Neuropediatrics 2024; 55(01): 042-048
DOI: 10.1055/a-2101-7860
Original Article

Duchenne Muscular Dystrophy Fatigue Trajectories

Yi Sally Wei
1   Children's Hospital London Health Sciences Centre, London, Canada
,
Mona Hnaini
2   Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
,
Basmah ElAloul
2   Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
,
Eugenio Zapata
2   Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
,
Craig Campbell
1   Children's Hospital London Health Sciences Centre, London, Canada
2   Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
3   Department of Paediatrics, Clinical Neurological Sciences and Epidemiology, Western University, London, Ontario, Canada
› Author Affiliations
Funding This study was supported by an investigator-initiated grant from PTC Therapeutics.

Abstract

Introduction Children with Duchenne muscular dystrophy (DMD) are at risk of experiencing fatigue that negatively impacts their health-related quality of life (HRQoL). This study aimed to assess the association between fatigue and HRQoL, by examining fatigue trajectories over 48 weeks, and assessing factors associated with these fatigue trajectories.

Methods The study sample consisted of 173 DMD subjects enrolled in a 48-week-long phase 2 clinical trial (NCT00592553) for a novel therapeutic who were between the ages of 5 and 16 years.

Results The results of regression modeling show baseline fatigue and baseline HRQoL (R 2 = 0. 54 for child self-report and 0.51 for parent proxy report) and change in fatigue and HRQoL over 48 weeks (R 2 = 0.47 for child self-report and 0.36 for parent proxy report) were significantly associated with one another. Three unique fatigue trajectories using Latent Class Growth Models were identified for child and parent proxy reported fatigue. The risk of being in the high fatigue group as compared to the low fatigue group increased by 24% with each year increase in age and also with decreasing walking distance, as reported by children and parent proxy, respectively.

Conclusion This study identified fatigue trajectories and risk factors associated with greater fatigue, helping clinicians and researchers identify the profile of fatigue in DMD children.

Disclosure

Craig Campbell has been a site investigator for ataluren clinical trials and served as Chair of the Advisory Committee for PTC Therapeutics.


