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Raymond K, Gagnon C, Levasseur M. Multiple Case Study of Changes in Participation of Adults with Myotonic Dystrophy Type 1: Importance of Redesigning Accomplishment and Resilience. J Neuromuscul Dis 2022; 9:731-755. [DOI: 10.3233/jnd-210780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Myotonic dystrophy type 1 (DM1) is the most prevalent adult form of neuromuscular disorders, for which a decrease of participation with age is known. However, little is known about facilitators and barriers to participation, especially from the perspective of both patients and caregivers. Objective: This study explored and explained changes in participation post-diagnosis with myotonic dystrophy type 1 from the perspective of six adults, their relatives and nurse case managers. Methods: A multiple case study was carried out with these triads (n = 6) using semi-structured individual interviews, medical charts, and a participation patient-reported outcome measure. The six cases were built around three women and three men (age: 40–56 years; disease duration: 19–39 years). Their “relatives” were mainly family members. Nurse case managers had done annual follow-ups with all the adults for approximately ten years. Changes in participation were characterized generally by: 1) heterogeneity, 2) insidious increase in restrictions, and more specifically by: 3) redesigning accomplishment, 4) progressive social isolation, 5) restrictions in life-space mobility, and 6) increasingly sedentary activities. Results: Important facilitators of participation were the adult’s resilience, highly meaningful activities, social support, living arrangement, and willingness to use technical aids. Barriers were mostly related to symptoms and a precarious social network, and were affected by misfit and potential syndemic interactions between personal (e.g., comorbidities) and environmental (e.g., stigma) factors. Conclusion: This study identified key facilitators and barriers and their underlying processes, which should be integrated into the evaluation and intervention framework to optimize participation over time.
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Affiliation(s)
- Kateri Raymond
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada. 3001, 12 avenue Nord, Sherbrooke (Québec), J1H 5N4, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay–Lac-St-Jean, Jonquière, Canada. 2230, rue de l’Hôpital, C.P. 1200, Jonquière (Québec), G7X 7X2, Canada
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada. 1036, rue Belvédère Sud, Sherbrooke (Québec), J1H 4C4, Canada
- Centre de recherche Charles-Le Moyne (CR-CLM), Centre intégré universitaire de santé et de services sociaux du Saguenay–Lac-St-Jean, Chicoutimi, Canada. 305, rue Saint-Vallier, Chicoutimi (Québec), G7H 5H6, Canada
| | - Cynthia Gagnon
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada. 3001, 12 avenue Nord, Sherbrooke (Québec), J1H 5N4, Canada
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay–Lac-St-Jean, Jonquière, Canada. 2230, rue de l’Hôpital, C.P. 1200, Jonquière (Québec), G7X 7X2, Canada
- Centre de recherche Charles-Le Moyne (CR-CLM), Centre intégré universitaire de santé et de services sociaux du Saguenay–Lac-St-Jean, Chicoutimi, Canada. 305, rue Saint-Vallier, Chicoutimi (Québec), G7H 5H6, Canada
| | - Mélanie Levasseur
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada. 3001, 12 avenue Nord, Sherbrooke (Québec), J1H 5N4, Canada
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada. 1036, rue Belvédère Sud, Sherbrooke (Québec), J1H 4C4, Canada
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Liu J, Guo ZN, Yan XL, Yang Y, Huang S. Brain Pathogenesis and Potential Therapeutic Strategies in Myotonic Dystrophy Type 1. Front Aging Neurosci 2021; 13:755392. [PMID: 34867280 PMCID: PMC8634727 DOI: 10.3389/fnagi.2021.755392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/20/2021] [Indexed: 12/17/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is the most common muscular dystrophy that affects multiple systems including the muscle and heart. The mutant CTG expansion at the 3′-UTR of the DMPK gene causes the expression of toxic RNA that aggregate as nuclear foci. The foci then interfere with RNA-binding proteins, affecting hundreds of mis-spliced effector genes, leading to aberrant alternative splicing and loss of effector gene product functions, ultimately resulting in systemic disorders. In recent years, increasing clinical, imaging, and pathological evidence have indicated that DM1, though to a lesser extent, could also be recognized as true brain diseases, with more and more researchers dedicating to develop novel therapeutic tools dealing with it. In this review, we summarize the current advances in the pathogenesis and pathology of central nervous system (CNS) deficits in DM1, intervention measures currently being investigated are also highlighted, aiming to promote novel and cutting-edge therapeutic investigations.
