Patient-reported impact of symptoms in myotonic dystrophy type 1 (PRISM-1).
OBJECTIVE
To determine the most critical symptoms in a national myotonic dystrophy type 1 (DM1) population and to identify the modifying factors that have the greatest effect on the severity of these symptoms.


METHODS
We performed a cross-sectional study of 278 adult patients with DM1 from the national registry of patients with DM1 between April and August 2010. We assessed the prevalence and relative significance of 221 critical DM1 symptoms and 14 disease themes. These symptoms and themes were chosen for evaluation based on prior interviews with patients with DM1. Responses were categorized by age, CTG repeat length, gender, and duration of symptoms.


RESULTS
Participants with DM1 provided symptom rating survey responses to address the relative frequency and importance of each DM1 symptom. The symptomatic themes with the highest prevalence in DM1 were problems with hands or arms (93.5%), fatigue (90.8%), myotonia (90.3%), and impaired sleep or daytime sleepiness (87.9%). Participants identified fatigue and limitations in mobility as the symptomatic themes that have the greatest effect on their lives. We found an association between age and the average prevalence of all themes (p < 0.01) and between CTG repeat length and the average effect of all symptomatic themes on participant lives (p < 0.01).


CONCLUSIONS
There are a wide range of symptoms that significantly affect the lives of patients with DM1. These symptoms, some previously underrecognized, have varying levels of importance in the DM1 population and are nonlinearly dependent on patient age and CTG repeat length.
University of Rochester, Rochester, NY, USA. chad_heatwole@urmc.rochester.edu
Chad
C
Heatwole
Rita
R
Bode
Nicholas
N
Johnson
Christine
C
Quinn
William
W
Martens
Michael P
MP
McDermott
Nan
N
Rothrock
Charles
C
Thornton
Barbara
B
Vickrey
David
D
Victorson
Richard
R
Moxley
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009223:Myotonic Dystrophy / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology