Muscle & NervePub Date : 2024-10-01Epub Date: 2024-07-26DOI: 10.1002/mus.28223
Simon Podnar
{"title":"Ultrasonographic abnormalities in clinically unaffected nerves of patients with nonvasculitic motor and sensorimotor mononeuropathies.","authors":"Simon Podnar","doi":"10.1002/mus.28223","DOIUrl":"10.1002/mus.28223","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Diagnostic criteria for multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensorimotor neuropathy (MADSAM) require the involvement of at least two peripheral nerves. However, many patients with very similar features have clinical involvement of only a single peripheral nerve, which may preclude their correct diagnosis and treatment. The present study aimed to present a cohort of such patients and discuss the role of ultrasonography (US) in their diagnosis.</p><p><strong>Methods: </strong>Patients with nonvasculitic immune-mediated motor mononeuropathies (MM) and sensorimotor mononeuropathies (SMM) were recruited prospectively or identified from the electronic records. They were invited to comprehensive follow-up visits consisting of clinical examination, electrodiagnostic (EDx), and US studies.</p><p><strong>Results: </strong>Twenty-four patients (13 men) were studied (11 with MM). The characteristics of MM and SMM patients were very similar to MMN and MADSAM, respectively. The US, in addition to a long-swollen segment (average length, 20 cm) in the clinically affected nerve, revealed nerve swelling in, on average, six additional sites in clinically unaffected nerves.</p><p><strong>Discussion: </strong>In patients with clinical and EDx involvement of only a single nerve, an US demonstration of multifocal peripheral nerve swelling points to a more widespread, probably dysimmune mechanism. Further studies are needed to evaluate the value of US as a supplementary method for the diagnosis of MADSAM and MMN in patients with clinical involvement of a single nerve.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muscle & NervePub Date : 2024-10-01Epub Date: 2024-08-02DOI: 10.1002/mus.28225
Alessandra Govoni, Giulia Ricci, Silvia Bonanno, Luca Bello, Francesca Magri, Megi Meneri, Francesca Torri, Claudia Caponnetto, Luigia Passamano, Marina Grandis, Francesca Trojsi, Federica Cerri, Giulio Gadaleta, Giuliana Capece, Luca Caumo, Raffaella Tanel, Elena Saccani, Veria Vacchiano, Gianni Sorarù, Eustachio D'Errico, Irene Tramacere, Sara Bortolani, Enrica Rolle, Cinzia Gellera, Riccardo Zanin, Mauro Silvestrini, Luisa Politano, Angelo Schenone, Stefano Carlo Previtali, Angela Berardinelli, Mara Turri, Lorenzo Verriello, Michela Coccia, Renato Mantegazza, Rocco Liguori, Massimiliano Filosto, Maria Antonietta Maioli, Isabella Laura Simone, Tiziana Mongini, Stefania Corti, Maria Laura Manca, Elena Pegoraro, Gabriele Siciliano, Giacomo Pietro Comi, Lorenzo Maggi
{"title":"Six-minute walk test as outcome measure of fatigability in adults with spinal muscular atrophy treated with nusinersen.","authors":"Alessandra Govoni, Giulia Ricci, Silvia Bonanno, Luca Bello, Francesca Magri, Megi Meneri, Francesca Torri, Claudia Caponnetto, Luigia Passamano, Marina Grandis, Francesca Trojsi, Federica Cerri, Giulio Gadaleta, Giuliana Capece, Luca Caumo, Raffaella Tanel, Elena Saccani, Veria Vacchiano, Gianni Sorarù, Eustachio D'Errico, Irene Tramacere, Sara Bortolani, Enrica Rolle, Cinzia Gellera, Riccardo Zanin, Mauro Silvestrini, Luisa Politano, Angelo Schenone, Stefano Carlo Previtali, Angela Berardinelli, Mara Turri, Lorenzo Verriello, Michela Coccia, Renato Mantegazza, Rocco Liguori, Massimiliano Filosto, Maria Antonietta Maioli, Isabella Laura Simone, Tiziana Mongini, Stefania Corti, Maria Laura Manca, Elena Pegoraro, Gabriele Siciliano, Giacomo Pietro Comi, Lorenzo Maggi","doi":"10.1002/mus.28225","DOIUrl":"10.1002/mus.28225","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Fatigue (subjective perception) and fatigability (objective motor performance worsening) are relevant aspects of disability in individuals with spinal muscular atrophy (SMA). The effect of nusinersen on fatigability in SMA patients has been investigated with conflicting results. We aimed to evaluate this in adult with SMA3.