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Donlevy GA, Cornett KMD, Garnett SP, Shy R, Estilow T, Yum SW, Anderson K, Pareyson D, Moroni I, Muntoni F, Reilly MM, Finkel RS, Herrmann DN, Eichinger KJ, Shy ME, Burns J, Menezes MP. Association of Body Mass Index With Disease Progression in Children With Charcot-Marie-Tooth Disease. Neurology 2023; 101:e717-e727. [PMID: 37380432 PMCID: PMC10437011 DOI: 10.1212/wnl.0000000000207488] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 04/20/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to evaluate the impact of body mass index (BMI) on disease progression over 2 years in children with Charcot-Marie-Tooth disease (CMT). METHODS BMI was classified in 242 participants aged 3-20 years with CMT enrolled in the Inherited Neuropathy Consortium, using the International Obesity Task Force (based on adult BMI values, kg/m2) criteria. Groups were categorized as severely underweight (BMI <17 kg/m2), underweight (BMI ≥17 to <18.5 kg/m2), healthy weight (BMI ≥18.5 to <25 kg/m2), overweight (BMI ≥25 to <30 kg/m2), and obese (BMI ≥30 kg/m2). Disease severity was assessed using the CMT Pediatric Scale (CMTPedS), a clinical outcome assessment of disability (0-44 points, mild to severe). RESULTS At baseline, compared with individuals being of a healthy weight (mean CMTPedS 15.48, SD 9.22), children who were severely underweight (mean CMTPedS difference 9.03, 95% CI 0.94-17.12; p = 0.02), underweight (mean CMTPedS difference 5.97, 95% CI 0.62-11.31; p = 0.02), or obese (mean CMTPedS difference 7.96, 95% CI 1.03-14.88; p = 0.015) exhibited greater disability. At 2 years, compared with individuals being of a healthy weight (mean CMTPedS 17.53, SD 9.41), children who were severely underweight exhibited greater disability (mean CMTPedS difference 9.27, 95% CI 0.90-17.64; p = 0.02). Over the 2-year periods, the mean CMTPedS for the whole sample deteriorated by 1.72 points (95% CI 1.09-2.38; p < 0.001), with severely underweight children progressing at the fastest rate (mean CMTPedS change of 2.3, 95% CI 1.53-6.13; p = 0.21). In children who did not have a change in BMI categories over 2 years (69% of sample), CMTPedS scores deteriorated faster in those who were severely underweight (mean CMTPedS change 6.40 points, 95% CI 2.42-10.38; p = 0.01) than those of healthy weight (mean CMTPedS change 1.79 points, 95% CI 0.93-2.69; p < 0.001). For children who changed BMI categories (31% of sample), CMTPedS scores deteriorated faster in children who became overweight/obese (mean CMTPedS change 2.76 points, 95% CI 0.11-5.41; p = 0.031). DISCUSSION Children with CMT who were severely underweight, underweight, or obese exhibited greater disability at baseline. Over the 2-year period in those whose BMI remained stable, severely underweight children deteriorated at the fastest rate. For children who changed BMI categories over the 2 years, CMTPedS scores deteriorated faster in children who became overweight/obese. Interventions that maintain or improve BMI toward healthy weight may reduce disability in children with CMT.
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Affiliation(s)
- Gabrielle A Donlevy
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY.
