Support International Myotonic Dystrophy Awareness Day on September 15th!
International Myotonic Dystrophy Awareness Day aims to garner the attention of the wider general public, policy makers, regulators, biopharmaceutical representatives, researchers, health care professionals, and anyone with an interest in changing the future of myotonic dystrophy. Do your part to help raise myotonic dystrophy awareneess by teaching others about DM.
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Myotonic Dystrophy at a Glance
Myotonic dystrophy is a rare, multi-systemic, inherited disease that affects an estimated 1 in 2,100 people, or over 3.6 million individuals across the world.1
Millions of people are living with DM globally, yet millions of people do not know they have the disease and are in need of care.1
Myotonic dystrophy is the most common form of adult muscular dystrophy and considered the most variable of all known conditions.2
Myotonic dystrophy is commonly referred to as DM, an abbreviation of the Latin name used by doctors and researchers worldwide: dystrophia myotonica. Other names for DM include myotonic muscular dystrophy (MMD), Steinert’s Disease for DM1, and Proximal myotonic myopathy (PROMM) for DM2.3-31
Myotonic dystrophy symptoms usually become more severe with each generation, yet there is currently no cure and there are no approved treatments.74-89
Mutations prevent genes from carrying out their functions properly, which can impact multiple body systems. Myotonic dystrophy type 1 is caused by a mutation in the DMPK gene, while Myotonic dystrophy type 2 is caused by a mutation in the CNBP gene.3-31
Myotonic dystrophy is inherited - people living with myotonic dystrophy have a 50% chance of passing on the mutated gene to their children.8
People living with myotonic dystrophy experience varied and complex symptoms, from skeletal muscle problems91-112, to heart113-126, breathing127-150, digestive151-166, hormonal198-219, speech and swallowing246, diabetic247, immune220-237, excessive daytime sleepiness248, early cataracts and vision challenges238-245, and cognitive difficulties167-197.
Myotonic dystrophy doesn’t always look the same. The different body systems affected, the severity of symptoms, and the age of onset of those symptoms vary greatly between individuals, even in the same family.249-250
Delays in diagnosing myotonic dystrophy are common. Despite the availability of simple genetic tests, a lack of familiarity with the disease on the part of healthcare providers can allow misdiagnoses to persist for decades.251
Over 35 biopharmaceutical companies are leading promising research which may result in new treatments for myotonic dystrophy, and, one day, a cure.251
Medical References & Citations for Myotonic Dystrophy
Disease Mechanism
Prevalence
- Nicholas E. Johnson, Russell J. Butterfield, Katie Mayne, Tara Newcomb,Carina Imburgia, Diane Dunn, Brett Duval, Marcia L. Feldkamp, Robert B. Weiss. Population-Based Prevalence of Myotonic Dystrophy Type 1 Using Genetic Analysis of Statewide Blood Screening Program, Neurology Feb 2021, 96 (7) e1045-e1053, 2021.
- National Organization for Rare Disorders. (2017). Myotonic dystrophy. Retrieved May 5, 2021, from https://rarediseases.org/rare-diseases/dystrophy-myotonic/
Causes of DM
- Cho, D.H.; Tapscott, S.J. Myotonic dystrophy: emerging mechanisms for DM1 and DM2. Biochim Biophys Acta Feb 1772:195-204, 2007.
- Ranum L.P.; Cooper T.A. RNA-mediated neuromuscular disorders. Annu Rev Neurosci 29:259-77, 2006.
- Machuca-Tzili L.; Brook J.D.; Hilton-Jones D. Clinical and molecular aspects of the myotonic dystrophies: a review. Muscle Nerve Jul 32:1-18, 2005.
- Harper P.S.; van Engelen B.G.; Eymard B.; Rogers M.; Wilcox D. (2004) 99th ENMC international workshop: myotonic dystrophy: present management, future therapy. 9-11 November 2001, Naarden, The Netherlands. Oxford University Press, Oxford UK.
- Day J.W.; Ranum L.P. RNA pathogenesis of the myotonic dystrophies. Neuromuscul Disord Jan 15:5-16, 2005.
- Meola G. Clinical aspects, molecular pathomechanisms and management of myotonic dystrophies. Acta Myol. 2013 Dec;32(3):154-65. PMID: 24803843; PMCID: PMC4006279.
