Hayashi Kouji, Hamano Tadanori, Kawamura Yasutaka, Kimura Hirohiko, Matsunaga Akiko, Ikawa Masamichi, Yamamura Osamu, Mutoh Tatsuro, Higuchi Itsuro, Kuriyama Masaru, Nakamoto Yasunari
Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Eur Neurol. 2016;76(1-2):87-94. doi: 10.1159/000448328. Epub 2016 Jul 29.
The purpose of this study was to explore the relation between muscle MRI findings and weakness of the upper extremity muscles in patients with myotonic dystrophy type 1 (DM1).
Nineteen DM1 patients from 15 families were enrolled in this study. Muscle weakness was evaluated using the modified Medical Research Council scale. Subjects also underwent a genetic study and muscle MRI of the upper extremities.
In patients with DM1, the flexor digitorum profundus (FDP), flexor pollicis longus, flexor digitorum superficialis (FDS), extensor pollicis, abductor pollicis longus (APL), lateral head of triceps brachii and infraspinatus (INF) muscles were frequently and severely affected. Muscle strength was significantly correlated with the severity of muscle MRI findings in the FDP, short head of biceps brachii (SBB), and medial head of triceps brachii muscles. Disease duration was correlated significantly with MRI findings in the FDP, FDS, long head of biceps brachii, INF, APL, and SBB muscles. Unexpectedly, the degree of trinucleotide expansion of myotonin protein kinase was not correlated with muscle MRI findings.
Muscle MRI of the upper extremity is useful to detect affected muscles in DM1 patients.
本研究旨在探讨1型强直性肌营养不良(DM1)患者肌肉MRI表现与上肢肌肉无力之间的关系。
本研究纳入了来自15个家庭的19例DM1患者。使用改良的医学研究理事会量表评估肌肉无力情况。受试者还接受了基因研究和上肢肌肉MRI检查。
在DM1患者中,指深屈肌(FDP)、拇长屈肌、指浅屈肌(FDS)、拇长伸肌、拇长展肌(APL)、肱三头肌外侧头和冈下肌(INF)经常且严重受累。FDP、肱二头肌短头(SBB)和肱三头肌内侧头肌的肌肉力量与肌肉MRI表现的严重程度显著相关。病程与FDP、FDS、肱二头肌长头、INF、APL和SBB肌肉的MRI表现显著相关。出乎意料的是,肌强直性蛋白激酶三核苷酸扩增的程度与肌肉MRI表现无关。
上肢肌肉MRI有助于检测DM1患者受累肌肉。