| | - Kayla M D Cornett
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Sarah P Garnett
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Rosemary Shy
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Timothy Estilow
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Sabrina W Yum
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Kimberly Anderson
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Davide Pareyson
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Isabella Moroni
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Francesco Muntoni
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Mary M Reilly
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Richard S Finkel
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - David N Herrmann
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Katy J Eichinger
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Michael E Shy
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Joshua Burns
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
| | - Manoj P Menezes
- From the Faculty of Medicine and Health & Children's Hospital at Westmead (G.A.D., K.M.D.C., S.P.G., J.B., M.P.M.), University of Sydney, Australia; Department of Neurology (R.S., M.E.S.), and Department of Pediatrics (T.E., S.W.Y.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (T.E., S.W.Y.), The Children's Hospital of Philadelphia, PA; Department of Neurology (T.E., S.W.Y.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Occupational Therapy (K.A.), Children's Hospital of Philadelphia, PA; Fondazione IRCCS (D.P., I.M.), Istituto Neurologico Carlo Besta, Milan, Italy; University College London Institute of Child Health & Great Ormond Street Hospital (F.M.); Department of Neuromuscular Diseases (M.M.R.), University College London Institute of Neurology, Queen Square, United Kingdom; Center for Experimental Neurotherapeutics (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (D.N.H., K.J.E.), University of Rochester, NY
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Fridman V, Sillau S, Bockhorst J, Smith K, Moroni I, Pagliano E, Pisciotta C, Piscosquito G, Laurá M, Muntoni F, Bacon C, Feely S, Grider T, Gutmann L, Shy R, Wilcox J, Herrmann DN, Li J, Ramchandren S, Sumner CJ, Lloyd TE, Day J, Siskind CE, Yum SW, Sadjadi R, Finkel RS, Scherer SS, Pareyson D, Reilly MM, Shy ME. Disease Progression in Charcot-Marie-Tooth Disease Related to MPZ Mutations: A Longitudinal Study. Ann Neurol 2023; 93:563-576. [PMID: 36203352 PMCID: PMC9977145 DOI: 10.1002/ana.26518] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 06/13/2022] [Revised: 08/29/2022] [Accepted: 09/23/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The paucity of longitudinal natural history studies in MPZ neuropathy remains a barrier to clinical trials. We have completed a longitudinal natural history study in patients with MPZ neuropathies across 13 sites of the Inherited Neuropathies Consortium. METHODS Change in Charcot-Marie-Tooth Examination Score (CMTES) and Rasch modified CMTES (CMTES-R) were evaluated using longitudinal regression over a 5-year period in subjects with MPZ neuropathy. Data from 139 patients with MPZ neuropathy were examined. RESULTS The average baseline CMTES and CMTES-R were 10.84 (standard deviation [SD] = 6.0, range = 0-28) and 14.60 (SD = 7.56, range = 0-32), respectively. A mixed regression model showed significant change in CMTES at years 2-5 (mean change from baseline of 0.87 points at 2 years, p = 0.008). Subgroup analysis revealed greater change in CMTES at 2 years in subjects with axonal as compared to demyelinating neuropathy (mean change of 1.30 points [p = 0.016] vs 0.06 points [p = 0.889]). Patients with a moderate baseline neuropathy severity also showed more notable change, by estimate, than those with mild or severe neuropathy (mean 2-year change of 1.14 for baseline CMTES 8-14 [p = 0.025] vs -0.03 for baseline CMTES 0-7 [p = 0.958] and 0.25 for baseline CMTES ≥ 15 [p = 0.6897]). The progression in patients harboring specific MPZ mutations was highly variable. INTERPRETATION CMTES is sensitive to change over time in adult patients with axonal but not demyelinating forms of MPZ neuropathy. Change in CMTES was greatest in patients with moderate baseline disease severity. These findings will inform future clinical trials of MPZ neuropathies. ANN NEUROL 2023;93:563-576.
