Cargando…

Candidate imaging biomarkers for PMP22 ‐related inherited neuropathies

OBJECTIVE: Charcot–Marie–Tooth type 1A (CMT1A) and hereditary neuropathy with liability to pressure palsy (HNPP) are caused by mutations to the peripheral myelin protein 22 (PMP22) gene. A need exists for sensitive and reliable biomarkers of progression and treatment response. Magnetic resonance ima...

Descripción completa

Detalles Bibliográficos
Autores principales: Roth, Alison R., Li, Jun, Dortch, Richard D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9268861/
https://www.ncbi.nlm.nih.gov/pubmed/35656877
http://dx.doi.org/10.1002/acn3.51561
_version_ 1784744090142769152
author Roth, Alison R.
Li, Jun
Dortch, Richard D.
author_facet Roth, Alison R.
Li, Jun
Dortch, Richard D.
author_sort Roth, Alison R.
collection PubMed
description OBJECTIVE: Charcot–Marie–Tooth type 1A (CMT1A) and hereditary neuropathy with liability to pressure palsy (HNPP) are caused by mutations to the peripheral myelin protein 22 (PMP22) gene. A need exists for sensitive and reliable biomarkers of progression and treatment response. Magnetic resonance imaging (MRI) metrics of nerve pathology and morphology were investigated for this purpose. METHODS: MRI was performed at 3.0 T in the thigh of CMT1A (N = 11) and HNPP patients (N = 12) and controls (N = 23). Three potential imaging biomarkers of the sciatic nerve were investigated: 1) magnetization transfer ratio (MTR), which assays myelin content, and 2) cross‐sectional area (CSA) and 3) circularity, which assay morphological changes. Potential imaging biomarkers were compared across cohorts and assessed for relationships with disability in the legs (CMTES(L)), compound motor action potentials (CMAP), and motor conduction velocities (MCV). Inter‐rater reliability and test–retest repeatability were established for each imaging metric. RESULTS: Significant differences in MTR, CSA, and circularity were observed in CMT1A relative to controls (p = 0.02, p < 0.001, and p = 0.003, respectively, via Wilcoxon rank‐sum tests). Differences were not observed in the HNPP cohort. Significant relationships were observed between MTR and clinical metrics (CMTES(L): p = 0.003, CMAP: p = 0.03, MCV: p = 0.01); and between CSA and electrophysiology (CMAP: p = 0.002, MCV: p < 0.001). All metrics were reliable and repeatable with MTR the most reliable (intraclass correlation coefficient [ICC] >0.999, CV = 0.30%) and repeatable (ICC = 0.84, CV = 3.16%). INTERPRETATION: MTR, CSA, and circularity showed promise as reliable and sensitive biomarkers of CMT1A, but not HNPP. These warrant longitudinal investigation as response biomarkers in upcoming clinical trials of CMT1A, while other methods should be considered for HNPP.
format Online
Article
Text
id pubmed-9268861
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-92688612022-07-14 Candidate imaging biomarkers for PMP22 ‐related inherited neuropathies Roth, Alison R. Li, Jun Dortch, Richard D. Ann Clin Transl Neurol Research Articles OBJECTIVE: Charcot–Marie–Tooth type 1A (CMT1A) and hereditary neuropathy with liability to pressure palsy (HNPP) are caused by mutations to the peripheral myelin protein 22 (PMP22) gene. A need exists for sensitive and reliable biomarkers of progression and treatment response. Magnetic resonance imaging (MRI) metrics of nerve pathology and morphology were investigated for this purpose. METHODS: MRI was performed at 3.0 T in the thigh of CMT1A (N = 11) and HNPP patients (N = 12) and controls (N = 23). Three potential imaging biomarkers of the sciatic nerve were investigated: 1) magnetization transfer ratio (MTR), which assays myelin content, and 2) cross‐sectional area (CSA) and 3) circularity, which assay morphological changes. Potential imaging biomarkers were compared across cohorts and assessed for relationships with disability in the legs (CMTES(L)), compound motor action potentials (CMAP), and motor conduction velocities (MCV). Inter‐rater reliability and test–retest repeatability were established for each imaging metric. RESULTS: Significant differences in MTR, CSA, and circularity were observed in CMT1A relative to controls (p = 0.02, p < 0.001, and p = 0.003, respectively, via Wilcoxon rank‐sum tests). Differences were not observed in the HNPP cohort. Significant relationships were observed between MTR and clinical metrics (CMTES(L): p = 0.003, CMAP: p = 0.03, MCV: p = 0.01); and between CSA and electrophysiology (CMAP: p = 0.002, MCV: p < 0.001). All metrics were reliable and repeatable with MTR the most reliable (intraclass correlation coefficient [ICC] >0.999, CV = 0.30%) and repeatable (ICC = 0.84, CV = 3.16%). INTERPRETATION: MTR, CSA, and circularity showed promise as reliable and sensitive biomarkers of CMT1A, but not HNPP. These warrant longitudinal investigation as response biomarkers in upcoming clinical trials of CMT1A, while other methods should be considered for HNPP. John Wiley and Sons Inc. 2022-06-03 /pmc/articles/PMC9268861/ /pubmed/35656877 http://dx.doi.org/10.1002/acn3.51561 Text en © 2022 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Roth, Alison R.
Li, Jun
Dortch, Richard D.
Candidate imaging biomarkers for PMP22 ‐related inherited neuropathies
title Candidate imaging biomarkers for PMP22 ‐related inherited neuropathies
title_full Candidate imaging biomarkers for PMP22 ‐related inherited neuropathies
title_fullStr Candidate imaging biomarkers for PMP22 ‐related inherited neuropathies
title_full_unstemmed Candidate imaging biomarkers for PMP22 ‐related inherited neuropathies
title_short Candidate imaging biomarkers for PMP22 ‐related inherited neuropathies
title_sort candidate imaging biomarkers for pmp22 ‐related inherited neuropathies
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9268861/
https://www.ncbi.nlm.nih.gov/pubmed/35656877
http://dx.doi.org/10.1002/acn3.51561
work_keys_str_mv AT rothalisonr candidateimagingbiomarkersforpmp22relatedinheritedneuropathies
AT lijun candidateimagingbiomarkersforpmp22relatedinheritedneuropathies
AT dortchrichardd candidateimagingbiomarkersforpmp22relatedinheritedneuropathies