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Ivanovic V, Bjelica B, Palibrk A, Brankovic M, Bozovic I, Basta I, Savic A, Stojanovic VR, Kacar A. Physical and Mental Aspects of Quality of Life in Patients With Charcot-Marie-Tooth Disease Type 1A. Front Neurol 2022; 13:852150. [PMID: 35370888 PMCID: PMC8966677 DOI: 10.3389/fneur.2022.852150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/10/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Charcot-Marie-Tooth type 1A (CMT1A) comprises ~50% of all CMT cases. CMT1A is a slowly progressive motor and sensory neuropathy that leads to significant disability. We aimed to investigate the quality of life (QoL) in Serbian patients with CMT1A and to assess sociodemographic and clinical features associated with their QoL. Material and Methods Forty-five genetically confirmed patients with CMT1A were included −60% women [age 50.4 ± 12.6 years, disease duration 22 (12.5–31.5) years]. SF-36, Medical Research Council (MRC) Sum Score, CMT Examination Score (CMTES), Overall Neuropathy Limitation Scale (ONLS), Beck Depression Inventory (BDI), and Krupp's Fatigue Severity Scale (FSS) were used in the study. Results Regarding SF-36, Mental Health and Social Functioning were the scales with the best achievements, whereas Role Physical was the worst domain. Worse QoL in patients with CMT1A was associated with elder age (rho = −0.34, p < 0.05), longer disease duration (rho = −0.31, p < 0.05), more pronounced muscle weakness measured by MRC-SS (rho = 0.43, p < 0.01), presence of tremor (p < 0.05), worse CMTES (rho = −0.68, p < 0.01), more severe disability in upper (rho = −0.70, p < 0.01) and lower limbs (rho = −0.61, p < 0.01) measured by ONLS scores, use of walking aids (p < 0.01), and with depression (p < 0.01) and fatigue (p < 0.01). Worse scores on CMTES (beta = −0.43, p < 0.01), BDI (beta = −0.39, p < 0.01), and FSS (beta = −0.36, p < 0.01) were significant independent predictors of worse QoL in patients with CMT1A (adjusted R2 = 0.77, p < 0.001). Conclusion Besides impairment made directly by CMT1A itself, QoL in these patients was also strongly affected by the presence of depression and fatigue. Since CMT1A is still not a curable disease, it is of interest to identify factors associated with QoL that are amenable to treatment.
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Affiliation(s)
- Vukan Ivanovic
- Department of Neurology Clinic, Faculty of Medicine, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Bogdan Bjelica
- Department of Neurology, Hanover Medical School, Hanover, Germany
| | - Aleksa Palibrk
- Department of Neurology Clinic, Faculty of Medicine, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Marija Brankovic
- Department of Neurology Clinic, Faculty of Medicine, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Ivo Bozovic
- Department of Neurology Clinic, Faculty of Medicine, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Ivana Basta
- Department of Neurology Clinic, Faculty of Medicine, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Andrija Savic
- Department of Neurosurgery Clinic, Faculty of Medicine, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Vidosava Rakocevic Stojanovic
- Department of Neurology Clinic, Faculty of Medicine, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Kacar
- Department of Neurology Clinic, Faculty of Medicine, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
- *Correspondence: Aleksandra Kacar
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Johnson K, De Ridder W, Töpf A, Bertoli M, Phillips L, De Jonghe P, Baets J, Deconinck T, Rakocevic Stojanovic V, Perić S, Durmus H, Jamal-Omidi S, Nafissi S, Mongini T, Łusakowska A, Busby M, Miller J, Norwood F, Hudson J, Barresi R, Lek M, MacArthur DG, Straub V. Extending the clinical and mutational spectrum of TRIM32-related myopathies in a non-Hutterite population. J Neurol Neurosurg Psychiatry 2019; 90:490-493. [PMID: 29921608 PMCID: PMC6581110 DOI: 10.1136/jnnp-2018-318288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/24/2018] [Accepted: 05/29/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Katherine Johnson
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Willem De Ridder
- Neurogenetics Group, Center for Molecular Neurology, VIB, Antwerp, Belgium.,Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Ana Töpf
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Marta Bertoli
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Lauren Phillips
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Peter De Jonghe
- Neurogenetics Group, Center for Molecular Neurology, VIB, Antwerp, Belgium.,Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Jonathan Baets
- Neurogenetics Group, Center for Molecular Neurology, VIB, Antwerp, Belgium.,Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Tine Deconinck