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Affiliation(s)
- Vera Fridman
- Department of Neurology, University of Colorado Denver, Aurora, Colorado, USA
| | - Stefan Sillau
- Department of Neurology, University of Colorado Denver, Aurora, Colorado, USA
| | - Jacob Bockhorst
- Department of Neurology, University of Colorado Denver, Aurora, Colorado, USA
| | - Kaitlin Smith
- Department of Neurology, University of Colorado Denver, Aurora, Colorado, USA
| | - Isabella Moroni
- Department of Child Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Emanuela Pagliano
- Department of Child Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pisciotta
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Guiseppe Piscosquito
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Istituti Clinici Scientifici Maugeri, Neurorehabilitation Unit, Scientific Institute of Telese Terme (BN), Italy
| | - Matilde Laurá
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Chelsea Bacon
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Shawna Feely
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Tiffany Grider
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Laurie Gutmann
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Rosemary Shy
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Janel Wilcox
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - David N. Herrmann
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Jun Li
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
- Department of Neurology, Vanderbilt University, Nashville, Tennessee, USA
| | - Sindhu Ramchandren
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- PRA Health Sciences, Raleigh, North Carolina, USA
| | - Charlotte J. Sumner
- Departments of Neurology and Neuroscience, John Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thomas E. Lloyd
- Departments of Neurology and Neuroscience, John Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John Day
- Department of Neurology, Stanford University, Stanford, California, USA
| | - Carly E. Siskind
- Department of Neurology, Stanford University, Stanford, California, USA
| | - Sabrina W. Yum
- Department of Neurology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Reza Sadjadi
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Richard S. Finkel
- Department of Neurology, Nemours Children’s Hospital, Orlando, Florida, USA
| | - Steven S. Scherer
- Department of Neurology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Davide Pareyson
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mary M Reilly
- Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Michael E. Shy
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
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Zuccarino R, Prada V, Moroni I, Pagliano E, Foscan M, Robbiano G, Pisciotta C, Cornett K, Shy R, Schenone A, Pareyson D, Shy M, Burns J. Validation of the Italian version of the Charcot-Marie-Tooth disease Pediatric Scale. J Peripher Nerv Syst 2020; 25:138-142. [PMID: 32394473 DOI: 10.1111/jns.12383] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/30/2022]
Abstract
The Charcot-Marie-Tooth disease Pediatric Scale (CMTPedS) is a Rasch-built clinical outcome measure of disease severity. It is valid, reliable, and responsive to change for children and adolescents aged 3 to 20 years. The aim of this study was to translate and validate an Italian version of the CMTPedS using a validated framework of transcultural adaptation. The CMTPedS (Italian) was translated and culturally adapted from source into Italian by two experts in CMT with good English language proficiency. The two translations were reviewed by a panel of experts in CMT. The agreed provisional version was back translated into English by a professional translator. The definitive Italian version was developed during a consensus teleconference by the same panel. CMT patients were assessed with the final version of the outcome measure and a subset had a second assessment after 2 weeks to evaluate test-retest reliability. Seventeen patients with CMT aged 5 to 20 years (eight female) were evaluated with the CMTPedS (Italian), and test-retest was performed in three patients. The CMTPedS (Italian) showed a high test-retest reliability. No patient had difficulty in completing the scale. The instructions for the different items were clearly understood by clinicians and therefore the administration of the outcome measure was straight forward and easily understood by the children assessed. The CMTPedS (Italian) will be used for clinical follow-up and in clinical research studies in the Italian population. The data is fully comparable to that obtained from the English language version.
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Affiliation(s)
- Riccardo Zuccarino
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.,Neuromuscular Omnicentre (NEMO)-Fondazione Serena Onlus, Genoa, Liguria, Italy
| | - Valeria Prada
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova and IRCCS San Martino, Genoa, Italy
| | - Isabella Moroni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Maria Foscan
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giulia Robbiano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova and IRCCS San Martino, Genoa, Italy
| | | | - Kayla Cornett
- University of Sydney School of Health Sciences & Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Rosemary Shy
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova and IRCCS San Martino, Genoa, Italy
| | - Davide Pareyson
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Michael Shy
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Joshua Burns
- University of Sydney School of Health Sciences & Children's Hospital at Westmead, Sydney, New South Wales, Australia
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Mandarakas MR, Menezes MP, Rose KJ, Shy R, Eichinger K, Foscan M, Estilow T, Kennedy R, Herbert K, Bray P, Refshauge K, Ryan MM, Yiu EM, Farrar M, Sampaio H, Moroni I, Pagliano E, Pareyson D, Yum SW, Herrmann DN, Acsadi G, Shy ME, Burns J, Sanmaneechai O. Development and validation of the Charcot-Marie-Tooth Disease Infant Scale. Brain 2019; 141:3319-3330. [PMID: 30476010 DOI: 10.1093/brain/awy280] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/15/2018] [Indexed: 12/20/2022] Open
Abstract
Many genetic subtypes of Charcot-Marie-Tooth disease (CMT) show signs of symptomatic disease during the earliest years of life. This might be the ideal time to intervene before progression of clinical sequelae due to demyelination and axonal loss. In the absence of disease-specific clinical trial outcome measures for CMT during infancy and early childhood the aim of this study was to develop and validate a functional measure of disease severity, known as the Charcot-Marie-Tooth disease Infant Scale (CMTInfS). Development projects involved identification of a preliminary pool of 31 items representing the range of disability in affected patients aged 0-4 years from a systematic review of the literature, peer review by 12 expert clinicians and researchers in the field, design of a scoring algorithm and pilot testing in 22 participants. Subsequently, a series of validation projects were conducted based on 128 assessments of: 26 confirmed cases of inherited neuropathy (17 CMT1A, one CMT1B, one CMT1D, one CMT2C, one CMT2S, two CMT4C, one CMTX3, one Riboflavin Transporter Deficiency Type 2, and one unidentified mutation); seven 'at risk' cases and 95 unaffected healthy controls recruited through the NIH-funded Inherited Neuropathies Consortium. Validation projects included: Item, Factor and Rasch analysis, intra- and inter-rater reliability, discriminant ability and convergent validity with the CMT Pediatric Scale (CMTPedS) for children aged 3-4 years. Development and validation projects produced a psychometrically robust 15-item scale. Rasch analysis supported the viability of the CMTInfS as a unidimensional measure of disease severity and showed good overall model fit, no evidence of misfitting items or persons and was well targeted for affected children. The CMTInfS demonstrated high intra-rater reliability [intraclass correlation coefficient (ICC)3,1 0.999, 95% confidence interval 0.996-1.000) and inter-rater reliability (ICC2,1 0.997, 95% confidence interval 0.992-0.999). The CMTInfS was able to discriminate between the CMT group and controls (P = 0.006), and convergent validity demonstrated good agreement between CMTInfS and CMTPedS scores (r = 0.76, P = 0.01). The final version of the CMTInfS requires 20 min to administer and is a reliable and sensitive functional outcome measure for early onset CMT and related neuropathies.10.1093/brain/awy280_video1awy280media15970672819001.
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Affiliation(s)
- Melissa R Mandarakas
- The University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
| | - Manoj P Menezes
- The University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
| | - Kristy J Rose
- The University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
| | - Rosemary Shy
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Maria Foscan
- IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | - Timothy Estilow
- The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rachel Kennedy
- The Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne, Melbourne, Victoria, Australia
| | - Karen Herbert
- Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
| | - Paula Bray
- Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
| | | | - Monique M Ryan
- The Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne, Melbourne, Victoria, Australia
| | - Eppie M Yiu
- The Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle Farrar
- Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales Medicine, Sydney, New South Wales, Australia
| | - Hugo Sampaio
- Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
| | - Isabella Moroni
- IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | | | - Davide Pareyson
- IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | - Sabrina W Yum
- The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Gyula Acsadi
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Michael E Shy
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Joshua Burns
- The University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
| | - Oranee Sanmaneechai
- Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Estilow T, Glanzman AM, Burns J, Harrington A, Cornett K, Menezes MP, Shy R, Moroni I, Pagliano E, Pareyson D, Bhandari T, Muntoni F, Laurá M, Reilly MM, Finkel RS, Eichinger KJ, Herrmann DN, Troutman G, Bray P, Halaki M, Shy ME, Yum SW. Balance impairment in pediatric charcot-marie-tooth disease. Muscle Nerve 2019; 60:242-249. [PMID: 31026080 DOI: 10.1002/mus.26500] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 07/26/2018] [Revised: 04/17/2019] [Accepted: 04/22/2019] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Balance impairment contributes to gait dysfunction, falls, and reduced quality of life in adults with Charcot-Marie-Tooth disease (CMT) but has been minimally examined in pediatric CMT. METHODS The CMT Pediatric Scale (CMTPedS) was administered to 520 children with CMT. Associations between balance function (Bruininks-Oseretsky Test of Motor Proficiency [BOT-2]) and sensorimotor and gait impairments were investigated. RESULTS Daily trips/falls were reported by 42.3% of participants. Balance (BOT-2) varied by CMT subtype, was impaired in 42% of 4-year-olds, and declined with age (P < 0.001). Vibration (P < 0.001), pinprick (P < 0.004), ankle dorsiflexion strength (P < 0.001), and foot alignment (P < 0.004) were associated with BOT-2 balance (adjusted R2 = 0.28). The visual dependence of balance increased with age. DISCUSSION Balance impairment occurs from a young age in children with CMT. Balance intervention studies are required in pediatric CMT and should consider the degree of sensorimotor impairment, foot malalignment, and visual dependence. Muscle Nerve, 2019.
