Assessment of disease severity in a Canine Model of Duchenne Muscular Dystrophy: Classification of Quantitative MRI

Duchenne muscular dystrophy (DMD) is a fatal Xlinked muscle disorder caused by mutations in the dystrophin gene with a consequence of progressive degeneration of skeletal and cardiac muscle. Golden retriever muscular dystrophy (GRMD) is a spontaneous X-linked canine model of DMD with similar effects. Due to high soft-tissue contrast images, MRI is preferred as a non-invasive method to extract information corresponding to biological characteristics. We propose and evaluate non-invasive MRI-based imaging biomarkers to assess the severity of golden retriever muscular dystrophy (GRMD) using 3T and 4.7T MRI data of nine animals. These imaging biomarkers use first order statistics and texture (assessed by wavelets) in quantitative MRI (qMRI). In a leave-one-sampleout cross-validation framework, we use SVM to differentiate between young and old GRMD animals. The preliminary results show good differentiation between young and old animals for different qMRI sequences and based on a different selection of features.

Magnetic Resonance Monitoring of Disease Progression in mdx Mice on Different Genetic Backgrounds

Genetic modifiers alter disease progression in both preclinical models and subjects with Duchenne muscular dystrophy (DMD). Using multiparametric magnetic resonance (MR) techniques, we compared the skeletal and cardiac muscles of two different dystrophic mouse models of DMD, which are on different genetic backgrounds, the C57BL/10ScSn-Dmdmdx (B10-mdx) and D2.B10-Dmdmdx (D2-mdx). The proton transverse relaxation constant (T₂) using both MR imaging and spectroscopy revealed significant age-related differences in dystrophic skeletal and cardiac muscles as compared with their age-matched controls. D2-mdx muscles demonstrated an earlier and accelerated decrease in muscle T₂ compared with age-matched B10-mdx muscles. Diffusion-weighted MR imaging indicated differences in the underlying muscle structure between the mouse strains. The fractional anisotropy, mean diffusion, and radial diffusion of water varied significantly between the two dystrophic strains. Muscle structural differences were confirmed by histological analyses of the gastrocnemius, revealing a decreased muscle fiber size and increased fibrosis in skeletal muscle fibers of D2-mdx mice compared with B10-mdx and control. Cardiac involvement was also detected in D2-mdx myocardium based on both decreased function and myocardial T₂. These data indicate that MR parameters may be used as sensitive biomarkers to detect fibrotic tissue deposition and fiber atrophy in dystrophic strains.

X-ray phase-contrast tomography for high-spatial-resolution zebrafish muscle imaging

Imaging of muscular structure with cellular or subcellular detail in whole-body animal models is of key importance for understanding muscular disease and assessing interventions. Classical histological methods for high-resolution imaging methods require excision, fixation and staining. Here we show that the three-dimensional muscular structure of unstained whole zebrafish can be imaged with sub-5 μm detail with X-ray phase-contrast tomography. Our method relies on a laboratory propagation-based phase-contrast system tailored for detection of low-contrast 4-6 μm subcellular myofibrils. The method is demonstrated on 20 days post fertilization zebrafish larvae and comparative histology confirms that we resolve individual myofibrils in the whole-body animal. X-ray imaging of healthy zebrafish show the expected structured muscle pattern while specimen with a dystrophin deficiency (sapje) displays an unstructured pattern, typical of Duchenne muscular dystrophy. The method opens up for whole-body imaging with sub-cellular detail also of other types of soft tissue and in different animal models.

In vitro mouse model in Duchenne muscular dystrophy diagnosis using 50-MHz ultrasound waves

Duchenne muscular dystrophy (DMD) is caused by the absence of dystrophin, the protein that plays a key mechanical role in maintaining muscle membrane integrity. One of the major consequences of dystrophin deficiency is the degeneration of muscle fibres, with a progressive loss in muscle strength. The objective of this research was to find an ultrasonic parameter sensitive to DMD, which could give relevant information related to microstructure if compared to traditional investigations such as morphometrical analysis. This "in vitro" study focused on the Mdx mouse model and investigated the potential differences between wild-type and dystrophin-deficient mice diaphragms. Using a 50MHz ultrasonic sensor built in our group, we recorded an increase in ultrasonic wave attenuation in the dystrophin-deficient samples in comparison with normal muscles. A correlation between attenuation, mouse age and the percentage of non-muscular proportion in muscle was observed. As Mdx mouse is the best animal model for DMD and reproduces the degenerative pattern observed in human DMD muscles, this approach could be a powerful tool for in vitro DMD investigation and, more generally, for the characterisation of muscle properties.

