Dataset Information

Outcome reliability in non-ambulatory boys/men with Duchenne muscular dystrophy.

ABSTRACT: Therapeutic trials in Duchenne muscular dystrophy (DMD) often exclude non-ambulatory individuals. Here we establish optimal and reliable assessments in a multicenter trial.Non-ambulatory boys/men with DMD (N?=?91; 16.7?±?4.5 years of age) were assessed by trained clinical evaluators. Feasibility (percentage completing task) and reliability [intraclass correlation coefficients (ICCs) between morning and afternoon tests] were measured.Forced vital capacity (FVC), assessed in all subjects, showed a mean of 47.8?±?22% predicted (ICC 0.98). Brooke Upper Extremity Functional Rating (Brooke) and Egen Klassifikation (EK) scales in 100% of subjects showed ICCs ranging from 0.93 to 0.99. Manual muscle testing, range of motion, 9-hole peg test, and Jebsen-Taylor Hand Function Test (JHFT) demonstrated varied feasibility (99% to 70%), with ICCs ranging from 0.99 to 0.64. We found beneficial effects of different forms of corticosteroids for the Brooke scale, percent predicted FVC, and hand and finger strength.Reliable assessment of non-ambulatory boys/men with DMD is possible. Clinical trials will have to consider corticosteroid use.

SUBMITTER: Connolly AM

PROVIDER: S-EPMC4305351 | biostudies-other | 2015 Apr

REPOSITORIES: biostudies-other

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Outcome reliability in non-ambulatory boys/men with Duchenne muscular dystrophy.

Connolly Anne M AM Malkus Elizabeth C EC Mendell Jerry R JR Flanigan Kevin M KM Miller J Philip JP Schierbecker Jeanine R JR Siener Catherine A CA Golumbek Paul T PT Zaidman Craig M CM Mcdonald Craig M CM Johnson Linda L Nicorici Alina A Karachunski Peter I PI Day John W JW Kelecic Jason M JM Lowes Linda P LP Alfano Lindsay N LN Darras Basil T BT Kang Peter B PB Quigley Janet J Pasternak Amy E AE Florence Julaine M JM

Muscle & nerve 20150211 4

<h4>Introduction</h4>Therapeutic trials in Duchenne muscular dystrophy (DMD) often exclude non-ambulatory individuals. Here we establish optimal and reliable assessments in a multicenter trial.<h4>Methods</h4>Non-ambulatory boys/men with DMD (N = 91; 16.7 ± 4.5 years of age) were assessed by trained clinical evaluators. Feasibility (percentage completing task) and reliability [intraclass correlation coefficients (ICCs) between morning and afternoon tests] were measured.<h4>Results</h4>Forced vit ...[more]

PMID: 25056178

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Project description:BackgroundDuchenne muscular dystrophy (DMD) is the most common muscular dystrophy in the pediatric population. The manifestations of this disease include progressive muscle weakness, gait dysfunction, and motor impairment, leading to a loss of ambulation by the age of 13 years. Molecular diagnosis is the standard diagnostic tool for DMD. This study aimed to investigate disease progression and genetic patterns in Iranian ambulant boys and to find the correlation between genotypes and motor function phenotypes.MethodsThis study was performed on 152 DMD patients. Clinical history, including the disease phenotype, steroid therapy, and the North Star Ambulatory Assessment (NSAA) score, was taken for all the patients. Molecular diagnoses were confirmed by multiplex ligation-dependent probe amplification and next-generation sequencing tests.ResultsA total of 152 Iranian DMD patients were examined in this study. The mean age at the time of disease onset was 4.04 ± 2.00 years, and the mean age at diagnosis was 5.05 ± 2.08 years. The mean age of ambulation loss was 10.9 years. Contracture was reported in 38.9% of cases. In terms of age, the mean total NSAA score showed a peak at 4 years of age, with a mean NSAA score of 24. Annual changes in the NSAA score were determined for all cases, based on the mutation type and exon site. Deletion mutation was found in 79.1% of cases, duplication in 6.8%, nonsense in 12.8%, and splice site in 1.4%. The most common single exon deletion was exon 44 (5.3%), and the most common multiexon deletions were attributed to exons 45-50 and exons 45-52 (4.6%). The results did not indicate any correlation between the mutation type and age at the time of disease onset, loss of ambulation age, and wheelchair dependence; however, a significant association was found between contracture and mutation type. The results showed a significant difference in the NSAA score between the deletion and nonsense groups at the age of 3 years (P = 0.04). No significant correlation was found between the phenotype and exon site. Overall, 91.1% of the study population had a history of corticosteroid use, and 54.1% showed compliance with rehabilitation therapy.ConclusionThis study demonstrated the phenotypes and mutational features of Iranian DMD boys and provided information regarding the natural motor history of the disease, disease progression, diagnosis, and status of DMD management in Iran. The present findings can promote the development of clinical trials and future advanced molecular therapies in Iran.

Dataset Information

Outcome reliability in non-ambulatory boys/men with Duchenne muscular dystrophy.

Publications

Outcome reliability in non-ambulatory boys/men with Duchenne muscular dystrophy.

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