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Affiliation(s)
- Timothy Estilow
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Allan M Glanzman
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Joshua Burns
- The University of Sydney & Children's Hospital at Westmead, Sydney, Australia
| | - Ann Harrington
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kayla Cornett
- The University of Sydney & Children's Hospital at Westmead, Sydney, Australia
| | - Manoj P Menezes
- The University of Sydney & Children's Hospital at Westmead, Sydney, Australia
| | - Rosemary Shy
- Carver College of Medicine, Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA
| | - Isabella Moroni
- IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | | | - Davide Pareyson
- IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | - Trupti Bhandari
- UCL Institute of Child Health & Great Ormond Street Hospital, London, United Kingdom
| | - Francesco Muntoni
- UCL Institute of Child Health & Great Ormond Street Hospital, London, United Kingdom
| | - Matilde Laurá
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Mary M Reilly
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Richard S Finkel
- Neuromuscular Program, Division of Neurology, Nemours Children's Hospital, Orlando, Florida, USA
| | - Kate J Eichinger
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - David N Herrmann
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Gregory Troutman
- Department of Biostatistics and Clinical Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paula Bray
- The University of Sydney & Children's Hospital at Westmead, Sydney, Australia
| | - Mark Halaki
- Carver College of Medicine, Department of Neurology, University of Iowa, Iowa City, Iowa, USA
| | - Michael E Shy
- Carver College of Medicine, Department of Neurology, University of Iowa, Iowa City, Iowa, USA
| | - Sabrina W Yum
- Children's Hospital of Philadelphia, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Mandarakas MR, Menezes MP, Rose KJ, Shy R, Eichinger K, Foscan M, Estilow T, Kennedy R, Herbert K, Bray P, Refshauge K, Ryan MM, Yiu EM, Farrar M, Sampaio H, Moroni I, Pagliano E, Pareyson D, Yum SW, Herrmann DN, Acsadi G, Shy ME, Burns J, Sanmaneechai O. Erratum to: Development and validation of the Charcot-Marie-Tooth Disease Infant Scale. Brain 2019; 142:e14. [DOI: 10.1093/brain/awy332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Eichinger K, Burns J, Cornett K, Bacon C, Shepherd ML, Mountain J, Sowden J, Shy R, Shy ME, Herrmann DN. The Charcot-Marie-Tooth Functional Outcome Measure (CMT-FOM). Neurology 2018; 91:e1381-e1384. [PMID: 30232254 DOI: 10.1212/wnl.0000000000006323] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/05/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the feasibility, reliability, and convergent validity of the Charcot-Marie-Tooth Functional Outcome Measure (CMT-FOM), a new performance-based measure assessing functional ability in adults with CMT disease. METHODS Adults with CMT type 1A (CMT1A) were recruited at the Universities of Rochester and Iowa. Participants were assessed using the CMT-FOM, CMT Exam Score (CMTES), and a symptom report. Test-retest reliability was examined using intraclass correlation coefficients, internal consistency using Cronbach α, and convergent and known-groups validity using Spearman rank analysis and the Mann-Whitney test. RESULTS Forty-three individuals (70% women; mean age 41, SD 14.9 years) participated. The CMT-FOM (mean 25.3 ± 8.7, range 12-44/52) was moderately correlated with the CMTES (ρ = 0.62; p < 0.0001) and exhibited acceptable reliability (intraclass correlation coefficient = 0.92) and internal consistency (Cronbach α = 0.81). The CMT-FOM discriminated between participants with clinically mild vs moderate-severe CMT1A. Participants with the mildest CMT1A who demonstrated a floor effect on the CMTES showed functional limitations on the CMT-FOM. CONCLUSIONS The CMT-FOM is well tolerated and showed no floor/ceiling effects in an adult CMT1A cohort matching those likely to enter upcoming clinical trials. It appears to be reliable, and our data support convergent and known-groups validity in adults with CMT1A. Longitudinal studies further examining the psychometric properties of the CMT-FOM and its responsiveness to change before its application in therapeutic trials are necessary.