High-frequency ultrasound to grade disease progression in murine models of Duchenne muscular dystrophy

OBJECTIVE

This study used high-frequency ultrasound (HFU) imaging to assess muscle damage noninvasively in a longitudinal study of 2 transgenic murine models of Duchenne muscular dystrophy (DMD): mdx, which has mutated cytoskeletal protein dystrophin; and udx, which has mutated dystrophin and lacks another cytoskeleton protein, utrophin. The mdx group was further subdivided into exercised and nonexercised subgroups to assess exercise-induced damage.

METHODS

Muscle damage was assessed with HFU imaging (40 MHz) at biweekly intervals for 16 weeks. The assessment was based on the number of hyperechoic lesions, the lesion diameter, and muscle disorganization, giving a combined grade according to a 5-point scale.

RESULTS

High-frequency ultrasound discriminated the severity of muscle damage between wild-type and transgenic models of DMD and between mdx and udx models. Qualitative comparisons of 3-dimensional HFU images with serial histologic sections of the skeletal muscle showed the ability of ultrasound to accurately depict changes seen in the muscle architecture in vivo.

CONCLUSIONS

High-frequency ultrasound images soft tissue in mice at high contrast and spatial resolution, thereby showing that this microimaging modality has the capability to assess architectural changes in muscle fibers due to myotonic dystrophy-related diseases such as DMD.

Skeletal muscle ultrasound: correlation between fibrous tissue and echo intensity

In this study, we examined the correlation between muscle ultrasound and muscle structure. Echo intensity (EI) of 14 muscles of two golden retriever muscular dystrophy dogs was correlated to the percentage interstitial fibrous tissue and fat in muscle biopsy. A significant correlation between interstitial fibrous tissue and EI was found (r = 0.87; p < 0.001). The separate influence of interstitial fat on muscle EI could not be established as only little fat was present. We conclude that fibrous tissue causes increased muscle EI. The high correlation between interstitial fibrous tissue and EI makes ultrasound a reliable method to determine severity of structural muscle changes.

Influences of diabetes (db/db), obese (ob/ob) and dystrophic (dy/dy) genotype mutations on hind limb bone maturation: a morphometric, radiological and cytochemical indices analysis

The influences of single-gene missense mutations expressing diabetes (db/db), obese (ob/ob) or dystrophia (dy/dy) dysregulated metabolic syndromes on hind limb bone maturation and cytodevelopment in C57BL/KsJ mice were evaluated by radiological, macro- and cytomorphometric analysis of the resulting variances in os coxae, femur and tibia osteodevelopment indices relative to control parameters between 8 and 16 weeks of age. Associated with obesity and hyperglycaemic/hyperinsulinaemic states, both db/db and ob/ob mutants demonstrated significant suppression of hind limb maturation (length) and cytodensity indices relative to control growth parameters. By contrast, skeletal growth suppression induced by dy/dy mutation expression was associated with lean body mass and normoglycaemic/hypoinsulinaemic systemic endometabolic indices. In both db/db and ob/ob mutation syndromes, osteovascular, -interstitial and -cytolipidaemia were prominent cytochemical aberrations of the osteopaenic states relative to the dyslipidaemia/fibrodysplasia characteristic of dy/dy osteomaturation. Between 8 and 16 weeks of age, both ob/ob and db/db groups demonstrated extensive cortical interstitial (laminal) osteolipidaemia and suppressed cytodensities compared to control indices. These data demonstrate that the abnormal hyperglycaemic/hyperinsulinaemic endometabolic states associated with the expression of db/db and ob/ob genomutations promote extensive lipidaemia-induced osteopaenia, compromising hind limb osteomaturation and cytodensity indices, as compared to the hyperfibritic osteopaenia characteristic of dy/dy mutation syndromes. Recognized therapeutic modulation of the hypercytolipidaemic component of diabetes-obesity syndromes may prove to be effective towards amelioration of the deleterious influences of these expressed hyperglycaemic, dysregulated lipometabolic conditions on osteomaturation and cytodevelopment.

