title: Functional deterioration and selenium-vitamin E treatment in myotonic dystrophy. A placebo-controlled study.
abstract: OBJECTIVE
  The aim of the investigations was to study the effect of a combined selenium and vitamin E treatment in patients with myotonic dystrophy.
  
  
  METHODS
  A double-blind placebo-controlled trial.
  
  
  METHODS
  Twenty-seven patients with myotonic dystrophy divided into an experimental (n = 13) and a control (n = 14) group.
  
  
  METHODS
  The experimental group was given increasing doses for 4 months up to a maximum of 1.6 mg selenium and 800 mg vitamin E daily and the control group a corresponding number of placebo tablets. The total treatment period was 2 years.
  
  
  METHODS
  Muscle strength (knee extension, knee flexion, hand-grip), maximal walking speed for 30 m, function in daily activities (disability), well-being and cognitive functioning.
  
  
  RESULTS
  Before treatment, muscle strength showed moderately or markedly reduced values as did maximal walking speed. Disability was most markedly demonstrated in instrumental ADL-activities. Spatial ability was reduced in the majority of patients. During the 2-year follow-up period, the hand-grip strength and maximal walking speed decreased in both groups (P < 0.01). The reduction was not significantly different according to an 'intention-to-treat-analysis'. However, there was a significantly larger decline (P < 0.01) in the left-hand grip strength in the control group when all the patients with complete treatment compliance were included.
  
  
  CONCLUSIONS
  A useful set of measurements has been developed for following functional deterioration in myotonic dystrophy. No conclusive evidence of beneficial effects of selenium and vitamin E treatment has been produced.
authors.affiliation: Department of Rehabilitation Medicine, Sahlgrenska Hospital, Göteborg, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Orndahl
authors.forename: G
authors.initials: G
authors.lastname: Grimby
authors.forename: A
authors.initials: A
authors.lastname: Grimby
authors.forename: G
authors.initials: G
authors.lastname: Johansson
authors.forename: L
authors.initials: L
authors.lastname: Wilhelmsen
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects; D009223:Myotonic Dystrophy / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D011581:Psychological Tests; D012643:Selenium / Q000627:therapeutic use*; D016896:Treatment Outcome; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D014810:Vitamin E; D012643:Selenium