- Ranum L.P.W.; Day J.W. Myotonic Dystrophy: RNA Pathogenesis Comes into Focus. American Journal of Human Genetics 74: 793-804, 2004.
- Harper P.S. (2001) Myotonic Dystrophy, 3rd ed. W.B. Saunders, London.
- Korade-Mirnics Z.; Babitzke P.; Hoffman E. Myotonic dystrophy: molecular windows on a complex etiology. Nucleic Acids Res Mar 15 26:1363-8, 1998.
- Roses AD (1997) Myotonic dystrophy. In: Rosenberg RN, Prusiner SB, Dimauro S, Barchi RL (eds) The Molecular and Genetic Basis of Neurological Disease, 2 ed. Butterworth-Heinemann, Stoneham, MA.
- Harris S.; Moncrieff C.; Johnson K. Myotonic dystrophy: will the real gene please step forward! Hum Mol Genet 5 Spec 1417-23, 1996.
- Pizzuti A.; Friedman D.L.; Caskey C.T. The myotonic dystrophy gene. Arch. Neurol 50: 1173-9, 1993.
- Brook J.D.; McCurrach M.E.; Harley H.G.; Buckler A.J.; Church D.; Aburatani H.; Hunter K.; Stanton V.P.; Thirion J.-P.; Hudson T.; Sohn R.; Zemelman B.; Snell R.G.; Rundle S.A.; Crow S.; Davies J.; Shelbourne P.; Buxton J.; Jones C.; Juvonen V.; Johnson K.; Harper P.S.; Shaw D.J.; Housman D.E. Molecular basis of myotonic dystrophy: expansion of a trinucleotide (CTG) repeat at the 3-prime end of a transcript encoding a protein kinase family member. Cell 68: 799-808, 1992.
- Buxton J.; Shelbourne P.; Davies J.; Jones C.; Van Tongeren T.; Aslanidis C.; de Jong P.; Jansen G.; Anvret M.; Riley B.; Williamson R.; Johnson K. Detection of an unstable fragment of DNA specific to individuals with myotonic dystrophy. Nature 355: 547-8, 1992.
- Fu Y.-H.; Pizzuti A.; Fenwick R.G., Jr.; King J.; Rajnarayan S.; Dunne P.W.; Dubel J.; Nasser G.A.; Ashizawa T.; de Jong P.; Wieringa B.; Korneluk R.; Perryman M.B.; Epstein H.F.; Caskey C.T. An unstable triplet repeat in a gene related to myotonic muscular dystrophy. Science 255: 1256-8, 1992.
- Mahadevan M.; Tsilfidis C.; Sabourin L.; Shutler G.; Amemiya C.; Jansen G.; Neville C.; Narang M.; Barcelo J.; O’Hoy K.; Leblond S.; Earle-Macdonald J.; de Jong P.J.; Wieringa B.; Korneluk R.G. Myotonic dystrophy mutation: an unstable CTG repeat in the 3-prime untranslated region of the gene. Science 255: 1253-5, 1992.
Causes of DM2
- Ranum L.P.; Cooper T.A. RNA-mediated neuromuscular disorders. Annu Rev Neurosci 29:259-77, 2006.
- Udd B.; Meola G.; Krahe R.; Thornton C.; Ranum L.P.; Bassez G.; Kress W.; Schoser B.; Moxley R. 140th ENMC International Workshop: Myotonic Dystrophy DM2/PROMM and other myotonic dystrophies with guidelines on management. Neuromuscul Disord Jun 16:403-13, 2006.
- Day J.W.; Ranum L.P. RNA pathogenesis of the myotonic dystrophies. Neuromuscul Disord Jan 15:5-16, 2005.
- Machuca-Tzili L.; Brook J.D.; Hilton-Jones D. Clinical and molecular aspects of the myotonic dystrophies: a review. Muscle Nerve Jul 32:1-18, 2005.
- Meola G.; Moxley R.T. 3rd. Myotonic dystrophy type 2 and related myotonic disorders. J Neurol Oct 251:1173-82, 2004.
- Ranum L.P.W., and Day J.W. Myotonic Dystrophy: RNA Pathogenesis Comes into Focus. American Journal of Human Genetics 74: 793-804, 2004.
