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Muscle histology vs MRI in Duchenne muscular dystrophy.

Kinali, M and Arechavala-Gomeza, V and Cirak, S and Glover, A and Guglieri, M and Feng, L and Hollingsworth, K G and Hunt, D and Jungbluth, H and Roper, H P and Quinlivan, R M and Gosalakkal, J A and Jayawant, S and Nadeau, A and Hughes-Carre, L and Manzur, A Y and Mercuri, E and Morgan, J E and Straub, V and Bushby, K and Sewry, C and Rutherford, M and Muntoni, F (2011) Muscle histology vs MRI in Duchenne muscular dystrophy. Neurology, 76 (4). pp. 346-53. ISSN 1526-632X. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs

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Official URL: http://www.neurology.org/content/76/4/346.long

Abstract

OBJECTIVE

There are currently no effective treatments to halt the muscle breakdown in Duchenne muscular dystrophy (DMD), although genetic-based clinical trials are being piloted. Most of these trials have as an endpoint the restoration of dystrophin in muscle fibers, hence requiring sufficiently well-preserved muscle of recruited patients. The choice of the muscles to be studied and the role of noninvasive methods to assess muscle preservation therefore require further evaluation.

METHODS

We studied the degree of muscle involvement in the lower leg muscles of 34 patients with DMD >8 years, using muscle MRI. In a subgroup of 15 patients we correlated the muscle MRI findings with the histology of open extensor digitorum brevis (EDB) muscle biopsies. Muscle MRI involvement was assigned using a scale 0-4 (normal-severe).

RESULTS

In all patients we documented a gradient of involvement of the lower leg muscles: the posterior compartment (gastrocnemius > soleus) was most severely affected; the anterior compartment (tibialis anterior/posterior, popliteus, extensor digitorum longus) least affected. Muscle MRI showed EDB involvement that correlated with the patient's age (p = 0.055). We show a correlation between the MRI and EDB histopathologic changes, with MRI 3-4 grades associated with a more severe fibro-adipose tissue replacement. The EDB was sufficiently preserved for bulk and signal intensity in 18/22 wheelchair users aged 10-16.6 years.

CONCLUSION

This study provides a detailed correlation between muscle histology and MRI changes in DMD and demonstrates the value of this imaging technique as a reliable tool for the selection of muscles in patients recruited into clinical trials.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs
Subjects: WE Musculoskeletal. Orthopaedics
Divisions: Womens and Childrens > Paediatrics
Related URLs:
Depositing User: Sophie Rollason
Date Deposited: 11 Jun 2014 08:41
Last Modified: 11 Jun 2014 08:41
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/234

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