1
|
Bader I, Freilinger M, Landauer F, Waldmüller S, Mueller-Felber W, Rauscher C, Sperl W, Bittner RE, Schmidt WM, Mayr JA. A recurrent single-amino acid deletion (p.Glu500del) in the head domain of ß-cardiac myosin in two unrelated boys presenting with polyhydramnios, congenital axial stiffness and skeletal myopathy. Orphanet J Rare Dis 2022; 17:279. [PMID: 35854315 PMCID: PMC9295345 DOI: 10.1186/s13023-022-02421-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alterations in the MYH7 gene can cause cardiac and skeletal myopathies. MYH7-related skeletal myopathies are extremely rare, and the vast majority of causal variants in the MYH7 gene are predicted to alter the rod domain of the of ß-cardiac myosin molecule, resulting in distal muscle weakness as the predominant manifestation. Here we describe two unrelated patients harboring an in-frame deletion in the MYH7 gene that is predicted to result in deletion of a single amino acid (p.Glu500del) in the head domain of ß-cardiac myosin. Both patients display an unusual skeletal myopathy phenotype with congenital axial stiffness and muscular hypertonus, but no cardiac involvement. RESULTS Clinical data, MRI results and histopathological data were collected retrospectively in two unrelated boys (9 and 3.5 years old). Exome sequencing uncovered the same 3-bp in-frame deletion in exon 15 (c.1498_1500delGAG) of the MYH7 gene of both patients, a mutation which deletes a highly conserved glutamate residue (p.Glu500del) in the relay loop of the head domain of the ß-cardiac myosin heavy chain. The mutation occurred de novo in one patient, whereas mosaicism was detected in blood of the father of the second patient. Both boys presented with an unusual phenotype of prenatal polyhydramnios, congenital axial stiffness and muscular hypertonus. In one patient the phenotype evolved into an axial/proximal skeletal myopathy without distal involvement or cardiomyopathy, whereas the other patient exhibited predominantly stiffness and respiratory involvement. We review and compare all patients described in the literature who possess a variant predicted to alter the p.Glu500 residue in the ß-cardiac myosin head domain, and we provide in-silico analyses of potential effects on polypeptide function. CONCLUSION The data presented here expand the phenotypic spectrum of mutations in the MYH7 gene and have implications for future diagnostics and therapeutic approaches.
Collapse
Affiliation(s)
- Ingrid Bader
- Clinical Genetics Unit, University Hospital, Salzburger Landeskliniken and Paracelsus Medical University Salzburg, 5020, Salzburg, Austria. .,University Children's Hospital, Salzburger Landeskliniken and Paracelsus Medical University Salzburg, 5020, Salzburg, Austria. .,Institute of Medical Genetics and Applied Genomics, University of Tübingen, Calwerstr. 7, 72076, Tübingen, Germany.
| | - M Freilinger
- Universitätsklinik Für Kinder- Und Jugendheilkunde, Medical University of Vienna, 1090, Vienna, Austria
| | - F Landauer
- University Clinic of Orthopaedic and Trauma Surgery, SALK and Paracelsus Medical University Salzburg, 5020, Salzburg, Austria
| | - S Waldmüller
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Calwerstr. 7, 72076, Tübingen, Germany
| | - W Mueller-Felber
- Dr. V. Hauner Children's Hospital, Ludwig-Maximilian University of Munich, Munich, Germany
| | - C Rauscher
- University Children's Hospital, Salzburger Landeskliniken and Paracelsus Medical University Salzburg, 5020, Salzburg, Austria
| | - W Sperl
- University Children's Hospital, Salzburger Landeskliniken and Paracelsus Medical University Salzburg, 5020, Salzburg, Austria
| | - R E Bittner
- Neuromuscular Research Department, Center of Anatomy and Cell Biology, Medical University of Vienna, 1090, Vienna, Austria
| | - W M Schmidt
- Neuromuscular Research Department, Center of Anatomy and Cell Biology, Medical University of Vienna, 1090, Vienna, Austria
| | - J A Mayr
- University Children's Hospital, Salzburger Landeskliniken and Paracelsus Medical University Salzburg, 5020, Salzburg, Austria
| |
Collapse
|
2
|
Upper body involvement in GNE myopathy assessed by muscle imaging. Neuromuscul Disord 2022; 32:410-418. [DOI: 10.1016/j.nmd.2021.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/16/2021] [Accepted: 12/29/2021] [Indexed: 11/19/2022]
|
3
|
Gómez-Andrés D, Oulhissane A, Quijano-Roy S. Two decades of advances in muscle imaging in children: from pattern recognition of muscle diseases to quantification and machine learning approaches. Neuromuscul Disord 2021; 31:1038-1050. [PMID: 34736625 DOI: 10.1016/j.nmd.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 11/29/2022]
Abstract
Muscle imaging has progressively gained popularity in the neuromuscular field. Together with detailed clinical examination and muscle biopsy, it has become one of the main tools for deep phenotyping and orientation of etiological diagnosis. Even in the current era of powerful new generation sequencing, muscle MRI has arisen as a tool for prioritization of certain genetic entities, supporting the pathogenicity of variants of unknown significance and facilitating diagnosis in cases with an initially inconclusive genetic study. Although the utility of muscle imaging is increasingly clear, it has not reached its full potential in clinical practice. Pattern recognition is known for a number of diseases and will certainly be enhanced by the use of machine learning approaches. For instance, MRI heatmap representations might be confronted with molecular results by obtaining a probabilistic diagnosis based in each disease "MRI fingerprints". Muscle ultrasound as a screening tool and quantified techniques such as Dixon MRI seem still underdeveloped. In this paper, we aim to appraise the advances in recent years in pediatric muscle imaging and try to define areas of uncertainty and potential advances that might become standardized to be widely used in the future.