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Affiliation(s)
- Katy Eichinger
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City.
| | - Joshua Burns
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
| | - Kayla Cornett
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
| | - Chelsea Bacon
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
| | - Mary Lohse Shepherd
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
| | - Joan Mountain
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
| | - Janet Sowden
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
| | - Rosemary Shy
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
| | - Michael E Shy
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
| | - David N Herrmann
- From the Department of Neurology (K.E., J.M., J.S., D.N.H.), University of Rochester, NY; Faculty of Health Sciences & Children's Hospital at Westmead (J.B., K.C.), University of Sydney, Australia; and Departments of Neurology (C.B., M.E.S.), Physical Therapy (M.L.S.), and Pediatrics (R.S.), University of Iowa, Carver College of Medicine, Iowa City
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Fridman V, Bundy B, Reilly MM, Pareyson D, Bacon C, Burns J, Day J, Feely S, Finkel RS, Grider T, Kirk CA, Herrmann DN, Laurá M, Li J, Lloyd T, Sumner CJ, Muntoni F, Piscosquito G, Ramchandren S, Shy R, Siskind CE, Yum SW, Moroni I, Pagliano E, Zuchner S, Scherer SS, Shy ME. CMT subtypes and disease burden in patients enrolled in the Inherited Neuropathies Consortium natural history study: a cross-sectional analysis. J Neurol Neurosurg Psychiatry 2015; 86:873-8. [PMID: 25430934 PMCID: PMC4516002 DOI: 10.1136/jnnp-2014-308826] [Citation(s) in RCA: 223] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 10/06/2014] [Accepted: 10/24/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND The international Inherited Neuropathy Consortium (INC) was created with the goal of obtaining much needed natural history data for patients with Charcot-Marie-Tooth (CMT) disease. We analysed clinical and genetic data from patients in the INC to determine the distribution of CMT subtypes and the clinical impairment associated with them. METHODS We analysed data from 1652 patients evaluated at 13 INC centres. The distribution of CMT subtypes and pathogenic genetic mutations were determined. The disease burden of all the mutations was assessed by the CMT Neuropathy Score (CMTNS) and CMT Examination Score (CMTES). RESULTS 997 of the 1652 patients (60.4%) received a genetic diagnosis. The most common CMT subtypes were CMT1A/PMP22 duplication, CMT1X/GJB1 mutation, CMT2A/MFN2 mutation, CMT1B/MPZ mutation, and hereditary neuropathy with liability to pressure palsy/PMP22 deletion. These five subtypes of CMT accounted for 89.2% of all genetically confirmed mutations. Mean CMTNS for some but not all subtypes were similar to those previously reported. CONCLUSIONS Our findings confirm that large numbers of patients with a representative variety of CMT subtypes have been enrolled and that the frequency of achieving a molecular diagnosis and distribution of the CMT subtypes reflects those previously reported. Measures of severity are similar, though not identical, to results from smaller series. This study confirms that it is possible to assess patients in a uniform way between international centres, which is critical for the planned natural history study and future clinical trials. These data will provide a representative baseline for longitudinal studies of CMT. CLINICAL TRIAL REGISTRATION ID number NCT01193075.
