title: Balance impairment in individuals with Wolfram syndrome.
abstract: OBJECTIVE
  Wolfram syndrome (WFS), a rare neurodegenerative disorder, is characterized by early onset insulin-dependent diabetes mellitus, optic atrophy, deafness, diabetes insipidus, and neurological abnormalities. Although previously unreported, we hypothesized that neurological complications may be detectable in relatively early stages of the disease. As the cerebellum and brainstem seem particularly vulnerable in WFS, we focused on balance functions critically dependent on these regions. The primary goal of this investigation was to compare balance in young individuals with WFS, in relatively early stages of the disease, to an age-matched cohort using a clinically applicable test.
  
  
  METHODS
  Balance was assessed via the mini-BESTest in 13 children, adolescents and young adults with WFS and 30 typically developing age-matched individuals.
  
  
  RESULTS
  A significant difference was observed between groups in balance as well as in three of four subcomponents of the mini-BESTest and in two timed tasks related to balance. Mini-BESTest scores were correlated with age among typically developing individuals. In the WFS group, mini-BESTest scores were related to overall motor dysfunction, but not age.
  
  
  CONCLUSIONS
  Impairments in balance in WFS may occur earlier in the disease process than previously recognized and appear to be related to overall neurological progression rather than chronological age. Recognizing balance impairments and understanding which balance systems contribute to balance deficits in those with WFS may allow for development of effective patient-centered treatment paradigms.
authors: Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, United States.
authors: Kristen A
authors: KA
authors: Pickett
authors: Ryan P
authors: RP
authors: Duncan
authors: Alex R
authors: AR
authors: Paciorkowski
authors: M Alan
authors: MA
authors: Permutt
authors: Bess
authors: B
authors: Marshall
authors: Tamara
authors: T
authors: Hershey
authors: Gammon M
authors: GM
authors: Earhart
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000886:Anthropometry; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012678:Sensation Disorders / Q000175:diagnosis* / Q000209:etiology; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D014929:Wolfram Syndrome / Q000150:complications* / Q000175:diagnosis; D055815:Young Adult