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Selected items from the Charcot-Marie-Tooth (CMT) Neuropathy Score and secondary clinical outcome measures serve as sensitive clinical markers of disease severity in CMT1A patients
M. Mannil, A. Solari, A. Leha, AL. Pelayo-Negro, J. Berciano, B. Schlotter-Weigel, MC. Walter, B. Rautenstrauss, TJ. Schnizer, A. Schenone, P. Seeman, C. Kadian, O. Schreiber, NG. Angarita, GM. Fabrizi, F. Gemignani, L. Padua, L. Santoro, A....
Language English Country England, Great Britain
Document type Clinical Trial, Phase II, Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
Grant support
NT14348
MZ0
CEP Register
- MeSH
- Antioxidants therapeutic use MeSH
- Charcot-Marie-Tooth Disease diagnosis drug therapy genetics therapy MeSH
- Walking MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Outcome Assessment, Health Care * MeSH
- Cohort Studies MeSH
- Ascorbic Acid therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Pain Measurement MeSH
- Adolescent MeSH
- Young Adult MeSH
- Disease Progression MeSH
- Psychomotor Performance physiology MeSH
- Cluster Analysis MeSH
- Severity of Illness Index * MeSH
- Muscle Strength MeSH
- Age Factors MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial, Phase II MeSH
- Clinical Trial, Phase III MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
This study evaluates primary and secondary clinical outcome measures in Charcot-Marie-Tooth disease type 1A (CMT1A) with regard to their contribution towards discrimination of disease severity. The nine components of the composite Charcot-Marie-Tooth disease Neuropathy Score and six additional secondary clinical outcome measures were assessed in 479 adult patients with genetically proven CMT1A and 126 healthy controls. Using hierarchical clustering, we identified four significant clusters of patients according to clinical severity. We then tested the impact of each of the CMTNS components and of the secondary clinical parameters with regard to their power to differentiate these four clusters. The CMTNS components ulnar sensory nerve action potential (SNAP), pin sensibility, vibration and strength of arms did not increase the discriminant value of the remaining five CMTNS components (Ulnar compound motor action potential [CMAP], leg motor symptoms, arm motor symptoms, leg strength and sensory symptoms). However, three of the six additional clinical outcome measures - the 10m-timed walking test (T10MW), 9 hole-peg test (9HPT), and foot dorsal flexion dynamometry - further improved discrimination between severely and mildly affected patients. From these findings, we identified three different composite measures as score hypotheses and compared their discriminant power with that of the CMTNS. A composite of eight components CMAP, Motor symptoms legs, Motor symptoms arms, Strength of Legs, Sensory symptoms), displayed the strongest power to discriminate between the clusters. As a conclusion, five items from the CMTNS and three secondary clinical outcome measures improve the clinical assessment of patients with CMT1A significantly and are beneficial for upcoming clinical and therapeutic trials.
Catholic University Department of Neurosciences and Don Gnocchi Foundation Rome Italy
Charles University Prague 2nd Medical School and University Hospital Motol Prague Czech Republic
Department of Biochemistry University of Zurich Zurich Switzerland
Department of Clinical Neurophysiology University Medical Center Göttingen Göttingen Germany
Department of Medical Statistics University Medical Center Göttingen Göttingen Germany
Department of Neurological Sciences Naples Italy
Department of Neurology Carver College of Medicine University of Iowa Iowa City USA
Department of Neurosciences University of Parma Parma Italy
Department of Sleep Medicine and Neuromuscular Disorders University of Münster Münster Germany
Friedrich Baur Institute Department of Neurology Ludwig Maximilians Universität Munich Germany
Medizinisch Genetisches Zentrum Munich Germany
Service of Neurology University Hospital Marqués de Valdecilla UC and CIBERNED Santander Spain
Unit of Neuroepidemiology IRCCS Foundation C Besta Neurological Institute Milan Italy
References provided by Crossref.org
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