- Day J.W.; Ricker K.; Jacobsen J.F.; Rasmussen L.J.; Dick K.A.; Kress W.; Schneider C.; Koch M.C.; Beilman G.J.; Harrison A.R.; Dalton J.C.; Ranum L.P.; Myotonic dystrophy type 2: molecular, diagnostic and clinical spectrum. Neurology Feb 25 60:657-64, 2003.
- Finsterer J. Myotonic dystrophy type 2. Eur J Neurol Sep 9:441-7, 2002.
- Harper P.S. (2001) Myotonic Dystrophy, 3rd ed. W.B. Saunders, London.
- Liquori C.L.; Ricker K.; Moseley M.L.; Jacobsen J.F.; Kress W.; Naylor S.L.; Day J.W.; Ranum L.P. Myotonic dystrophy type 2 caused by a CCTG expansion in intron 1 of ZNF9. Science 293:864-7, 2001.
- Larkin K, Fardaei M. Myotonic dystrophy--a multigene disorder. Brain Res Bull Oct-Nov 1 56:389-95, 2001.
- Day J.W.; Roelofs R.; Leroy B.; Pech I.; Benzow K.; Ranum L.P. Clinical and genetic characteristics of a five- generation family with a novel form of myotonic dystrophy (DM2). Neuromuscul Disord 9:19-27, 1999.
- Udd B.; Krahe R.; Wallgren-Pettersson C.; Falck B.; Kalimo H. Proximal myotonic dystrophy--a family with autosomal dominant muscular dystrophy, cataracts, hearing loss and hypogonadism: heterogeneity of proximal myotonic syndromes? Neuromuscul Disord 7:217-28, 1997.
- Meola G.; Sansone V.; Radice S.; Skradski S.; Ptacek L. A family with an unusual myotonic and myopathic phenotype and no CTG expansion (proximal myotonic myopathy syndrome): a challenge for future molecular studies. Neuromuscul Disord 6:143-50, 1996.
- Thornton, C.A.; Griggs, R.C.; Moxley, R.T.III. Myotonic dystrophy with no trinucleotide repeat expansion. Ann. Neurol 35: 269-72, 1994.
RNA Pathogenesis
- Wang G.-S.; Kearney D.L.; De Biasi M.; Taffet G.; Cooper T.A. Elevation of RNA-binding protein CUGBP1 is an early event in an inducible heart-specific mouse model of myotonic dystrophy. J. Clin. Invest 117: 2802-11, 2007.
- Wheeler T.M.; Lueck J.D.; Swanson M.S.; Dirksen R.T.; Thornton C.A. Correction of ClC-1 splicing eliminates chloride channelopathy and myotonia in mouse models of myotonic dystrophy. J Clin Invest 117:3952-7, 2007.
- Smith K.P.; Byron M.; Johnson C.; Xing Y.; Lawrence J.B. Defining early steps in mRNA transport: mutant mRNA in myotonic dystrophy type I is blocked at entry into SC-35 domains. J Cell Biol Sep 10 178:951- 64, 2007.
- Yuan Y.; Compton S.A.; Sobczak K.; Stenberg M.G.; Thornton C.A.;, Griffith J.D.; Swanson M.S. Muscleblind- like 1 interacts with RNA hairpins in splicing target and pathogenic RNAs. Nucleic Acids Res 35:5474-86, 2007.
- Paul S.; Dansithong W.; Kim D.; Rossi J.; Webster N.J.; Comai L.; Reddy S. Interaction of muscleblind, CUG- BP1 and hnRNP H proteins in DM1-associated aberrant IR splicing. EMBO J Sep 20 25:4271-83, 2006.
- Timchenko, L. Reversal of fortune. Nature Genet 38: 976-7, 2006.
- Kanadia R.N.; Shin J.; Yuan Y.; Beattie S.G.; Wheeler T.M.; Thornton C.A.; Swanson M.S. Reversal of RNA missplicing and myotonia after muscleblind overexpression in a mouse poly(CUG) model for myotonic dystrophy. Proc Natl Acad Sci USA Aug 1 103:11748-53, 2006.
- Mahadevan M.S.; Yadava R.S.; Yu Q.; Balijepalli S.; Frenzel-McCardell C.D.; Bourne T.D.; Phillips L.H. Reversible model of RNA toxicity and cardiac conduction defects in myotonic dystrophy. Nature Genet 38: 1066-70, 2006.
