A quantitative measure of handgrip myotonia in non-dystrophic myotonia

Muscle Nerve. 2012 Oct;46(4):482-9. doi: 10.1002/mus.23402.

Abstract

Introduction: Non-dystrophic myotonia (NDM) is characterized by myotonia without muscle wasting. A standardized quantitative myotonia assessment (QMA) is important for clinical trials.

Methods: Myotonia was assessed in 91 individuals enrolled in a natural history study using a commercially available computerized handgrip myometer and automated software. Average peak force and 90% to 5% relaxation times were compared with historical normal controls studied with identical methods.

Results: Thirty subjects had chloride channel mutations, 31 had sodium channel mutations, 6 had DM2 mutations, and 24 had no identified mutation. Chloride channel mutations were associated with prolonged first handgrip relaxation times and warm-up on subsequent handgrips. Sodium channel mutations were associated with prolonged first handgrip relaxation times and paradoxical myotonia or warm-up, depending on underlying mutations. DM2 subjects had normal relaxation times but decreased peak force. Sample size estimates are provided for clinical trial planning.

Conclusion: QMA is an automated, non-invasive technique for evaluating myotonia in NDM.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Chloride Channels / genetics
  • Diagnosis, Computer-Assisted / methods
  • Diagnosis, Computer-Assisted / standards
  • Exercise Test / methods*
  • Exercise Test / standards
  • Female
  • Hand Strength / physiology*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Muscle Weakness / diagnosis*
  • Muscle Weakness / genetics
  • Muscle Weakness / physiopathology*
  • Mutation
  • Myotonia / diagnosis*
  • Myotonia / genetics
  • Myotonia / physiopathology*
  • Sodium Channels / genetics
  • Young Adult

Substances

  • Chloride Channels
  • Sodium Channels

Supplementary concepts

  • Nondystrophic myotonia