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Affiliation(s)
- Jie Liu
- Department of Neurology, Stroke Center & Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Changchun, China
- China National Comprehensive Stroke Center, Changchun, China
- Jilin Provincial Key Laboratory of Cerebrovascular Disease, Changchun, China
| | - Zhen-Ni Guo
- Department of Neurology, Stroke Center & Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Changchun, China
- China National Comprehensive Stroke Center, Changchun, China
- Jilin Provincial Key Laboratory of Cerebrovascular Disease, Changchun, China
| | - Xiu-Li Yan
- Department of Neurology, Stroke Center & Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Changchun, China
| | - Yi Yang
- Department of Neurology, Stroke Center & Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Changchun, China
- China National Comprehensive Stroke Center, Changchun, China
- Jilin Provincial Key Laboratory of Cerebrovascular Disease, Changchun, China
| | - Shuo Huang
- Department of Neurology, Stroke Center & Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Changchun, China
- China National Comprehensive Stroke Center, Changchun, China
- Jilin Provincial Key Laboratory of Cerebrovascular Disease, Changchun, China
- *Correspondence: Shuo Huang,
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Miller JN, Kruger A, Moser DJ, Gutmann L, van der Plas E, Koscik TR, Cumming SA, Monckton DG, Nopoulos PC. Cognitive Deficits, Apathy, and Hypersomnolence Represent the Core Brain Symptoms of Adult-Onset Myotonic Dystrophy Type 1. Front Neurol 2021; 12:700796. [PMID: 34276551 PMCID: PMC8280288 DOI: 10.3389/fneur.2021.700796] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/03/2021] [Indexed: 12/11/2022] Open
Abstract
Myotonic dystrophy type 1 is the most common form of muscular dystrophy in adults, and is primarily characterized by muscle weakness and myotonia, yet some of the most disabling symptoms of the disease are cognitive and behavioral. Here we evaluated several of these non-motor symptoms from a cross-sectional time-point in one of the largest longitudinal studies to date, including full-scale intelligence quotient, depression, anxiety, apathy, sleep, and cerebral white matter fractional anisotropy in a group of 39 adult-onset myotonic dystrophy type 1 participants (27 female) compared to 79 unaffected control participants (46 female). We show that intelligence quotient was significantly associated with depression (P < 0.0001) and anxiety (P = 0.018), but not apathy (P < 0.058) or hypersomnolence (P = 0.266) in the DM1 group. When controlling for intelligence quotient, cerebral white matter fractional anisotropy was significantly associated with apathy (P = 0.042) and hypersomnolence (P = 0.034), but not depression (P = 0.679) or anxiety (P = 0.731) in the myotonic dystrophy type 1 group. Finally, we found that disease duration was significantly associated with apathy (P < 0.0001), hypersomnolence (P < 0.001), IQ (P = 0.038), and cerebral white matter fractional anisotropy (P < 0.001), but not depression (P = 0.271) or anxiety (P = 0.508). Our results support the hypothesis that cognitive deficits, hypersomnolence, and apathy, are due to the underlying neuropathology of myotonic dystrophy type 1, as measured by cerebral white matter fractional anisotropy and disease duration. Whereas elevated symptoms of depression and anxiety in myotonic dystrophy type 1 are secondary to the physical symptoms and the emotional stress of coping with a chronic and debilitating disease. Results from this work contribute to a better understanding of disease neuropathology and represent important therapeutic targets for clinical trials.
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Affiliation(s)
- Jacob N Miller
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Alison Kruger
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - David J Moser
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Laurie Gutmann
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ellen van der Plas
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Timothy R Koscik
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Sarah A Cumming
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Darren G Monckton
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Peggy C Nopoulos
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, United States.,Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States.,Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
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Leddy S, Cercignani M, Serra L, Bozzali M. Social cognition in type 1 myotonic dystrophy - A mini review. Cortex 2021; 142:389-399. [PMID: 34154799 DOI: 10.1016/j.cortex.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/13/2021] [Accepted: 05/08/2021] [Indexed: 12/11/2022]
Abstract
Our ability to interact with those around us plays an important role in our relationships, mental well being and ability to successfully navigate the complex social society in which we live. Research in social cognitive neuroscience aims to understand the underlying neurobiology of our social behaviours and interactions with others. Myotonic dystrophy type 1 (DM1) is a genetically inherited neuromuscular disorder characterized by mytonia with systemic manifestations such as cardiac disease, respiratory insufficiency, ophthalmic complications, diabetes and frontal balding among others. Individuals with myotonic dystophy have been found to have widespread changes throughout the brain in both grey and white matter territories. They have been noted to experience difficulty with social cognitive function, and to more frequently display atypical personality traits leading to often unrecognized difficulties with everyday life. In this mini review we explore the anatomical basis of social cognition, current techniques for measuring and investigating this impairment including facial emotion recognition and theory of mind. We examine the evidence for general cognitive dysfunction, autism spectrum and personality disorders in DM1. Throughout the review we discuss neuroimaging highlights relevant to social cognition in DM1. Finally, we discuss practical implications relevant to managing people with myotonic dystrophy and highlight future research needs.
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Affiliation(s)
- Sara Leddy
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom; Brighton and Sussex University Hospital Trust, Brighton, East Sussex, United Kingdom
| | - Mara Cercignani
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom; Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Laura Serra
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marco Bozzali
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom; 'Rita Levi Montalcini' Department of Neuroscience, University of Torino, Turin, Italy.
