Clinical study on cognitive impairment in Duchenne muscular dystrophy

• Published in: Neuromuscular disorders : NMD 2023-07, Vol.33 (7), p.596-604
• Main Authors: Zhang, Xiao-fang, Luo, Yuan-yuan, Jiang, Li, Hong, Si-qi
• Format: Article
• Language: English
• Subjects: Cognitive impairment; Duchenne muscular dystrophy; Dystrophin; Glucocorticoids
• ISSN: 0960-8966; 1873-2364
• DOI: 10.1016/j.nmd.2023.06.001

•Children with Duchenne muscular dystrophy may exhibit cognitive impairment.•Cognitive impairment in boys with DMD rises with increasing brain dystrophin loss.•Boys with DMD may show improved cognition after glucocorticoids treatment. Our study aimed to explore the intellectual function of patients with Duchenne muscular dystrophy (DMD) in China and examine the correlation of full-scale intelligence quotient (FSIQ) with age, mutation locations, mutation class, and dystrophin isoforms. We assessed 64 boys with DMD using The Wechsler Intelligence Scales for Children-Fourth Edition and compared intellectual function at enrollment and follow-up in the 15 patients who completed the follow-up. Our findings confirm that boys with DMD may exhibit cognitive impairment, with the Working Memory Index being the most impaired. There was no significant correlation between FSIQ and age; however, a positive correlation was noted between age and the Verbal Comprehension Index. FSIQ was not associated with mutation class, the number of affected mutated exons, or mutation locations. However, there was a significant difference in FSIQ between the groups with intact and deficient Dp140. Fifteen participants adhered to glucocorticoid therapy throughout the two-year follow-up period, and eleven of them showed an improvement in FSIQ compared to their initial scores, with improvement ranging from 2 to 20. In conclusion, patients with the cumulative loss of isoforms in the brain are at a higher risk of cognitive deficits and may require early cognitive interventions.