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study, including adult ambulant patients with SMA3, data available on 6-minute walk test (6MWT) and Hammersmith Functional Motor Scale-Expanded (HFMSE) at baseline and at least at 6 months of treatment with nusinersen. We investigated fatigability, estimated as 10% or higher decrease in walked distance between the first and sixth minute of the 6MWT, at baseline and over the 14-month follow-up.</p><p><strong>Results: </strong>Forty-eight patients (56% females) were included. The 6MWT improved after 6, 10, and 14 months of treatment (p < 0.05). Of the 27 patients who completed the entire follow-up, 37% improved (6MWT distance increase ≥30 m), 48.2% remained stable, and 14.8% worsened (6MWT distance decline ≥30 m). Fatigability was found at baseline in 26/38 (68%) patients and confirmed at subsequent time points (p < 0.05) without any significant change over the treatment period. There was no correlation between fatigability and SMN2 copy number, sex, age at disease onset, age at baseline, nor with 6MWT total distance and baseline HFMSE score.</p><p><strong>Discussion: </strong>Fatigability was detected at baseline in approximately 2/3 of SMA3 walker patients, without any correlation with clinical features, included motor performance. No effect on fatigability was observed during the 14-month treatment period with nusinersen.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical and pathological characteristics of OPDM4 patients in advanced disease.","authors":"Haixia Tang, Ying Xiong, Kaiyan Jiang, Yu Shen, Yanyan Yu, Pengcheng Huang, Min Zhu, Xiaobing Li, Yilei Zheng, Meihong Zhou, Jiaxi Yu, Jianwen Deng, Zhaoxia Wang, Daojun Hong, Yusen Qiu, Dandan Tan","doi":"10.1002/mus.28200","DOIUrl":"10.1002/mus.28200","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Oculopharyngodistal myopathy type 4 (OPDM4) arises from a CGG repeat expansion in the 5' UTR of the RILPL1 gene. Reported cases of OPDM4 have been limited. The aim of this study was to investigate the clinical and myopathological characteristics of OPDM4 patients with advanced disease.</p><p><strong>Methods: </strong>We assessed a total of 8 affected and 12 unaffected individuals in an OPDM4 family with autosomal dominant inheritance. Muscle biopsy tissue from the proband underwent histological, enzyme histochemical, and immunohistochemical stains, and electron microscopy analysis. Whole exome sequencing and repeat primer PCR (RP-PCR) were conducted to investigate underlying variants.</p><p><strong>Results: </strong>OPDM4 patients displayed a progressive disease course. Most experienced lower limb weakness and diminished walking ability in their 20s and 30s, followed by ptosis, ophthalmoplegia, swallowing difficulties, and dysarthria in their 30s to 50s, By their 50s to 70s, they became non-ambulatory. Muscle magnetic resonance imaging (MRI) of the proband in advanced disease revealed severe fatty infiltration of pelvic girdle and lower limb muscles. Biopsied muscle tissue exhibited advanced changes typified by adipose connective tissue replacement and the presence of multiple eosinophilic and p62-positive intranuclear inclusions. Immunopositivity for the intranuclear inclusions was observed with anti-glycine antibody and laboratory-made polyA-R1 antibody. RP-PCR unveiled an abnormal CGG repeat expansion in the 5' UTR of the RILPL1 gene.</p><p><strong>Discussion: </strong>The clinical and radiological features in this family broaden the phenotypic spectrum of OPDM4. The presence of intranuclear inclusions in the proliferative adipose connective tissues of muscle biopsy specimens holds diagnostic significance for OPDM4 in advanced disease.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muscle & NervePub Date : 2024-10-01Epub Date: 2024-07-24DOI: 10.1002/mus.28217
Alexander De La Rosa-Cabral, Christopher Bonilla-Durango, Anelys Torres-Rivera, Ana Cintrón-Rodríguez