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Affiliation(s)
- V Fridman
- Departments of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - B Bundy
- University of South Florida Epidemiology Center, Tampa, Florida, USA
| | - M M Reilly
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - D Pareyson
- Departments of Neurology, IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | - C Bacon
- Departments of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - J Burns
- Departments of Neurology, University of Sydney & Children's Hospital, Sydney, Australia
| | - J Day
- Departments of Neurology, Stanford University, Stanford, California, USA
| | - S Feely
- Departments of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA Departments of Neurology, Wayne State University, Detroit, Michigan, USA
| | - R S Finkel
- Departments of Neurology, Nemours Children's Hospital, Orlando, Florida, USA
| | - T Grider
- Departments of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - C A Kirk
- University of South Florida Epidemiology Center, Tampa, Florida, USA
| | - D N Herrmann
- Departments of Neurology, University of Rochester, Rochester, New York, USA
| | - M Laurá
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - J Li
- Departments of Neurology, Vanderbilt University, Nashville, Tennessee, USA
| | - T Lloyd
- Departments of Neurology, John Hopkins University, Baltimore, Maryland, USA
| | - C J Sumner
- Departments of Neurology, John Hopkins University, Baltimore, Maryland, USA
| | - F Muntoni
- Departments of Neurology, UCL Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - G Piscosquito
- Departments of Neurology, IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | - S Ramchandren
- Departments of Neurology, Wayne State University, Detroit, Michigan, USA Departments of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - R Shy
- Departments of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA Departments of Neurology, Wayne State University, Detroit, Michigan, USA
| | - C E Siskind
- Departments of Neurology, Stanford University, Stanford, California, USA
| | - S W Yum
- Departments of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA Departments of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - I Moroni
- Departments of Neurology, IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | - E Pagliano
- Departments of Neurology, IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | - S Zuchner
- Departments of Neurology, Center for Human Molecular Genomics, University of Miami, Miami, Florida, USA
| | - S S Scherer
- Departments of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - M E Shy
- Departments of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA Departments of Neurology, Wayne State University, Detroit, Michigan, USA
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Burns J, Menezes M, Finkel RS, Estilow T, Moroni I, Pagliano E, Laurá M, Muntoni F, Herrmann DN, Eichinger K, Shy R, Pareyson D, Reilly MM, Shy ME. Transitioning outcome measures: relationship between the CMTPedS and CMTNSv2 in children, adolescents, and young adults with Charcot-Marie-Tooth disease. J Peripher Nerv Syst 2014; 18:177-80. [PMID: 23781965 DOI: 10.1111/jns5.12024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Long-term studies of Charcot-Marie-Tooth (CMT) disease across the entire lifespan require stable endpoints that measure the same underlying construct (e.g., disability). The aim of this study was to assess the relationship between the CMT Pediatric Scale (CMTPedS) and the adult CMT Neuropathy Score (CMTNSv2) in 203 children, adolescents, and young adults with CMT. There was a moderate curvilinear correlation between the CMTPedS and the CMTNSv2 (Spearman's rho ρ = 0.716, p < 0.0001), although there appears to be a floor effect of the CMTNSv2 in patients with a milder CMT phenotype. Univariate analyses indicate that the relationship between the CMTPedS and CMTNSv2 scores improves with worsening disease severity and advancing age. Although one universal scale throughout life would be ideal, our data supports the transition from the CMTPedS in childhood to the CMTNSv2 in adulthood as a continuum of measuring lifelong disability in patients with CMT.
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Affiliation(s)
- Joshua Burns
- The University of Sydney & Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
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Burns J, Ouvrier R, Estilow T, Shy R, Laurá M, Eichinger K, Muntoni F, Reilly MM, Pareyson D, Acsadi G, Shy ME, Finkel RS. Symmetry of foot alignment and ankle flexibility in paediatric Charcot-Marie-Tooth disease. Clin Biomech (Bristol, Avon) 2012; 27:744-7. [PMID: 22424781 PMCID: PMC3389135 DOI: 10.1016/j.clinbiomech.2012.02.006] [Citation(s) in RCA: 14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 02/13/2012] [Accepted: 02/16/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Charcot-Marie-Tooth disease is the most common inherited nerve disorder and typically presents with pes cavus foot deformity and ankle equinus during childhood. Level in the variation of symmetry of musculoskeletal lower limb involvement across the clinical population is unknown, despite early reports describing gross asymmetry. METHODS We measured foot alignment and ankle flexibility of the left and right limbs using accurate and reliable standardised paediatric outcome measures in 172 patients aged 3-20 years with a variety of disease subtypes recruited from the United States, United Kingdom, Italy and Australia. FINDINGS While a large range of differences existed between left and right feet for a small proportion of children, there was no overall significant difference between limbs. INTERPRETATION There are two important implications of these findings. Children with Charcot-Marie-Tooth disease generally exhibit symmetrical foot alignment and ankle flexibility between limbs. As such, analysing one limb only for biomechanical-related research is appropriate and satisfies the independence requirements for statistical analysis. However, because there are large differences between feet for a small proportion of children, an individualised limb-focused approach to clinical care is required.
