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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2022; 80(05): 475-481
DOI: 10.1590/0004-282X-ANP-2021-0038
Articles

Ultrasonographic assessment of lower limb muscle architecture in children with early-stage Duchenne muscular dystrophy

Avaliação ultrassonográfica da arquitetura muscular dos membros inferiores em crianças com distrofia muscular de Duchenne em estágio inicial
Numan BULUT 
1   Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
,
Ayşe KARADUMAN 
1   Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
2   Lokman Hekim University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
,
İpek ALEMDAROĞLU-GÜRBÜZ 
1   Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
,
Öznur YILMAZ 
1   Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
,
Haluk TOPALOĞLU 
3   Hacettepe University, Medical School, Department of Pediatrics, Division of Pediatric Neurology, Ankara, Turkey.
4   Yeditepe University Hospital, Department of Child Health and Diseases, İstanbul, Turkey.
,
Levent ÖZÇAKAR 
5   Hacettepe University, Medical School, Department of Physical Medicine and Rehabilitation, Ankara, Turkey.
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ABSTRACT

Background: Muscle imaging methods such as ultrasound and magnetic resonance imaging have been used for many years to determine the dystrophic process in muscular dystrophies. However, the knowledge regarding muscle architecture in children at early-stage Duchenne muscular dystrophy (DMD) with different functional levels is limited. Objective: To explore the effect of functional level on muscle architectural properties in children with early stage DMD and the difference between DMD and typically developing (TD) peers. Methods: Thirty children with DMD (15 Grade 1 and 15 Grade 2 according to the Vignos Scale) and 5 TD peers were included. Ultrasound imaging was used to measure muscle thickness (MT), fascicle length (FL), and pennation angle (PA) of vastus lateralis (VL) and medial gastrocnemius (MG) muscles bilaterally. Results: The MT and FL values for VL, and MT, FL and PA values for MG muscles were higher in children with DMD compared with those of TD peers (p<0.05). The FL of VL, and MT and FL of GM muscles of children with DMD Grade 2 were higher than those of children with DMD Grade 1 (p<0.05). Conclusions: MT and FL are increased in children with DMD compared with TD peers. Additionally, muscle architecture seems to be affected even at the early stages of the disease.

RESUMO

Antecedentes: Métodos de imagem muscular, como ultrassom e ressonância magnética, têm sido usados há muitos anos para determinar o processo distrófico em distrofias musculares. No entanto, o conhecimento a respeito da arquitetura muscular em crianças com distrofia muscular de Duchenne (DMD) em estágio inicial, com diferentes níveis funcionais, é limitado. Objetivo: Explorar o efeito do nível funcional nas propriedades arquitetônicas do músculo em crianças com DMD em estágio inicial e a diferença entre DMD e seus pares em desenvolvimento típico (DT). Métodos: Trinta crianças com DMD (15 Grau 1 e 15 Grau 2 de acordo com a Escala de Vignos) e cinco colegas DT foram incluídos. A ultrassonografia foi usada para medir a espessura muscular (EM), o comprimento do fascículo (FL) e o ângulo de penetração (PA) dos músculos vasto lateral (VL) e gastrocnêmio medial (MG) bilateralmente. Resultados: Os valores de EM e FL para VL e os valores de EM, FL e PA para músculos MG foram maiores em crianças com DMD em comparação com os de seus pares DT (p<0,05). O FL do VL e o EM e o FL dos músculos GM de crianças com DMD Grau 2 foram maiores do que aqueles de crianças com DMD Grau 1 (p<0,05). Conclusões: TM e FL estão aumentados em crianças com DMD em comparação com seus pares DT. Além disso, a arquitetura muscular parece ser afetada mesmo nos estágios iniciais da doença.

Keywords:

Muscles - Ultrasonography - Muscular Dystrophies - Architecture - Physical Functional Performance

Palavras-chave:

Músculos - Ultrassonografia - Distrofias Musculares - Arquitetura - Desempenho Físico Funcional

Authors’ contributions:

NB: conceptualization, investigation, writing-original draft; AK: conceptualization, interpretation of data, revising draft version; IAG: investigation, formal analysis, writing-original draft; OY: conceptualization, methodology, writing-original draft; HT: supervision, interpretation of data, revising draft version; LO: conceptualization, investigation, revising draft version. All authors approved the final version of this manuscript.




Publication History

Received: 28 January 2021

Accepted: 03 August 2021

Article published online:
06 February 2023

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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