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5
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Azotla-Vilchis CN, Sanchez-Celis D, Agonizantes-Juárez LE, Suárez-Sánchez R, Hernández-Hernández JM, Peña J, Vázquez-Santillán K, Leyva-García N, Ortega A, Maldonado V, Rangel C, Magaña JJ, Cisneros B, Hernández-Hernández O. Transcriptome Analysis Reveals Altered Inflammatory Pathway in an Inducible Glial Cell Model of Myotonic Dystrophy Type 1. Biomolecules 2021; 11:biom11020159. [PMID: 33530452 PMCID: PMC7910866 DOI: 10.3390/biom11020159] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/22/2021] [Accepted: 01/22/2021] [Indexed: 12/12/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1), the most frequent inherited muscular dystrophy in adults, is caused by the CTG repeat expansion in the 3′UTR of the DMPK gene. Mutant DMPK RNA accumulates in nuclear foci altering diverse cellular functions including alternative splicing regulation. DM1 is a multisystemic condition, with debilitating central nervous system alterations. Although a defective neuroglia communication has been described as a contributor of the brain pathology in DM1, the specific cellular and molecular events potentially affected in glia cells have not been totally recognized. Thus, to study the effects of DM1 mutation on glial physiology, in this work, we have established an inducible DM1 model derived from the MIO-M1 cell line expressing 648 CUG repeats. This new model recreated the molecular hallmarks of DM1 elicited by a toxic RNA gain-of-function mechanism: accumulation of RNA foci colocalized with MBNL proteins and dysregulation of alternative splicing. By applying a microarray whole-transcriptome approach, we identified several gene changes associated with DM1 mutation in MIO-M1 cells, including the immune mediators CXCL10, CCL5, CXCL8, TNFAIP3, and TNFRSF9, as well as the microRNAs miR-222, miR-448, among others, as potential regulators. A gene ontology enrichment analyses revealed that inflammation and immune response emerged as major cellular deregulated processes in the MIO-M1 DM1 cells. Our findings indicate the involvement of an altered immune response in glia cells, opening new windows for the study of glia as potential contributor of the CNS symptoms in DM1.
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Affiliation(s)
- Cuauhtli N. Azotla-Vilchis
- Laboratory of Genomic Medicine, Department of Genetics, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (C.N.A.-V.); (D.S.-C.); (L.E.A.-J.); (R.S.-S.); (N.L.-G.); (J.J.M.)
- Department of Genetics and Molecular Biology, Centro de Investigación y de Estudios Avanzados, CINVESTAV-IPN, Mexico City 07360, Mexico; (J.M.H.-H.); (B.C.)
| | - Daniel Sanchez-Celis
- Laboratory of Genomic Medicine, Department of Genetics, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (C.N.A.-V.); (D.S.-C.); (L.E.A.-J.); (R.S.-S.); (N.L.-G.); (J.J.M.)
- Department of Genetics and Molecular Biology, Centro de Investigación y de Estudios Avanzados, CINVESTAV-IPN, Mexico City 07360, Mexico; (J.M.H.-H.); (B.C.)
| | - Luis E. Agonizantes-Juárez
- Laboratory of Genomic Medicine, Department of Genetics, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (C.N.A.-V.); (D.S.-C.); (L.E.A.-J.); (R.S.-S.); (N.L.-G.); (J.J.M.)
- Escuela Nacional de Ciencias Biologicas-Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Rocío Suárez-Sánchez
- Laboratory of Genomic Medicine, Department of Genetics, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (C.N.A.-V.); (D.S.-C.); (L.E.A.-J.); (R.S.-S.); (N.L.-G.); (J.J.M.)
| | - J. Manuel Hernández-Hernández
- Department of Genetics and Molecular Biology, Centro de Investigación y de Estudios Avanzados, CINVESTAV-IPN, Mexico City 07360, Mexico; (J.M.H.-H.); (B.C.)
| | - Jorge Peña
- Computational and Integrative Genomics Laboratory, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico; (J.P.); (C.R.)
- Institute of Mathematical Sciences, Claremont Graduate University, Claremont, CA 91711, USA
| | - Karla Vázquez-Santillán
- Epigenetics Laboratory, Instituto Nacional de Medicina Genomica, Mexico City 14610, Mexico; (K.V.-S.); (V.M.)
| | - Norberto Leyva-García
- Laboratory of Genomic Medicine, Department of Genetics, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (C.N.A.-V.); (D.S.-C.); (L.E.A.-J.); (R.S.-S.); (N.L.-G.); (J.J.M.)
| | - Arturo Ortega
- Department of Toxicology, Centro de Investigación y de Estudios Avanzados, CINVESTAV-IPN, Mexico City 07360, Mexico;
| | - Vilma Maldonado
- Epigenetics Laboratory, Instituto Nacional de Medicina Genomica, Mexico City 14610, Mexico; (K.V.-S.); (V.M.)
| | - Claudia Rangel
- Computational and Integrative Genomics Laboratory, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico; (J.P.); (C.R.)
| | - Jonathan J. Magaña
- Laboratory of Genomic Medicine, Department of Genetics, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (C.N.A.-V.); (D.S.-C.); (L.E.A.-J.); (R.S.-S.); (N.L.-G.); (J.J.M.)
- School of Engineering and Sciences, Department of Bioengineering, Tecnológico de Monterrey-Campus, Mexico City 14380, Mexico
| | - Bulmaro Cisneros
- Department of Genetics and Molecular Biology, Centro de Investigación y de Estudios Avanzados, CINVESTAV-IPN, Mexico City 07360, Mexico; (J.M.H.-H.); (B.C.)
| | - Oscar Hernández-Hernández
- Laboratory of Genomic Medicine, Department of Genetics, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (C.N.A.-V.); (D.S.-C.); (L.E.A.-J.); (R.S.-S.); (N.L.-G.); (J.J.M.)
