1. An observational study of functional abilities in infants, children, and adults with type 1 SMA
- Author
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Pane, Marika, Palermo, Concetta, Messina, Sonia, Sansone, Valeria A, Bruno, Claudio, Catteruccia, Michela, Sframeli, Maria, Albamonte, Emilio, Pedemonte, Marina, D'Amico, Adele, Brigati, Giorgia, De Sanctis, Roberto, Coratti, Giorgia, Lucibello, Simona, Bertini, Enrico Silvio, Vita, Giuseppe, Tiziano, Francesco Danilo, Mercuri, Eugenio Maria, Italian EAP Working Group: Daniela Leone, Gloria, Ferrantini, Beatrice, Berti, Pera, Maria Carmela, Nicola, Forcina, Sara, Carnicella, Giulia, Norcia, Piastra, Marco, Genovese, Orazio, Pedicelli, Alessandro, Paola, Cimbolli, Antonio, Versaci, Imma, Rulli, Eloisa, Gitto, Cristina, Faraone, Stefania La Foresta, Maria, Macrì, Giulia, Colia, Anna Maria Bonetti, Adelina, Carlesi, Renato, Cutrera, Maria Beatrice Chiarini, Marta, Ferretti, Alberto, Garaventa, Giovanni, Montobbio, Carlo, Gandolfo, Valentina, Iurilli, Paola, Tacchetti, Emilia, Bobeica, Valentina, Lanzillotta, Alice, Pirola, Sara, Lupone, Elisa De Mattia, Elisa, Falcier, Fabrizio, Rao, Elisabetta, Roma, Caterina, Conti, Francesca, Salmin, Cristina, Grandi, Fausto, Fedeli, Luca, Mancini, Nicola, Tovaglieri, Paolo, Stoia, Maurizio, Heinen, Valeria, Cozzi, Beatrice, Travaglia, Emma, Mizzotti, Daniela, Lauro, Luca, Binetti, Anita, Pallara, Simona, Spinoglio, Maria Letizia Solinas, Grazia, Zappa, Francesca, Penno, Cristina, Ponzanelli, and Casiraghi, Jacopo Luca
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Activities of daily living ,Cross-sectional study ,medicine.medical_treatment ,Oligonucleotides ,Neurological examination ,Spinal Muscular Atrophies of Childhood ,Severity of Illness Index ,Cohort Studies ,03 medical and health sciences ,Disability Evaluation ,0302 clinical medicine ,Settore MED/39 - NEUROPSICHIATRIA INFANTILE ,Severity of illness ,Activities of Daily Living ,medicine ,Humans ,030212 general & internal medicine ,SMA ,Age of Onset ,Child ,Interactive Ventilatory Support ,Preschool ,medicine.diagnostic_test ,business.industry ,Spinal muscular atrophy type 1, Phenotype, SMN2 copies, Survival, Gastrostomy, Tracheostomy, Noninvasive ventilation ,Infant ,Spinal muscular atrophy ,medicine.disease ,Gastrostomy ,Survival of Motor Neuron 1 Protein ,Settore MED/26 - NEUROLOGIA ,Cross-Sectional Studies ,Child, Preschool ,Mutation ,Female ,Neurology (clinical) ,Age of onset ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
ObjectiveTo report cross-sectional clinical findings in a large cohort of patients affected by type 1 spinal muscular atrophy.MethodsWe included 122 patients, of age ranging between 3 months and 22 years, 1 month. More than 70% (85/122) were older than 2 years and 25% (31/122) older than 10 years. Patients were classified according to the severity of phenotype and to the number of SMN2 copies.ResultsPatients with the more common and the most severe phenotype older than 2 years were, with few exceptions, on noninvasive ventilation and, with increasing age, more often had tracheostomy or >16-hour ventilation and a gastrostomy inserted. In contrast, 25 of the 28 patients with the mildest phenotype older than 2 years had no need for tracheostomy or other ventilatory or nutritional support. In patients older than 2 years, the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders scores were generally lower compared to those found in younger patients and showed distinct levels of functional abilities according to the severity of the phenotype. Similar findings were also observed on the Hammersmith Infant Neurological Examination.ConclusionsOur findings confirm that, after the age of 2 years, patients with type 1 spinal muscular atrophy generally survive only if they have gastrostomy and tracheostomy or noninvasive ventilation >16 hours and have low scores on the functional scales. More variability, however, can be expected in those with the mildest phenotype, who achieve head control. These data provide important baseline information at the time treatments are becoming available.
- Published
- 2018