{"title":"Phantom radiculopathy: An electrodiagnostic challenge.","authors":"Alexander De La Rosa-Cabral, Christopher Bonilla-Durango, Anelys Torres-Rivera, Ana Cintrón-Rodríguez","doi":"10.1002/mus.28217","DOIUrl":"10.1002/mus.28217","url":null,"abstract":"","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Structural changes and contractility in muscle assessed by magnetic resonance imaging in individuals with ryanodine receptor 1-related rhabdomyolysis or myalgia.","authors":"Zhe Lyu, Tuva Åsatun Solheim, Nanna Scharff Poulsen, Anne-Sofie Vibæk Eisum, Gry Hatting Beha, Freja Fornander, Annarita Ghosh Andersen, Nanna Witting, John Vissing","doi":"10.1002/mus.28219","DOIUrl":"10.1002/mus.28219","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Ryanodine receptor 1 (RYR1)-related myopathies associated with variants in the RYR1 gene present with a wide range of symptoms and severity. Two of the milder phenotypes associated with dominant pathogenic variants in RYR1 are rhabdomyolysis and myalgia. Only a few studies have investigated the muscle function and structure of individuals with RYR1-related rhabdomyolysis/myalgia objectively, showing inconsistent results. This study aimed to describe structural changes and contractility of muscles in individuals with RYR1-related rhabdomyolysis/myalgia.</p><p><strong>Methods: </strong>We investigated 15 individuals with dominant variants in the RYR1-gene and compared them with 15 age-, sex-, and body mass index (BMI)-matched controls using MRI, stationary isokinetic dynamometry, and comprehensive clinical evaluation.</p><p><strong>Results: </strong>No significant differences were found between individuals with RYR1-related rhabdomyolysis/myalgia and healthy controls in peak torque, fat fraction, cross-sectional area, contractile cross-sectional area, or contractility (p > .05) in muscles of the lower back (MRI data only), thigh, or calf. On clinical examination, three individuals exhibited weakness in hip or back extension on the Medical Research Council (MRC) test and eight had muscle hypertrophy. Individuals with weakness were not hypertrophic.</p><p><strong>Discussion: </strong>Most individuals with RYR1-related rhabdomyolysis/myalgia have close to normal strength, and normal fat fraction and contractility of muscles, and therefore constitute a mild phenotype of RYR1-related myopathies.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muscle & NervePub Date : 2024-10-01Epub Date: 2024-08-09DOI: 10.1002/mus.28230
Marcelo R S Briones, João H Campos, Renata C Ferreira, Lisa Schneper, Ilda M Santos, Fernando M Antoneli, James R Broach
{"title":"Mitochondrial genome variants associated with amyotrophic lateral sclerosis and their haplogroup distribution.","authors":"Marcelo R S Briones, João H Campos, Renata C Ferreira, Lisa Schneper, Ilda M Santos, Fernando M Antoneli, James R Broach","doi":"10.1002/mus.28230","DOIUrl":"10.1002/mus.28230","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Amyotrophic lateral sclerosis (ALS) may be familial or sporadic, and twin studies have revealed that even sporadic forms have a significant genetic component. Variants in 55 nuclear genes have been associated with ALS and although mitochondrial dysfunction is observed in ALS, variants in mitochondrial genomes (mitogenomes) have not yet been tested for association with ALS. The aim of this study was to determine whether mitogenome variants are associated with ALS.</p><p><strong>Methods: </strong>We conducted a genome-wide association study (GWAS) in mitogenomes of 1965 ALS patients and 2547 controls.</p><p><strong>Results: </strong>We identified 51 mitogenome variants with p values <10<sup>-7</sup>, of which 13 had odds ratios (ORs) >1, in genes RNR1, ND1, CO1, CO3, ND5, ND6, and CYB, while 38 variants had OR <1 in genes RNR1, RNA2, ND1, ND2, CO2, ATP8, ATP6, CO3, ND3, ND4, ND5, ND6, and CYB. The frequencies of haplogroups H, U, and L, the most frequent in our ALS data set, were the same in different onset sites (bulbar, limb, spinal, and axial). Also, intra-haplogroup GWAS revealed unique ALS-associated variants in haplogroups L and U.</p><p><strong>Discussion: </strong>Our study shows that mitogenome single nucleotide variants (SNVs) are associated with ALS and suggests that these SNVs could be included in routine genetic testing for ALS and that mitochondrial replacement therapy has the potential to serve as a basis for ALS treatment.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11474277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muscle & NervePub Date : 2024-10-01Epub Date: 2024-07-13DOI: 10.1002/mus.28202
Giuseppe Cosentino, Paolo Prunetti, Giulia Tammam, Chiara Zaffina, Matteo Gastaldi, Cristina Tassorelli, Enrico Alfonsi, Massimiliano Todisco
