Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jensen, T. D.
Right arrow Articles by Vissing, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jensen, T. D.
Right arrow Articles by Vissing, J.
Related Collections
Right arrow Diagnostic test assessment
Right arrow Muscle disease
Right arrow Mitochondrial disorders

Neurology 2002;58:1533-1538
© 2002 American Academy of Neurology

A forearm exercise screening test for mitochondrial myopathy

Tina D. Jensen, BS, Pedram Kazemi-Esfarjani, MD, Elwira Skomorowska, MD and John Vissing, MD PhD

From the Copenhagen Muscle Research Center (Drs. Kazemi-Esfarjani and Vissing, and T. Jensen) and Departments of Neurology (Drs. Kazemi–Esfarjani and Vissing, and T. Jensen) and Radiology (Dr. Skomorowska), National University Hospital, Rigshospitalet, Copenhagen, Denmark.

Address correspondence and reprint requests to Dr. John Vissing, Director, Neuromuscular Clinic, Department of Neurology 2082, National University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; e-mail: vissing{at}rh.dk

Background: The authors hypothesized that impaired oxygen extraction in mitochondrial myopathy (MM) results in a high oxygen saturation in venous effluent blood from working muscle and that this phenomenon can be used as a diagnostic tool for MM.

Methods: Twelve patients with MM, 10 patients with muscular dystrophy, and 12 healthy subjects were studied. All subjects performed intermittent static handgrip exercise (1/2 Hz) at 40% of maximal voluntary contraction (MVC) for 3 minutes. Cubital venous oxygen saturation and brachial artery flow were measured in the exercised arm.

Results: Exercise-induced venous oxygen desaturation was smaller in patients with MM ({Delta} - 7 ± 5%) than in subjects with muscular dystrophy ({Delta} - 38 ± 2%; p = 0.00001) and healthy subjects ({Delta} - 43 ± 2%; p = 0.0000002). MVC and exercise blood flow were similar in patients with MM (18 ± 3 kg; 436 ± 65 mL/min) and patients with muscular dystrophy (15 ± 3 kg; 460 ± 85 mL/min), but were higher in healthy subjects (32 ± 4 kg; 630 ± 58 mL/min; p < 0.03). In seven patients with MM and seven patients with McArdle disease, studied with a slightly different protocol, exercise-induced oxygen desaturation was also impaired in MM ({Delta} - ± 5%) compared with McArdle disease ({Delta} - 26 ± 3%; p = 0.007).

Conclusion: Oxygen desaturation in venous blood from exercising muscle is markedly lower in patients with mitochondrial myopathy than in subjects with other muscle diseases and healthy subjects, suggesting that a forearm exercise test can be a diagnostic screening tool for mitochondrial myopathy.




This article has been cited by other articles:


Home page
 NEJMHome page
M. Schwartz and J. Vissing
Paternal Inheritance of Mitochondrial DNA
N. Engl. J. Med., August 22, 2002; 347(8): 576 - 580.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2002 by AAN Enterprises, Inc.