Muscle MRI characteristic pattern for late-onset TK2 deficiency diagnosis.


Journal

Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161

Informations de publication

Date de publication:
Jul 2022
Historique:
received: 08 11 2021
accepted: 30 12 2021
revised: 29 12 2021
pubmed: 15 3 2022
medline: 25 6 2022
entrez: 14 3 2022
Statut: ppublish

Résumé

TK2 deficiency (TK2d) is a rare mitochondrial disorder that manifests predominantly as a progressive myopathy with a broad spectrum of severity and age of onset. The rate of progression is variable, and the prognosis is poor due to early and severe respiratory involvement. Early and accurate diagnosis is particularly important since a specific treatment is under development. This study aims to evaluate the diagnostic value of lower limb muscle MRI in adult patients with TK2d. We studied a cohort of 45 genetically confirmed patients with mitochondrial myopathy (16 with mutations in TK2, 9 with mutations in other nuclear genes involved in mitochondrial DNA [mtDNA] synthesis or maintenance, 10 with single mtDNA deletions, and 10 with point mtDNA mutations) to analyze the imaging pattern of fat replacement in lower limb muscles. We compared the identified pattern in patients with TK2d with the MRI pattern of other non-mitochondrial genetic myopathies that share similar clinical characteristics. We found a consistent lower limb muscle MRI pattern in patients with TK2d characterized by involvement of the gluteus maximus, gastrocnemius medialis, and sartorius muscles. The identified pattern in TK2 patients differs from the known radiological involvement of other resembling muscle dystrophies that share clinical features. By analyzing the largest cohort of muscle MRI from patients with mitochondrial myopathies studied to date, we identified a characteristic and specific radiological pattern of muscle involvement in patients with TK2d that could be useful to speed up its diagnosis.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
TK2 deficiency (TK2d) is a rare mitochondrial disorder that manifests predominantly as a progressive myopathy with a broad spectrum of severity and age of onset. The rate of progression is variable, and the prognosis is poor due to early and severe respiratory involvement. Early and accurate diagnosis is particularly important since a specific treatment is under development. This study aims to evaluate the diagnostic value of lower limb muscle MRI in adult patients with TK2d.
METHODS METHODS
We studied a cohort of 45 genetically confirmed patients with mitochondrial myopathy (16 with mutations in TK2, 9 with mutations in other nuclear genes involved in mitochondrial DNA [mtDNA] synthesis or maintenance, 10 with single mtDNA deletions, and 10 with point mtDNA mutations) to analyze the imaging pattern of fat replacement in lower limb muscles. We compared the identified pattern in patients with TK2d with the MRI pattern of other non-mitochondrial genetic myopathies that share similar clinical characteristics.
RESULTS RESULTS
We found a consistent lower limb muscle MRI pattern in patients with TK2d characterized by involvement of the gluteus maximus, gastrocnemius medialis, and sartorius muscles. The identified pattern in TK2 patients differs from the known radiological involvement of other resembling muscle dystrophies that share clinical features.
CONCLUSIONS CONCLUSIONS
By analyzing the largest cohort of muscle MRI from patients with mitochondrial myopathies studied to date, we identified a characteristic and specific radiological pattern of muscle involvement in patients with TK2d that could be useful to speed up its diagnosis.

Identifiants

pubmed: 35286480
doi: 10.1007/s00415-021-10957-0
pii: 10.1007/s00415-021-10957-0
pmc: PMC9217784
doi:

Substances chimiques

DNA, Mitochondrial 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3550-3562

Subventions

Organisme : Instituto de Salud Carlos III
ID : PI18/01374
Organisme : Instituto de Salud Carlos III
ID : PMP15/00025

Informations de copyright

© 2022. The Author(s).

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Auteurs

Cristina Domínguez-González (C)

Neuromuscular Diseases Unit, Neurology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
Hospital 12 de Octubre Research Institute (imas12), Madrid, Spain.
Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.

Roberto Fernández-Torrón (R)

Neurology Department, Biodonostia Health Research Institute, Neuromuscular Area, Hospital Donostia, Basque Health Service, Doctor Begiristain, Donostia-San Sebastian, Spain.

Ursula Moore (U)

John Walton Muscular Dystrophy Research Center, University of Newcastle, Newcastle, UK.

Carlos Pablo de Fuenmayor-Fernández de la Hoz (CP)

Neuromuscular Diseases Unit, Neurology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.

Beatriz Vélez-Gómez (B)

Neuromuscular Diseases Unit, Neurology Department, Hospital Universitario Virgen del Rocío/ Instituto de Biomedicina de Sevilla, Sevilla, Spain.
Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.

Juan Antonio Cabezas (JA)

Neuromuscular Diseases Unit, Neurology Department, Hospital Universitario Virgen del Rocío/ Instituto de Biomedicina de Sevilla, Sevilla, Spain.

Jorge Alonso-Pérez (J)

Neuromuscular Diseases Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Bellaterra, Spain.

Laura González-Mera (L)

Neuromuscular Diseases Unit, Neurology Department, IDIBELL-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.

Montse Olivé (M)

Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
Neuromuscular Diseases Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Bellaterra, Spain.
Institut de Recerca, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Jorge García-García (J)

Department of Neurology. Hospital, Universitario de Albacete., Albacete, Spain.

Germán Moris (G)

Neuromuscular Diseases Unit. Neurology Department. Hospital, Universitario Central de Asturias, Asturias, Spain.

Juan Carlos León Hernández (JC)

Neurology Department. Hospital, Universitario Nuestra Señora de Candelaria, Tenerife, Spain.

Nuria Muelas (N)

Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari i Politecnic La Fe, Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.

Emilia Servian-Morilla (E)

Neuromuscular Diseases Unit, Neurology Department, Hospital Universitario Virgen del Rocío/ Instituto de Biomedicina de Sevilla, Sevilla, Spain.
Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.

Miguel A Martin (MA)

Hospital 12 de Octubre Research Institute (imas12), Madrid, Spain.
Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
Mitochondrial Disorders Laboratory, Clinical Biochemistry Department, Hospital Universitario 12 de Octubre, Madrid, Spain.

Jordi Díaz-Manera (J)

Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain. jordi.diaz-manera@newcastle.ac.uk.
John Walton Muscular Dystrophy Research Center, University of Newcastle, Newcastle, UK. jordi.diaz-manera@newcastle.ac.uk.
Institut de Recerca, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. jordi.diaz-manera@newcastle.ac.uk.
John Walton Muscular Dystrophy Research Centre Newcastle University Translational and Clinical Research Institute Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK. jordi.diaz-manera@newcastle.ac.uk.

Carmen Paradas (C)

Neuromuscular Diseases Unit, Neurology Department, Hospital Universitario Virgen del Rocío/ Instituto de Biomedicina de Sevilla, Sevilla, Spain. cparadas@us.es.
Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain. cparadas@us.es.
Unidad de Enfermedades Neuromusculares (CSUR/EURO-NMD), Hospital Universitario Virgen del Rocío/ Instituto de Biomedicina de Sevilla, Sevilla, Spain. cparadas@us.es.

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