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Duchenne Muscular Dystrophy (DMD) patients often suffer from both muscle wasting and osteoporosis. Our previous studies have revealed reduced regeneration potential in skeletal muscle and bone, concomitant with ectopic calcification of soft tissues in double knockout (dKO, dystrophin-/-; utrophin-/-) mice, a severe murine model for DMD. We found significant involvement of RhoA/ROCK (Rho-Associated Protein Kinase) signaling in mediating ectopic calcification of muscles in dKO mice. However, the cellular identity of these RhoA+ cells, and the role that RhoA plays in the chronic inflammation-associated pathologies has not been elucidated. Here, we report that CD68+ macrophages are highly prevalent at the sites of ectopic calcification of dKO mice, and that these macrophages highly express RhoA. Macrophages from dKO mice feature a shift towards a more pro-inflammatory M1 polarization and an increased expression of various senescence-associated secretory phenotype (SASP) factors that was reduced with the RhoA/ROCK inhibitor Y-27632. Further, systemic inhibition of RhoA activity in dKO mice led to reduced number of RhoA+/CD68+ cells, as well as a reduction in fibrosis and ectopic calcification. Together, these data revealed that RhoA signaling may be a key regulator of imbalanced mineralization in the dystrophic musculoskeletal system and consequently a therapeutic target for the treatment of DMD or other related muscle dystrophies.

Dystrophin proteomic regulation in muscular dystrophies (MDs) remains unclear. We report that a long noncoding RNA (lncRNA), H19, associates with dystrophin and inhibits E3-ligase-dependent polyubiquitination at Lys 3584 (referred to as Ub-DMD) and its subsequent protein degradation. In-frame deletions in BMD and a DMD non-silent mutation (C3340Y) resulted in defects in the ability of the protein to interact with H19, which caused elevated Ub-DMD levels and dystrophin degradation. Dmd C3333Y mice exhibited progressive MD, elevated serum creatine kinase, heart dilation, blood vessel irregularity and respiratory failure with concurrently reduced dystrophin and increased Ub-DMD status. H19 RNA oligonucleotides conjugated with agrin (AGR–H19) and nifenazone competed with or inhibited TRIM63. Dmd C3333Y animals, induced-pluripotent-stem-cell-derived skeletal muscle cells from patients with Becker MD and mdx mice subjected to exon skipping exhibited inhibited dystrophin degradation, preserved skeletal and cardiac muscle histology, and improved strength and heart function following AGR–H19 or nifenazone treatment. Our study paves the way for meaningful targeted therapeutics for Becker MD and for certain patients with Duchenne MD. Zhang et al. report that the lncRNA H19 stabilizes dystrophin by competing with the ubiquitin E3 ligase TRIM63 for association with dystrophin, thereby alleviating muscular dystrophies.

Objective: To investigate the effect of Alpiniae oxyphyllae fructus (AOF) on the alleviation of musculoskeletal disorders caused by aging, we conducted experiments on osteoporosis and muscle atrophy. Methods: The experimental group was classified into a control group, aging-elicited (AE) group and A...

Due to muscle dystrophy, diabetes patients suffer from foot gait movement and need to define whether their muscle contraction-relaxation is normal. However, the way to determine diabetic foot is inconvenient and may give stress to patients during the test by attaching multiple electrodes on their foot. Also, after measuring the EMG, it takes several hours or days to figure out whether the testing subject has a diabetic foot. Therefore, we developed an EMG measured diabetic determination system by machine learning protocol based on LSTM (Long Short-Term Memory). We tested 15 individuals with normal glycemia and 15 diabetic patients who have been suffered more than 10 years with fasting glucose levels over 180mg/dl. Every patient’s EMG wave pulse was measured for one minute with 3-second terms of contraction and relaxation for three times, Subjects’ wave pulse was correct as normal and diabetes to clear machine learning process. Every second 150 data were created and the middle range was normalized. Numbers between 0 and 1 range were used as a y normalization for machine learning test training. After test learning, we input normal and diabetes wave pulse patterns whether this LSTM model could make a clear definition. (Fig 1.) As result, this machine learning model could distinguish 88.21% of diabetes patients’ feet by comparing foot EMG wave pulse, but 11.79% of diabetes foot cannot be determined due to an inefficient data pool. Disclosure D. Kim: None. M. Park: None. D. Jee: None. G. Im: None. J. Lee: None. J. Shin: None. J. Kim: None. W. Kim: None. Funding Korea Institute of Startup & Entrepreneurship Development

