A clinical approach to diagnosis and management of mitochondrial myopathies

This paper provides an overview of the different types of mitochondrial myopathies (MM), associated phenotypes, genotypes as well as a practical clinical approach towards disease diagnosis, surveillance, and management. nDNA-related MM are more common in pediatric-onset disease whilst mtDNA-related...

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Bibliographic Details
Published in:Neurotherapeutics 2024-01, Vol.21 (1), p.e00304-e00304, Article e00304
Main Authors: Chin, Hui-Lin, Lai, Poh San, Tay, Stacey Kiat Hong
Format: Article
Language:English
Subjects:
Child
Diagnostic approach
Genetic sequencing
High-Throughput Nucleotide Sequencing
Humans
Mitochondria
Mitochondrial disease
Mitochondrial disease treatment
Mitochondrial Diseases - diagnosis
Mitochondrial Diseases - genetics
Mitochondrial Diseases - therapy
Mitochondrial Myopathies - diagnosis
Mitochondrial Myopathies - genetics
Mitochondrial Myopathies - therapy
Mitochondrial myopathy
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Summary:This paper provides an overview of the different types of mitochondrial myopathies (MM), associated phenotypes, genotypes as well as a practical clinical approach towards disease diagnosis, surveillance, and management. nDNA-related MM are more common in pediatric-onset disease whilst mtDNA-related MMs are more frequent in adults. Genotype-phenotype correlation in MM is challenging due to clinical and genetic heterogeneity. The multisystemic nature of many MMs adds to the diagnostic challenge. Diagnostic approaches utilizing genetic sequencing with next generation sequencing approaches such as gene panel, exome and genome sequencing are available. This aids molecular diagnosis, heteroplasmy detection in MM patients and furthers knowledge of known mitochondrial genes. Precise disease diagnosis can end the diagnostic odyssey for patients, avoid unnecessary testing, provide prognosis, facilitate anticipatory management, and enable access to available therapies or clinical trials. Adjunctive tests such as functional and exercise testing could aid surveillance of MM patients. Management requires a multi-disciplinary approach, systemic screening for comorbidities, cofactor supplementation, avoidance of substances that inhibit the respiratory chain and exercise training. This update of the current understanding on MMs provides practical perspectives on current diagnostic and management approaches for this complex group of disorders. [Display omitted]
ISSN:1878-7479
1933-7213
1878-7479
DOI:10.1016/j.neurot.2023.11.001