Collapse
Affiliation(s)
- David Gómez-Andrés
- Pediatric Neurology, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, ERN-RND - EURO-NMD, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; European Network for Reference Centers on Neuromuscular Disorders (Euro-NMD ERN)
| | - Amal Oulhissane
- Université Paris-Saclay, APHP, Neuromuscular Unit, Pediatric Neurology and ICU Department, Raymond Poincaré Hospital, 92390 Garches, France
| | - Susana Quijano-Roy
- Université Paris-Saclay, APHP, Neuromuscular Unit, Pediatric Neurology and ICU Department, Raymond Poincaré Hospital, 92390 Garches, France; UMR 1179, Laboratoire handicap neuromusculaire: physiopathologie biothérapie pharmacologie appliquées (END-ICAP), UFR Simone Veil, Montigny Le Bretonneux, France; French Network of Neuromuscular Reference Centers (FILNEMUS), France.
| |
Collapse
|
4
|
Oatmen K, Camelo-Piragua S, Zaghloul N. Novel mutation in the MYH2 gene in a symptomatic neonate with a hereditary myosin myopathy. J Neonatal Perinatal Med 2021; 15:63-68. [PMID: 34459418 DOI: 10.3233/npm-210780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Hereditary myosin myopathies are muscle disorders caused by mutations in myosin heavy chain genes. The MYH2 gene encodes the fast 2A skeletal muscle isoform, and mutations manifest as joint contractures, muscle weakness, and external ophthalmoplegia. Muscle biopsy shows decreased type 2A fibers, and vacuoles are sometimes present in adults with progressive disease. PRESENTATION OF CASE This case describes a full term baby boy with hypotonia, dysmorphic features, dysphagia, and aspiration. Whole genome sequencing detected a novel heterozygous variant in the MYH2 gene. Muscle biopsy showed decreased type 2A fibers and vacuoles in myofibers. DISCUSSION Hypotonia and dysphagia are common in infants with a MYH2 myopathy. However, dysmorphic features and vacuoles on biopsy have not previous been described in infants with MYH2 myopathies. CONCLUSION This case reports an unusual phenotype of a rare neonatal-onset congenital myopathy associated with a novel heterozygous variant in MYH2.
Collapse
Affiliation(s)
- K Oatmen
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - S Camelo-Piragua
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - N Zaghloul
- Department of Pediatrics, Division of Neonatology, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
5
|
Yu M, Zhu Y, Lu Y, Lv H, Zhang W, Yuan Y, Wang Z. Clinical features and genotypes of Laing distal myopathy in a group of Chinese patients, with in-frame deletions of MYH7 as common mutations. Orphanet J Rare Dis 2020; 15:344. [PMID: 33298082 PMCID: PMC7727133 DOI: 10.1186/s13023-020-01626-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/26/2020] [Indexed: 11/24/2022] Open
Abstract
Background Laing distal myopathy is a rare autosomal dominant inherited distal myopathy caused by mutations of the MYH7 gene affecting mainly the rod region. We described the clinical features, muscle MRI and pathological changes as well as genetic mutations in a group of Chinese patients with Laing distal myopathy. Results Six patients with the confirmed diagnoses of Laing distal myopathy were recruited. Ankle dorsiflexion and finger extension weakness, as well as neck flexion weakness were common in our patients. Myopathic as well as neurogenic lesions were suggested by electromyography in different patients. Respiratory abnormality of sleep apnea was detected in two of our patients stressing the necessity of close respiratory monitoring in this disease. Muscle MRIs showed similar features of concentric fatty infiltration of anterior thigh muscles together with early involvement of tibialis anterior and extensor hallucis longus. However, muscle pathological presentations were varied depending on the biopsied muscles and the severity of the disease. In-frame deletions of the MYH7 gene made up 3/4 of mutations in our patients, suggesting that these are common mutations of Laing distal myopathy. Conclusions Our study further expanded the phenotypes and genotypes of Laing distal myopathy. In-frame deletions of the MYH7 gene are common causes of Laing distal myopathy.