- Machuca-Tzili L.; Thorpe H.; Robinson T.E.; Sewry C.; Brook J.D. Flies deficient in muscleblind protein model features of myotonic dystrophy with altered splice forms of Z-band associated transcripts. Hum. Genet 120: 487-99, 2006.
- Dansithong W.; Paul S.; Comai L.; Reddy S. MBNL1 is the Primary Determinant of Focus Formation and Aberrant Insulin Receptor Splicing in DM1. JBC 280: 5773-80, 2005.
- Jiang H.; Mankodi A.; Swanson M.S.; Moxley R.T.; Thornton C.A. Myotonic dystrophy type 1 is associated with nuclear foci of mutant RNA, sequestration of muscleblind proteins and deregulated alternative splicing in neurons. Hum. Molec. Genet 13: 3079-88, 2004.
- Kanadia R.N.; Johnstone K.A.; Mankodi A.; Lungu C.; Thornton C.A.; Esson D.; Timmers A.M.; Hauswirth W.W.; Swanson M.S. A muscleblind knockout model for myotonic dystrophy. Science 302: 1978-80, 2003.
- Fardaei M.; Rogers M.T.; Thorpe H.M.; Larkin K.; Hamshere M.G.; Harper P.S.; Brook J.D. Three proteins, MBNL, MBLL and MBXL, co-localize in vivo with nuclear foci of expanded-repeat transcripts in DM1 and DM2 cells. Hum Mol Genet Apr 1 11:805-14, 2002.
- Mankodi A.; Urbinati C.R.; Yuan Q.-P.; Moxley R.T.; Sansone V.; Krym M.; Henderson D.; Schalling M.; Swanson M.S.; Thornton C.A. Muscleblind localizes to nuclear foci of aberrant RNA in myotonic dystrophy types 1 and 2. Hum. Molec. Genet 10: 2165-70, 2001.
- Ladd A.N.; Charlet-B.N.; Cooper T.A. The CELF family of RNA binding proteins is implicated in cell- specific and developmentally regulated alternative splicing. Molec. Cell. Biol 21: 1285-96, 2001.
- Miller J.W.; Urbinati C.R.; Teng-umnuay P.; Stenberg M G.; Byrne B.J.; Thornton C.A.; Swanson M.S. Recruitment of human muscleblind proteins to CUG(n) expansions associated with myotonic dystrophy. EMBO J 19: 4439-48, 2000.
- Mankodi A.; Logigian E.; Callahan L.; McClain C.; White R.; Henderson D.; Krym M.; Thornton C.A. Myotonic dystrophy in transgenic mice expressing an expanded CUG repeat. Science 289:1769-72, 2000.
- Timchenko, L. T. Myotonic dystrophy: the role of RNA CUG triplet repeats. Am. J. Hum. Genet 64: 360-4, 1999.
- Philips A.V.; Timchenko L.T.; Cooper T.A. Disruption of splicing regulated by a CUG-binding protein in myotonic dystrophy. Science 280: 737-41, 1998.
- Davis B.M.; McCurrach M.E.; Taneja K.L.; Singer R.H.; Housman D.E. Expansion of CUG trinucleotide repeat in the 3’ untranslated region of myotonic dystrophy protein kinase transcripts results in nuclear retention of transcripts. Proceedings of the National Academy of Sciences 94: 7388-93, 1997.
- Roberts R.; Timchenko N.A.; Miller J.W.; Reddy S.; Caskey C.T.; Swanson M.S.; Timchenko L.T. Altered phosphorylation and intracellular distribution of a (CUG)n triplet repeat RNA-binding protein in patients with myotonic dystrophy and in myotonin protein kinase knockout mice. Proc. Nat. Acad. Sci 94: 13221-6, 1997.
- Timchenko L.T.; Miller J.W.; Timchenko N.A.; DeVore D.R.; Datar K.V.; Lin L.; Roberts R.; Caskey C.T.; Swanson M.S. Identification of a (CUG)n triplet repeat RNA-binding protein and its expression in myotonic dystrophy. Nucleic Acids. Res 24: 4407-14, 1996.
- Wang J.; Pegoraro E.; Menegazzo E.; Gennarelli M.; Hoop R.C.; Angelini C.; Hoffman E.P. Myotonic dystrophy: evidence for a possible dominant-negative RNA mutation. Hum. Molec. Genet 4: 599-606, 1995.
