The integrated use of imaging and functional scales can help monitor the progression of Duchenne muscular dystrophy (DMD), according to a new study published in the journal Medicina.

The study aimed to evaluate longitudinal changes using arm muscle magnetic resonance imaging (MRI) and arm performance in patients who are and are not able to walk.

The team led by Eugenio Mercuri MD, PhD, assessed the muscle MRI and upper limb performance of 27 patients with DMD at baseline and then 1 year later. Of these, 10 were still able to walk while 17 had lost the ability to walk.

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The muscle MRIs of the patients showed increased abnormality equal to or higher than 1.5 points on all domains. Precisely, 12 of the 27 patients (44%) had abnormalities at shoulder level, 4 (15%) had abnormalities at arm level, and 6 (22%) had abnormalities at forearm level.

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In terms of performance, 8 (30%) of patients had a lower score at follow-up at shoulder level and 9 (33%) at mid-level. There were no functional changes at the distal level between baseline and 1-year follow-up.

The researchers also found that patients who had a moderate impairment on MRI scores at baseline (between 16 and 34) at shoulder level had the highest risk of decreased function on upper limb performance 1 year later.

“Our results confirm that muscle MRI could represent a reliable biomarker to monitor upper limb muscle involvement also in young DMD patients,” the researchers concluded.

They proposed that the integrated use of imaging and functional scales may help identify patients at higher risk of deterioration.

“This information can be useful at the time of designing clinical trials or intervention studies to exclude or select patients or to select the most appropriate imaging protocol.”


Brogna C, Cristiano L, Verdolotti T, et al. Longitudinal motor functional outcomes and magnetic resonance imaging patterns of muscle involvement in upper limbs in Duchenne muscular dystrophy. Medicina. 2021;57(11):1267. doi:10.3390/medicina57111267