Protein O-glucosyltransferase 1 (POGLUT1) activity is critical for the Notch signaling pathway, being one of the main enzymes responsible for the glycosylation of the extracellular domain of Notch receptors. A biallelic mutation in the POGLUT1 gene has been reported in one family as the cause of an adult-onset limb-girdle muscular dystrophy (LGMD R21; OMIM# 617232). As the result of a collaborative international effort, we have identified the first cohort of 15 patients with LGMD R21, from nine unrelated families coming from different countries, providing a reliable phenotype–genotype and mechanistic insight. Patients carrying novel mutations in POGLUT1 all displayed a clinical picture of limb-girdle muscle weakness. However, the age at onset was broadened from adult to congenital and infantile onset. Moreover, we now report that the unique muscle imaging pattern of “inside-to-outside” fatty degeneration observed in the original cases is indeed a defining feature of POGLUT1 muscular dystrophy. Experiments on muscle biopsies from patients revealed a remarkable and consistent decrease in the level of the NOTCH1 intracellular domain, reduction of the pool of satellite cells (SC), and evidence of α-dystroglycan hypoglycosylation. In vitro biochemical and cell-based assays suggested a pathogenic role of the novel POGLUT1 mutations, leading to reduced enzymatic activity and/or protein stability. The association between the POGLUT1 variants and the muscular phenotype was established by in vivo experiments analyzing the indirect flight muscle development in transgenic Drosophila, showing that the human POGLUT1 mutations reduced its myogenic activity. In line with the well-known role of the Notch pathway in the homeostasis of SC and muscle regeneration, SC-derived myoblasts from patients’ muscle samples showed decreased proliferation and facilitated differentiation. Together, these observations suggest that alterations in SC biology caused by reduced Notch1 signaling result in muscular dystrophy in LGMD R21 patients, likely with additional contribution from α-dystroglycan hypoglycosylation. This study settles the muscular clinical phenotype linked to POGLUT1 mutations and establishes the pathogenic mechanism underlying this muscle disorder. The description of a specific imaging pattern of fatty degeneration and muscle pathology with a decrease of α-dystroglycan glycosylation provides excellent tools which will help diagnose and follow up LGMD R21 patients., This work was supported in part by the Instituto de Salud Carlos III and FEDER (FIS PI16-01843 to C. Paradas and JR15/00042 to M. Cabrera-Serrano), the Consejería de Salud, Junta de Andalucía (PI-0085-2016 and PE-S1275 to C. Paradas, and B-0005-2017 to M. Cabrera-Serrano), NIH/NIGMS (R01GM084135 and R35GM130317 to H. Jafar-Nejad, and R01GM061126 to R.S. Haltiwanger), JSPS KAKENHI Grants-in-Aid for Research Activity Start-up and Scientific Research (B) (JP17H06743 and JP19H03176 to H. Takeuchi), and Takeda Science Foundation and Daiichi Sankyo Foundation of Life Science (to H. Takeuchi). MYO-SEQ has been supported by Sanofi Genzyme, Ultragenyx, the LGMD2I Research Fund, Samantha J Brazzo Foundation, LGMD2D Foundation, Kurt + Peter Foundation, Muscular Dystrophy UK and Coalition to Cure Calpain 3. Work in CGB’s group is supported by NINDS/NIH intramural funds.

Kyphoscoliotic Ehlers-Danlos syndrome associated with FKBP14 (FKBP14-kEDS) is an ultrarare autosomal recessive disorder reported in less than 30 individuals so far. In its original description, emphasis was put on the mild muscle involvement. Further reports confirm that FKBP14-kEDS is distinguishable from primary muscle disorders by the lack of progressive muscle disease. We report a 15-year-old girl with FKBP14-kEDS as a result of the recurrent c.362dupC variant, who also showed severe involvement of the lower limb muscles. She never attained autonomous walking and presented significant lower limb weakness. Lower limb magnetic resonance imaging showed a pattern of multiple muscle involvement. Further musculoskeletal assessment revealed significant bone mass density reduction of the spine, unilateral congenital hip dysplasia, and occipitoatlantoaxial instability. This patient points out the existence of a wider phenotypic spectrum of FKBP14-kEDS to include early onset muscle disease.

Summary Go-sha-jinki-gan (GJG), a traditional Japanese herbal medicine has a clinical implication to alleviate age-related symptoms, especially in some motor disorders. However, the scientific evidence is limited, and there is a possibility to expand the medical application range of GJG. Using senescence-accelerated mice, our group showed that GJG exerted an effect to prevent sarcopenia, the aged-related loss of skeletal muscle. Because muscular dystrophy is characterized by a progressive loss of skeletal muscle, we examined the effects of GJG on a mouse model of muscular dystrophy. Using a newly established mouse model for Duchenne muscular dystrophy (DMD), DBA/2-mdx, we showed that GJG significantly increased the body and skeletal muscle weights in comparison to the control DBA/2-mdx mice, regardless of gender. The increased skeletal muscle mass resulted from an increment in the myofiber size, but not from the myofiber number. Both the skeletal muscle regenerative ability and the accumulation of fibrosis (the dystrophic pathology) in GJG-fed DBA/2-mdx mice were comparable to those in control DBA/2-mdx mice, suggesting that the cellular target of GJG is myofibers, with no contribution from the muscle satellite cells neither in an direct nor in an indirect manner. Taken together, GJG increased the skeletal muscle mass in a mouse model of muscular dystrophy, in addition to our previously tested sarcopenia mouse model.

This article clarifies the current role of MR imaging in the assessment of myopathies. Typical MR imaging findings are discussed for different forms of myopathies, including idiopathic inflammatory myopathies, muscular dystrophies, and congenital myopathies. The last section deals with advanced MR imaging techniques and their potential role in further characterization of muscular disease.