- Correspondence: or ; Tel.: +52-55-5999-1000 (ext. 14710)
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Simoncini C, Spadoni G, Lai E, Santoni L, Angelini C, Ricci G, Siciliano G. Central Nervous System Involvement as Outcome Measure for Clinical Trials Efficacy in Myotonic Dystrophy Type 1. Front Neurol 2020; 11:624. [PMID: 33117249 PMCID: PMC7575726 DOI: 10.3389/fneur.2020.00624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/28/2020] [Indexed: 01/18/2023] Open
Abstract
Increasing evidences indicate that in Myotonic Dystrophy type 1 (DM1 or Steinert disease), an autosomal dominant multisystem disorder caused by a (CTG)n expansion in DMPK gene on chromosome 19q13. 3, is the most common form of inherited muscular dystrophy in adult patients with a global prevalence of 1/8000, and involvement of the central nervous system can be included within the core clinical manifestations of the disease. Variable in its severity and progression rate over time, likely due to the underlying causative molecular mechanisms; this component of the clinical picture presents with high heterogeneity involving cognitive and behavioral alterations, but also sensory-motor neural integration, and in any case, significantly contributing to the disease burden projected to either specific functional neuropsychological domains or quality of life as a whole. Principle manifestations include alterations of the frontal lobe function, which is more prominent in patients with an early onset, such as in congenital and childhood onset forms, here associated with severe intellectual disabilities, speech and language delay and reduced IQ-values, while in adult onset DM1 cognitive and neuropsychological findings are usually not so severe. Different methods to assess central nervous system involvement in DM1 have then recently been developed, these ranging from more classical psychometric and cognitive functional instruments to sophisticated psycophysic, neurophysiologic and especially computerized neuroimaging techniques, in order to better characterize this disease component, at the same time underlining the opportunity to consider it a suitable marker on which measuring putative effectiveness of therapeutic interventions. This is the reason why, as outlined in the conclusive section of this review, the Authors are lead to wonder, perhaps in a provocative and even paradoxical way to arise the question, whether or not the myologist, by now the popular figure in charge to care of a patient with the DM1, needs to remain himself a neurologist to better appreciate, evaluate and speculate on this important aspect of Steinert disease.
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Affiliation(s)
- Costanza Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Spadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Lai
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lorenza Santoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Rosado-Bartolomé A, Gutiérrez-Gutiérrez G, Prieto-Matos J. [Adult myotonic dystrophy type 1: an update]. Semergen 2020; 46:355-362. [PMID: 32646725 DOI: 10.1016/j.semerg.2020.01.002] [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: 09/30/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 10/23/2022]
Abstract
Myotonic dystrophy type 1 (DM1) or Steinert's disease (CIE-9-C: 359.21; CIE-10-ES: G71.11, ORPHA: 273) is a rare autosomal dominant inherited myopathy with almost complete penetrance and multisystemic consequences (neurological, cardiological, respiratory, endocrinological, and gastrointestinal). It is one of the clinical most variable diseases. The most bothersome symptoms for the patients (mobility problems, fatigue, hypersomnia, or gastrointestinal symptoms) and their families (apathy, lack of initiative) are not necessarily the most dangerous. Respiratory problems and cardiac arrhythmias shorten life expectancy. There is no specific treatment. The role of the Primary Care physician is crucial in the follow-up of DM1, either by coordinating the different professionals or detecting treatable complications. This work addresses the latter.
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Affiliation(s)
- A Rosado-Bartolomé
- Medicina Familiar y Comunitaria, Centro de Salud Mar Báltico, Madrid, España; Grupo de Trabajo de Neurología SEMERGEN, España.
| | - G Gutiérrez-Gutiérrez
- Servicio de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España; Grupo de Estudio de Enfermedades Neuromusculares SEN, España
| | - J Prieto-Matos
- Medicina Familiar y Comunitaria, Centro de Salud Periurbana Norte, Villares de la Reina, Salamanca, España; Grupo de Trabajo de Neurología SEMERGEN, España
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Wang J, Liu M, Shang W, Chen Z, Peng G. Myotonic dystrophy type 1 accompanied with normal pressure hydrocephalus: a case report and literature review. BMC Neurol 2020; 20:53. [PMID: 32050933 PMCID: PMC7017494 DOI: 10.1186/s12883-020-01636-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/05/2020] [Indexed: 01/13/2023] Open
Abstract
Background Myotonic dystrophy type 1 (DM1) is the most common disease that can cause muscle weakness and atrophy among adults. Normal pressure hydrocephalus (NPH) is characterized by the triad of gait disturbance, cognitive impairment and urinary incontinence. The association between DM1 and NPH is extremely rare. We report a Chinese female patient with DM1 in association with NPH. Case presentation The patient presented with a history of 3-year of walking instability and cognitive impairment. Her brain MRI showed ventriculomegaly with normal cerebrospinal fluid (CSF) pressure and the CSF tap-test was positive, which indicated the diagnosis of probable NPH. DM1 was confirmed by genetic testing. Conclusions Four patients with DM1-NPH association were found before. The association between NPH and DM1 may not be just a coincidence, NPH may occur in DM1 later in life and it is vital to recognize the association as a shunt surgery may improve patients’ quality of life.
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Affiliation(s)
- Junyang Wang
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Ming Liu
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Wenjie Shang
- Department of Neurology, Shengzhou People's Hospital, 666 Dangui Road, Shengzhou, 312403, China
| | - Zhongqin Chen
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Guoping Peng
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China.
