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Richard M, Barrois R, Desguerre I, Deladrière E, Leloup-Germa V, Barnerias C, Gitiaux C. Correlations between clinical motor scores and CMAP in patients with type 2 spinal muscular amyotrophy treated with nusinersen. Arch Pediatr 2024; 31:26-31. [PMID: 37989659 DOI: 10.1016/j.arcped.2023.08.011] [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: 09/13/2022] [Revised: 04/23/2023] [Accepted: 08/21/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is a neuromuscular disorder characterized by the degeneration of the anterior horn cells of the spinal cord. Nusinersen for the treatment of SMA has been covered by public healthcare in France since May 2017. OBJECTIVE Our aim was to investigate whether there is a correlation between clinical and compound motor action potential (CMAP) measurements in SMA patients treated with nusinersen after 3 years' follow-up. METHOD Motor skills were evaluated regularly between M0 and M36 using the Motor Function Measure (MFM) score. CMAP measurements were collected regularly between M0 and M22. RESULTS Data for 10 patients with SMA type 2 were collected and divided into two age groups (< 5 years and > 5 years). Motor function improved, but not significantly, regarding distal motor skills (D3) in both groups, and in axial and proximal motor function (D2) in the younger group. CMAP measurements improved in all patients. CMAP increased significantly for the median nerve, and this improvement correlated significantly with global MFM and with axial and proximal tone (D2). CONCLUSION Our study shows gain in distal motor function with nusinersen, especially in younger patients with SMA type 2. These results encourage the screening of SMA patients and treatment as early as possible. CMAP measurements of the median nerve show clear improvement in patients treated with nusinersen and could be performed as routine follow-up.
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Affiliation(s)
- M Richard
- Centre de référence des pathologies neuromusculaires Paris-Nord-Est, AP-AH, Hôpital Necker Enfants Malades, Paris, France.
| | - R Barrois
- Centre de référence des pathologies neuromusculaires Paris-Nord-Est, AP-AH, Hôpital Necker Enfants Malades, Paris, France
| | - I Desguerre
- Centre de référence des pathologies neuromusculaires Paris-Nord-Est, AP-AH, Hôpital Necker Enfants Malades, Paris, France
| | - E Deladrière
- Centre de référence des pathologies neuromusculaires Paris-Nord-Est, AP-AH, Hôpital Necker Enfants Malades, Paris, France
| | - V Leloup-Germa
- Centre de référence des pathologies neuromusculaires Paris-Nord-Est, AP-AH, Hôpital Necker Enfants Malades, Paris, France
| | - C Barnerias
- Centre de référence des pathologies neuromusculaires Paris-Nord-Est, AP-AH, Hôpital Necker Enfants Malades, Paris, France
| | - C Gitiaux
- Centre de référence des pathologies neuromusculaires Paris-Nord-Est, AP-AH, Hôpital Necker Enfants Malades, Paris, France; Service d'explorations fonctionnelles, unité de Neurophysiologie Clinique, AP-HP, Hôpital Necker Enfants Malades, Paris, France
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Barrois R, Barnerias C, Deladrière E, Leloup-Germa V, Tervil B, Audic F, Boulay C, Cances C, Cintas P, Davion JB, Espil-Taris C, Manel V, Pereon Y, Piarroux J, Quijano Roy S, Vuillerot C, Walther-Louvier U, Desguerre I, Gitiaux C. A new score combining compound muscle action potential (CMAP) amplitudes and motor score is predictive of motor outcome after AVXS-101 (Onasemnogene Abeparvovec) SMA therapy. Neuromuscul Disord 2023; 33:309-314. [PMID: 36881951 DOI: 10.1016/j.nmd.2023.02.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/17/2023] [Accepted: 02/10/2023] [Indexed: 02/13/2023]
Abstract
Spinal muscular atrophy 1 (SMA1) is a severe early genetic disease with degeneration of motor neurons. Motor development is still suboptimal after gene replacement therapy in symptomatic patients. In this study, compound muscle action potential (CMAP) amplitudes were explored as predictors of motor recovery after gene therapy. Thirteen symptomatic SMA1 patients were prospectively included at the Necker Enfants Malades Hospital, Paris, France (Cohort 1) and 12 at the other pediatric neuromuscular reference centers of the French Filnemus network (Cohort 2). In Cohort 1, median CMAP amplitudes showed the best improvement between baseline and the 12 months visit compared to the other tested nerves (ulnar, fibular and tibial). High median CMAP amplitudes at baseline was associated with unaided sitting achievement at M6 (AUC 90%). None of the patients with CHOPINTEND at M0 < 30/64 and median CMAP < 0.5 mV achieved unaided sitting at M6 and this result was confirmed on Cohort 2 used as an independent validation data. Thus, median CMAP amplitude is a valid biomarker for routine practice to predict sitting at M6. A median CMAP amplitude over 0.5 mV at baseline may predict better motor recovery.
