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PubMed1976

Clinical observations of juvenile nonprogressive muscular atrophy localized in hand and forearm.

Twenty-seven patients with juvenile nonprogressive muscular atrophy localized in the hand and forearm were analyzed. The clinical characteristics were juvenile male occurrence, insidious onset, specific distribution of localized muscular atrophy and a stationary course. On electromyography, denervation voltage (or giant NMU) is found in the atrophied muscles and sometimes in contralateral nonatrophied ones. Sensory disturbance was not remarkable. Although the etiological factor was not known, strenuous exercise of arms in sports was noted frequently in the history.

Adolescent↗
PubMed1976

Genetic investigations on chronic forms of infantile and juvenile spinal muscular atrophy.

A material of 247 cases selected from 260 cases of spinal muscular atrophy in the Warsaw Department of Neurology in 1960-1974 was analyzed. The size of sibships was established and calculations were made of the mean distribution of the age at onset, also according to sex, for the different clinical forms, genetical proportions by the method of siblings and of probands, and coefficient of sib-sib correlation for the material as a whole and separately for males, females and male-female pairs. The analysis shows the course of the disease to differ between the sexes and to be mild in males more often than in females, as is particularly noticeable in the higher age groups. Cases of Kugelberg-Welander's disease are predominantly male. The hypothesis is advanced that a proportion of male patients have a sex-linked modifying gene of a fairly high frequency (possibly of the range of 1 in 5 males, and 1 in 25, in the homozygous state, in females). Although it would not disprove conclusively the nosological distinctness of different forms of infantile and juvenile spinal muscular atrophy, the existence of the modifying gene, if proved, would tend rather to add to the likelihood of their constituting a single recessive autosomal disease.

Adolescent↗
PubMed1994

Linkage disequilibrium analysis of childhood-onset spinal muscular atrophy (SMA) in the French-Canadian population.

Spinal muscular atrophy (SMA) is, after Duchenne muscular dystrophy, the most common neuromuscular disorder in childhood. The gene responsible for childhood SMA has been mapped to the q11.2-q13.3 region of chromosome 5. We have extended our linkage studies of SMA in the French-Canadian population to include microsatellite markers at the D5S125, D5S351, D5S435, JK53CA1/2 and MAP1B loci. These markers span about 4 cM of the SMA candidate region. We observed significant evidence for linkage between SMA and all the markers tested. The analysis of recombinant chromosomes provide evidence for the following genetic order: D5S125-D5S435-MAP1B-3'-JK53CA1/2 and places D5S351 proximal to JK53CA1/2. Furthermore, we confirm the current localization of the SMA gene distal to D5S435. Finally, we provide demonstration of significant linkage disequilibrium between childhood-onset SMA and four of the five marker loci, D5S125, D5S435, D5S351 and JK53CA1/2. Analysis of SMA-region haplotypes suggests that there may be a predominant SMA allele that is present on about 17% of SMA chromosomes in this sample of the French-Canadian population. We conclude that the observed linkage disequilibrium is likely due to genetic drift among regions of Quebec, consistent with this population's early history.

Age of Onset↗
PubMed1992

[Clinical and histochemical findings in spinal muscular atrophy].

The childhood form of the spinal muscular atrophy (SMA) is classically subdivided into three groups on the basis of a combination of age of onset, milestones of development and age of survival: acute Werdning-Hoffmann (type I), intermediate Werdnig-Hoffmann (type II) and Kugelberg-Welander disease (type III). Now we examined 7 cases of type I and 9 cases of type II on clinical and histochemical ground. Of the total of 16 cases, 5 cases had a family history of the disease. (1) In type I, three were males and 4 females. The onset was within 30 days and the disease was manifest before or at delivery in 3 cases. The progression was so severe. All cases were dead by 10 months. They showed generalized hypotonia, abnormal respiration and could not sit without support. In type II, five were males and 4 females. The onset of the disease was between the age of 3 and 15 months. The progression was slow. All patients couldn't walk by themselves at all but 7 of them had abilities to sit without support. Clinically it was easy to classify type I from type II. (2) The most characteristic histochemical findings of both types were group atrophy, fiber hypertrophy, fiber type predominance and fibrosis. Though there was a slight difference between two types in histological pattern, the basis was so similar. There is controversy about the proper classification of recessive childhood SMA. Now it is suggested that the majority of both acute and chronic cases are allelic, similar to the patterns of Duchenne and Becker forms of muscular dystrophy.

Biopsy↗
PubMed1977

Infantile spinal muscular atrophy (morbus Werdnig-Hoffmann) causing neonatal asphyxia.

A case of infantile spinal muscular atrophy (Werdnig-Hoffmann's disease) with complete proximal pareses obvious at birth giving rise to neonatal asphyxia is reported. Reduction of fetal movements was noted from the 32nd week of pregnancy. The infant was extremely floppy at birth and spontaneous movements were restricted to hands, feet and face. Fibrillations of the tongue, diaphragmatic hemiparesis and dysphagia were observed. Unassisted ventilation was not compatible with survival and the infant succumbed to the disease in the neonatal period. Muscle biopsy and autopsy confirmed the clinical diagnosis. Infantile spinal muscular atrophy causing neonatal asphyxia seems to be unusual and not earlier described. Constant muscular hypotonus in an asphyctic newborn should raise suspicion of a neuromuscular disorder.