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Predicting daytime sleepiness and fatigue: a 9-year prospective study in myotonic dystrophy type 1. J Neurol 2019; 267:461-468. [PMID: 31673761 DOI: 10.1007/s00415-019-09592-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Daytime sleepiness and fatigue are prominent symptoms of myotonic dystrophy type I (DM1) that exact a heavy toll on patients' quality of life, but information is scarce on their predictive factors. This study aimed to determine factors that may influence levels of daytime sleepiness and fatigue in a large cohort of DM1 patients followed for 9 years. METHODS This study included 115 patients with DM1 at baseline (Time 1, T1) and at Time 2 (T2) who were questioned for daytime sleepiness, fatigue, history of depression, psychological distress, pain, hypothyroidism, and sleep habits. Also, their muscular impairment and intellectual quotient were evaluated. Regression models were used to identify correlates of daytime sleepiness and fatigue while controlling for time effect. RESULTS Both daytime sleepiness and fatigue increased between T1 and T2, but their rate of change are higher when CTG repeat number is higher (p < 0.05). Also, higher psychological distress level is associated with higher daytime sleepiness and fatigue levels both at T1 and T2 (p < 0.01). Moreover, patients with a history of depression report higher daytime sleepiness levels both at T1 and T2 (p < 0.05). In addition, patients with higher fatigue levels both at T1 and T2 have more severe muscular impairment (p < 0.01) and report a longer habitual sleep duration (p < 0.05). Finally, a higher BMI and a history of hypothyroidism predict higher daytime sleepiness levels at T2 (p < 0.05). CONCLUSION This study identified potentially modifiable risk factors of future daytime sleepiness and fatigue in DM1 patients, including BMI, psychological distress, hypothyroidism, and sleep habits.
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Berends J, Tieleman AA, Horlings CGC, Smulders FHP, Voermans NC, van Engelen BGM, Raaphorst J. High incidence of falls in patients with myotonic dystrophy type 1 and 2: A prospective study. Neuromuscul Disord 2019; 29:758-765. [PMID: 31540818 DOI: 10.1016/j.nmd.2019.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 01/01/2023]
Abstract
We aimed to examine the incidence as well as the circumstances and the consequences of falling in adult patients with myotonic dystrophy type 1 and 2 (DM1/DM2). We performed a prospective cohort study in 209 subjects, of which 102 had DM1, 42 had DM2 and 65 healthy controls. An assessment of their falls was carried out during 100 consecutive days. In addition, falls during the previous year were reported. The primary outcome measure was the number of self-reported falls per participant during these 100 days. The secondary outcome measures included self-reported causes, circumstances and consequences of the falls. Mean (SD) falls per participant in 100 days was seven- to eightfold higher in patients with DM1 (0.74 (0.14)) and DM2 (0.62 (0.20)) compared to the controls (0.09 (0.04); p < 0.001)). Sixteen percent of DM1 and 17% of DM2 patients fell at least twice. Two-thirds of the falls occurred inside. Fifty percent of falls resulted in an injury, including a head trauma in four patients. Compared to non-fallers, those patients who fell were older (DM1/DM2), had a lower DM1-Activ score (DM1), had more muscle weakness (DM1), and reported less confidence in balance (DM1). This study demonstrates a high incidence and clinical relevance of falling in patients with DM1 and DM2. Fall prevention strategies in both DM1 and DM2 should focus on adaptations of the home environment and the patient's interaction in this environment.
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Affiliation(s)
- Joost Berends
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Alide A Tieleman
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Corinne G C Horlings
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Neurology, Medical University Innsbruck, Austria.
| | - Fran H P Smulders
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Joost Raaphorst
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, Netherlands
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11
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Holmøy AKT, Johannessen CH, Hope S, van Walsem MR, Aanonsen NO, Hassel B. Uncovering health and social care needs among myotonic dystrophy patients: Utility of the Needs and Provisions Complexity Scale. Acta Neurol Scand 2019; 139:526-532. [PMID: 30848487 DOI: 10.1111/ane.13086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/21/2019] [Accepted: 03/04/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Myotonic dystrophy type 1 (DM1) is a slowly progressive multisystem disorder. Guidelines recommend multidisciplinary follow-up. We aimed to investigate the presence of unmet health and social care needs among patients with DM1 and whether unmet needs correlated with motor function, cognitive impairments, or quality of life. MATERIAL AND METHODS Patients were 22 adults with DM1. "Needs and Provisions Complexity Scale" (NPCS) was applied to evaluate the individual's needs and provision of health and social services. The Muscular Impairment Rating Scale (MIRS) was used to measure motor function and disease stage. All patients underwent neuropsychological testing. The EQ-5D-3L questionnaire was used to evaluate the patients' health-related quality of life (HRQoL). RESULTS Median time from diagnosis was 11 years (range: 1-40). Twenty patients had developed needs related to social care, personal care, and rehabilitation that had not been met, whereas need for medical follow-up was largely met. The more pronounced the muscular impairment, the more unmet needs were experienced by DM1 patients (r = 0.50, P = 0.019). Degree of unmet needs did not correlate with full-scale IQ (r = -0.27, P = 0.23) or HRQoL (r = -0.14, P = 0.55). CONCLUSION Using NPCS, we discovered that patients with DM1 had unmet needs with respect to social care, personal care, and rehabilitation although their need for medical follow-up was met. Thus, the use of NPCS helped bring our practice in better accordance with guidelines. A higher MIRS grade should alert the clinician to the likelihood of unmet needs.
