Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
Pt 6
pubmed:dateCreated
2006-6-1
pubmed:abstractText
Spinal and bulbar muscular atrophy (SBMA) is an adult-onset motoneuron disease caused by a CAG-repeat expansion in the androgen receptor (AR) gene and for which no curative therapy exists. However, since recent research may provide opportunities for medical treatment, information concerning the natural history of SBMA would be beneficial in planning future clinical trials. We investigated the natural course of SBMA as assessed by nine activities of daily living (ADL) milestones in 223 Japanese SBMA patients (mean age at data collection = 55.2 years; range = 30-87 years) followed from 1 to 20 years. All the patients were diagnosed by genetic analysis. Hand tremor was an early event that was noticed at a median age of 33 years. Muscular weakness occurred predominantly in the lower limbs, and was noticed at a median age of 44 years, followed by the requirement of a handrail to ascend stairs at 49, dysarthria at 50, dysphagia at 54, use of a cane at 59 and a wheelchair at 61 years. Twenty-one of the patients developed pneumonia at a median age of 62 and 15 of them died at a median age of 65 years. The most common cause of death in these cases was pneumonia and respiratory failure. The ages at onset of each ADL milestone were strongly correlated with the length of CAG repeats in the AR gene. However CAG-repeat length did not correlate with the time intervals between each ADL milestone, suggesting that although the onset age of each ADL milestone depends on the CAG-repeat length in the AR gene, the rate of disease progression does not. The levels of serum testosterone, an important triggering factor for polyglutamine-mediated motoneuron degeneration, were maintained at relatively high levels even at advanced ages. These results provide beneficial information for future clinical therapeutic trials, although further detailed prospective studies are also needed.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1460-2156
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
129
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1446-55
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:16621916-Activities of Daily Living, pubmed-meshheading:16621916-Adult, pubmed-meshheading:16621916-Age Distribution, pubmed-meshheading:16621916-Age of Onset, pubmed-meshheading:16621916-Aged, pubmed-meshheading:16621916-Aged, 80 and over, pubmed-meshheading:16621916-Cause of Death, pubmed-meshheading:16621916-Disability Evaluation, pubmed-meshheading:16621916-Disease Progression, pubmed-meshheading:16621916-Follow-Up Studies, pubmed-meshheading:16621916-Humans, pubmed-meshheading:16621916-Male, pubmed-meshheading:16621916-Middle Aged, pubmed-meshheading:16621916-Muscle Weakness, pubmed-meshheading:16621916-Muscular Atrophy, Spinal, pubmed-meshheading:16621916-Prognosis, pubmed-meshheading:16621916-Receptors, Androgen, pubmed-meshheading:16621916-Tremor, pubmed-meshheading:16621916-Trinucleotide Repeats
pubmed:year
2006
pubmed:articleTitle
Natural history of spinal and bulbar muscular atrophy (SBMA): a study of 223 Japanese patients.
pubmed:affiliation
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't