Collapse
Affiliation(s)
- Meng Yu
- Department of Neurology, Peking University First Hospital, No. 8 Xishiku Street, Beijing, 100034, China
| | - Ying Zhu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Yuanyuan Lu
- Department of Neurology, Peking University First Hospital, No. 8 Xishiku Street, Beijing, 100034, China
| | - He Lv
- Department of Neurology, Peking University First Hospital, No. 8 Xishiku Street, Beijing, 100034, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, No. 8 Xishiku Street, Beijing, 100034, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, No. 8 Xishiku Street, Beijing, 100034, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, No. 8 Xishiku Street, Beijing, 100034, China.
| |
Collapse
|
6
|
Muelas N, Frasquet M, Más-Estellés F, Martí P, Martínez-Vicente L, Sevilla T, Azorín I, Poyatos-García J, Argente-Escrig H, Vílchez R, Vázquez-Costa JF, Bataller L, Vilchez JJ. A study of the phenotypic variability and disease progression in Laing myopathy through the evaluation of muscle imaging. Eur J Neurol 2020; 28:1356-1365. [PMID: 33151602 DOI: 10.1111/ene.14630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/25/2020] [Accepted: 10/22/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Laing myopathy is characterized by broad clinical and pathological variability. They are limited in number and protocol of study. We aimed to delineate muscle imaging profiles and validate imaging analysis as an outcome measure. METHODS This was a cross-sectional and longitudinal cohort study. Data from clinical, functional and semi-quantitative muscle imaging (60 magnetic resonance imaging [MRI] and six computed tomography scans) were studied. Hierarchical analysis, graphic heatmap representation and correlation between imaging and clinical data using Bayesian statistics were carried out. RESULTS The study cohort comprised 42 patients from 13 families harbouring five MYH7 mutations. The cohort had a wide range of ages, age at onset, disease duration, and myopathy extension and Gardner-Medwin and Walton (GMW) functional scores. Intramuscular fat was evident in all but two asymptomatic/pauci-symptomatic patients. Anterior leg compartment muscles were the only affected muscles in 12% of the patients. Widespread extension to the thigh, hip, paravertebral and calf muscles and, less frequently, the scapulohumeral muscles was commonly observed, depicting distinct patterns and rates of progression. Foot muscles were involved in 40% of patients, evolving in parallel to other regions with absence of a disto-proximal gradient. Whole cumulative imaging score, ranging from 0 to 2.9 out of 4, was associated with disease duration and with myopathy extension and GMW scales. Follow-up MRI studies in 24 patients showed significant score progression at a variable rate. CONCLUSIONS We confirmed that the anterior leg compartment is systematically affected in Laing myopathy and may represent the only manifestation of this disorder. However, widespread muscle involvement in preferential but variable and not distance-dependent patterns was frequently observed. Imaging score analysis is useful to categorize patients and to follow disease progression over time.