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Affiliation(s)
| | - Cecilie Haggag Johannessen
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
- NORMENT, KG Jebsen Centre of Psychosis Research, Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Sigrun Hope
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
- NORMENT, KG Jebsen Centre of Psychosis Research, Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Marleen R. van Walsem
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
- Research center for Habilitation and Rehabilitation Models and Services, Institute of Health and Society University of Oslo Oslo Norway
| | - Nils Olav Aanonsen
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
| | - Bjørnar Hassel
- Department of Neurohabilitation Oslo University Hospital Ullevål Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
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12
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van der Velden BG, Okkersen K, Kessels RP, Groenewoud J, van Engelen B, Knoop H, Raaphorst J. Affective symptoms and apathy in myotonic dystrophy type 1 a systematic review and meta-analysis. J Affect Disord 2019; 250:260-269. [PMID: 30870776 DOI: 10.1016/j.jad.2019.03.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND To gain insight into the prevalence of apathy, depression and anxiety symptoms in myotonic dystrophy type 1 (DM1) patients on the basis of a systematic review with a meta-analysis. METHODS One author systematically searched and selected studies from Embase, Medline, PsychInfo and Web of Science (index periods up to August 2018). Data extraction and bias assessment were performed independently by two authors. We calculated (1) a weighted pooled prevalence and (2) weighted pooled standardized mean difference (Hedges' g) from studies comparing DM1 patients to healthy and/or neuromuscular disease controls separately for symptoms of depression, anxiety and apathy. RESULTS The pooled prevalences of depression (26 studies, n = 1267 DM1 patients), anxiety (19 studies, n = 896) and apathy (5 studies, n = 428), were 18% (95%CI: 12-25), 16 (95%CI: 13-18) and 55% (95%CI: 50-60), respectively. Effect sizes (Hedges' g) for depression, anxiety and apathy in DM1 patients compared to healthy controls were 1.04 (95%-CI: 0.71 to 1.37), 0.87 (95%-CI: 0.51 to 1.24) and 1.13 (95%-CI:0.54-1.71). Effect sizes for symptoms of depression, anxiety and apathy were 0.29 (95% CI: -0.12 to 0.70), 0.45 (95%-CI: -0.31 to 1.22) and 1.12 (95%-CI: 0.32-1.93) for DM1 patients versus neuromuscular disease controls. In most analyses, statistical heterogeneity was high. CONCLUSIONS Estimated pooled prevalences of clinically significant levels of symptoms of depression, anxiety and apathy in DM1 are 19, 17 and 55% respectively. Symptoms of depression and anxiety in DM1 may reflect reactive adjustment to progressive impairment and restricted participation similar to other chronic neuromuscular disease. The literature on the prevalence and severity of apathy, although a clinically relevant and characteristic symptom of DM1, is relatively scarce.
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Affiliation(s)
- Bianca Gj van der Velden
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Reinier Postlaan 4, 6525GC Nijmegen, the Netherlands.
| | - Kees Okkersen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Reinier Postlaan 4, 6525GC Nijmegen, the Netherlands.
| | - Roy Pc Kessels
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
| | - Johannes Groenewoud
- Department of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Baziel van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Reinier Postlaan 4, 6525GC Nijmegen, the Netherlands.
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Joost Raaphorst
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience Institute, Amsterdam, the Netherlands.
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13
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Minier L, Lignier B, Bouvet C, Gallais B, Camart N. A Review of Psychopathology Features, Personality, and Coping in Myotonic Dystrophy Type 1. J Neuromuscul Dis 2018; 5:279-294. [PMID: 30040740 PMCID: PMC6087440 DOI: 10.3233/jnd-180310] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The last literature review on psychopathological features in Myotonic Dystrophy type 1 had been conducted by Ambrosini and Nurnberg in 1979. Since that date, many researches had been carried out. OBJECTIVE The aim of this study is (i) to systematically obtain and evaluate the relevant literature on psychopathological features, personality, and coping in individuals with adult phenotypes of Myotonic Dystrophy type 1. (ii) To summarize current research findings and draw conclusions for future research. METHODS A systematic search was conducted on Pubmed, PubPsych, PsycInfo, Science Direct, and Scopus covering the period of January 1979 to July 2017. RESULTS In view of our literature review, patients show mild psychopathological problems, such as interpersonal difficulties, lack of interest, dysphoria, concern about bodily functioning, and hypersensibility. However, they do not experience more psychiatric disorder in comparison to the general population, except for personality disorders and depression. We discussed problems concerning depression's assessment tool. Patients also present symptoms of several personality disorders: avoidant personality disorder was the most common. Finally, coping strategies relative to limitations resulting from their disease have a negative impact on their quality of life. CONCLUSIONS In conclusion, Myotonic Dystrophy type 1 patients did not present homogeneous psychopathological and psychological features. However, based on tendencies observed among Myotonic Dystrophy type 1 patients, elements to conceptualize their social difficulties are provided.