Objectives: The present study aimed at investigating the therapeutic effect of Salidroside on skeletal muscle atrophy in a rat model of cigarette smoking-induced chronic obstructive pulmonary disease (COPD) and its potential mechanisms. Methods: Male Wistar rats were randomized, and treated intraperitoneally (IP) with vehicle (injectable water) or a low, medium or high dose of Salidroside, followed by exposure to cigarette smoking daily for 16 weeks. A healthy control received vehicle injection and air exposure. Their lung function, body weights and gastrocnemius (GN) weights, grip strength and cross-section area (CSA) of individual muscular fibers in the GN were measured. The levels of TNF-α, IL-6, malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) in serum and GN tissues as well as myostatin and myogenin expression in GN tissues were measured. Results: In comparison with that in the healthy control, long-term cigarette smoking induced emphysema, significantly impaired lung function, reduced body and GN weights and CSA values in rats, accompanied by significantly increased levels of TNF-α, IL-6 and MDA, but decreased levels of SOD and GSH in serum and GN tissues. Furthermore, cigarette smoking significantly up-regulated myostatin expression, but down-regulated myogenin expression in GN tissues. Salidroside treatment decreased emphysema, significantly ameliorated lung function, increased antioxidant, but reduced MDA, IL-6 and TNF-α levels in serum and GN tissues of rats, accompanied by decreased myostain, but increased myogenin expression in GN tissues. Conclusion: Salidroside mitigates the long-term cigarette smoking-induced emphysema and skeletal muscle atrophy in rats by inhibiting oxidative stress and inflammatory responses and regulating muscle-specific transcription factor expression.

Introduction Motor unit hyperexcitability (MUH) may become manifest in needle electromyography (EMG) recordings as fasciculation potentials, myokymic discharges, or neuromyotonic discharges. Here, we describe a further MUH phenomenon. Methods Needle EMG recordings of the Neurology Hospital of Halle (Saale) stored in a video mode as .wav data between 2000 and 2015 were screened for spontaneous continuous motor unit single discharges (SCMUSD). Results We identified 23 video needle EMG waveforms from 14 patients with SCMUSD. The corresponding motor units discharged at a rate of about 6 H Z (6.3 ± 4.0; range, 1.3-18.1). The coefficient of variation of the discharge rate was 3.5% ± 1.7%. Neurogenic disorders were diagnosed in 12 patients, limb girdle muscle dystrophy was diagnosed in one patient, and stiff-limb syndrome was diagnosed in one patient. Discussion Spontaneous continuous motor unit single discharge, as described here, widens the spectrum of MUH phenomena.

The co-existence of facioscapulohumeral muscle dystrophy (FSHD) and myasthenia gravis (MG) is very rare and few cases have been described in the literature. To increase the awareness of the health care providers, we present herein a rare case of MG in a patient with FSHD, discuss the diagnostic challenges, pre- and post-treatment findings and provide a literature review.

The maintenance of muscle mass and its ability to function relies on a bioenergetic efficient mitochondrial network. This network is highly impacted by fusion and fission events. We have recently shown that the acute deletion of the fusion protein Opa1 induces muscle atrophy, systemic inflammatory response, precocious epithelial senescence, and premature death that are caused by muscle-dependent secretion of FGF21. However, both fusion and fission machinery are suppressed in aging sarcopenia, cancer cachexia, and chemotherapy-induced muscle wasting. We generated inducible muscle-specific Opa1 and Drp1 double-knockout mice to address the physiological relevance of the concomitant impairment of fusion and fission machinery in skeletal muscle. Here we show that acute ablation of Opa1 and Drp1 in adult muscle causes the accumulation of abnormal and dysfunctional mitochondria, as well as the inhibition of autophagy and mitophagy pathways. This ultimately results in ER stress, muscle loss, and the reduction of force generation. However, the simultaneous inhibition of the fission protein Drp1 when Opa1 is absent alleviates FGF21 induction, oxidative stress, denervation, and inflammation rescuing the lethal phenotype of Opa1 knockout mice, despite the presence of any muscle weakness. Thus, the simultaneous inhibition of fusion and fission processes mitigates the detrimental effects of unbalanced mitochondrial fusion and prevents the secretion of pro-senescence factors.

TRIM32 is a E3 ubiquitin -ligase containing RING, B-box, coiled-coil and six C-terminal NHL domains. Mutations involving NHL and coiled-coil domains result in a pure myopathy (LGMD2H/STM) while the only described mutation in the B-box domain is associated with a multisystemic disorder without myopathy (Bardet-Biedl syndrome type11), suggesting that these domains are involved in distinct processes. Knock-out (T32KO) and knock-in mice carrying the c.1465G > A (p.D489N) involving the NHL domain (T32KI) show alterations in muscle regrowth after atrophy and satellite cells senescence. Here, we present phenotypical description and functional characterization of mutations in the RING, coiled-coil and NHL domains of TRIM32 causing a muscle dystrophy. Reduced levels of TRIM32 protein was observed in all patient muscle studied, regardless of the type of mutation (missense, single amino acid deletion, and frameshift) or the mutated domain. The affected patients presented with variable phenotypes but predominantly proximal weakness. Two patients had symptoms of both muscular dystrophy and Bardet-Biedl syndrome. The muscle magnetic resonance imaging (MRI) pattern is highly variable among patients and families. Primary myoblast culture from these patients demonstrated common findings consistent with reduced proliferation and differentiation, diminished satellite cell pool, accelerated senescence of muscle, and signs of autophagy activation., Supported in part by grants from the Health Institute Carlos III and FEDER a way to achieve Europe (PI16–01843 to CP, JR15/00042 to MC-S), the Fundación Progreso y Salud, Junta de Andalucía (PI-0085-2016 to JLN-G), and Australian National Health and Medical Research Council (NHMRC) Fellowships (APP1122952 and APP1117510 to GR and NGL).