- Fu Y-H.; Friedman D.L.; Richards S.; Pearlman J.A.; Gibbs R.A.; Pizzuti A.; Ashizawa T.; Perryman M.B.; Scarlato G.; Fenwick R.G.Jr.; Caskey C.T. Decreased expression of myotonin protein kinase messenger RNA and protein in adult form of myotonic dystrophy. Science 260: 235-8, 1993.
- Hull K.L. Jr; Roses A.D. Stoichiometry of sodium and potassium transport in erythrocytes from patients with myotonic muscular dystrophy. J Physiol Jan 254:169-81, 1976.
Somatic Mosaicism
- Foiry L, Dong L, Savouret C, Hubert L, Riele HT, Junien C, Gourdon G. Msh3 is a limiting factor in the formation of intergenerational CTG expansions in DM1 transgenic mice. Hum Genet 119: 520-6, 2006.
- Fortune MT, Vassilopoulos C, Coolbaugh MI, Siciliano MJ, Monckton DG. Dramatic, expansion-biased, age-dependent, tissue-specific somatic mosaicism in a transgenic mouse model of triplet repeat instability. Hum Mol Genet 9: 439-45, 2000.
- Gomes-Pereira M, Fortune MT, Ingram L, McAbney JP, Monckton DG. Pms2 is a genetic enhancer of trinucleotide CAG.CTG repeat somatic mosaicism: implications for the mechanism of triplet repeat expansion. Hum Mol Genet 13: 1815-25, 2004.
- Martorell L, Martinez JM, Carey N, Johnson K, Baiget M. Comparison of CTG repeat length expansion and clinical progression of myotonic dystrophy over a five year period. J Med Genet 32: 593-596, 1995.
- Martorell L, Monckton DG, Gamez J, Baiget M. Complex patterns of male germline instability and somatic mosaicism in myotonic dystrophy type 1. Eur J Hum Genet 8: 423-30, 2000.
- Monckton DG, Wong LJC, Ashizawa T, Caskey CT. Somatic mosaicism, germline expansions, germline reversions and intergenerational reductions in myotonic dystrophy males: small pool PCR analyses. Hum Mol Genet 4: 1-8, 1995.
- van den Broek WJ, Nelen MR, Wansink DG, Coerwinkel MM, te Riele H, Groenen PJ, Wieringa B. Somatic expansion behaviour of the (CTG)n repeat in myotonic dystrophy knock-in mice is differentially affected by Msh3 and Msh6 mismatch-repair proteins. Hum Mol Genet 11: 191-8, 2002.
- Savouret C.; Brisson E.; Essers J.;, Kanaar R.; Pastink A.; te Riele H.; Junien C.; Gourdon G. CTG repeat instability and size variation timing in DNA repair-deficient mice. EMBO J May 1 22:2264-73, 2003.
- Khajavi M.; Tari A. M.; Patel N. B.; Tsuji K.; Siwak D.R.; Meistrich M.L.; Terry N.H.A.; Ashizawa T. ‘Mitotic drive’ of expanded CTG repeats in myotonic dystrophy type 1 (DM1). Hum. Molec. Genet 10: 855-63, 2001.
- Gomes-Pereira M.; Fortune M.T.; Monckton D.G. Mouse tissue culture models of unstable triplet repeats: in vitro selection for larger alleles, mutational expansion bias and tissue specificity, but no association with cell division rates. Hum. Molec. Genet 10: 845-54, 2001.
- Martorell L.; Monckton D.G.; Gamez J.; Johnson, K.J.; Gich I.; Lopez de Munain A.; Baiget M. Progression of somatic CTG repeat length heterogeneity in the blood cells of myotonic dystrophy patients. Hum. Molec. Genet 7: 307-12, 1998.
- Lia A.-S.; Seznec H.; Hofmann-Radvanyi H.; Radvanyi F.; Duros C.; Saquet C.; Blanche M.; Junien C.; Gourdon G. Somatic instability of the CTG repeat in mice transgenic for the myotonic dystrophy region is age dependent but not correlated to the relative intertissue transcription levels and proliferative capacities. Hum. Molec. Genet 7: 1285-91, 1998.