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Affiliation(s)
- Lisa Minier
- Department of Psychology, Laboratoire CliPsyD, EA4430, Université Paris Nanterre, France
| | - Baptiste Lignier
- Department of Psychology, Laboratoire Psy-DREPI, EA 7458, Université de Bourgogne Franche-Comté, Dijon, France
- Espace Psychothérapique, pôle B Côte-d’Or Sud de Psychiatrie Générale, CH La Chartreuse, Dijon, France
| | - Cyrille Bouvet
- Department of Psychology, Laboratoire CliPsyD, EA4430, Université Paris Nanterre, France
| | - Benjamin Gallais
- ÉCOBES - Recherche et transfert, Cégep de Jonquière, QC, Canada
- Groupe de Recherche Interdisciplinaire sur les Maladies Neuromusculaires (GRIMN), Jonquière, QC, Canada
| | - Nathalie Camart
- Department of Psychology, Laboratoire CliPsyD, EA4430, Université Paris Nanterre, France
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14
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Callus E, Bertoldo EG, Beretta M, Boveri S, Cardani R, Fossati B, Brigonzi E, Meola G. Neuropsychological and Psychological Functioning Aspects in Myotonic Dystrophy Type 1 Patients in Italy. Front Neurol 2018; 9:751. [PMID: 30298045 PMCID: PMC6160752 DOI: 10.3389/fneur.2018.00751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/17/2018] [Indexed: 12/12/2022] Open
Abstract
Introduction: Myotonic Dystrophy Type 1 (DM1) is an autosomal dominant genetic illness, characterized by a progressive loss of strength. Important deficits in cognitive functioning and a significant prevalence of psychiatric disorders have been previously reported. Methods:A neuropsychological and psychological assessment was carried out in 31 DM1 patients (61% males) in order to measure the cognitive functioning and explore their personality profiles. The MMSE Mini-Mental State Examination, Frontal Assessment Battery (FAB), ENB-2 Battery assessing memory (short term, long term and working memory), integration capacities, visual-spatial ability, attention (selective, divided, shifting/switching) executive functions, praxis, discrimination and logic capabilities and psychopathology Symptom Check List 90-R (SCL-90-R) were administered. The neuropsychological and psychological evaluation of DM1 patients was carried out taking into consideration the clinical parameters (CTG repeat, age at onset, disease duration, Muscular Impairment Rate Scale (MIRS), Medical Research Council Scale (MRC) and the Epworth Sleepiness Scales (EPS)). Results: Regarding psychopathology 19.4% of patients scored a moderate or high level of symptoms intensity index (GSI), 12.9% reported a high number of symptoms (PST) and 16.1% reported a high intensity level of the perceived symptoms (PSDI). Fatigue and daytime sleepiness resulted as being associated with higher levels of psychoticism (PSY). Only 1 patient reported a severe impairment in the spatial and temporal orientation, memory, language, praxis, attention and calculation. Longer disease duration was also associated with cognitive impairment evaluated through ENB-2 (p < 0.05). Discussions and Conclusions:There are indications of the utility of neuropsychological and psychological screening and support for these patients and their families due to the link between disease duration and cognitive performances. A proposal of a clinical protocol, with an illustration of a clinical case report of a family is presented.
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Affiliation(s)
- Edward Callus
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Enrico G Bertoldo
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Maria Beretta
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Sara Boveri
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Rosanna Cardani
- Laboratory of Muscle Histopathology and Molecular Biology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Barbara Fossati
- Department of Neurology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Elisa Brigonzi
- Department of Neurology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Giovanni Meola
- Department of Neurology, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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15
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Lecordier D, Cartron E, Jovic L. [Understanding people with Steinert’s disease to provide them with better care.]. Rech Soins Infirm 2018:13-28. [PMID: 29436800 DOI: 10.3917/rsi.131.0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION the lifestyles of individuals with myotonic dystrophy type 1 (DM1), also known as Steinert’s disease, are poorly understood and yet they need to be considered when it comes to effective long-term care. The nursing care provided in referral centers is mindful of the clinical diversity of Steinert’s disease when it comes to interdisciplinary care, but the disease is more complex from a relational point of view. The objective of this qualitative study was to understand the life experiences of individuals with Steinert’s disease, by looking at the limitations of their bodies and the adaptation strategies they develop. METHOD this social science and nursing science study examines this problem of care, adopting an ethno-sociological perspective. RESULTS The study brought to light the changes that Steinert’s disease imposes on a body. These changes contribute to individuals’ construction of a body schema and social identity, which, despite allowing them to maintain a “normal” daily life for as long as possible, can also reach limits, requiring them to make radical life changes. The study’s results are discussed using an analytical framework based on the four different ways of interpreting the body proposed by Nicolas Vonarx: the “material body,” the “able body,” the “feeling body,” and the “knowing/judging body.” To discuss the role the body plays for people living with Steinert’s disease within a normative society, we propose that the concept of the “socializing body” be added to this framework.
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16
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Fujino H, Saito T, Takahashi MP, Takada H, Nakayama T, Ogata K, Rose MR, Imura O, Matsumura T. Validation of The Individualized Neuromuscular Quality of Life in Japanese patients with myotonic dystrophy. Muscle Nerve 2018; 58:56-63. [PMID: 29342319 DOI: 10.1002/mus.26071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 01/10/2018] [Accepted: 01/14/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The Individualized Neuromuscular Quality of Life (INQoL) is used to measure the quality of life (QoL) of patients with neuromuscular disease. We conducted this study to translate and validate the Japanese version of the INQoL in patients with myotonic dystrophy. METHODS Forward and backward translation, patient testing, and psychometric validation were performed. We used the 36-Item Short Form Health Survey (SF-36) and the modified Rankin scale for concurrent validation. RESULTS The Japanese INQoL was administered to 90 adult patients. The coefficients for internal consistency and test-retest reliability were adequately high in most domains (Cronbach α 0.88-0.96 and intraclass coefficient 0.64-0.99). INQoL domains were moderately to strongly associated with relevant SF-36 subscales (Spearman's ρ -0.23 to -0.74). Symptom severity, disease duration, employment status, and use of a ventilator influenced overall QoL. DISCUSSION The INQoL is a reliable and validated measure of QoL for Japanese patients with myotonic dystrophy. Muscle Nerve, 2018.