This paper describe to the Children’s Adjustable Habilitation Tool (CAHT). CAHT can change a wheelchair into an electric wheelchair. We started on this CAHT project is aid children with muscle dystrophy or Cerebral Palsy in their mobility. This provide them with the one of the assistance that they need. We will continue to improve this device by understanding its pros and cons. I experimented with a boy. He tried in five times at two month. As a result, our try against him succeeded.

Background Collagen VI-related myopathies are a spectrum of muscular diseases with features of muscle weakness and atrophy, multiple contractures of joints, distal hyperextensibility, severe respiratory dysfunction and cutaneous alterations, attributable to mutations in the COL6A1, COL6A2, and COL6A3 genes. However, no case of collagen VI mutations with hematuria has been reported. We report a 14-year-old boy who had both Bethlem myopathy and recurrent hematuria and who carried a known de novo COL6A1 missense mutation c.877G > A (p.G293R). Case presentation The patient was a 14-year-old boy presenting with muscle weakness from 3 years of age without any family history. Six months before admission, he developed recurrent gross hematuria, three bouts in total, with the presence of blood clots in the urine. Next-generation sequencing of his whole-exome was performed. The result of sequencing revealed a de novo heterozygous G-to-A nucleotide substitution at position 877 in exon 10 of the COL6A1 gene. After treatment, the hematuria healed, but the muscle weakness failed to improve. Conclusions Hematuria in Bethlem myopathy can be caused by COL6 mutations, which may be related to the aberrant connection between collagen VI and collagen IV. Electronic supplementary material The online version of this article (10.1186/s12883-019-1263-0) contains supplementary material, which is available to authorized users.

Duchenne muscular dystrophy (DMD) is characterized by a severe and progressive destruction of muscle fibers associated with altered Ca2+ homeostasis. We have previously shown that the IP3 receptor (IP3R) plays a role in elevating basal cytoplasmic Ca2+ and that pharmacological blockade of IP3R restores muscle function. Moreover, we have shown that the IP3R pathway negatively regulates autophagy by controlling mitochondrial Ca2+ levels. Nevertheless, it remains unclear whether IP3R is involved in abnormal mitochondrial Ca2+ levels, mitochondrial dynamics, or autophagy and mitophagy observed in adult DMD skeletal muscle. Here, we show that the elevated basal autophagy and autophagic flux levels were normalized when IP3R was downregulated in mdx fibers. Pharmacological blockade of IP3R in mdx fibers restored both increased mitochondrial Ca2+ levels and mitochondrial membrane potential under resting conditions. Interestingly, mdx mitochondria changed from a fission to an elongated state after IP3R knockdown, and the elevated mitophagy levels in mdx fibers were normalized. To our knowledge, this is the first study associating IP3R1 activity with changes in autophagy, mitochondrial Ca2+ levels, mitochondrial membrane potential, mitochondrial dynamics, and mitophagy in adult mouse skeletal muscle. Moreover, these results suggest that increased IP3R activity in mdx fibers plays an important role in the pathophysiology of DMD. Overall, these results lead us to propose the use of specific IP3R blockers as a new pharmacological treatment for DMD, given their ability to restore both autophagy/mitophagy and mitochondrial function.

International audience; This study introduces local pattern texture anisotropy as a novel parameter to differentiate healthy and disordered muscle and to gauge the severity of muscle impairments based on B-mode ultrasound images. Preliminary human results are also presented. A local pattern texture anisotropy index (TAI) was computed in one region of interest in the short head of the biceps brachii. The effects of gain settings and box sizes required for TAI computation were investigated. Between-day reliability was studied in patients with sporadic inclusion body myositis (n = 26). The ability of the TAI to discriminate dystrophic from healthy muscle was evaluated in patients with Duchenne muscular dystrophy and healthy controls (n = 16). TAI values were compared with a gray-scale index (GSI). TAI values were less influenced by gain settings than were GSI values. TAI had lower between-day variability (typical error = 2.3%) compared with GSI (typical error = 2.3% vs. 8.3%, respectively). Patients with Duchenne muscular dystrophy had lower TAIs than controls (0.76 ± 0.06 vs. 0.87 ± 0.03, respectively, p