Asphyxia Neonatorum↗
PubMed1995

Constitutive muscular abnormalities in culture in spinal muscular atrophy.

To explore the cause of spinal muscular atrophy (SMA), we used an in-vitro model of nerve-muscle co-cultures in which motoneurons were normal and satellite cells were obtained from SMA patients. In co-cultures initiated with satellite cells from type I and type II SMA patients only, we observed degeneration of the innervated fibres after 1-3 weeks of nerve-muscle co-culture. This process involved vacuolisation, disorganisation, and death of the innervated muscle fibres. This observation points to a muscular implication in the severe forms of SMAs.

Culture Techniques↗
PubMed1994

[Changes of some proteins expression of the spinal cord and muscles in infantile spinal muscular atrophy].

The various types of childhood spinal muscular atrophy (SMA) represent a spectrum of clinical disorders resulting from the degeneration of motor neurons (MN). The genetic defect has been recently localized to chromosome 5q in the region 11.2-13.3. Under normal conditions, half of the motor neurons die during embryonic development, while the remaining 50% survive to innervate muscle fibers and form neuromuscular junctions. Numerous studies using in vivo and in vitro models have shown that survival of MNs depends on the presence of trophic factors of neuronal and muscular origin. However, at the present time, no molecular mechanisms can be proposed to account for the nature and the sequence of the interactions leading to the formation and maintenance of a functional neuromuscular junction. To gain a better understanding of the SMA disorders, an alternative to genetic studies consists in analyzing the molecular mechanisms underlying this pathology. Variations in the expression of proteins, for instance, might reflect the pathological phenotype. We thought it possible to detect differences in the protein(s) which would correlate with the molecular deficit of childhood SMA. We, therefore, compared the patterns of human protein expression from normal controls and SMA spinal cord and muscle. Significant variations in the expression of some proteins, which have been quantified by a computerized Bio-Image electrophoresis system, have been found. In particular, two proteins, a and b (126 kDa and 112 kDa) which are very probably common to spinal cord and muscle show a marked increase of their expression in children with SMA.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1996

Motor nerve conduction studies on children with spinal muscular atrophy.

Median and posterior tibial motor nerve conduction studies were performed on 10 children with spinal muscular atrophy (SMA). Three patients with SMA type I, in whom rapid deterioration occurred, showed reduced motor nerve conduction velocity and a remarkably low M-wave amplitude in both nerves. In type II and III patients, the motor nerve conduction velocity was normal in the median nerve, although the M-wave amplitude was small in the tibial nerve. In four patients, a reduction of the M-wave amplitude was observed as clinical symptoms advanced. These findings may suggest that motor conduction studies in spinal muscular atrophy provide complementary information for understanding the pathogenesis and are also useful to clarify the heterogeneity of this disease.

Child↗
PubMed1978

Anterior-horn cell degeneration and gross calf hypertrophy with adolescent onset. A new spinal muscular atrophy syndrome.

A new variant of spinal muscular atrophy (S.M.A.), characterised by adolescent onset, gross hypertrophy of calves, and a slowly progressive clinical course, was found in 5 patients, 3 of them in a series of 102 cases being studied in North-East England. Biopsy and electrophysiological studies indicated the presence of chronic progressive degeneration of anterior-horn cells.

Adolescent↗
PubMedDate not supplied

Scapuloperoneal muscular atrophy: Davidenkow's syndrome. Family report.

The nosology of scapuloperoneal syndrome remains controversial. Is it a variant of Charcot-Marie-Tooth's disease, a form of myopathy, or of spinal muscular atrophy is still unknown. A family with a scapuloperoneal syndrome caused by anterior horn cell involvement is described. Data for sensory involvement were also found. In addition one member of the family had motor nerves and corticospinal tract involvement. The distribution of weakness and muscle wasting was unusual--only lower limbs were involved. However, electromyographic data for both upper and lower limbs involvement were evident. The combination of scapuloperoneal syndrome with sensory loss has been described by Davidenkow, but was not proved by neurographic investigation. Later only one case with proved sensory disturbances was reported. Patients with motor nerves involvement in addition were reported, but not received satisfactory explanation. Probably in some patients the disease could be manifested only with anterior horn cell involvement, while in other both motor and sensory nerves could be involved. In conclusion we suppose that the scapuloperoneal muscular atrophy is a form of spinal muscular atrophy which could be manifested by different symptoms.

Adolescent↗
PubMed1983

Unilateral scapulohumeral muscular atrophy.

A peculiar form of chronic spinal muscular atrophy is described, 5 unrelated young males developed muscle wasting of the left shoulder and upper arm region, mainly in the distribution of myotomes C5 and C6. This muscle atrophy remained confined to the primary site for 13-18 years, being followed in 4 cases by a mild muscle atrophy of the right upper arm or or the left forearm and hand and in 1 case by atrophy of the legs and the facial muscles. On EMG examination, muscle involvement was always found to be more widespread than on clinical examination. The repeated and extensive EMG examinations gave results typical of an anterior horn cell disease. Pyramidal signs were absent. During the observation period of 21-40 years the course was benign and at least partial working capacity was retained until retiring age.