The effects of muscular dystrophy on the craniofacial shape of Mus musculus

Skeletal anomalies are common in patients with muscular dystrophy, despite an absence of mutations to genes that specifically direct skeletogenesis. In order to understand these anomalies further, we examined two strains of muscular dystrophy (laminin- and merosin-deficient) relative to controls, to determine how the weakened muscle forces affected skull shape in a mouse model. Shape was characterized with geometric morphometric techniques, improving upon the limited analytical power of the standard linear measurements. Through these techniques, we document the specific types of cranial skeletal deformation produced by the two strains, each with individual shape abnormalities. The mice with merosin deficiency (with an earlier age of onset) developed skulls with more deformation, probably related to the earlier ontogenetic timing of disease onset. Future examinations of these mouse models may provide insight regarding the impact of muscular forces and the production and maintenance of craniofacial integration and modularity.

RADIOGRAPHIC FEATURES OF GOLDEN RETRIEVER MUSCULAR DYSTROPHY

Golden Retriever muscular dystrophy is an inherited, degenerative myopathy due to the absence of dystrophin and is used as a model of Duchenne muscular dystrophy of young boys. This report describes the radiographic abnormalities of Golden Retriever muscular dystrophy in 26 dogs. The thoracic abnormalities included diaphragmatic asymmetry (18/26), diaphragmatic undulation (18/26), and gastro-esophageal hiatal hernia (6/26). Pelvic abnormalities included narrowing of the body of the ilia (14/19), ventral deviation and curvature of the tuber ischii (14/19), elongation of the obturator foramen with a decrease in opacity of the surrounding bone (12/19), and lateral flaring of the wings of the ilia (12/19). Abdominal abnormalities consisted of hepatomegaly (14/22) and poor serosal detail (12/22). The unique thoracic abnormalities were a consistent finding in affected Golden Retriever muscular dystrophy dogs. The diagnosis of muscular dystrophy should be included in the differential list if the combination of diaphragm undulation and asymmetry, and gastro-esophageal hiatal hernia are identified. These diaphragmatic abnormalities are related to hypertrophy and hyperplasia of the diaphragm. Additionally, the skeletal changes of pelvic tilt, elongation of the pelvis, widening of the obturator foramina and thinning of the ischiatic tables appear to be specific to Golden Retriever muscular dystrophy in dogs. These pelvic abnormalities are most likely secondary to bone remodeling associated with the progressive skeletal myopathy and subsequent contracture/fibrosis.

Tissue Doppler imaging for detection of radial and longitudinal myocardial dysfunction in a family of cats affected by dystrophin-deficient hypertrophic muscular dystrophy

Diagnosis of feline hypertrophic cardiomyopathy currently is based on the presence of myocardial hypertrophy detected using conventional echocardiography. The accuracy of tissue Doppler imaging (TDI) for earlier detection of the disease has never been described. The objective of this sudy was to quantify left ventricular free wall (LVFW) velocities in cats with hypertrophic muscular dystrophy (HFMD) during preclinical cardiomyopathy using TDI. The study animals included 22 healthy controls and 7 cats belonging to a family of cats with HFMD (2 affected adult males, 2 heterozygous adult females, one 2.5-month-old affected male kitten, and 2 phenotypically normal female kittens from the same litter). All cats were examined via conventional echocardiography and 2-dimensional color TDI. No LVFW hypertrophy was detected in the 2 carriers or in the affected kitten when using conventional echocardiography and histologic examination, respectively. The LVFW also was normal for 1 affected male and at the upper limit of normal for the 2nd male. Conversely, LVFW dysfunction was detected in all affected and carrier cats with HFMD when using TDI. TDI consistently detects LVFW dysfunction in cats with HFMD despite the absence of myocardial hypertrophy. Therefore, TDI appears more sensitive than conventional echocardiography in detecting regional myocardial abnormalities.

Muscular dystrophy with truncated dystrophin in a family of Japanese Spitz dogs

Muscular dystrophy was diagnosed in seven male Japanese Spitz dogs with clinical signs of slowly progressive exercise intolerance, generalized weakness, myalgia, difficulty chewing and dysphagia. Serum creatine kinase (CK) concentrations were markedly elevated. Histopathology showed degeneration and regeneration of muscle, consistent with a dystrophic phenotype. Immunohistochemical staining for dystrophin and related proteins showed no staining with a monoclonal antibody against the rod domain of dystrophin but near-normal staining with an antibody against the C terminus. Immunoblot analysis in two affected dogs showed a truncated dystrophin protein of approximately 70-80 kDa. The severity of disease showed that this fragment was not large enough to protect from the dystrophic process.