Limb Girdle Muscular Dystrophies type 2I (LGMD2I), a recessive autosomal muscular dystrophy, is caused by mutations in the Fukutin Related Protein (FKRP) gene. It has been proposed that FKRP, a ribitol-5-phosphate transferase, is a participant in α-dystroglycan (αDG) glycosylation, which is important to ensure the cell/matrix anchor of muscle fibers. A LGMD2I knock-in mouse model was generated to express the most frequent mutation (L276I) encountered in patients. The expression of FKRP was not altered neither at transcriptional nor at translational levels, but its function was impacted since abnormal glycosylation of αDG was observed. Skeletal muscles were functionally impaired from 2 months of age and a moderate dystrophic pattern was evident starting from 6 months of age. Gene transfer with a rAAV2/9 vector expressing Fkrp restored biochemical defects, corrected the histological abnormalities and improved the resistance to eccentric stress in the mouse model. However, injection of high doses of the vector induced a decrease of αDG glycosylation and laminin binding, even in WT animals. Finally, intravenous injection of the rAAV-Fkrp vector into a dystroglycanopathy mouse model due to Fukutin (Fktn) knock-out indicated a dose-dependent toxicity. These data suggest requirement for a control of FKRP expression in muscles.

ncRNAs are the most recently identified class of regulatory RNAs with vital functions in gene expression regulation and cell development. Among the variety of roles they play, their involvement in human diseases has opened new avenues of research towards the discovery and development of novel therapeutic approaches. Important data come from the field of hereditary muscle dystrophies, like Duchenne muscle dystrophy and Myotonic dystrophies, rare diseases affecting 1 in 7000–15,000 newborns and is characterized by severe to mild muscle weakness associated with cardiac involvement. Novel therapeutic approaches are now ongoing for these diseases, also based on splicing modulation. In this review we provide an overview about ncRNAs and their behavior in muscular dystrophy and explore their links with diagnosis, prognosis and treatments, highlighting the role of regulatory RNAs in these pathologies.

Breath isoprene accounts for most of the hydrocarbon removal via exhalation and is thought to serve as a non-invasive indicator for assaying several metabolic effects in the human body. The primary objective of this paper is to introduce a novel working hypothesis with respect to the endogenous source of this compound in humans: the idea that muscle tissue acts as an extrahepatic production site of substantial amounts of isoprene. This new perspective has its roots in quantitative modeling studies of breath isoprene dynamics under exercise conditions and is further investigated here by presenting pilot data from a small cohort of late stage Duchenne muscle dystrophy patients (median age 21, 4 male, 1 female). For these prototypic test subjects isoprene concentrations in end-tidal breath and peripheral venous blood range between 0.09-0.47 and 0.11-0.72 nmol/l, respectively, amounting to a reduction by a factor of 8 and more as compared to established nominal levels in normal healthy adults. While it remains unclear whether isoprene can be ascribed a direct physiological mechanism of action, some indications are given as to why isoprene production might have evolved in muscle.

Background and Purpose. There are few studies on possible effects of physiotherapy for adults with muscular dystrophy. The aim of this study was to examine if treatment based on the Bobath concept may influence specific gait parameters in some of these patients. Methods. A single-subject experimental design with A–B–A–A phases was used, and four patients, three with limb-girdle muscular dystrophy (LGMD) and one with fascioscapulohumeral muscular dystrophy (FSHD), were included. The patients had 1 hour of individually tailored physiotherapy at each working day for a period of 3 weeks. Step length, step width and gait velocity were measured during the A–B–A–A phases by use of an electronic walkway. Walking distance and endurance were measured by use of the ‘6 minute walk test’. Results. The three LGMD patients, who initially walked with a wide base of support, had a narrower, velocity-adjusted step width after treatment, accompanied with the same or even longer step length. These changes lasted throughout follow-up. Moreover, two of the patients were able to walk a longer distance within 6 minutes after the treatment period. The fourth patient (with FSHD) had a normal step width at baseline, which did not change during the study. Conclusions. The results indicate that physiotherapy treatment based on the Bobath concept may influence the gait pattern in patients with LGMD. However, in order to evaluate the effectiveness of physiotherapy to patients with muscular dystrophies, we call for larger studies and controlled trials. Copyright © 2010 John Wiley & Sons, Ltd.

Facial muscle weakness from paralysis or muscle dystrophy can significantly affect lip strength and function. Lip muscle weakness may result in articulation difficulties and spillage of food, both of which are socially and functionally disruptive for patients. There are few quantitative data on the effect of facial paralysis on lip strength.To quantify the effect of facial paralysis and muscular dystrophy on lip strength and evaluate the effectiveness of targeted lip injection augmentation.Analysis of patients at the Johns Hopkins Hospital between January 1, 2008, and July 31, 2014, presenting for treatment of lip incompetence due to facial paralysis and facial muscular dystrophy was prospectively undertaken. Patients who had undergone direct surgical lip procedures were excluded.Lip pressure measurements, anterior bolus spillage, and articulation of bilabial sounds before and after treatment were assessed by a single speech pathologist. Lip pressures were measured with the Iowa Oral Performance Instrument.Twenty-two patients with unilateral facial paralysis were evaluated for this study. Three patients with facioscapulohumeral muscular dystrophy were also evaluated. In unilateral facial paralysis, central lip strength was reduced in all patients compared with sex-corrected normative data (mean [SD] central lip strength, 5.5 [2.5] kPa in females and 9.6 [4.6] kPa in males). Compared with the nonparalyzed side, labial strength on the paralyzed sided was reduced by 69%. After injection augmentation of the paralyzed side, labial strength improved across the entire lip. Mean lip strength improved by 0.7-fold in the central lip from 5.60 to 9.30 kPa (P = .009), by 1.4-fold on the paralyzed side from 2.2 to 5.33 kPa (P = .006), and by 0.4-fold on the unaffected side from 7.11 to 9.56 kPa (P = .12). Lip strength in the 3 patients with facioscapulohumeral muscular dystrophy were uniformly reduced across the entire lip and improved by 6- to 7-fold after injection augmentation. All patients were noted by the speech pathologist to have improved articulation of plosive sounds and decreased anterior bolus spillage after the injection.Labial strength is reduced across the lip in patients with unilateral facial paralysis. The Iowa Oral Performance Instrument is an effective tool for measuring labial strength and can be use to evaluate the effectiveness of facial reanimation procedures. Injection augmentation of the lip is a simple and effective means of improving labial strength, bilabial sounds, and anterior spillage in patients with facial paralysis or facial muscular dystrophy.3.