- Wong L.J.; Ashizawa T.; Monckton D.G.; Caskey C.T.; Richards C.S. Somatic heterogeneity of the CTG repeat in myotonic dystrophy is age and size dependent. Am J Hum Genet Jan 56:114-22, 1995.
- López de Munain A.; Cobo A.M.; Huguet E.; Marti Massó J.F.; Johnson K.; Baiget M. CTG trinucleotide repeat variability in identical twins with myotonic dystrophy. Ann Neurol Mar 35:374-5, 1994.
- Thornton CA, Johnson K, Moxley RT 3rd. Myotonic dystrophy patients have larger CTG expansions in skeletal muscle than in leukocytes. Ann Neurol Jan 35:104-7, 1994.
- Lavedan C.; Hofmann-Radvanyi H.; Shelbourne P.; Rabes J.-P.; Duros C.; Savoy D.; Dehaupas I.; Luce S.; Johnson K.; Junien C. Myotonic dystrophy: size- and sex-dependent dynamics of CTG meiotic instability, and somatic mosaicism. Am. J. Hum. Genet 52: 875-83, 1993.
- Anvret M.; Ahlberg G.; Grandell U.; Hedberg B.; Johnson K.; Edstrom L. Larger expansions of the CTG repeat in muscle compared to lymphocytes from patients with myotonic dystrophy. Hum. Molec. Genet 2: 1397-400, 1993.
- Ashizawa T.; Dubel J.R.; Harati Y. Somatic instability of CTG repeat in myotonic dystrophy. Neurology Dec 43:2674-8, 1993.
Anticipation
- Yang J.; Freudenreich C.H. Haploinsufficiency of yeast FEN1 causes instability of expanded CAG/CTG tracts in a length-dependent manner. Gene May 15 393:110-5, 2007.
- Dean N.L.; Loredo-Osti J.C.; Fujiwara T.M.; Morgan K.; Tan S.L.; Naumova A.K.; Ao A. Transmission ratio distortion in the myotonic dystrophy locus in human preimplantation embryos. Eur J Hum Genet 14:299-306, 2006.
- Savouret C, Garcia-C, Megret J, te Riele H, Junien C, Gourdon G. MSH2-dependent germinal CTG repeat expansions are produced continuously in spermatogonia from DM1 transgenic mice. Mol Cell Biol 2004 Jan 24:629-37, 2004.
- De Temmerman N.; Sermon K.; Seneca S.; De Rycke M.; Hilven P.; Lissens W.; Van Steirteghem A.; Liebaers I. Intergenerational instability of the expanded CTG repeat in the DMPK gene: studies in human gametes and preimplantation embryos. Am J Hum Genet Aug 75:325-9, 2004.
- Martorell L.; Monckton D.G.; Sanchez A.; Lopez de Munain A.; Baiget M. Frequency and stability of the myotonic dystrophy type 1 premutation. Neurology 56: 328-35, 2001.
- Seznec H.; Lia-Baldini A.-S.; Duros, C.; Fouquet C.; Lacroix C.; Hofmann-Radvanyi H.; Junien C.; Gourdon G. Transgenic mice carrying large human genomic sequences with expanded CTG repeat mimic closely the DM CTG repeat intergenerational and somatic instability. Hum. Molec. Genet 9: 1185-94, 2000.
- Cohen H.; Sears D.D.; Zenvirth D.; Hieter P.; Simchen G. Increased instability of human CTG repeat tracts on yeast artificial chromosomes during gametogenesis. Mol Cell Biol Jun 19:4153-8, 1999.
- Simmons Z.; Thornton C.A.; Seltzer W.K.; Richards C.S. Relative stability of a minimal CTG repeat expansion in a large kindred with myotonic dystrophy. Neurology 50: 1501-4, 1998.
- Magee, A.C.; Hughes, A.E. Segregation distortion in myotonic dystrophy. J. Med. Genet 35:1045-6, 1998.
- Gourdon G.; Radvanyi F.; Lia A.-S.; Duros C.; Blanche M.; Abitbol M.; Junien C.; Hofmann- Radvanyi H. Moderate intergenerational and somatic instability of a 55-CTG repeat in transgenic mice. Nature Genet 15: 190-2, 1997.
- Leeflang, E.P.; McPeek, M.S.; Arnheim, N. Analysis of meiotic segregation, using singlesperm typing: meiotic drive at the myotonic dystrophy locus. Am. J. Hum. Genet 59: 896-904, 1996.