- Neurogenetics Group, Center for Molecular Neurology, VIB, Antwerp, Belgium.,Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | | | - Stojan Perić
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Hacer Durmus
- Department of Neurology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Shirin Jamal-Omidi
- Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Nafissi
- Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Tiziana Mongini
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
| | - Anna Łusakowska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Mark Busby
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - James Miller
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Judith Hudson
- Northern Molecular Genetics Service, Biomedicine East Wing, Newcastle upon Tyne, UK
| | - Rita Barresi
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.,Muscle Immunoanalysis Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Monkol Lek
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Daniel G MacArthur
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
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Johnson K, Töpf A, Bertoli M, Phillips L, Claeys KG, Stojanovic VR, Perić S, Hahn A, Maddison P, Akay E, Bastian AE, Łusakowska A, Kostera-Pruszczyk A, Lek M, Xu L, MacArthur DG, Straub V. Identification of GAA variants through whole exome sequencing targeted to a cohort of 606 patients with unexplained limb-girdle muscle weakness. Orphanet J Rare Dis 2017; 12:173. [PMID: 29149851 PMCID: PMC5693551 DOI: 10.1186/s13023-017-0722-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 06/12/2017] [Accepted: 11/06/2017] [Indexed: 12/30/2022] Open
Abstract
Background Late-onset Pompe disease is a rare genetic neuromuscular disorder caused by a primary deficiency of α-glucosidase and the associated accumulation of glycogen in lysosomal vacuoles. The deficiency of α-glucosidase can often be detected using an inexpensive and readily accessible dried blood spot test when Pompe disease is suspected. Like several neuromuscular disorders, Pompe disease typically presents with progressive weakness of limb-girdle muscles and respiratory insufficiency. Due to the phenotypic heterogeneity of these disorders, however, it is often difficult for clinicians to reach a diagnosis for patients with Pompe disease. Six hundred and six patients from a European population were recruited onto our study. Inclusion criteria stipulated that index cases must present with limb-girdle weakness or elevated serum creatine kinase activity. Whole exome sequencing with at least 250 ng DNA was completed using an Illumina exome capture and a 38 Mb baited target. A panel of 169 candidate genes for limb-girdle weakness was analysed for disease-causing variants. Results A total of 35 variants within GAA were detected. Ten distinct variants in eight unrelated index cases (and four siblings not sequenced in our study) were considered disease-causing, with the patients presenting with heterogeneous phenotypes. The eight unrelated individuals were compound heterozygotes for two variants. Six patients carried the intronic splice site c.-13 T > G transversion and two of the six patients also carried the exonic p.Glu176ArgfsTer45 frameshift. Four of the ten variants were novel in their association with Pompe disease. Conclusions Here, we highlight the advantage of using whole exome sequencing as a tool for detecting, diagnosing and treating patients with rare, clinically variable genetic disorders.
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Affiliation(s)
- Katherine Johnson
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - Ana Töpf
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - Marta Bertoli
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - Lauren Phillips
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - Kristl G Claeys
- Department of Neurology and Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Laboratory for Muscle Diseases and Neuropathies, Research Group Experimental Neurology, Department of Neurosciences, KU Leuven (University of Leuven), Leuven, Belgium
| | | | - Stojan Perić
- Neurology Clinic CCS, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Andreas Hahn
- Department of Child Neurology, Justus-Liebig University, Gießen, Germany
| | | | - Ela Akay
- Queen's Medical Centre, Nottingham, UK
| | - Alexandra E Bastian
- Clinical Hospital Colentina, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Anna Łusakowska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | - Monkol Lek
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Liwen Xu
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Daniel G MacArthur
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.
