894 results match your criteria: "Neuromuscular Center[Affiliation]"

Muscle Contractility in Hypokalemic Periodic Paralysis.

Muscle Nerve

December 2024

Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Introduction/aims: Primary hypokalemic periodic paralysis (HypoPP) can present with periodic paralysis and/or permanent muscle weakness. Permanent weakness is accompanied by fat replacement of the muscle. It is unknown whether the permanent muscle weakness is solely due to fat replacement or if other factors affect the ability of the remaining muscle fibers to contract.

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Congenital titinopathies reported to date show autosomal recessive inheritance and are caused by a variety of genomic variants, most of them located in metatranscript (MTT)-only exons. The aim of this study was to describe additional patients and establish robust genotype-phenotype associations in titinopathies. This study involved analyzing molecular, clinical, pathological, and muscle imaging features in 20 patients who had at least one pathogenic or likely pathogenic variant in MTT-only exons, with onset occurring antenatally or in the early postnatal stages.

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Objective: Limb-girdle muscular dystrophy R9 (LGMDR9, formerly known as LGMD2I), caused by variants in the fukutin-related protein (FKRP) gene leads to progressive muscle weakness of the shoulder and pelvic limb-girdles and loss of motor function over time. Clinical management and future trial design are improved by determining which standardized clinical outcome assessments (COA) of function are most appropriate to capture disease presentation and progression, informing endpoint selection and enrollment criteria. The purpose of our study was to evaluate the cross-sectional validity and reliability of clinical outcome assessments in patients with FKRP-related LGMDR9 participating in the Genetic Resolution and Assessments Solving Phenotypes in LGMD (GRASP) natural history study.

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Diagnosing missed cases of spinal muscular atrophy in genome, exome, and panel sequencing datasets.

Genet Med

December 2024

Program in Medical and Population Genetics, Broad Center for Mendelian Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

Purpose: We set out to develop a publicly available tool that could accurately diagnose spinal muscular atrophy (SMA) in exome, genome or panel sequencing datasets aligned to a GRCh37, GRCh38, or T2T reference genome.

Methods: The SMA Finder algorithm detects the most common genetic causes of SMA by evaluating reads that overlap the c.840 position of the SMN1 and SMN2 paralogs.

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Background: Early detection and diagnosis of myasthenia gravis (MG) is important to improve the chance of remission and overall prognosis. This study aims to investigate the factors affecting the diagnostic delay of MG thereby highlighting the challenges in the diagnostic process.

Methods: We conducted a retrospective study examining characteristics and factors involved in the diagnostic process of MG.

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Robert Schumann (1810-1856), one of the greatest music composers of the Romantic era, was suspected to have had syphilis. Syphilis was a stigmatized disease during the time, and Schumann's followers tended to deny the infection itself or to destroy evidence of possible infection; therefore, no solid evidence is available in this regard. However, based on records (obtained 130 years after his death), which describe his stay in a psychiatric hospital, it is concluded that Schumann was certainly diagnosed with syphilis.

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Quantitative Muscle MRI to Monitor Disease Progression in Hypokalemic Period Paralysis.

Neurol Genet

December 2024

From the Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark.

Article Synopsis
  • Primary hypokalemic periodic paralysis (HypoPP) is a muscle condition that causes episodes of paralysis and can lead to permanent muscle weakness; understanding its natural progression could help in treatment evaluation.* -
  • A study examined 37 individuals with HypoPP using MRI to measure fat replacement in muscles and strength tests to track changes over 20 months, revealing increased fat in many muscles but no significant muscle strength changes.* -
  • The findings suggest that MRI is an effective tool for detecting subclinical progression of HypoPP, helping to assess disease progression in both symptomatic and asymptomatic patients.*
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Characteristics and healthcare utilization of patients with myasthenia gravis exacerbation.

J Neurol Sci

November 2024

Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States.

Purpose: This retrospective cohort study describes the characteristics of patients with myasthenia gravis (MG) who developed exacerbations (MG-E) and compares their healthcare utilization (HRU) to patients who did not experience exacerbations (MG-O).

Method: De-identified data from patients who had ≥2 MG-related diagnostic code submissions were extracted from the National Veterans Affairs Health Care Network electronic health records between 1999 and 2022. Descriptive statistics, Kaplan-Meier analysis, and per-patient per-year (PPPY) HRU were used to compare the two patient groups.

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Functional Outcome Measures to Optimize Drug Development in Spinal and Bulbar Muscular Atrophy: Results From a Meta-Analysis of the Global SBMA Dataset.