Collapse
Affiliation(s)
- Nuria Muelas
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain.,Neuromuscular Reference Centre, ERN-EURO-NMD, Valencia, Spain.,Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain
| | - Marina Frasquet
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain.,Neuromuscular Reference Centre, ERN-EURO-NMD, Valencia, Spain.,Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Fernando Más-Estellés
- Ascires, Neuroradiology Section, Área Clínica de Imagen Médica, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Pilar Martí
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain
| | - Laura Martínez-Vicente
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain.,Neuromuscular Reference Centre, ERN-EURO-NMD, Valencia, Spain.,Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain
| | - Teresa Sevilla
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain.,Neuromuscular Reference Centre, ERN-EURO-NMD, Valencia, Spain.,Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain.,Department of Medicine, Universitat de València, Valencia, Spain
| | - Inmaculada Azorín
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain
| | - Javier Poyatos-García
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Herminia Argente-Escrig
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain.,Neuromuscular Reference Centre, ERN-EURO-NMD, Valencia, Spain.,Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Roger Vílchez
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain
| | - Juan F Vázquez-Costa
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain.,Neuromuscular Reference Centre, ERN-EURO-NMD, Valencia, Spain.,Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain.,Department of Medicine, Universitat de València, Valencia, Spain
| | - Luis Bataller
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain.,Neuromuscular Reference Centre, ERN-EURO-NMD, Valencia, Spain.,Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain.,Department of Medicine, Universitat de València, Valencia, Spain
| | - Juan J Vilchez
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain.,Neuromuscular Reference Centre, ERN-EURO-NMD, Valencia, Spain.,Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U763, Valencia, Spain
| |
Collapse
|
7
|
Savarese M, Sarparanta J, Vihola A, Jonson PH, Johari M, Rusanen S, Hackman P, Udd B. Panorama of the distal myopathies. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2020; 39:245-265. [PMID: 33458580 PMCID: PMC7783427 DOI: 10.36185/2532-1900-028] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022]
Abstract
Distal myopathies are genetic primary muscle disorders with a prominent weakness at onset in hands and/or feet. The age of onset (from early childhood to adulthood), the distribution of muscle weakness (upper versus lower limbs) and the histological findings (ranging from nonspecific myopathic changes to myofibrillar disarrays and rimmed vacuoles) are extremely variable. However, despite being characterized by a wide clinical and genetic heterogeneity, the distal myopathies are a category of muscular dystrophies: genetic diseases with progressive loss of muscle fibers. Myopathic congenital arthrogryposis is also a form of distal myopathy usually caused by focal amyoplasia. Massive parallel sequencing has further expanded the long list of genes associated with a distal myopathy, and contributed identifying as distal myopathy-causative rare variants in genes more often related with other skeletal or cardiac muscle diseases. Currently, almost 20 genes (ACTN2, CAV3, CRYAB, DNAJB6, DNM2, FLNC, HNRNPA1, HSPB8, KHLH9, LDB3, MATR3, MB, MYOT, PLIN4, TIA1, VCP, NOTCH2NLC, LRP12, GIPS1) have been associated with an autosomal dominant form of distal myopathy. Pathogenic changes in four genes (ADSSL, ANO5, DYSF, GNE) cause an autosomal recessive form; and disease-causing variants in five genes (DES, MYH7, NEB, RYR1 and TTN) result either in a dominant or in a recessive distal myopathy. Finally, a digenic mechanism, underlying a Welander-like form of distal myopathy, has been recently elucidated. Rare pathogenic mutations in SQSTM1, previously identified with a bone disease (Paget disease), unexpectedly cause a distal myopathy when combined with a common polymorphism in TIA1. The present review aims at describing the genetic basis of distal myopathy and at summarizing the clinical features of the different forms described so far.
Collapse
Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Neuromuscular Research Center, Department of Genetics, Fimlab Laboratories, Tampere, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Salla Rusanen
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
| |
Collapse
|
8
|
Warman-Chardon J, Diaz-Manera J, Tasca G, Straub V. 247th ENMC International Workshop: Muscle magnetic resonance imaging - Implementing muscle MRI as a diagnostic tool for rare genetic myopathy cohorts. Hoofddorp, The Netherlands, September 2019. Neuromuscul Disord 2020; 30:938-947. [PMID: 33004285 DOI: 10.1016/j.nmd.2020.08.360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/19/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Jodi Warman-Chardon
- Jodi Warman Chardon, Neurology/Genetics, The Ottawa Hospital/Research Institute, Canada; Children's Hospital of Eastern Ontario/Research Institute, Canada
| | - Jordi Diaz-Manera
- Neuromuscular Disorders Unit, Neurology department, Hospital Universitari de la Santa Creu i Sant Pau, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain; John Walton Muscular Dystrophy Research Center, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, UK
| | - Giorgio Tasca
- Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Volker Straub
- John Walton Muscular Dystrophy Research Center, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, UK.
