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Diagnostic interest of whole-body MRI in early- and late-onset LAMA2 muscular dystrophies: a large international cohort

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  • Susana Quijano-Roy
  • Jana Haberlova
  • Claudia Castiglioni
  • John Vissing
  • Francina Munell
  • François Rivier
  • Tanya Stojkovic
  • Edoardo Malfatti
  • Marta Gómez García de la Banda
  • Giorgio Tasca
  • Laura Costa Comellas
  • Audrey Benezit
  • Helge Amthor
  • Ivana Dabaj
  • Clara Gontijo Camelo
  • Pascal Laforêt
  • John Rendu
  • Norma B Romero
  • Eliana Cavassa
  • Fabiana Fattori
  • Christophe Beroud
  • Jana Zídková
  • Nicolas Leboucq
  • Nicoline Løkken
  • Ángel Sanchez-Montañez
  • Ximena Ortega
  • Martin Kynčl
  • Corinne Metay
  • David Gómez-Andrés
  • Robert Y Carlier
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BACKGROUND: LAMA2-related muscular dystrophy (LAMA2-RD) encompasses a group of recessive muscular dystrophies caused by mutations in the LAMA2 gene, which codes for the alpha-2 chain of laminin-211 (merosin). Diagnosis is straightforward in the classic congenital presentation with no ambulation and complete merosin deficiency in muscle biopsy, but is far more difficult in milder ambulant individuals with partial merosin deficiency.

OBJECTIVE: To investigate the diagnostic utility of muscle imaging in LAMA2-RD using whole-body magnetic resonance imaging (WBMRI).

RESULTS: 27 patients (2-62 years, 21-80% with acquisition of walking ability and 6 never ambulant) were included in an international collaborative study. All carried two pathogenic mutations, mostly private missense changes. An intronic variant (c.909 + 7A > G) was identified in all the Chilean cases. Three patients (two ambulant) showed intellectual disability, epilepsy, and brain structural abnormalities. WBMRI T1w sequences or T2 fat-saturated images (Dixon) revealed abnormal muscle fat replacement predominantly in subscapularis, lumbar paraspinals, gluteus minimus and medius, posterior thigh (adductor magnus, biceps femoris, hamstrings) and soleus. This involvement pattern was consistent for both ambulant and non-ambulant patients. The degree of replacement was predominantly correlated to the disease duration, rather than to the onset or the clinical severity. A "COL6-like sandwich sign" was observed in several muscles in ambulant adults, but different involvement of subscapularis, gluteus minimus, and medius changes allowed distinguishing LAMA2-RD from collagenopathies. The thigh muscles seem to be the best ones to assess disease progression.

CONCLUSION: WBMRI in LAMA2-RD shows a homogeneous pattern of brain and muscle imaging, representing a supportive diagnostic tool.

Original languageEnglish
JournalJournal of Neurology
Volume269
Issue number5
Pages (from-to)2414-2429
Number of pages16
ISSN0340-5354
DOIs
Publication statusPublished - May 2022

Bibliographical note

© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.

    Research areas

  • Congenital muscular dystrophy, Heatmap, Merosin, Muscle MRI, Myopathy

ID: 70396761