Neurology

December 2024

From the Nido Biosciences (S.B.H., A.T.N.T., V.V.), Inc., Boston, MA; Institute of Developmental and Regenerative Medicine (IDRM) (C.R.), University of Oxford; Department of Neuromuscular Diseases (D.J., L.Z., P.F.), University College of London, United Kingdom; Department of Neurosciences (L.B., A.F., G.S.), Neuromuscular Center, University of Padova, Italy; Neurogenetics Branch (A.A., A.K., C.G.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Copenhagen Neuromuscular Center (J.D., J.V.), Rigshospitalet, University of Copenhagen, Denmark; Fondazione IRCSS (S.F., E.C., A.B., C.M., D.P.), Istituto Neurologico Carlo Besta Milano, Italy; Department of Neurology (T.K., Y.K., S.Y.), Nagoya University Graduate School of Medicine; Department of Neurology and Department of Clinical Research Education (M. Katsuno), Nagoya University Graduate School of Medicine, Japan; Centro Clinico Nemo Adulti-Fondazione Serena onlus (A.C.), Policlinico Universitario Agostino Gemelli IRCCS; Centro Clinico Nemo Adulti-Fondazione Serena onlus (M.S.), Policlinico Universitario Agostino Gemelli IRCCS, Section of Neurology, Department of Neuroscience, Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy; and Department of Neurology (M. Kang, J.-S.P.), School of Medicine, Kyungpook National University, Chilgok Hospital, Daegu, Korea.

Background And Objectives: Spinal and bulbar muscular atrophy (SBMA) is a rare, slowly progressive, and debilitating disease without effective treatments available. Lack of reliable biomarkers and sensitive outcome measures makes clinical research conduct challenging. The primary objective of this study was to identify clinically meaningful and statistically sensitive outcome measures enabling the evaluation of therapeutic interventions in late-stage clinical trials.

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The physiological actions of a gut hormone, glucagon-like peptide-1 (GLP-1), in Alzheimer's disease (AD) brain remain poorly understood, although GLP-1 receptor (GLP-1R) expression in this organ has been shown in several experimental studies. Therefore, we explored whether the GLP-1R signaling promotes the clearance of amyloid β (Aβ) (1-42) which is a core pathological hallmark of AD, focusing on the water channel protein aquaporin 4 (AQP4) localized to astrocyte endfeet perivascular membranes in intact brain. First, we confirmed that Glp1r mRNA is predominantly expressed at perivascular site of astrocytes in normal mouse cerebral cortex through in situ hybridization analysis.

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Article Synopsis
  • The MMPOWER-3 clinical trial initially found no overall benefit of elamipretide for adults with primary mitochondrial myopathy, but a subgroup with nuclear DNA variants showed improvement in a six-minute walk test.
  • A large portion of the trial subjects had mitochondrial DNA variants, with particular improvements noted among those possessing pathogenic variants related to mtDNA maintenance.
  • Further analyses aim to identify trends among responders to assist in designing a more targeted Phase 3 trial for those likely to benefit from elamipretide.
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Introduction: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease with no known cure, limited treatment options with minimal benefits, and significant unmet need for disease modifying therapies.

Aims: This study investigated memantine's impact on ALS progression, with an additional focus on the effects of memantine on cognitive and behavioral changes associated with the disease.

Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2018 to September 2020.

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Gene therapy for spinal muscular atrophy: timing is key.

Lancet Reg Health Eur

December 2024

MDUK Oxford Neuromuscular Centre, Department of Paediatrics, University of Oxford and NIHR Oxford Biomedical Research Center, Oxford OX3 9DU, United Kingdom.

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Article Synopsis
  • Becker muscular dystrophy (BMD) is an X-linked neuromuscular disorder caused by mutations in the DMD gene, impacting dystrophin production in muscle tissues, which is important for patient care and treatment development.
  • A study of 943 BMD patients revealed the median age at diagnosis was 7.5 years, with significant findings including that about 13.5% lost mobility by an estimated age of 69, while 30% experienced cardiac issues.
  • Different types of DMD mutations correlated with variations in disease progression, particularly affecting loss of ambulation and heart functionality, highlighting the importance of precise genetic characterization for managing BMD.
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Efficacy and safety of gene therapy with onasemnogene abeparvovec in children with spinal muscular atrophy in the D-A-CH-region: a population-based observational study.

Lancet Reg Health Eur

December 2024

Heidelberg University, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Department I, Division of Pediatric Neurology and Metabolic Medicine, Im Neuenheimer Feld 430, Heidelberg 69120, Germany.

Background: Real-world data on gene addition therapy (GAT) with onasemnogene abeparvovec (OA), including all age groups and with or without symptoms of the disease before treatment are needed to provide families with evidence-based advice and realistic therapeutic goals. Aim of this study is therefore a population-based analysis of all patients with SMA treated with OA across Germany, Austria and Switzerland (D-A-CH).