The impact of muscular dystrophy on limb bone growth and scaling in mice

Muscular loading affects bone growth and the factors determining size and shape. However, it is not known what epigenetic impact muscular dystrophy (dystrophia muscularis) has on limb bone growth or ontogenetic scaling. To assess the effects of two types of muscular dystrophy (genotypes dy/dy and dy2J/dy2J) on limb bone growth, we measured lengths and widths of the right humerus, femur and tibia, and lengths of the ulna and radius from dorsal/ventral radiographs of mice taken over a period of 270 days. Radiographs were taken approximately 3 times a week, and the sampling frequency was gradually reduced to once a month. We plotted measurements from each individual against time and fit a Gompertz equation to the growth of each bone. Parameters of the equation were compared using ANOVA across genotypes and between sexes. Slopes of length versus width were calculated for the limb bones of each individual using linear regression. Slope differences among genotypes and between sexes were tested using ANOVA. Control and dy2J values were significantly longer than those of dy mice in all bones, but there was considerable variation across genotypes for the various width measurements. Sexual dimorphism was found in several measurements, where males were always larger than females. There were few significant differences in limb scaling (lengths vs. widths) among genotypes and almost no scaling differences between sexes despite the size differences. Differences among widths suggest that muscular dystrophy affects different parts of limb bones in different ways. This may be the effect of the type and number of muscular attachments, as well as the usage of the limb. The sexually dimorphic measurements suggest that there are size differences in the skeleton between sexes, regardless of the genotype. Our ontogenetic allometry results indicate that size is affected by the muscular dystrophic condition and by sexual dimorphism, while shape remains largely unchanged.

A study of the relationship between mechanical and ultrasonic properties of dystrophic and normal skeletal muscle

A study has been made of the application of radio frequency (RF) ultrasound to the detection of muscular dystrophy by monitoring passively stretched skeletal muscle. The tests included detection of integrated backscatter changes in response to both static loading, in which muscle samples were stretched and allowed to relax, and stress relaxation. In both static and step strain loading conditions, the dystrophic muscle was found to exhibit little change in backscatter power while normal muscle responded to loading with significant changes in integrated backscatter. The backscatter response is compared with mechanical properties of the tissue (time constants and stress-strain constants). Both mechanical and ultrasonic time constants of relaxation are not significantly different between normal and dystrophic tissue, but stress-strain constants do differ. The difference in response of dystrophic and normal tissue appears to be due to a repression of motion of the constituent anatomy of dystrophic muscle which is responsible for the change of echogenicity with passive stretch.

Duchenne's cardiomyopathy in a canine model: electrocardiographic and echocardiographic studies

Thirteen dogs affected with X-linked Duchenne's muscular dystrophy and 11 female carrier dogs were studied by electrocardiography (ECG) and echocardiography. Twelve of the affected dogs were studied as immature animals and followed at 1 to 6 month intervals until they were 7 to 46 months of age. Compared with control dogs, affected dogs had significantly increased (p less than 0.02) Q/R ratios in ECG leads II, III, aVF, CV6LL (V2) and CV6LU (V4). Carrier dogs had significantly increased (p less than 0.02) Q/R ratios in leads V2 and V4. The Q/R ratio increased in three of six dogs followed up from age 6 months to greater than 2 years. The PR intervals were significantly shorter (p less than 0.02) in affected dogs. Ventricular arrhythmias were identified in four of six mature affected dogs. Two-dimensional echocardiography revealed distinctive hyperechoic lesions in 12 of the 13 affected dogs and in 6 of the 11 carrier dogs. Hyperechoic lesions corresponded to calcified myocardium and surrounding dense connective tissue. This study establishes the dog affected with Duchenne's muscular dystrophy as an animal model of Duchenne's cardiomyopathy and demonstrates that the heart in carrier dogs is affected by the dystrophic process.

[Diagnostic value of radioisotope methods of studying the thyroid of sheep]

Studies were carried out on the diagnostic effectiveness of the 131I-captation test, the thyro-cap, thyro-con, res-o-mat method, and the scintigraphic method in the investigation of sheep with hypo- and hyperfunction of the thyroid gland. It was established that the first of these methods displayed negligible diagnostic capacity, embracing the changes in the inorganic phase of the iodine metabolism at hypo- and hyperfunction of the thyroid. The data obtained for the T-3, T-4, and FT-4 values on the basis of the radioimmune tests used reflected precisely and differentially the changes in the level of the hormone synthesis taking place in the thyroid at various physiologic conditions. Scintigraphic studies with 131I and 99mTc did not give account for the functional changes taking place in the parenchyma of the thyroid gland.