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Affiliation(s)
- Haruo Fujino
- Department of Special Needs Education, Oita University, 700 Dannoharu, Oita, Japan, 870-1192
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Toshio Saito
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Toyonaka, Japan
| | - Masanori P Takahashi
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroto Takada
- Department of Neurology, National Hospital Organization Aomori National Hospital, Aomori, Japan
| | | | - Katsuhisa Ogata
- Department of Neurology, National Hospital Organization Higashisaitama Hospital, Hasuda, Saitama, Japan
| | - Michael R Rose
- Department of Neurology, King's College Hospital, London, United Kingdom
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Toyonaka, Japan
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17
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Fujino H, Shingaki H, Suwazono S, Ueda Y, Wada C, Nakayama T, Takahashi MP, Imura O, Matsumura T. Cognitive impairment and quality of life in patients with myotonic dystrophy type 1. Muscle Nerve 2017; 57:742-748. [PMID: 29193182 DOI: 10.1002/mus.26022] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 11/25/2017] [Accepted: 11/27/2017] [Indexed: 01/25/2023]
Abstract
INTRODUCTION This study sought to clarify whether specific cognitive abilities are impaired in patients with myotonic dystrophy type 1 (DM1) as well as to investigate the relationships among quality of life (QoL), cognitive function, and psychological factors. METHODS Sixty patients with DM1 were evaluated on cognitive functioning (abstract reasoning, attention/working memory, executive function, processing speed, and visuoconstructive ability), apathy, depression, excessive daytime sleepiness, fatigue, and QoL. QoL was assessed by 2 domains of the Muscular Dystrophy Quality of Life Scale (Psychosocial Relationships and Physical Functioning and Health). RESULTS More than half of the patients exhibited cognitive impairment in attention/working memory, executive function, processing speed, and visuoconstructive ability. The Psychosocial Relationships factor was associated with processing speed, attention/working memory, and apathy, whereas depression and fatigue were associated with 2 QoL domains. DISCUSSION Our study identified specific cognitive impairments in DM1. Specific cognitive functions and psychological factors may be potential contributors to QoL. Muscle Nerve 57: 742-748, 2018.
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Affiliation(s)
- Haruo Fujino
- Department of Special Needs Education, Oita University, 700 Dannoharu, Oita, Japan, 870-1192.,Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Honoka Shingaki
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Shugo Suwazono
- Department of Neurology, National Hospital Organization Okinawa Hospital, Okinawa, Japan
| | | | - Chizu Wada
- Department of Neurology, National Hospital Organization Akita National Hospital, Yurihonjo, Japan
| | | | - Masanori P Takahashi
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Osaka, Japan
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18
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Peric S, Vujnic M, Dobricic V, Marjanovic A, Basta I, Novakovic I, Lavrnic D, Rakocevic-Stojanovic V. Five-year study of quality of life in myotonic dystrophy. Acta Neurol Scand 2016; 134:346-351. [PMID: 27696366 DOI: 10.1111/ane.12549] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2015] [Indexed: 12/18/2022]
Abstract
Background - Myotonic dystrophy type 1 (DM1) is the most common muscular dystrophy in adults. There is a complete lack of studies that assessed quality of life (QoL) trajectory during time in DM1 cohorts. Aim - To analyze changes of QoL in patients with DM1 during a 5-year follow-up period and to assess responsiveness of the SF-36 questionnaire. Patients and Method - At the baseline, this study comprised 84 DM1 patients, of whom 62 were retested after the mean period of 64.2 ± 3.9 months. Severity of muscular weakness was assessed using the Muscular Impairment Rating Scale (MIRS). Patients completed Serbian version of the SF-36 questionnaire as a measure of health-related QoL. Results - After 5 years, MIRS score of our DM1 patients showed significant progression of 0.5 grade (P < 0.01). All mental subdomains, role physical, and total SF-36 scores significantly improved after 5 years (P < 0.01). Unexpectedly, worsening of muscular weakness from mild to severe was in association with improvement of QoL. Conclusion - QoL improved in our cohort of DM1 patients during a 5-year period despite the progression of the disease. SF-36 should be used with caution as a patient-reported outcome measure in DM1 clinical trials.
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Affiliation(s)
- S. Peric
- Neurology Clinic; Clinical Center of Serbia; School of Medicine; University of Belgrade; Belgrade Serbia
| | - M. Vujnic
- Department of Pathophysiology; Faculty of Medicine; University of Banja Luka; Banja Luka Republic of Srpska Bosnia and Herzegovina
| | - V. Dobricic
- Neurology Clinic; Clinical Center of Serbia; School of Medicine; University of Belgrade; Belgrade Serbia
| | - A. Marjanovic
- Neurology Clinic; Clinical Center of Serbia; School of Medicine; University of Belgrade; Belgrade Serbia
| | - I. Basta
- Neurology Clinic; Clinical Center of Serbia; School of Medicine; University of Belgrade; Belgrade Serbia
| | - I. Novakovic
- Neurology Clinic; Clinical Center of Serbia; School of Medicine; University of Belgrade; Belgrade Serbia
- Institute of Human Genetics; School of Medicine; University of Belgrade; Belgrade Serbia
| | - D. Lavrnic
- Neurology Clinic; Clinical Center of Serbia; School of Medicine; University of Belgrade; Belgrade Serbia
| | - V. Rakocevic-Stojanovic
- Neurology Clinic; Clinical Center of Serbia; School of Medicine; University of Belgrade; Belgrade Serbia
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