Magnetic resonance imaging-based lower limb muscle evaluation in Charcot-Marie-Tooth disease type 1A patients and its correlation with clinical data

Abstract

We aimed to derive comprehensive MRI parameters that reflect intramuscular fat infiltration severity for designated lower extremity levels, based on semiquantitative analyses in Charcot-Marie-Tooth disease type 1A (CMT1A) patients. We reviewed lower extremity MRIs of 116 CMT1A patients. Intramuscular fat infiltration grading using the Mercuri scale was performed for the non-dominant lower extremity at three levels (proximal, mid, and distal) for the thigh and at two levels (proximal and distal) for the lower leg. Based on MRI results, the following parameters were calculated for each level and for entire muscles: fat infiltration proportion (FIP), significant fat infiltration proportion (SigFIP), and severe fat infiltration proportion (SevFIP). The relationships between the MRI parameters and clinical data were evaluated using Spearman’s correlation analysis. FIP, SigFIP, and SevFIP measured for entire muscles significantly correlated with Charcot-Marie-Tooth Neuropathy Score (p < 0.001), functional disability scale (p < 0.001), 10-m walk test time (p = 0.0003, 0.0010, and 0.0011), and disease duration (p < 0.001). Similar correlations were demonstrated for FIP, SigFIP, and SevFIP acquired from the lower leg. Our MRI parameters obtained through semiquantitative analyses of muscles significantly correlated with clinical parameters in CMT1A patients, suggesting their potential applicability as imaging markers for clinical severity.

MRI based semi-quantitative scoring system analysis of thigh muscles in patients with VCP disease

“…The results demonstrated signi cant correlations between the semi-quantitative scoring and clinical parameters, particularly with functional disability scale (FDS score), 10-minute walk test (10-MWT) time, and disease duration, re ecting the progressive nature of intramuscular fat in ltration in CMT1A patients. However, it is worth noting that contrary to our study which found strong correlations in the thigh muscles, the CMT1A study revealed stronger correlations between clinical parameters and the semi-quantitative scoring obtained from the lower legs [40]. Undoubtedly, a more comprehensive investigation is warranted to examine the correlation between muscle functionality and the MRI parameter in VCP disease.…”

“…Interestingly, the same semi-quantitative method employed in our study has also proven successful in a recent investigation correlating disease severity in CMT1A [40]. The results demonstrated signi cant correlations between the semi-quantitative scoring and clinical parameters, particularly with functional disability scale (FDS score), 10-minute walk test (10-MWT) time, and disease duration, re ecting the progressive nature of intramuscular fat in ltration in CMT1A patients.…”