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Affiliation(s)
- R Barrois
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, AP-HP, Hôpital Necker Enfants Malades, Université Paris-Cité, Paris, France; Centre Borelli - UMR 9010 Centre Borelli, Gif-sur-Yvette 91190, France.
| | - C Barnerias
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, AP-HP, Hôpital Necker Enfants Malades, Université Paris-Cité, Paris, France
| | - E Deladrière
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, AP-HP, Hôpital Necker Enfants Malades, Université Paris-Cité, Paris, France
| | - V Leloup-Germa
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, AP-HP, Hôpital Necker Enfants Malades, Université Paris-Cité, Paris, France
| | - B Tervil
- Centre Borelli - UMR 9010 Centre Borelli, Gif-sur-Yvette 91190, France
| | - F Audic
- Centre de Référence des Maladies Neuromusculaires, Service de Neuropédiatrie, Hôpital Timone Enfants, Marseille, France
| | - C Boulay
- Centre de Référence des Maladies Neuromusculaires, Service de Neuropédiatrie, Hôpital Timone Enfants, Marseille, France
| | - C Cances
- Unité d'explorations neurophysiologiques, Département de neurologie, CHU de Toulouse - Hôpital Pierre-Paul Riquet, Toulouse, France
| | - P Cintas
- Unité d'explorations neurophysiologiques, Département de neurologie, CHU de Toulouse - Hôpital Pierre-Paul Riquet, Toulouse, France
| | - J B Davion
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Service de Neuropédiatrie, Hôpital Salengro CHU Lille, Lille, France
| | - C Espil-Taris
- Centre de référence Maladies neuromusculaires AOC, Neurologie pédiatrique, CHU de Bordeaux, Bordeaux, France
| | - V Manel
- Service de neurologie pédiatrique, Hôpital Femme Mère Enfant, Lyon, France
| | - Y Pereon
- Centre de Référence des Maladies Neuromusculaires Atlantique Occitanie Caraïbes, Filnemus, Euro-NMD, Explorations Fonctionnelles, CHU Nantes, Nantes, France
| | - J Piarroux
- Service de neuropédiatrie, Pôle Femme Mère Enfant, CHU de Montpellier - Hôpital Gui de Chauliac, Montpellier, France
| | - S Quijano Roy
- Centre de Références des Maladies Neuromusculaires, Service de Neurologie Pédiatrique et Réanimation, Hôpital Raymond Poincaré, AP-HP Université Paris Saclay (UVSQ), Garches, France
| | - C Vuillerot
- Service de Médecine physique et réadaptation pédiatriques, Hôpital Femme Mère Enfant, Lyon, France
| | - U Walther-Louvier
- Centre de Référence des Maladies Neuromusculaires, Hôpital Gui de Chauliac, CHU Montpellier, Montpellier, France
| | - I Desguerre
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, AP-HP, Hôpital Necker Enfants Malades, Université Paris-Cité, Paris, France; Université Paris Cité, IHU Imagine, Paris F-75015, France
| | - C Gitiaux
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, AP-HP, Hôpital Necker Enfants Malades, Université Paris-Cité, Paris, France; Service d'explorations Fonctionnelles, unité de Neurophysiologie Clinique, AP-HP, Hôpital Necker Enfants Malades, Paris, France
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