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Evolution of Charcot–Marie–Tooth disease type 1A duplication: a 2-year clinico-electrophysiological and lower-limb muscle MRI longitudinal study

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Abstract

The objective of this study was to analyze Charcot–Marie–Tooth disease type 1A (CMT1A) evolution. We conducted a 2-year longitudinal study in 14 CMT1A patients and 14 age- and sex-matched controls. In the patients, we performed neurological examination with hand-held dynamometry, electrophysiology, and lower-limb muscle MRI, both at baseline and 2 years later, while controls were examined at baseline only. Patients’ ages ranged from 12 to 51 years. Outstanding manifestations on initial evaluation included pes cavus, areflexia, lower-limb weakness, and foot hypopallesthesia. In evaluating muscle power, good correlation was observed between manual testing and dynamometry. Compared to controls, Lunge, 10-Meter-Walking, and 9-Hole-Peg tests were impaired. Their CMT neuropathy score and functional disability scale showed that patients exhibited mild phenotype and at most slight walking difficulty. Electrophysiology revealed marked nerve conduction slowing and variable compound muscle action potential amplitude reduction. On lower-limb muscle MRI, there was distally accentuated fatty infiltration accompanied by edema in calf muscles. All these clinico-electrophysiological and imaging findings remained almost unaltered during monitoring. Using multivariate analysis, no significant predictors of progression associated to the disease were obtained. We conclude that in the 2-year period of study, CMT1A patients showed mild progression with good concordance between clinico-electrophysiological and imaging findings.

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Acknowledgments

We thank our patients and controls for their collaboration in this study, without which this study would not have been possible. This study was supported by Research Institute of University Hospital “Marqués de Valdecilla” (IFIMAV) Grants (BFR 05/10 and WLA 03/12).

Conflicts of interest

We declare no conflicts of interest.

Ethical standard statement

Ethical approval was obtained and all patients, and control subjects gave informed consent for this study. This investigation was approved by the “Comité Ético de Investigación Clínica de Cantabria”.

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Correspondence to José Berciano.

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Pelayo-Negro, A.L., Gallardo, E., García, A. et al. Evolution of Charcot–Marie–Tooth disease type 1A duplication: a 2-year clinico-electrophysiological and lower-limb muscle MRI longitudinal study. J Neurol 261, 675–685 (2014). https://doi.org/10.1007/s00415-014-7248-4

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  • DOI: https://doi.org/10.1007/s00415-014-7248-4

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