Quantitative nuclear magnetic resonance imaging (MRI) has been considered a promising non-invasive tool for monitoring therapeutic essays in small size mouse models of muscular dystrophies. Here, we combined MRI (anatomical images and transverse relaxation time constant—T2—measurements) to texture analyses in the study of four mouse strains covering a wide range of dystrophic phenotypes. Two still unexplored mouse models of muscular dystrophies were analyzed: The severely affected Largemyd mouse and the recently generated and worst double mutant mdx/Largemyd mouse, as compared to the mildly affected mdx and normal mice. The results were compared to histopathological findings. MRI showed increased intermuscular fat and higher muscle T2 in the three dystrophic mouse models when compared to the wild-type mice (T2: mdx/Largemyd: 37.6±2.8 ms; mdx: 35.2±4.5 ms; Largemyd: 36.6±4.0 ms; wild-type: 29.1±1.8 ms, p

Muscular dystrophy syndrome refers to a group of genetic diseases resulting in muscle weakness and low functional capacity. This purpose of this study is to investigate the effect of an eight-week selective training on muscle strength of patients with muscular dystrophy. A quasi-experimental method was used in this study. Eleven patients with muscular dystrophy were selected through purposive sampling and divided into two groups randomly including in water selective exercises (n = 6) and control groups (n = 5) respectively. The study conducted under the supervision of researcher for eight weeks, three sessions per week, and the time allocated was between 60-45 minutes. Moreover, a t-test was used for statistical analysis and the significant level was set at p < 0.05 level. After an eight-week training a significant increase (P < 0.05) was observed in extensor muscle strength in patients with muscular dystrophy. However, no significant difference was observed in the control group (p ≥0.05). Comparing the changes made during eight weeks (difference between pre-test and post-test) a significant difference (P < 0.05) was observed between intervention and control groups. According to obtained findings in this study, in water selective exercise is an effective way to improve muscular strength in patients with muscular dystrophy.

Reduction in number of motor units (nMU) and fast fibre ratio (FFR) is associated with disease or atrophy when this is rapid. There is a need to study the effect of nMU and FFR to analyse the association with ageing and disease. This study has developed a mathematical model to investigate the relationship between nMU and FFR on surface electromyogram (sEMG) of the biceps muscles. The model has been validated by comparing the simulation outcomes with experiments comparing the sEMG of physically active younger and older cohort. The results show that there is statistically significant difference between the two groups, and the simulation studies closely model the experimental results. This model can be applied to identify the cause of muscle weakness among the elderly due to factors such as muscle dystrophy or preferential loss of type F muscle fibres.

Sarcoglycans (SGs) are components of the dystrophin-glycoprotein complex, genetic defects in which cause skeletal muscle dystrophy and cardiomyopathy in humans and animals. To obtain insight into the roles of SGs, we characterized properties of myotubes prepared from cells of the rat L6 line or primary myoblast cultures of rat gastrocnemius muscle that were made SG-deficient by treatment with antisense oligodeoxynucleotides (AS-ODNs). Immunoblot and immunoprecipitation analyses revealed that dystrophin and its remaining associated proteins were tightly associated in these cells despite SG deficiency. 45Ca2+ influx into SG AS-ODN-treated L6 myotubes under resting conditions was significantly higher (1.7-fold at 6 min) than in controls, suggesting that Ca2+ influx is activated in these SG-deficient myotubes. When these cells were subjected to cyclic elongation of up to 20% for 1 h, a marked increase in creatine phosphokinase (CK) release into the medium was observed. Nifedipine, tranilast, FK506 and E64 or intracellular loading with 1,2-bis(2-aminophenoxy)ethane- N,N,N',N'-tetraacetic acid, tetrakis(acetoxymethyl)ester (BAPTA/AM) reduced the stretch-induced CK release; a raised extracellular [Ca2+] increased CK release. The stretch-induced damage to SG-deficient myotubes thus appears to be caused by alterations in cell Ca2+ homeostasis. A similar abnormality in Ca2+ handling has been reported for myoctes from mdx mice or dystrophin-deficient patients, in whom SGs are also greatly reduced or absent. Thus it is possible that SG deficiency may play a critical role in the pathology of dystrophin-deficient muscle.

