Melhora da função psicomotora em pacientes com distrofia muscular de Duchenne tratados como corticóides
Japão – o tratamento com corticóides é o único que retarda a evolução da distrofia muscular de Duchenne mas poucas informações existem sobre seu efeito sobre a função psicomotora. Os autores observaram um aumento do quociente de inteligência (QI) nos meninos tratados com corticóides, em especial naqueles com mutação sem sentido (mutação de ponto). Além disso os tratados com corticóides tiveram aumento de força muscular e apresentaram redução do peptídeo natriurético cerebral, que normalizou-se em 73% dos casos.
O resumo em inglês pode ser lido abaixo:
(Pediatric Neurology, 2013) Corticosteroid Therapy for Duchenne Muscular Dystrophy: Improvement of Psychomotor Function
Background:
Of the numerous clinical trials for Duchenne muscular dystrophy, only the corticosteroid prednisolone has shown potential for temporal improvement in motor ability. In this study, the effects of prednisolone on intellectual ability are examined in 29 cases of Duchenne muscular dystrophy because little information has been reported. And also, motor functions and cardiac functions were evaluated.
Methods
The treated group was administered prednisolone (0.75 mg/kg) orally on alternate days and the compared with the untreated control group. Gene mutations were investigated. The patients were examined for intelligence quotient adequate for age, brain natriuretic peptide, creatine kinase, and manual muscle testing before treatment and after the period 6 months to 2 years.
Results
Intelligence quotient scores of the treated increased to 6.5 ± 11.9 (mean ± standard deviation) were compared with the controls 2.1 ± 4.9 (P = 0.009). Intelligence quotient scores of the patients with nonsense point mutations improved significantly (21.0 ± 7.9) more than those with deletion or duplication (1.9 ± 9.0; P = 0.015). Motor function, such as time to stand up, of those treated improved significantly and brain natriuretic peptide level was reduced to a normal level after treatment in 15 patients (73%).
Conclusions
Our results demonstrate the effectiveness of prednisolone in improving intellectual impairment as well as in preserving motor function and brain natriuretic peptide levels. We presume that prednisolone has a read-through effect on the stop codons in the central nervous systems of Duchenne muscular dystrophy because intelligence quotient of point mutation case was improved significantly.