Aged↗
PubMed1984

HLA antigens and spinal muscular atrophy.

Fifty-four patients with spinal muscular atrophy were examined and HLA typing performed on blood from each. A, B and DR antigens were determined. No statistical difference in antigen prevalence was found between patients and a control population. The clinical and genetic heterogeneity found in this disorder does not appear to be related to HLA status.

Adult↗
PubMedDate not supplied

Late-onset X-linked recessive spinal and bulbar muscular atrophy.

A family is described in which five males have late-onset facial weakness, dysarthria, dysphagia, and slowly progressive proximal weakness. Electrodiagnostic studies and muscle biopsy were compatible with spinal muscular atrophy. This family appears quite similar to several previously reported families with late-onset X-linked recessive spinal and bulbar muscular atrophy. Because of the relative homogeneity of this particular phenotype of spinal muscular atrophy, a single metabolic derangement was sought. Three obligate carriers were studied, and no abnormality was detected. A further family with this condition is briefly discussed.

Aged↗
PubMed1992

Strong correlation between the number of CAG repeats in androgen receptor genes and the clinical onset of features of spinal and bulbar muscular atrophy.

X-linked spinal and bulbar muscular atrophy (SBMA), a motor neuron disease associated with androgen insensitivity, is caused by androgen receptor gene mutations with an increased number of tandem CAG repeats in exon 1. We investigated the increased number of CAG repeats in androgen receptor genes of 19 SBMA patients and found that this correlated strongly with the age at onset of muscle weakness. Thus, SBMA is the first genetic disease in which a strong correlation between the degree of genetic abnormality (number of CAG tandem repeats) and clinical phenotypic expression is demonstrable. The results further indicate that androgen gene mutation is directly involved in the degeneration of motor neurons.

Adult↗
PubMed1993

[A novel primer extension method to detect the number of CAG repeats in the androgen receptor gene in families with X-linked spinal and bulbar muscular atrophy].

X-linked spinal and bulbar muscular atrophy (SBMA), an adult-onset form of motor neuron disease, was recently reported to be caused by amplification of the CAG repeats in the androgen receptor gene. We report here a simple and rapid strategy to detect the precise number of the CAGs. After the DNA fragment containing the CAG repeats is amplified by the polymerase chain reaction, a primer extension is carried out; the extension of the end-labelled reverse primer adjacent to 3' end of CAG repeats stops at the first T after CAG repeats with the incorporation of dideoxy ATP in the reaction mixture. The resultant primer products are analysed by denaturing polyacrylamide gel electrophoresis and autoradiography. This method could be quite useful to detect not only CAG repeats in SBMA but also other polymorphic dinucleotide and trinucleotide repeats.

Adolescent↗
PubMed1988

CT muscle scanning in the evaluation of patients with spinal muscular atrophy (SMA).

One hundred patients with spinal muscular atrophy (SMA) were assessed by CT scanning using a standardised technique. The spectrum of CT abnormality occurring in SMA was observed and by overall analysis the patients were divided into 4 groups. While the CT appearances of these groups correlated well with clinical assessment of severity of disease, the disease process was usually much more widespread than clinical examination suggested. CT abnormality was first observed in the leg and gluteal muscles, progressing to the posterior spinal, thigh, shoulder girdle and sternomastoid muscles. Hypertrophy of sartorius and gracilis was observed in a significant number of patients. Fascial planes were preserved in involved muscles in over half of the patients, even in late-stage disease. Asymmetrical muscle involvement was seen with increasing frequency as the disease process increased in extent as evaluated by CT scanning. There was no discernible difference in the CT appearances in those patients who clinically had limb-girdle, facioscapulohumeral or scapuloperoneal distribution of weakness.

Adolescent↗
PubMed1990

[Computed tomographic analyses on skeletal muscles in bulbar spinal muscular atrophy].

We analysed the patterns of skeletal muscular involvement in 18 patients with bulbar-spinal muscular atrophy (BSMA) of the Kennedy-Alter-Sung type by using the computed tomographic scanner. Fatty infiltrations were prominent in various skeletal muscles of extremities and trunk, and its degree was severe in the following numerical orders; the gluteal muscles, flexors of the thighs, flexors of the lower extremities, extensors and the adductors of the thighs, the paraspinal muscles, and extensors of the lower extremities. There was statistically significant correlation between fatty infiltrations in flexors of the lower extremities and duration of illness. And were noted findings that the skeletal muscle lesion progressed with the preserved fasciae and sectional areas, fatty infiltrations in the lower extremities were more conspicuous in flexors than in extensors, and compensatory hypertrophic muscles in the thigh were apparent in 50% of cases. In conclusions, the computed tomographic analyses on skeletal muscle of BSMA may be useful to detect distributions, progression of the muscle lesion, in addition to a profile of the myopathic alterations of the disease.

Adult↗