Supplementary Material



Publication History

Received: 14 February 2022

Accepted: 23 May 2023

Accepted Manuscript online:
26 May 2023

Article published online:
04 July 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Bushby K, Finkel R, Birnkrant DJ. et al; DMD Care Considerations Working Group. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Lancet Neurol 2010; 9 (01) 77-93
  • 2 Drousiotou A, Ioannou P, Georgiou T. et al. Neonatal screening for Duchenne muscular dystrophy: a novel semiquantitative application of the bioluminescence test for creatine kinase in a pilot national program in Cyprus. Genet Test 1998; 2 (01) 55-60
  • 3 Parsons EP, Clarke AJ, Hood K, Lycett E, Bradley DM. Newborn screening for Duchenne muscular dystrophy: a psychosocial study. Arch Dis Child Fetal Neonatal Ed 2002; 86 (02) F91-F95
  • 4 Emery AE. Population frequencies of inherited neuromuscular diseases: a world survey. Neuromuscul Disord 1991; 1 (01) 19-29
  • 5 Bushby K, Finkel R, Birnkrant DJ. et al; DMD Care Considerations Working Group. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol 2010; 9 (02) 177-189
  • 6 Eagle M, Baudouin SV, Chandler C, Giddings DR, Bullock R, Bushby K. Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Neuromuscul Disord 2002; 12 (10) 926-929
  • 7 Lou J-S, Weiss MD, Carter GT. Assessment and management of fatigue in neuromuscular disease. Am J Hosp Palliat Care 2010; 27 (02) 145-157
  • 8 Shen J, Barbera J, Shapiro CM. Distinguishing sleepiness and fatigue: focus on definition and measurement. Sleep Med Rev 2006; 10 (01) 63-76
  • 9 Carter BD, Edwards JF, Kronenberger WG, Michalczyk L, Marshall GS. Case control study of chronic fatigue in pediatric patients. Pediatrics 1995; 95 (02) 179-186
  • 10 Nutini M, Karczewski M, Capoor J. Fatigue in children with neurologic impairments. Phys Med Rehabil Clin N Am 2009; 20 (02) 339-346
  • 11 Wei Y, Speechley KN, Zou G, Campbell C. Factors associated with health-related quality of life in children with Duchenne muscular dystrophy. J Child Neurol 2016; 31 (07) 879-886
  • 12 El-Aloul B, Speechley KN, Wei Y, Wilk P, Campbell C. Fatigue in Young People with Duchenne Muscular Dystrophy. Dev Med Child Neurol 2020; 62: 245-251
  • 13 Messina S, Vita GL, Sframeli M. et al. Health-related quality of life and functional changes in DMD: A 12-month longitudinal cohort study. Neuromuscul Disord 2016; 26 (03) 189-196
  • 14 Pangalila RF, van den Bos GA, Bartels B, Bergen M, Stam HJ, Roebroeck ME. Prevalence of fatigue, pain, and affective disorders in adults with Duchenne muscular dystrophy and their associations with quality of life. Arch Phys Med Rehabil 2015; 96 (07) 1242-1247
  • 15 Crichton A, Knight S, Oakley E, Babl FE, Anderson V. Fatigue in child chronic health conditions: a systematic review of assessment instruments. Pediatrics 2015; 135 (04) e1015-e1031
  • 16 Carroll S, Chalder T, Hemingway C, Heyman I, Moss-Morris R. Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors. Dev Med Child Neurol 2016; 58 (03) 229-239
  • 17 Ketelslegers IA, Catsman-Berrevoets CE, Boon M. et al. Fatigue and depression in children with multiple sclerosis and monophasic variants. Eur J Paediatr Neurol 2010; 14 (04) 320-325
  • 18 Parrish JB, Weinstock-Guttman B, Smerbeck A, Benedict RH, Yeh EA. Fatigue and depression in children with demyelinating disorders. J Child Neurol 2013; 28 (06) 713-718
  • 19 Maher C, Crettenden A, Evans K. et al. Fatigue is a major issue for children and adolescents with physical disabilities. Dev Med Child Neurol 2015; 57 (08) 742-747
  • 20 Bushby K, Finkel R, Wong B. et al; PTC124-GD-007-DMD STUDY GROUP. Ataluren treatment of patients with nonsense mutation dystrophinopathy. Muscle Nerve 2014; 50 (04) 477-487
  • 21 Varni JW, Seid M, Rode CA. The PedsQL: measurement model for the pediatric quality of life inventory. Med Care 1999; 37 (02) 126-139
  • 22 Varni JW, Burwinkle TM, Katz ER, Meeske K, Dickinson P. The PedsQL in pediatric cancer: reliability and validity of the Pediatric Quality of Life Inventory Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module. Cancer 2002; 94 (07) 2090-2106
  • 23 Varni JW, Burwinkle TM, Szer IS. The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: reliability and validity. J Rheumatol 2004; 31 (12) 2494-2500
  • 24 Varni JW, Seid M, Kurtin PS. PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001; 39 (08) 800-812
  • 25 Davis SE, Hynan LS, Limbers CA. et al. The PedsQL in pediatric patients with Duchenne muscular dystrophy: feasibility, reliability, and validity of the Pediatric Quality of Life Inventory Neuromuscular Module and Generic Core Scales. J Clin Neuromuscul Dis 2010; 11 (03) 97-109
  • 26 Panepinto JA, Torres S, Bendo CB. et al. PedsQL™ sickle cell disease module: feasibility, reliability, and validity. Pediatr Blood Cancer 2013; 60 (08) 1338-1344
  • 27 Enright PL. The six-minute walk test. Respir Care 2003; 48 (08) 783-785
  • 28 McDonald CM, Henricson EK, Han JJ. et al. The 6-minute walk test as a new outcome measure in Duchenne muscular dystrophy. Muscle Nerve 2010; 41 (04) 500-510
  • 29 McDonald CM, Henricson EK, Han JJ. et al. The 6-minute walk test in Duchenne/Becker muscular dystrophy: longitudinal observations. Muscle Nerve 2010; 42 (06) 966-974
  • 30 McDonald CM, Henricson EK, Abresch RT. et al; PTC124-GD-007-DMD Study Group. The 6-minute walk test and other clinical endpoints in Duchenne muscular dystrophy: reliability, concurrent validity, and minimal clinically important differences from a multicenter study. Muscle Nerve 2013; 48 (03) 357-368
  • 31 Jones BL, Nagin DS, Roeder K. A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods & Research 2001; 29 (03) 374-393
  • 32 Nagin DS. Group-Based Trajectory Modeling: An Overview. Ann Nutr Metab 2014; 65: 205-210
  • 33 Andruff A, Carraro N, Thompson A, Gaudreau P. Latent class growth modelling: A Tutorial. Tutor Quant Methods Psychol 2009; 05 (01) 11-24
  • 34 Daniel LC, Li Y, Kloss JD, Reilly AF, Barakat LP. The impact of dexamethasone and prednisone on sleep in children with acute lymphoblastic leukemia. Support Care Cancer 2016; 24 (09) 3897-3906
  • 35 Bowden SA, Connolly AM, Kinnett K, Zeitler PS. Management of adrenal insufficiency risk after long-term systemic glucocorticoid therapy in Duchenne muscular dystrophy: clinical practice recommendations. J Neuromuscul Dis 2019; 6 (01) 31-41
  • 36 El-Aloul B, Speechley KN, Wei Y, Wilk P, Campbell C. Fatigue in young people with Duchenne muscular dystrophy. Dev Med Child Neurol 2020; 62 (02) 245-251
  • 37 Lim Y, Velozo C, Bendixen RM. The level of agreement between child self-reports and parent proxy-reports of health-related quality of life in boys with Duchenne muscular dystrophy. Qual Life Res 2014; 23 (07) 1945-1952
  • 38 Uzark K, King E, Cripe L. et al. Health-related quality of life in children and adolescents with Duchenne muscular dystrophy. Pediatrics 2012; 130 (06) e1559-e1566
  • 39 Bray P, Bundy AC, Ryan MM, North KN, Everett A. Health-related quality of life in boys with Duchenne muscular dystrophy: agreement between parents and their sons. J Child Neurol 2010; 25 (10) 1188-1194
  • 40 Stromberg A, Darin N, Kroksmark AK, Tulinius M. S.P.31 what was the age and cause of death in patients with Duchenne muscular dystrophy in Sweden during 2000–2010. Neuromuscul Disord 2012; 22 (09) 880-881
  • 41 Michorowska S. Ataluren: promising therapeutic premature termination codon readthrough frontrunner. Pharmaceuticals (Basel) 2021; 14 (08) 785