- Jansen G.; Willems P.; Coerwinkel M.; Nillesen W.; Smeets H.; Vits L.; Höweler C.; Brunner H.; Wieringa B. Gonosomal mosaicism in myotonic dystrophy patients: involvement of mitotic events in (CTG)n repeat variation and selection against extreme expansion in sperm. Am J Hum. Genet Apr 54:575-85, 1994.
- Abeliovich D, Lerer I, Pashut-Lavon I, Shmueli E, Raas-Rothschild A, Frydman M. Negative expansion of the myotonic dystrophy unstable sequence. Am J Hum Genet Jun 52:1175-81, 1993.
- Lavedan C, Hofmann-Radvanyi H, Shelbourne P, Rabes JP, Duros C, Savoy D, Dehaupas I, Luce S, Johnson K, Junien C. Myotonic dystrophy: size- and sex-dependent dynamics of CTG meiotic instability, and somatic mosaicism. Am J Hum Genet May 52:875-83, 1993.
- Sutherland G.R.; Richards R.I. Anticipation legitimized: unstable DNA to the rescue. Am J Hum Genet Jul 51:7-9, 1992.
- Harper P.S.; Harley H.G.; Reardon W.; Shaw D.J. Anticipation in myotonic dystrophy: new light on an old problem. Am J Hum Genet 1992 Jul 51:10-6. Erratum in: Am J Hum Genet Oct 51:942, 1992.
Multisystemic Features
Skeletal Muscle
- Benders A.A., Timmermans J.A., Oosterhof A., Ter Laak H.J., van Kuppevelt T.H., Wevers R.A., Veerkamp J.H. Deficiency of Na+/K(+)-ATPase and sarcoplasmic reticulum Ca(2+)-ATPase in skeletal muscle and cultured muscle cells of myotonic dystrophy patients. Biochem J Jul 1 293:269-74, 1993.
- Benders A.A.G.M., Groenen P.J.T.A., Oerlmans F.T.J.J., Veerkamp J.H., Wieringa B. Myotonic dystrophy protein kinase is involved in the modulation of the Ca(2+) homeostasis in skeletal muscle cells. J. Clin. Invest 100: 1440-7, 1997.
- Casanova G., Jerusalem F. Myopathology of myotonic dystrophy: a morphometric study. Acta Neuropath (Berlin) 45: 213-40, 1979.
- de Swart B.J., van Engelen B.G., van de Kerkhof J.P., Maassen B.A. Myotonia and flaccid dysarthria in patients with adult onset myotonic dystrophy. J Neurol Neurosurg Psychiatry 75:1480-2, 2004.
- Drachman D. B., Fambrough D. M. Are muscle fibers denervated in myotonic dystrophy? Arch. Neurol 33: 485-8, 1976.
- Dubowitz Z. (1995) Muscle Disorders in Childhood, 2 ed. W.B. Saunders Co, London.
- Kalkman J.S., Schillings M.L., van der Werf S.P., Padberg G.W., Zwarts M.J., van Engelen B.G., Bleijenberg G. Experienced fatigue in facioscapulohumeral dystrophy, myotonic dystrophy, and HMSN-I. J Neurol Neurosurg Psychiatry 76:1406-9, 2005.
- Kurihara T. New Classification and Treatment for Myotonic Disorders. Internal Medicine 44: 1027-32, 2005.
- Logigian E.L., Ciafaloni E., Quinn L.C., Dilek N., Pandya S., Moxley R.T. 3rd, Thornton C.A. Severity, type, and distribution of myotonic discharges are different in type 1 and type 2 myotonic dystrophy. Muscle Nerve Apr 35:479-85, 2007.
- Logigian E.L., Blood C.L., Dilek N.,Martens W.B., Moxley R.T.4th, Wiegner A.W., Thornton C.A., Moxley R.T. 3rd. Quantitative analysis of the “warm-up” phenomenon in myotonic dystrophy type 1. Muscle Nerve 32:35-42, 2005.
- Logigian E.L., Moxley R.T., IV, Blood C.L., Barbieri C.A., Martens W.B., Wiegner A.W., Thornton C.A., Moxley R.T., 3rd. Leukocyte CTG repeat length correlates with severity of myotonia in myotonic dystrophy type 1. Neurology 62: 1081-9, 2004.
