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September 17, 2019; 93 (12) Article

Patient-Reported Symptoms in Facioscapulohumeral Muscular Dystrophy (PRISM-FSHD)

Johanna Hamel, Nicholas Johnson, Rabi Tawil, William B. Martens, Nuran Dilek, Michael P. McDermott, Chad Heatwole
First published August 13, 2019, DOI: https://doi.org/10.1212/WNL.0000000000008123
Johanna Hamel
From the Department of Neurology (J.H., R.T., W.B.M., N.D., M.P.M., C.H.) and Department of Biostatistics and Computational Biology (M.P.M.), University of Rochester Medical Center, NY; and Department of Neurology (N.J.), Virginia Commonwealth University, Richmond.
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Nicholas Johnson
From the Department of Neurology (J.H., R.T., W.B.M., N.D., M.P.M., C.H.) and Department of Biostatistics and Computational Biology (M.P.M.), University of Rochester Medical Center, NY; and Department of Neurology (N.J.), Virginia Commonwealth University, Richmond.
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Rabi Tawil
From the Department of Neurology (J.H., R.T., W.B.M., N.D., M.P.M., C.H.) and Department of Biostatistics and Computational Biology (M.P.M.), University of Rochester Medical Center, NY; and Department of Neurology (N.J.), Virginia Commonwealth University, Richmond.
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William B. Martens
From the Department of Neurology (J.H., R.T., W.B.M., N.D., M.P.M., C.H.) and Department of Biostatistics and Computational Biology (M.P.M.), University of Rochester Medical Center, NY; and Department of Neurology (N.J.), Virginia Commonwealth University, Richmond.
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Nuran Dilek
From the Department of Neurology (J.H., R.T., W.B.M., N.D., M.P.M., C.H.) and Department of Biostatistics and Computational Biology (M.P.M.), University of Rochester Medical Center, NY; and Department of Neurology (N.J.), Virginia Commonwealth University, Richmond.
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Michael P. McDermott
From the Department of Neurology (J.H., R.T., W.B.M., N.D., M.P.M., C.H.) and Department of Biostatistics and Computational Biology (M.P.M.), University of Rochester Medical Center, NY; and Department of Neurology (N.J.), Virginia Commonwealth University, Richmond.
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Chad Heatwole
From the Department of Neurology (J.H., R.T., W.B.M., N.D., M.P.M., C.H.) and Department of Biostatistics and Computational Biology (M.P.M.), University of Rochester Medical Center, NY; and Department of Neurology (N.J.), Virginia Commonwealth University, Richmond.
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Patient-Reported Symptoms in Facioscapulohumeral Muscular Dystrophy (PRISM-FSHD)
Johanna Hamel, Nicholas Johnson, Rabi Tawil, William B. Martens, Nuran Dilek, Michael P. McDermott, Chad Heatwole
Neurology Sep 2019, 93 (12) e1180-e1192; DOI: 10.1212/WNL.0000000000008123

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Abstract

Objective To determine the frequency and relative importance of the most meaningful symptoms in facioscapulohumeral muscular dystrophy (FSHD) and to identify the demographic and clinical features that are associated with the greatest disease burden in this population.

Methods We performed a cross-sectional study involving 328 participants with FSHD. Collectively, participants reported the prevalence and relative importance of 274 symptoms and 15 symptomatic themes. We assessed the association between symptomatic theme prevalence and participants' age, sex, disease duration, pain level, employment status, and education.

Results Participants answered >48,000 questions regarding their disease burden. The symptomatic themes with the highest prevalence in our sample were problems with shoulders or arms (96.9%), limitations with activities (94.7%), core weakness (93.8%), fatigue (93.8%), limitations with mobility and walking (93.6%), changed body image due to the disease (91.6%), and pain (87.7%). Problems with shoulders and arms and limitations with mobility and walking had the greatest effect on participants' lives. Employment status and the report of pain had the most extensive association with the prevalence of symptoms, with employment being associated with 8 of 15 of the symptomatic themes and pain being associated with 7 of 15 of the symptomatic themes. Men and women with FSHD experienced a similar prevalence of all symptomatic themes.

Conclusions Adults with FSHD experience a variety of symptoms that play an important role in their disease burden. These symptoms have a variable prevalence and importance in the FSHD population and are associated with disease duration, employment status, and pain level.

Glossary

FSHD=
facioscapulohumeral muscular dystrophy;
MD=
myotonic dystrophy;
PRISM-FSHD=
Patient-Reported Impact of Symptoms in Facioscapulohumeral Muscular Dystrophy;
SMA=
spinal muscular atrophy

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received July 6, 2018.
  • Accepted in final form April 24, 2019.
  • © 2019 American Academy of Neurology
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