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Paunic T, Peric S, Cvitan E, Raspopovic S, Peric M, Mandic Stojmenovic G, Rakocevic Stojanovic V. Reply. J Chin Med Assoc 2017; 80:742-743. [PMID: 28951122 DOI: 10.1016/j.jcma.2017.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/24/2017] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Stojan Peric
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Edita Cvitan
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Srdjan Raspopovic
- Cardiology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marina Peric
- Mother and Child Health Care Institute, Belgrade, Serbia
| | - Gorana Mandic Stojmenovic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
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Paunic T, Peric S, Cvitan E, Raspopovic S, Peric M, Mandic Stojmenovic G, Rakocevic Stojanovic V. Routine echocardiography in patients with myotonic dystrophy type 1. J Chin Med Assoc 2017; 80:408-412. [PMID: 28601625 DOI: 10.1016/j.jcma.2017.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 12/07/2016] [Accepted: 01/11/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Myotonic dystrophy type 1 (DM1) is an autosomal-dominant disease. One third of DM1 patients die suddenly, most of them due to the heart conduction abnormalities and arrhythmias. The aim of this study was to analyze echocardiographic findings in a large cohort of DM1 patients. METHODS This retrospective study comprised 111 patients and 71 healthy controls (HCs) matched for gender and age. RESULTS Mitral valve (MV) prolapse was observed in 23% of our DM1 patients vs. 8.5% of HCs (p < 0.05). Left ventricle (LV) systolic dysfunction was observed in 6% of patients and none of the HCs (p < 0.05). Frequency of diastolic dysfunction showed no significant difference between DM1 patients and HCs (8.1% vs. 15.5%, p > 0.05). Systolic dysfunction was more common in patients with severe electrocardiographic (ECG) abnormality (18.8% vs. 2.7%, p < 0.01). CONCLUSION One fourth of DM1 patients have MV prolapse. Approximately 15% of DM1 patients have systolic or diastolic LV dysfunction. These patients should have benefit from medical therapy. Furthermore, it seems that treatment of conduction defects might prevent development of the heart failure (HF).
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Affiliation(s)
| | - Stojan Peric
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Edita Cvitan
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Srdjan Raspopovic
- Cardiology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marina Peric
- Mother and Child Health Care Institute, Belgrade, Serbia
| | - Gorana Mandic Stojmenovic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
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Peric S, Brajkovic L, Belanovic B, Ilic V, Salak-Djokic B, Basta I, Rakocevic Stojanovic V. Brain positron emission tomography in patients with myotonic dystrophy type 1 and type 2. J Neurol Sci 2017; 378:187-192. [DOI: 10.1016/j.jns.2017.05.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 04/24/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022]
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Peric S, Rakocevic Stojanovic V, Mandic Stojmenovic G, Ilic V, Kovacevic M, Parojcic A, Pesovic J, Mijajlovic M, Savic-Pavicevic D, Meola G. Clusters of cognitive impairment among different phenotypes of myotonic dystrophy type 1 and type 2. Neurol Sci 2016; 38:415-423. [DOI: 10.1007/s10072-016-2778-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/18/2016] [Indexed: 11/30/2022]
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Nikolic A, Basta I, Stojanovic VR, Stevic Z, Peric S, Lavrnic D. Myopathic changes detected by quantitative electromyography in patients with MuSK and AChR positive myasthenia gravis. J Clin Neurosci 2016; 27:126-9. [PMID: 26778359 DOI: 10.1016/j.jocn.2015.08.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 03/04/2015] [Revised: 07/10/2015] [Accepted: 08/30/2015] [Indexed: 11/17/2022]
Abstract
Myopathic changes are frequent a electrophysiological finding in patients with muscle specific tyrosine kinase (MuSK) positive myasthenia gravis (MG). The aim of this study was to explore the importance of quantitative electromyography (EMG) in the detection of myopathic changes in MuSK MG patients. Classical and quantitative EMG were performed in 31 MuSK and 28 acetylcholine receptor (AChR) positive MG patients, matched by sex, age, disease duration and severity. Classical EMG revealed the presence of myopathic changes more frequently in MuSK MG compared to AChR MG patients, especially in the facial muscles. Quantitative EMG registered myopathic lesions more frequently than classical EMG, but the frequency was similar between MuSK and AChR MG patients. Quantitative EMG revealed myopathic changes in the majority of both MuSK and AChR positive MG patients. This examination is sensitive, but it cannot be used to differentiate between MG patients belonging to the different disease groups. It should not be used in isolation. Rather, it should complement classical EMG in the detection of myopathic changes.