- Lovell M.E., Morcuende J.A. Neuromuscular disease as the cause of late clubfoot relapses: report of 4 cases. Iowa Orthop J 27:82-4, 2007.
- Lueck J.D., Mankodi A., Swanson M.S., Thornton C.A., Dirksen R.T. Muscle chloride channel dysfunction in two mouse models of myotonic dystrophy. J Gen Physiol Jan 129:79-94, 2007.
- Mankodi A., Takahashi M.P., Jiang H., Beck C.L., Bowers W.J., Moxley R.T., Cannon S.C., Thornton C.A. Expanded CUG repeats trigger aberrant splicing of ClC-1 chloride channel pre-mRNA and hyperexcitability of skeletal muscle in myotonic dystrophy. Mol Cell 10:35-44, 2002.
- Mounsey J.P., Xu P., John J.E. 3rd, Horne L.T., Gilbert J., Roses A.D., Moorman J.R. Modulation of skeletal muscle sodium channels by human myotonin protein kinase. J Clin Invest May 95:2379-84. 1995.
- Orngreen M. C., Olsen D. B., Vissing J. Aerobic training in patients with myotonic dystrophy type 1. Ann. Neurol 57: 754-7, 2005.
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- Streib E.W., Sun S.F. Distribution of electrical myotonia in myotonic muscular dystrophy. Ann Neurol 14:80-2, 1983.
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Respiratory System
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Gastrointestinal System
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Central Nervous System
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Reproductive and Endocrine
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Immune System and Tumor
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Vision
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- Versino M., Rossi B., Beltrami G., et al. Ocular motor myotonic phenomenon in myotonic dystrophy. J Neurol Neurosurg Psychiat 72:236-240, 2002.
Speech and Swallowing
- Lisa Bengtsson, MS; Kiera Berggren, MA/CCC-SLP, MS; Lenie van den Engel-Hoek, PhD; Simone Knuijt, PhD; Lotta Sjögreen, PhD; Kristi Williams, M.S. CCC-SLP. Care Guidelines for Speech and Language Pathologists Treating Adults and Children with Myotonic Dystrophy. 2020. Myotonic Dystrophy Foundation. https://www.myotonic.org/sites/default/files/pages/files/MDF_SLP_Guide_1_2021.pdf
Diabetes
- Renna LV, Bosè F, Iachettini S, Fossati B, Saraceno L, Milani V, Colombo R, Meola G, Cardani R. Receptor and post-receptor abnormalities contribute to insulin resistance in myotonic dystrophy type 1 and type 2 skeletal muscle. PLoS One. Sep 15;12(9):e0184987, 2017.
Excessive Daytime Sleepiness
- Franco Giubilei, Giovanni Antonini, Stefano Bastianello, Stefania Morino, Andrea Paolillo, Marco Fiorelli, Cinzia Ferretti, Cesare Fieschi. Excessive daytime sleepiness in myotonic dystrophy. Journal of the Neurological Sciences, Vol 164, Issue 1, 1999, Pages 60-63.
Genetic Testing
- Savić Pavićević D, Miladinović J, Brkušanin M, Šviković S, Djurica S, Brajušković G, Romac S. Molecular genetics and genetic testing in myotonic dystrophy type 1. Biomed Res Int. 2013:391821, 2013.
Diagnostic Odyssey
- Sarah Howe, Marigold Foundation and the Christopher Project Reference Group. The Christopher Project: Report to the Myotonic Dystrophy Community. Marigold Foundation. Pages 23-24. Spring 2019.
Drug Development
- Newcastle University John Walton Muscular Dystrophy Research Centre. Myotonic Dystrophy Drug Development Pipeline. 2021. Accessed May 7, 2021: https://www.myotonic.org/sites/default/files/pages/files/Myotonic-Dystrophy-Drug-Development-Pipeline-as-of-March-8th-2021.pdf
- Myotonic Dystrophy Foundation. Voice of the Patient Report Summary report resulting from an Externally-led Patient-Focused Drug Development meeting, an effort to expand the benefits of the U.S. Food and Drug Administration’s (FDA’s) Patient-Focused Drug Development Initiative. 2017. Accessed May 7, 2021: https://www.myotonic.org/sites/default/files/MDFVoicePatientReportMay2017.pdf