Limb-girdle muscular dystrophies (LGMDs) is a heterogeneous group of muscular dystrophies that mostly affect the pelvic and shoulder girdle muscle groups. We report here a case of neuromuscular disease associated with Dupuytren's contracture, which has never been described before as cosegregating with an autosomal dominant type of inheritance. Dupuytren's contracture is a common disease, especially in Northern Europe. Comorbid conditions associated with Dupuytren's contracture are repetitive trauma to the hands, diabetes, and seizures, but it has never before been associated with neuromuscular disease. We hypothesize that patients may harbor mutations in genes with functions related to neuromuscular disease and Dupuytren's contracture development.

Improving stem cell therapy is a major goal for the treatment of muscle diseases, where physiological muscle regeneration is progressively exhausted. Vessel-associated stem cells, such as mesoangioblasts (MABs), appear to be the most promising cell type for the cell therapy for muscular dystrophies and have been shown to significantly contribute to restoration of muscle structure and function in different muscular dystrophy models. Here, we report that melanoma antigen-encoding gene (MAGE) protein necdin enhances muscle differentiation and regeneration by MABs. When necdin is constitutively overexpressed, it accelerates their differentiation and fusion in vitro and it increases their efficacy in reconstituting regenerating myofibres in the α-sarcoglycan dystrophic mouse. Moreover, necdin enhances survival when MABs are exposed to cytotoxic stimuli that mimic the inflammatory dystrophic environment. Taken together, these data demonstrate that overexpression of necdin may be a crucial tool to boost therapeutic applications of MABs in dystrophic muscle.Cell Death and Differentiation advance online publication, 18 November 2011; doi:10.1038/cdd.2011.160.

Congenital muscle dystrophy (CMD) is a heterogeneous group of autosomal recessive myopathies. It is known that CMD may affect the central nervous system (CNS). Some authors have shown that merosin-negative CMD patients may have encephalic metabolic disturbances. In order to study metabolic changes within the brain, the authors performed a magnetic resonance spectroscopy (MRS) study in a 1-year-old girl with merosin-positive CMD (MP-CMD). MRS of brain demonstrated that NAA/Cr ratio was decreased (1.52), while Cho/Cr ratio was increased (1.78). These findings suggest that metabolic changes in CNS can also be found in patients with MP-CMD.

We present a case of severe optic neuropathy following linezolid treatment, which led to complete irreversible blindness, in a patient with progressive muscular dystrophy, treated with linezolid for 16 days for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Interruption of antibiotic therapy did not lead to remission of ocular symptoms. Administration of linezolid may lead to severe neuropathy even in the case of short-term treatment. Copyright © 2006 John Wiley & Sons, Ltd.

Efficient delivery of cells to target tissues is a major problem in cell therapy. We report that enhancing delivery of mesoangioblasts leads to a complete reconstitution of downstream skeletal muscles in a mouse model of severe muscular dystrophy (α-sarcoglycan ko). Mesoangioblasts, vessel-associated stem cells, were exposed to several cytokines, among which stromal- derived factor (SDF) 1 or tumor necrosis factor (TNF) α were the most potent in enhancing transmigration in vitro and migration into dystrophic muscle in vivo. Transient expression of α4 integrins or L-selectin also increased several fold migration both in vitro and in vivo. Therefore, combined pretreatment with SDF-1 or TNF-α and expression of α4 integrin leads to massive colonization (>50%) followed by reconstitution of >80% of α-sarcoglycan–expressing fibers, with a fivefold increase in efficiency in comparison with control cells. This study defines the requirements for efficient engraftment of mesoangioblasts and offers a new potent tool to optimize future cell therapy protocols for muscular dystrophies.

Non-invasive measurements and quantitative evaluation of the natural course of disease need to be established in anticipation of replacement therapy in Duchenne muscular dystrophy (DMD). A cohort of 23 DMD boys (6–18years, 14 non-ambulant), were enrolled specifically to characterize disease progression of upper limbs, to be targeted in future therapeutic trials. Prior studies in the GRMD canine model showed that Nuclear Magnetic Resonance imaging (NMRI) and phosphorous spectroscopy (NMRS) could provide quantitative indices which graded with therapeutic dose. A similar approach was implemented in patients, who were examined in a 3T-60cm Siemens Magnetom TRIO system, with the arm along the body. The two arms were examined in separate sessions, to be repeated yearly, comprising NMRI (measurement of T2 of muscle water, and of fat fraction by 3-point Dixon imaging) and NMRS of phosphate metabolites. Each item lasted ∼20min. Twelve indices were analysed: –2 in NMRI: %fat signal (%F), muscle water T2 (deconvoluted from fat) –10 in NMRS: 8 ratios of metabolites combining: ATP, phosphocreatine, phospho mono- and di-esters and two pools of inorganic phosphate: cytosolic (Pia) and an anomalous alkaline pool present in dystrophic muscle (Pib), and 2 indices for respective pH values. T2 was above laboratory norms in 15% of cases, % F exceeded 10% of signal in 70% of cases and correlated to patient age ( R =.58, P R =.38 to .46, P F , ( R =.46 to .77, P Quantitative NMRI and NMRS provided a variety of indices which were abnormal in forearms of DMD patients, covering a broad range of fat infiltration, and metabolic abnormalities which graded together and with patient age and could provide biomarkers of therapeutic efficacy.

