2011 to 2015. A second questionnaire was then sent to confirm the diagnoses of SMA based on clinical and genetic features. RESULTS Responses were received from all of the hospitals, and four patients were diagnosed with infantile SMA among 147,950 live births. We estimated the incidence of infantile SMA patients as 2.7 per 100,000 live births (95% confidence interval, 0.1-5.4). A comparison of the four prefectures indicated that the incidence of infantile SMA was significantly higher in Ehime Prefecture than in the other three prefectures; 5.6 per 100,000 live births (95% confidence interval, -0.7 to 11.9) in Ehime Prefecture and 1.1 per 100,000 live births (95% confidence interval, -1.0 to 3.1) in the other prefectures. CONCLUSION We estimated the incidence of infantile SMA in an isolated area of Japan. For more precise determination of the incidence of infantile SMA, further studies that include neonatal screening will be needed.
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Affiliation(s)
- Kentaro Okamoto
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Pediatrics, Ehime Prefectural Imabari Hospital, Ehime, Japan.
| | - Mitsumasa Fukuda
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Isao Saito
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Risako Urate
- School of Medicine, Ehime University, Ehime, Japan
| | - Satoshi Maniwa
- Department of Pediatrics, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Daisuke Usui
- Department of Pediatrics, Tano Hospital, Kochi, Japan
| | - Takahiro Motoki
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Toshihiro Jogamoto
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Kaori Aibara
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Takatoshi Hosokawa
- Department of Pediatrics, Hosogi Hospital, Kochi, Japan; Department of Pediatrics, Kochi Medical School, Kochi, Japan
| | - Yukihiko Konishi
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Reiko Arakawa
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenji Mori
- Department of Child Health & Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Eiichi Ishii
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Kayoko Saito
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Hisahide Nishio
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Hyogo, Japan; Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, Hyogo, Japan
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