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Preferential changes of skeletal muscle echogenicity in myotonic dystrophy type 1
Author(s) -
Takamatsu N.,
Sogawa K.,
Nodera H.,
Hashiguchi S.,
Osaki Y.,
Saito M.,
Mori A.,
Izumi Y.,
Kaji R.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13212
Subject(s) - medicine , flexor carpi ulnaris , echogenicity , myotonic dystrophy , forearm , anatomy , biceps , muscular dystrophy , extensor digitorum communis , elbow , ultrasonography , surgery , ulnar nerve , tendon
Background and purpose In myotonic dystrophy type 1 (DM1), weakness of distal limb muscles affects quality of life. Non‐invasive evaluation of muscular involvement by muscle sonography could be useful for characterizing muscle‐specific involvement. Methods Sonography of the lower leg and forearm was performed in 19 patients with DM1 and 10 control subjects. The mean echo intensities (EIs) of seven limb muscles were obtained by computer‐assisted histogram analysis and compared within DM1 according to the overall clinical severity. Results The EIs of the muscles were significantly higher in DM1 than in the controls ( P < 0.01), except for the soleus ( P = 0.4). Comparison of adjacent muscles showed the following: (i) greater EIs in flexor digitorum profundus than flexor carpi ulnaris ( P < 0.01) and flexor digitorum superficialis ( P = 0.02), and (ii) greater EIs in the medial head of the gastrocnemius than the soleus ( P < 0.00001). In a subgroup analysis of DM1 according to the modified Rankin Scale (mRS), the more severe subgroup (mRS = 4−5) had lower mean EIs than the less severe subgroup (mRS from 1−3) ( P = 0.01) in the flexor digitorum superficialis but not in other muscles. Conclusions Preferential high echogenicity in the medial gastrocnemius and deep finger flexors is suggestive of DM1. Muscle echogenicity is not generally related to functional dysfunction in DM1.