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Can long-term thiamine treatment improve the clinical outcomes of myotonic dystrophy type 1？

Neural Regeneration Research 2016年第9期11卷 1487-1491页

作者： Antonio Costantini Erika Trevi Maria immacolata Pala Roberto Fancellu Department of Neurological Rehabilitation "Villa Immacolata" Clinic Viterbo Italy School of Physiotherapy Catholic University of Rome Rome Italy Neurology Unit IRCCS San Martino University Hospital IST Genoa Italy

myotonic dystrophy type 1, also known as Steinert＇s disease, is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles, the eyes, and the endocrine system. Thiamine （vitamin B1） is a cofactor of fundamental enzymes involved in the energetic cell me- tabolism; recent studies described its role in oxidative stress, protein processing, peroxisomal function, and gene expression. Thiamine deficiency is critical mainly in the central and peripheral nervous system, as well as in the muscular cells. Our aim was to investigate the potential therapeutical effects of long-term treatment with thiamine in myotonic dystrophy type 1 in an observational open-label pilot study. We de- scribed two patients with myotonic dystrophy type 1 treated with intramuscular thiamine 100 mg twice a week for 12 or 11 months. We evaluated the patients using the grading of muscle strength according to Medical Research Council （MRC）, the Muscular impairment Rating Scale （MiRS）, and the Modified Barthel index. High-dose thiamine treatment was well tolerated and effective in improving the motor symptomatology, particularly the muscle strength evaluated with the MRC scale, and the patients＇ activi- ties of daily living using the Modified Barthel index. At the end of treatment, the MRC score was 5 in the proximal muscles and 2-4 in the distal muscles （the MRG score before the treatment was 3-4 and 1-3, re- spectively）. The MiRS grade improved by 25% compared to baseline for both patients. in patient #1, the Modified Barthel index improved by 44%, and in patient #2 by 29%. These findings suggest that clinical outcomes are improved by long-term thiamine treatment.

关键词： nerve regeneration myotonic dystrophy type i thiamine Steinert＇s disease muscular strength activity of daily living neural regeneration

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