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Affiliation(s)
- Joshua Burns
- The Children's Hospital at Westmead & The University of Sydney, Australia
| | - Robert Ouvrier
- The Children's Hospital at Westmead & The University of Sydney, Australia
| | - Tim Estilow
- Neuromuscular Program, The Children's Hospital of Philadelphia, PA, USA
| | - Rosemary Shy
- Department of Pediatrics, The Children's Hospital of Michigan, Detroit, MI, USA
| | - Matilde Laurá
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, UK
| | | | - Francesco Muntoni
- UCL Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Mary M. Reilly
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, UK
| | - Davide Pareyson
- IRCCS Foundation, Carlo Besta Neurological Institute, Milan, Italy
| | - Gyula Acsadi
- Neurology Division, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Michael E. Shy
- School of Medicine, Wayne State University, Detroit, MI & Dept of Neurology, University of Iowa, Iowa City IA, USA
| | - Richard S. Finkel
- Neuromuscular Program, The Children's Hospital of Philadelphia, PA, USA,Depts. of Neurology and Pediatrics, University of Pennsylvania School of Medicine, PA, USA
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Burns J, Ouvrier R, Estilow T, Shy R, Laurá M, Pallant JF, Lek M, Muntoni F, Reilly MM, Pareyson D, Acsadi G, Shy ME, Finkel RS. Validation of the Charcot-Marie-Tooth disease pediatric scale as an outcome measure of disability. Ann Neurol 2012; 71:642-52. [PMID: 22522479 DOI: 10.1002/ana.23572] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Charcot-Marie-Tooth disease (CMT) is a common heritable peripheral neuropathy. There is no treatment for any form of CMT, although clinical trials are increasingly occurring. Patients usually develop symptoms during the first 2 decades of life, but there are no established outcome measures of disease severity or response to treatment. We identified a set of items that represent a range of impairment levels and conducted a series of validation studies to build a patient-centered multi-item rating scale of disability for children with CMT. METHODS As part of the Inherited Neuropathies Consortium, patients aged 3 to 20 years with a variety of CMT types were recruited from the USA, United Kingdom, Italy, and Australia. Initial development stages involved definition of the construct, item pool generation, peer review, and pilot testing. Based on data from 172 patients, a series of validation studies were conducted, including item and factor analysis, reliability testing, Rasch modeling, and sensitivity analysis. RESULTS Seven areas for measurement were identified (strength, dexterity, sensation, gait, balance, power, endurance), and a psychometrically robust 11-item scale was constructed (CMT Pediatric Scale [CMTPedS]). Rasch analysis supported the viability of the CMTPedS as a unidimensional measure of disability in children with CMT. It showed good overall model fit, no evidence of misfitting items, and no person misfit, and it was well targeted for children with CMT. INTERPRETATION The CMTPedS is a well-tolerated outcome measure that can be completed in 25 minutes. It is a reliable, valid, and sensitive global measure of disability for children with CMT from the age of 3 years.
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Affiliation(s)
- Joshua Burns
- Children's Hospital at Westmead and University of Sydney, Australia.
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Shy M, Ouvrier R, Estilow T, Laura M, Pallant J, Lek M, Pagliano E, Moroni I, Shy R, Reilly M, Pareyson D, Muntoni F, Finkel R, Burns J. Validation of the Charcot-Marie-Tooth Pediatric Scale as an Outcome Measure of Disability (P05.142). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Affiliation(s)
- Rosemary Shy
- Wayne State University, Children's Hospital of Michigan, Detroit, MI, USA
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14
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Shy R, Kamat D. Diagnosis: cystic fibrosis. Clin Pediatr (Phila) 2007; 46:285-9. [PMID: 17427306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Rosemary Shy
- The Carman and Ann Adams Department of Pediatrics,Wayne State University, Children's Hospital of Michigan,Detroit, Michigan, USA
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Affiliation(s)
- Divya Seth
- Pediatric Residency Program, Wayne State University, Children's Hospital of Michigan, Detroit, MI 48201, USA
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