Methods: This observational study included individuals with Spinal Muscular Atrophy (SMA) treated with OA in 29 specialized neuromuscular centers in the D-A-CH-region.

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275th ENMC international workshop: Seronegative myasthenia gravis: An update paradigm for diagnosis and management, 9-11 February 2024, Hoofddorp, the Netherlands.

Neuromuscul Disord

November 2024

Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Instituto Neurologico Carlo Besta, Milano, Italy. Electronic address:

The 275th ENMC workshop on the diagnosis and management of seronegative myasthenia gravis (SNMG) was held on February 9-11, 2024. The participants included experts in the field of adult and pediatric MG together with patient representatives. This workshop aimed to redefine SNMG in view of recent diagnostic and therapeutic updates and to identify patient unmet needs.

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Safety, tolerability, and efficacy of fasudil in amyotrophic lateral sclerosis (ROCK-ALS): a phase 2, randomised, double-blind, placebo-controlled trial.

Lancet Neurol

November 2024

Department of Neurology, Klinikum rechts der Isar, Technical University Munich, School of Medicine and Health, Munich, Germany; German Center for Neurodegenerative Diseases, Site Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany. Electronic address:

Background: Fasudil is a small molecule inhibitor of Rho-associated kinase (ROCK) and is approved for the treatment of subarachnoid haemorrhage. In preclinical studies, fasudil has been shown to attenuate neurodegeneration, modulate neuroinflammation, and foster axonal regeneration. We aimed to investigate the safety, tolerability, and efficacy of fasudil in patients with amyotrophic lateral sclerosis.

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Biological biomarkers in muscle diseases relevant for follow-up and evaluation of treatment.

Brain

October 2024

Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark.

Muscle diseases cover a diverse group of disorders that in most cases are hereditary. The rarity of the individual muscle diseases provides a challenge for researchers when wanting to establish natural history of the conditions and when trying to develop diagnostic tools, therapies, and outcome measures to evaluate disease progression. With emerging molecular therapies in many genetic muscle diseases, as well as biological therapies for the immune-mediated ones, biological biomarkers play an important role in both drug development and evaluation.

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Article Synopsis
  • This study investigates health care resource utilization (HCRU) and the economic impact of myasthenia gravis (MG) in Denmark, Finland, and Sweden, using nationwide data over a 20-year period.
  • It assesses costs associated with MG, including direct (inpatient care, medications) and indirect costs (like early retirement and sick leave), finding that severe MG significantly increases overall expenses.
  • The results indicate that the average yearly cost per person ranges from €5,997 to €12,185, with severe cases incurring costs up to €33,495, highlighting the substantial financial burden of MG in these countries.
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Graph theory network analysis reveals widespread white matter damage in brains of patients with classic ALS.

Amyotroph Lateral Scler Frontotemporal Degener

October 2024

Department of Neurology, Neuromuscular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

: Amyotrophic lateral sclerosis (ALS) exhibits several different presentations and clinical phenotypes. Of these, classic ALS (ALS-Cl), which is the most common phenotype, presents with relatively equal amounts of upper motor neuron and lower motor neuron signs. Magnetic resonance imaging (MRI) provides a noninvasive way to assess central nervous system damage in these patients.

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There is a growing focus on person-centered care, emphasizing the importance of respecting inter-individual differences and implementing individualized treatment initiatives. Prior research has established an association between personality traits, body mass index, and health-related behaviors. The aim of this study was to explore the potential of personality trait assessments in identifying individuals at risk of glycemic dysregulation and increasing BMI.

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Background: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune disease of the peripheral nervous system that can lead to severe disability from muscle weakness and sensory disturbances. Around a third of patients do not respond to currently available treatments, and many patients with a partial response have residual neurological impairment, highlighting the need for effective alternatives. Efgartigimod alfa, a human IgG1 antibody Fc fragment, has demonstrated efficacy and safety in patients with generalised myasthenia gravis.

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Article Synopsis
  • The study investigates the effectiveness and safety of rozanolixizumab in treating patients with muscle-specific tyrosine kinase (MuSK) autoantibody-positive generalized myasthenia gravis (gMG), which is a severe form of the condition.
  • Conducted as a randomized, double-blind, placebo-controlled phase III trial, it involved participants aged 18 and older who were randomly assigned to receive either rozanolixizumab (at two different dosages) or a placebo over 6 weeks.
  • Results showed significant improvements in the Myasthenia Gravis Activities of Daily Living (MG-ADL) scores for both doses of rozanolixizumab compared to placebo, with manageable side effects reported;
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