| | | |
Collapse
|
9
|
Alessi CE, Wu Q, Whitaker CH, Felice KJ. Laing Myopathy: Report of 4 New Families With Novel MYH7 Mutations, Double Mutations, and Severe Phenotype. J Clin Neuromuscul Dis 2020; 22:22-34. [PMID: 32833721 DOI: 10.1097/cnd.0000000000000297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Laing distal myopathy (LDM) is an autosomal dominant disorder caused by mutations in the slow skeletal muscle fiber myosin heavy chain (MYH7) gene on chromosome 14q11.2. The classic LDM phenotype-including early-onset, initial involvement of foot dorsiflexors and great toe extensors, followed by weakness of neck flexors and finger extensors-is well documented. Since the original report by Laing et al in 1995, the spectrum of MYH7-related myopathies has expanded to include congenital myopathies, late-onset myopathies, myosin storage myopathy, and scapuloperoneal myopathies. Most patients with LDM harbor mutations in the midrod domain of the MYH7 gene, but rare cases document disease-associated mutations in the globular head region. In this report, we add to the medical literature by describing the clinicopathological findings in 8 affected family members from 4 new LDM families-including 2 with novel MYH7 mutations (Y162D and A1438P), one with dual mutations (V39M and K1617del), and one family (E1508del) with severe early-onset weakness associated with contractures, respiratory insufficiency, and dilated cardiomyopathy. Our families highlight the ever-expanding clinical spectrum and genetic variation of the skeletal myopathies related to MYH7 gene mutations.
Collapse
Affiliation(s)
| | - Qian Wu
- Pathology and Laboratory Medicine, University of Connecticut School of Medicine, Farmington, CT; and
| | - Charles H Whitaker
- Department of Neuromuscular Medicine, Muscular Dystrophy Association Care Center, Hospital for Special Care, New Britain, CT
| | - Kevin J Felice
- Department of Neuromuscular Medicine, Muscular Dystrophy Association Care Center, Hospital for Special Care, New Britain, CT
| |
Collapse
|
10
|
Arbustini E, Di Toro A, Giuliani L, Favalli V, Narula N, Grasso M. Cardiac Phenotypes in Hereditary Muscle Disorders: JACC State-of-the-Art Review. J Am Coll Cardiol 2019; 72:2485-2506. [PMID: 30442292 DOI: 10.1016/j.jacc.2018.08.2182] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/20/2018] [Accepted: 08/10/2018] [Indexed: 01/05/2023]
Abstract
Hereditary muscular diseases commonly involve the heart. Cardiac manifestations encompass a spectrum of phenotypes, including both cardiomyopathies and rhythm disorders. Common biomarkers suggesting cardiomuscular diseases include increased circulating creatine kinase and/or lactic acid levels or disease-specific metabolic indicators. Cardiac and extra-cardiac traits, imaging tests, family studies, and genetic testing provide precise diagnoses. Cardiac phenotypes are mainly dilated and hypokinetic in dystrophinopathies, Emery-Dreifuss muscular dystrophies, and limb girdle muscular dystrophies; hypertrophic in Friedreich ataxia, mitochondrial diseases, glycogen storage diseases, and fatty acid oxidation disorders; and restrictive in myofibrillar myopathies. Left ventricular noncompaction is variably associated with the different myopathies. Conduction defects and arrhythmias constitute a major phenotype in myotonic dystrophies and skeletal muscle channelopathies. Although the actual cardiac management is rarely based on the cause, the cardiac phenotypes need precise characterization because they are often the only or the predominant manifestations and the prognostic determinants of many hereditary muscle disorders.
Collapse
Affiliation(s)
- Eloisa Arbustini
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy.
| | - Alessandro Di Toro
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy
| | - Lorenzo Giuliani
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy
| | | | - Nupoor Narula
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy; Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York
| | - Maurizia Grasso
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
11
|
Abstract
There is a great clinical and genetic heterogeneity in congenital myopathies. Myo-MRI with pattern recognition has become a first-line complementary tool in clinical practice for this group of diseases. For diagnostic purposes, whole-body imaging techniques are preferred when involvement is axial or diffuse, as in most congenital myopathies, because of involvement of the tongue, masticator, neck or trunk muscles. Myo-MRI is widely used to identify abnormalities in muscle signal, volume or texture. Recognizable profiles or patterns have been identified in many of these genetic myopathies. The role of the radiologist is crucial in order to adapt the Myo-MRI protocols to the age of the patient and several clinical situations. Myo-MRI in children with congenital myopathies is a very demanding technique with a balance between acceptable time of examination and sufficient spatial resolution in order to detect subtle changes. Technical evolutions combining qualitative and quantitative analysis are useful to follow disease progression overtime. Outcome measures are expected to play a role in natural history description as well as in future therapeutic trials. Genetic diagnosis and interpretation of next generation sequencing results could be greatly influenced by statistical analysis with tools such as algorithms as well as graphical representations using heatmaps.
Collapse
|
12
|
|
13
|
|