{"title":"Diagnostic accuracy of voluntary and stimulated neuromuscular jitter studies in ocular myasthenia gravis.","authors":"Giuseppe Cosentino, Paolo Prunetti, Giulia Tammam, Chiara Zaffina, Matteo Gastaldi, Cristina Tassorelli, Enrico Alfonsi, Massimiliano Todisco","doi":"10.1002/mus.28202","DOIUrl":"10.1002/mus.28202","url":null,"abstract":"<p><strong>Introduction/aims: </strong>There is a lack of studies comparing the accuracy of neuromuscular jitter analysis during voluntary activation (v-jitter study) versus axonal stimulation (s-jitter study). The study aimed to compare these two techniques in the same population of patients with suspected ocular myasthenia gravis (OMG).</p><p><strong>Methods: </strong>Fourteen control subjects (mean age: 55.5 ± 15.2 years) and 34 patients with suspected OMG (mean age: 59 ± 13.9 years) were prospectively evaluated. Twenty spike pairs and 30 individual spikes were analyzed during v-jitter and s-jitter study, respectively. Two different criteria for abnormal individual jitter values were evaluated: ≥ or > than 10% values exceeding the upper normal limit.</p><p><strong>Results: </strong>OMG was diagnosed in 19 patients based on clinical and laboratory findings, without considering jitter measurements. In most patients, v-jitter and s-jitter analyses provided comparable results. The maximum sensitivity (89%) was achieved with s-jitter study using the ≥10% criterion, while the maximum specificity (93%) was found with v-jitter study using the >10% criterion.</p><p><strong>Discussion: </strong>Both v-jitter and s-jitter studies showed good to very good accuracy for the diagnosis of OMG, in the absence of any statistically significant difference. Therefore, the patient's cooperation level and examiner's experience should guide the choice of performing v-jitter or s-jitter analysis in patients with suspected OMG.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141600776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muscle & NervePub Date : 2024-10-01Epub Date: 2024-07-26DOI: 10.1002/mus.28213
Mariska D Nieuwenhoff, Hoang-Ton Nguyen, Sjoerd P Niehof, Frank J P M Huygen, Ajay Verma, Erica S Klaassen, Malik Bechakra, Wouter J Geelhoed, Joost L M Jongen, Annette C Moll, Alexander F J E Vrancken, Axel Petzold, Geert Jan Groeneveld
{"title":"Differences in corneal nerve fiber density and fiber length in patients with painful chronic idiopathic axonal polyneuropathy and diabetic polyneuropathy.","authors":"Mariska D Nieuwenhoff, Hoang-Ton Nguyen, Sjoerd P Niehof, Frank J P M Huygen, Ajay Verma, Erica S Klaassen, Malik Bechakra, Wouter J Geelhoed, Joost L M Jongen, Annette C Moll, Alexander F J E Vrancken, Axel Petzold, Geert Jan Groeneveld","doi":"10.1002/mus.28213","DOIUrl":"10.1002/mus.28213","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Corneal confocal microscopy (CCM) detects small nerve fiber loss and correlates with skin biopsy findings in diabetic neuropathy. In chronic idiopathic axonal polyneuropathy (CIAP) this correlation is unknown. Therefore, we compared CCM and skin biopsy in patients with CIAP to healthy controls, patients with painful diabetic neuropathy (PDN) and diabetics without overt neuropathy (DM).</p><p><strong>Methods: </strong>Participants with CIAP and suspected small fiber neuropathy (n = 15), PDN (n = 16), DM (n = 15), and healthy controls (n = 16) underwent skin biopsy and CCM testing. Inter-center intraclass correlation coefficients (ICC) were calculated for CCM parameters.</p><p><strong>Results: </strong>Compared with healthy controls, patients with CIAP and PDN had significantly fewer nerve fibers in the skin (IENFD: 5.7 ± 2.3, 3.0 ± 1.8, 3.9 ± 1.5 fibers/mm, all p < .05). Corneal nerve parameters in CIAP (fiber density 23.8 ± 4.9 no./mm<sup>2</sup>, branch density 16.0 ± 8.8 no./mm<sup>2</sup>, fiber length 13.1 ± 2.6 mm/mm<sup>2</sup>) were not different from healthy controls (24.0 ± 6.8 no./mm<sup>2</sup>, 22.1 ± 9.7 no./mm<sup>2</sup>, 13.5 ± 3.5 mm/mm<sup>2</sup>, all p > .05). In patients with PDN, corneal nerve fiber density (17.8 ± 5.7 no./mm<sup>2</sup>) and fiber length (10.5 ± 2.7 mm/mm<sup>2</sup>) were reduced compared with healthy controls (p < .05). CCM results did not correlate with IENFD in CIAP patients. Inter-center ICC was 0.77 for fiber density and 0.87 for fiber length.</p><p><strong>Discussion: </strong>In contrast to patients with PDN, corneal nerve parameters were not decreased in patients with CIAP and small nerve fiber damage. Therefore, CCM is not a good biomarker for small nerve fiber loss in CIAP patients.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}