Summary The lesser diameter of the fibers, separately of type 1 and type 2 fibers, and the capillary density evaluated as number of capillarieslarea and number of capillaries/fiber were quantitatively estimated in muscle biopsies from 12 patients with systemic sclerosis. Nine patients with polymyositis or rheumatoid arthritis and six patients with muscle dystrophy and neurogenic atrophy served as controls. The results showed that patients with systemic sclerosis had low values of the lesser diameter of the fibers. This reduction was most obvious in type 2 fibers. The capillaries were also significantly reduced when compared with the control groups. When considering the capillaries1fiber ratio, seven out of eight patients with values lower than 0.7 belonged to the systemic sclerosis group. In systemic sclerosis the capillary density values were not significantly correlated with those of the lesser diameters of the fibers.

Validation studies of bioelectric impedance analysis (BIA) were performed in children with obesity, Duchenne muscle dystrophy and juvenile rheumatoid arthritis. BIA allowed an accurate assessment of total body water in all groups (CV from 4.1 to 5.1%). However, the prediction of extracellular water by BIA was not always satisfactory (CV from 8.5 to 12.5%), being better in the groups of children with the lowest variability in body water distribution.

Bericht uber einen 40jahrigen Patienten, der seit 5 Jahren an einer progredienten Myopathie litt und neurologisch das Bild einer atypischen Beckengurteldystrophie bot. Im EMG wurden myotone und pseudomyotone Entladungen beobachtet. Die enzymhistochemischen und elektronenoptischen Untersuchungen der Muskelbiopsien und eines Leberpunktates wiesen auf eine Glykogenose hin; die biochemische Untersuchung bestatigte den Mangel an saurer Maltase. Weitere Literaturfalle von Saure-Maltase-Mangel-Syndrom im juvenilen und Erwachsenenalter wurden uberpruft. Es stellt sich heraus, das mit zunehmendem Alter des Patienten ein fast selektiver Befall der proximalen Muskeln auftritt, was oft Anlas zur Verwechslung mit anderen sog. degenerativen neuromuskularen Erkrankungen gibt. Bioptische und biochemische Untersuchungen sind daher in solchen Fallen besonders indiziert. Der langsamere Verlauf dieser generalisierten Speicherkrankheit im Erwachsenenalter — gegenuber der rasch verlaufenden infantilen Form (Pompesche Erkrankung) — bleibt ungeklart.

In a 57-yr-old female with dystrophia myotonica, attempts to reverse residual non-depolanzmg block with neostigmine 1.0 mg were only partially effective and the administration of a further dose (0.5 mg) produced long-lasting muscle weakness. The train-of-four response of this patient resembled that of a depolarizing block and suggested an alteration in the electrical properties of the muscle membrane A 50-yr-old male with a 30-yr history of progressive muscle dystrophy, exhibited a tonic response to neosugmine in the evoked mechanomyogra M. During recovery from partial neuromuscular block. It is concluded that the type of reaction to neostigmine in patients with neuromuscular disease is unpredictable.

SummaryA deficiency in pups produced from dogs maintained for long periods of time on mineralized evaporated milk has been described. The condition is undoubtedly identical with muscle dystrophy previously described in rats, guinea pigs and rabbits and is cured by synthetic α-tocopherol if therapy is initiated before the symptoms are too far advanced.

The nutritional muscle dystrophy of guinea pigs and rabbits is primarily a degeneration of the muscle fibers and is not associated with visible alterations of the peripheral nerves or their motor terminals.

I am very pleased to be a participant in this Colloquium in honor of Dr. Tsoo King. This Colloquium on Membrane Biochemistry and Bioenergetics is a very nice tribute to Dr. King for his career of accomplishments. Since Dr. King invited me to present an overview, I include a little nostalgia, but I wish to emphasize some new data on the survival rates of patients with advanced cardiomyopathy when they are treated with coenzyme Q10 (CoQ10) in addition to conventional therapy. Also, I shall emphasize some new data on treating patients with muscle dystrophy with CoQ10. The new therapy of muscle dystrophy with CoQ10 is the only known therapy which offers a better quality of life to such patients. This disease appears to be ideal for combining the biochemical and clinical aspects of CoQ10, and particularly because of the new availability of phosphorus NMR as currently studied by Britton Chance and other investigators. Phosphorus NMR allows the determinations of tissue levels of phosphocreatine, P1, and ATP with accuracy.

The presence of fibrillation in the muscles of the Bar Harbor strain of dystrophic mice has previously been reported from this laboratory.1We have observed that the electromyogram from dystrophic mice of this strain is strikingly similar to that recorded from muscles of patients suffering from dystrophia myotonica. The muscles of such patients and animals are hyperirritable, and the records obtained by the insertion of a concentric needle electrode reveal the presence of short motor volleys of high frequency against a background of electrical activity characteristic of denervated muscle. In order to demonstrate the presence of fibrillation, free of the superimposed activity from innervated structures, it was decided to study the electrical activity of muscles in dystrophic mice and patients in whom the motor nerves were blocked. The identification of characteristics common to both the dystrophy in this strain of mice and a particular form of dystrophy in man