title: Quality of life, fatigue and mental health in patients with the m.3243A > G mutation and its correlates with genetic characteristics and disease manifestation.
abstract: BACKGROUND
  Mitochondrial disorders belong to the most prevalent inherited metabolic diseases with the m.3243A > G mutation reflecting being one of the most common mutations in mitochondrial DNA. Previous studies showed little relationship between mitochondrial genetics and disease manifestation. Relationship between genotype and disease manifestation with patient reported quality of life and other patient reported outcomes is still unexplored.
  
  
  METHODS
  Seventy-two out of the 122 invited adult patients with m.3243A > G mutation completed online standardized questionnaires on quality of life, functional impairment, fatigue and mental health as assessed by the RAND-SF36, the Sickness Impact Profile (SIP), the Checklist Individual Strength (CIS) and the Hospital Anxiety and Depression scale (HADS). Data were related to clinical manifestation reflected by the Newcastle Mitochondrial Disease Adult Scale (NMDAS) score and heteroplasmy levels of the mutation in urine epithelial cells.
  
  
  RESULTS
  Patients reported impaired quality of life. Sixty percent showed severe levels of fatigue, and 37% showed clinical relevant mental health problems, which was significantly more than healthy norms. These patient reported health outcomes showed negligible relationship with levels of heteroplasmy (r = <.30) and weak (.30 < r < .50) to moderate (.50 < r < .70) relationship with clinical manifestation.
  
  
  CONCLUSIONS
  Patient reported outcomes on quality of life, fatigue and mental health problems, are only partly reflected by clinical assessments. In order to support patients more effectively, integration of patient reported outcomes, alongside symptoms of their disease, in clinical practice is warranted.
authors.affiliation: Department of Medical Psychology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. chris.verhaak@radboudumc.nl.
authors.forename: Christianne
authors.initials: C
authors.lastname: Verhaak
authors.affiliation: Department of Pediatrics, Radboud Center for Mitochondrial Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: de Laat
authors.affiliation: Department of Pediatrics, Radboud Center for Mitochondrial Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Koene
authors.affiliation: Department of Medical Psychology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Marijke
authors.initials: M
authors.lastname: Tibosch
authors.affiliation: Department of Pediatrics, Radboud Center for Mitochondrial Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: Rodenburg
authors.affiliation: Department of rehabilitation, Radboud Center for Mitochondrial Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Imelda
authors.initials: I
authors.lastname: de Groot
authors.affiliation: Department of Medical Psychology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Knoop
authors.affiliation: Department of Internal Medicine; Radboud Center for Mitochondrial Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Mirian
authors.initials: M
authors.lastname: Janssen
authors.affiliation: Department of Pediatrics, Radboud Center for Mitochondrial Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Smeitink
mesh_terms: D004272:DNA, Mitochondrial / Q000235:genetics*; D005221:Fatigue / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D028361:Mitochondrial Diseases / Q000235:genetics*; D009154:Mutation; D011788:Quality of Life
chemical_list: D004272:DNA, Mitochondrial
keywords: Fatigue; Mental health; Mitochondrial disease; Participation; Patient reported outcomes; Quality of life; m.3243A > G mutation