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Affiliation(s)
- Ana Nikolic
- Neurology Clinic, Department for Neuromuscular Disorders, Clinical Center of Serbia, Dr Subotica 6, 11000 Belgrade, Serbia; Medical Faculty, Belgrade University, Belgrade, Serbia.
| | - Ivana Basta
- Neurology Clinic, Department for Neuromuscular Disorders, Clinical Center of Serbia, Dr Subotica 6, 11000 Belgrade, Serbia; Medical Faculty, Belgrade University, Belgrade, Serbia
| | - Vidosava Rakocevic Stojanovic
- Neurology Clinic, Department for Neuromuscular Disorders, Clinical Center of Serbia, Dr Subotica 6, 11000 Belgrade, Serbia; Medical Faculty, Belgrade University, Belgrade, Serbia
| | - Zorica Stevic
- Neurology Clinic, Department for Neuromuscular Disorders, Clinical Center of Serbia, Dr Subotica 6, 11000 Belgrade, Serbia; Medical Faculty, Belgrade University, Belgrade, Serbia
| | - Stojan Peric
- Neurology Clinic, Department for Neuromuscular Disorders, Clinical Center of Serbia, Dr Subotica 6, 11000 Belgrade, Serbia
| | - Dragana Lavrnic
- Neurology Clinic, Department for Neuromuscular Disorders, Clinical Center of Serbia, Dr Subotica 6, 11000 Belgrade, Serbia; Medical Faculty, Belgrade University, Belgrade, Serbia
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Peric S, Pavlovic A, Ralic V, Dobricic V, Basta I, Lavrnic D, Rakocevic Stojanovic V. Transcranial sonography in patients with myotonic dystrophy type 1. Muscle Nerve 2014; 50:278-82. [PMID: 24395217 DOI: 10.1002/mus.24162] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 04/02/2013] [Revised: 12/16/2013] [Accepted: 12/31/2013] [Indexed: 12/16/2022]
Abstract
INTRODUCTION In this study we analyzed transcranial sonography (TCS) in patients with myotonic dystrophy type 1 (DM1). METHODS This cross-sectional study included 66 DM1 patients and 55 matched healthy controls (HCs). Echogenicity of the brainstem raphe (BR) and substantia nigra (SN) and third ventricle width (DTV) were assessed by TCS. RESULTS BR hypoechogenicity was more common in DM1 patients than in HCs (37.7% vs. 7.8%, P < 0.01). Patients with depression or fatigue were more likely to have BR hypoechogenicity (80.0% vs. 29.4%, P < 0.01 and 51.9% vs. 24.2%, P < 0.05, respectively). Both hypoechogenicity and hyperechogenicity of SN were more frequent in DM1 patients than in controls (26.2% vs. 10.9% and 13.1% vs. 1.8%, respectively, P < 0.01). DTV was increased in DM1 patients compared with HCs (6.0 ± 1.4 vs. 4.9 ± 0.9 mm, P < 0.01). CONCLUSION TCS can offer new insight into structural changes of several cerebral areas in patients with DM1.
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Affiliation(s)
- Stojan Peric
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, 6 Dr Subotica Street, 11000, Belgrade, Serbia
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Nikolic A, Basta I, Stojanovic VR, Stevic Z, Lavrnic D. Electrophysiological profile of the patients with MuSK positive myasthenia gravis. Neurol Res 2014; 36:945-9. [DOI: 10.1179/1743132814y.0000000387] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Peric S, Stojanovic VR, Nikolic A, Kacar A, Basta I, Pavlovic S, Lavrnic D. Peripheral neuropathy in patients with myotonic dystrophy type 1. Neurol Res 2013; 35:331-5. [DOI: 10.1179/1743132812y.0000000144] [Citation(s) in RCA: 16] [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] [Indexed: 10/31/2022]
Affiliation(s)
- Stojan Peric
- Neurology ClinicClinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Ana Nikolic
- Neurology ClinicClinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Kacar
- Neurology ClinicClinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Basta
- Neurology ClinicClinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sanja Pavlovic
- Neurology ClinicClinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dragana Lavrnic
- Neurology ClinicClinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
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Stojanovic VR, Peric S, Paunic T, Pavlovic S, Cvitan E, Basta I, Peric M, Milicev M, Lavrnic D. Cardiologic predictors of sudden death in patients with myotonic dystrophy type 1. J Clin Neurosci 2013; 20:1002-6. [DOI: 10.1016/j.jocn.2012.09.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Revised: 09/19/2012] [Accepted: 09/29/2012] [Indexed: 11/16/2022]
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Nikolic A, Rakocevic Stojanovic V, Romac S, Savic D, Basta I, Lavrnic D. The coexistence of myasthenia gravis and myotonic dystrophy type 2 in a single patient. J Clin Neurol 2013; 9:130-2. [PMID: 23626652 PMCID: PMC3633191 DOI: 10.3988/jcn.2013.9.2.130] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 12/17/2011] [Revised: 02/14/2012] [Accepted: 02/14/2012] [Indexed: 12/03/2022] Open
Abstract
Background Myasthenia gravis (MG) and myotonic dystrophy type 2 (DM2) are rare disorders individually, and their coexistence in the same patient is very rare. We present a patient in which these two diseases coexisted. Case Report The patient complained of diplopia, fluctuating limb weakness, and difficulties in swallowing and speaking. A neurological examination revealed diplopia, facial, weakness of the neck and proximal limb muscles, dysphagia, dysphonia, and myotonia. The patient's mother had DM2 and her maternal grandfather had cataracts. MG was confirmed in our patient by positive results for neostigmine and a repetitive nerve stimulation test, and elevated serum anti-acetylcholine-receptor antibodies, while DM2 was confirmed by electromyography and genetic testing. The patient improved remarkably after treatment with anticholinesterases, corticosteroids, and azathioprine. Conclusions This is the second reported case of the coexistence of DM2 and MG in the same patient. Since the symptoms of these two diseases overlap it is very important to keep in mind the possibility of their coexistence, so that MG is not overlooked in patients with a family history of myotonic dystrophy.
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Affiliation(s)
- Ana Nikolic
- Neurology Clinic, Department for Neuromuscular Disorders, Clinical Center of Serbia, Belgrade, Serbia
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Dedic SIK, Stevic Z, Dedic V, Stojanovic VR, Milicev M, Lavrnic D. Is hyperlipidemia correlated with longer survival in patients with amyotrophic lateral sclerosis? Neurol Res 2012; 34:576-80. [PMID: 22732100 DOI: 10.1179/1743132812y.0000000049] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is the most serious form of degenerative motor neuron disease in adults, whose relentless course leads to death within 2-5 years, generally due to respiratory failure. Apart from the age and site of onset, no other factors have consistently demonstrated to be related to the ALS outcome. The aim of the study was to investigate the influence of fasting serum lipid levels (cholesterol and triglycerides) and the body mass index (BMI) at the time of diagnosis on survival in ALS patients. The study included 82 patients with ALS residing in the Belgrade area who were diagnosed with ALS over a time period of 4 years (2006-2009). Survival was assessed by the Kaplan-Meier method. In this retrospective study, 39 (47.56%) patients had normal values of lipids and 43 (52.43%) patients had hyperlipidemia. The mean survival time from the onset of symptoms for patients with normal lipidemia was 4.21 ± 0.5 years, while the mean survival time from the onset of symptoms for patients with hyperlipidemia was 5.0 ± 0.67 years (P = 0.36). We also did not register a significant difference in survival in relation to gender, the site or age of onset, even though we noticed a longer survival in patients with hyperlipidemia in all of the examined groups, especially in the group of younger patients, with the onset of the disease before the age of 45 years. If we take into account the fact that BMI is pathophysiologically associated with cholesterol and triglyceride serum levels, the results in our study complement each other showing that patients with a higher BMI, registered in 28.8% of the cases, do not live longer. Our findings show that hyperlipidemia, which we found in 52.43% of our ALS patients, at the time of diagnosis, is not related to significantly longer survival.
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