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Item does not contain fulltext Brody disease is an inherited myopathy associated with a defective function of sarcoplasmic/endoplasmic reticulum Ca(2+)-ATPase 1 (SERCA1) protein. Mutations in the ATP2A1 gene have been reported only in some patients. Therefore it has been proposed to distinguish patients with ATP2A1 mutations, Brody disease (BD), from patients without mutations, Brody syndrome (BS). We performed a detailed study of SERCA1 protein expression in muscle of patients with BD and BS, and evaluated the alternative splicing of SERCA1 in primary cultures of normal human muscle and in infant muscle. SERCA1 reactivity was observed in type 2 muscle fibers of patients with and without ATP2A1 mutations and staining intensity was similar in patients and controls. Immunoblot analysis showed a significant reduction of SERCA1 band in muscle of BD patients. In addition we demonstrated that the wild type and mutated protein exhibits similar solubility properties and that RIPA buffer improves the recovery of the wild type and mutated SERCA1 protein. We found that SERCA1b, the SERCA1 neonatal form, is the main protein isoform expressed in cultured human muscle fibers and infant muscle. Finally, we identified two novel heterozygous mutations within exon 3 of the ATP2A1 gene from a previously described patient with BD.

An international panel has recently proposed consensus definitions for pediatric multiple sclerosis and related disorders. These are important diagnostic improvements, but exceptions have been acknowledged. Further insight about clinical overlap between pediatric multiple sclerosis and all forms of relapsing acute disseminated encephalomyelitis may be gained from long-term follow-up. We report an 8-year follow-up of a girl who developed multiple episodes of central nervous system demyelination at the age of 3 years consistent with multiphasic acute disseminated encephalomyelitis. At 10 years of age (7 years after the first clinical event), she developed progressive cognitive deterioration, mood disorder, and headache, suggesting a secondary progressive form of multiple sclerosis. Magnetic resonance imaging and cerebrospinal fluid analysis were equivocal while visual evoked potentials were the sole test in favor of a diagnosis of multiple sclerosis. A multifaceted approach may be needed when dealing with atypical cases of demyelinating disease in young children.

This study investigated the possible prognostic factors for relapse, and the diagnostic criteria for multiple sclerosis and related disorders, in pediatric acute disseminated encephalomyelitis. The study population comprised 24 Italian children with a mean age at onset of 6.9 years, and a mean follow-up time of 52.8 months (range, 12-180). Clinical, neurophysiologic, spinal-fluid, neuroradiologic, and outcome features were investigated. All patients but 2, who were reclassified as exhibiting clinically isolated syndromes, fulfilled the new classification criteria for acute disseminated encephalomyelitis recently proposed by the International Pediatric Multiple Sclerosis Study Group. Three patients relapsed after 3 months, 2 years, and 8 years, respectively. By the second attack, the diagnosis of multiple sclerosis, as well as of multiphasic disseminated encephalomyelitis, could be rendered using the revised criteria of McDonald et al. Long-term follow-up seemed to confirm a chronic disease course in 2 children. We could not identify features at onset to predict outcomes of patients. However, early in follow-up, the appearance of oligoclonal immunoglobulin G bands in spinal fluid and the persistence of visual-evoked potential abnormalities were associated with poor outcomes.

Facioscapulohumeral muscular dystrophy (FSHD) is a progressive hereditary neuromuscular disorder, transmitted in an autosomal dominant fashion. Its clinical expression is highly variable, ranging from almost asymptomatic subjects to wheelchair dependent patients. The molecular defect has been linked to chromosome 4q35 markers and has been related to deletions of tandemly repeated sequences located in the subtelomeric region detected by probe p13E-11 (D4F104S1). We describe a pair of monozygotic male twins affected by FSHD, carrying an identical de novo p13E-11 EcoRI fragment of paternal origin and showing great variability in the clinical expression of the disease, one being almost asymptomatic and the other severely affected. Their medical history was the same, with the exception of an anti-rabies vaccination performed at the age of 5 in the more severely affected twin. We hypothesise that the vaccination might have triggered an inflammatory immune reaction contributing to the more severe phenotype.

The aim of this work is to define the pattern of summation of the muscle fibre twitches in the surface mechanomyogram (MMG) generation process. For this purpose, two groups of muscle fibres of the extensor digitorum communis (EDC) were stimulated using needle electrodes. To these two artificial (because made by different muscle fibre types) motor units (MU1 and MU2), we administered: (a) separate stimulations: 3 and 9 Hz (MU1), 8 and 20 Hz (MU2) for 5 s; (b) simultaneous stimulation: 3 Hz (MU1) + 8 Hz (MU2); 9 Hz (MU1) + 20 Hz (MU2) for 5 s. The mechanomyograms, recorded during separate stimulation of MU1 and MU2, were linearly summated for the generation of a mechanomyographic signal to be compared with the one detected during (b) stimulation procedure. The bispectrum and the bicoherence of the generated MMG (MMGg) and of the MMG recorded during simultaneous (MMGs) stimulation were calculated for the detection of the quadratic non-linearity in the system responses. It was found that the MMGg and MMGs presented difference in the bispectrum and bicoherence index only when the 9–20 Hz stimulation pair was considered. In conclusion, our data indicate that the MMG derives from the summation of the active muscle fibres twitches and that the latter is linear only for very low firing rates. This is to be carefully considered when studies on MMG modelling will be undertaken.

Weanling and adult rats were intraperitoneally injected with d -carnitine for 40 days. After 15 days of treatment a statistically significant depletion in the muscle levels of free and total l -carnitine was observed, but after 40 days this depletion became slight and statistically not significant. These findings suggest the presence of a compensatory mechanism acting on the inhibition of l -carnitine transport into skeletal muscle fibres.