Biomarkers; SMN2 protein, human; Survival of Motor Neuron 2 Protein; Humans; Biomarkers/analysis; Consensus Development Conferences as Topic; Gene Dosage; Prognosis; Muscular Atrophy, Spinal/diagnosis; Muscular Atrophy, Spinal/genetics; Survival of Motor Neuron 2 Protein/genetics; Consensus; Infant, Newborn; Muscular Atrophy, Spinal; Netherlands; Reproducibility of Results; Pediatrics, Perinatology and Child Health; Neurology; Neurology (clinical); Genetics (clinical)
Abstract :
[en] The 270th ENMC workshop aimed to develop a common procedure to optimize the reliability of SMN2 gene copy number determination and to reinforce collaborative networks between molecular scientists and clinicians. The workshop involved neuromuscular and clinical experts and representatives of patient advocacy groups and industry. SMN2 copy number is currently one of the main determinants for therapeutic decision in SMA patients: participants discussed the issues that laboratories may encounter in this molecular test and the cruciality of the accurate determination, due the implications as prognostic factor in symptomatic patients and in individuals identified through newborn screening programmes. At the end of the workshop, the attendees defined a set of recommendations divided into four topics: SMA molecular prognosis assessment, newborn screening for SMA, SMN2 copies and treatments, and modifiers and biomarkers. Moreover, the group draw up a series of recommendations for the companies manufacturing laboratory kits, that will help to minimize the risk of errors, regardless of the laboratories' expertise.
Disciplines :
Pediatrics
Author, co-author :
Abiusi, Emanuela; Section of Genomic Medicine, Department of Public Health and Life Sciences, Università Cattolica del Sacro Cuore, Roma, Italy
Costa-Roger, Mar; Clinical and Molecular Genetics Area, Vall d'Hebron Hospital, Medicine Genetics Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
Bertini, Enrico Silvio; Research Unit of Neuromuscular Disease, Bambino Gesu’ Children's Hospital, IRCCS, Roma, Italy
Tiziano, Francesco Danilo; Section of Genomic Medicine, Department of Public Health and Life Sciences, Università Cattolica del Sacro Cuore, Roma, Italy ; Complex Unit of Medical Genetics, Fondazione Policlinico Universitario IRCCS “A. Gemelli”, Roma, Italy
Tizzano, Eduardo F; Clinical and Molecular Genetics Area, Vall d'Hebron Hospital, Medicine Genetics Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
SMN2 Study group
Abiusi, Emanuela; Section of Genomic Medicine, Dept. of Life Sciences and Public Health, Catholic University of the Sacred Heart, Roma, Italy
Baranello, Giovanni; The Dubowitz Neuromuscular Centre, Developmental Neuroscience Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, NIHR Great Ormond Street Hospital Biomedical Research Centre & Great Ormond Street Hospital NHS Foundation Trust, 30 Guilford Street, London WC1N 1EH, UK
Bertini, Enrico; Italy, Research Unit of Neuromuscular Disease, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
Boemer, François ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Burghes, Arthur; Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
Codina-Solà, Marta; Neuromuscular Reference Center, Department of Paediatrics, University Hospital Liege & University of Liege, Belgium
Costa-Roger, Mar; Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
Dangouloff, Tamara ; Université de Liège - ULiège > Département des sciences cliniques ; Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland
Groen, Ewout; Department of Neurology, Medical University of Warsaw, Warsaw, Poland
Gos, Monika; Department of Neuropediatrics and Muscle Disorders, Medical Center University of Freiburg, Faculty of Medicine, Freiburg, Germany
Jędrzejowska, Maria; Department of Genetics, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
Kirschner, Janbernd; Centre for Neuromuscular Disorders, Center for Translational Neuro and Behavioral Sciences, Department of Pediatric Neurology, University Duisburg-Essen, 45147 Essen, Germany
Lemmink, Henny H; AFM Téléthon, Évry, France, SMA Europe, European Alliance for Newborn Screening in Spinal Muscular Atrophy
Müller-Felber, Wolfgang; Pediatric Neuromuscular Unit (NEIDF Reference Center at FILNEMUS & Euro-NMD), Child Neurology Department, Raymond Poincaré Hospital (UVSQ), APHP Université Paris Saclay, Garches France
Ouillade, Marie-Christine; Fundacja SMA, Warsaw, Poland, SMA Europe, European Alliance for Newborn Screening in Spinal Muscular Atrophy
Quijano-Roy, Susana; Univ Rouen Normandie, Inserm U1245, Normandie Univ and CHU Rouen, Department of Genetics and Nord/Est/Ile de France Neuromuscular Reference Center, F-76000 Rouen, France
Rucinski, Kacper; Institute of Medical Genomics, Dept. of Life Sciences and Public Health, Catholic University of the Sacred Heart, and Complex Unit of Medical Genetics, Fondazione Policlinico Universitario IRCCS “A. Gemelli”, Roma, Italy
Saugier-Veber, Pascale; Institute of Human Genetics, University Hospital of Cologne, Center for Molecular Medicine, University of Cologne and Center for Rare Diseases Cologne, University Hopsital of Cologne, Cologne, Germany
Tiziano, Francesco Danilo; Institute of Medical Genomics, Dept. of Life Sciences and Public Health, Catholic University of the Sacred Heart, and Complex Unit of Medical Genetics, Fondazione Policlinico Universitario IRCCS “A. Gemelli”, Roma, Italy
Tizzano, Eduardo Fidel; Clinical and Molecular Genetics Area, Vall d'Hebron Hospital, Medicine Genetics Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
Wirth, Brunhilde; Institute of Human Genetics, University Hospital of Cologne, Center for Molecular Medicine, University of Cologne and Center for Rare Diseases Cologne, University Hopsital of Cologne, Cologne, Germany
This workshop was supported by the SMA NBS Alliance.The workshop and early-career programme are made possible thanks to the financial support of the European Neuromuscular Centre (ENMC) and its Full Partners: Association Française contre les Myopathies (France), Deutsche Gesellschaft für Muskelkranke (Germany), Muscular Dystrophy Campaign (UK), Muskelsvindfonden (Denmark), Prinses Beatrix Spierfonds (the Netherlands), Schweizerische Stiftung für die Erforschung der Muskelkrankheiten (Switzerland), Spierziekten Nederland (the Netherlands), Telethon Foundation (Italy). In addition, we would like to thank the Associated Partners: Finnish Neuromuscular Association (Finland), Österreichische Muskelforschung (Austria), SMA Europe, and World Duchenne Organisation, and the members of the ENMC Company Forum: Amicus Therapeutics, Astellas, Biogen, Ionis Pharmaceuticals, Lupin Neuroscience, Novartis, PerkinElmer, Roche, Sanofi, and Sarepta.
Lefebvre, S., Bürglen, L., Reboullet, S., Clermont, O., Burlet, P., Viollet, L., et al. Identification and characterization of a spinal muscular atrophy-determining gene. Cell 80:1 (1995), 155–165.
Vitte, J., Fassier, C., Tiziano, F.D., Dalard, C., Soave, S., Roblot, N., et al. Refined characterization of the expression and stability of the SMN gene products. Am J Pathol 171:4 (2007), 1269–1280.
Feldkötter, M., Schwarzer, V., Wirth, R., Wienker, T.F., Wirth, B., Quantitative analyses of SMN1 and SMN2 based on real-time lightCycler PCR: fast and highly reliable carrier testing and prediction of severity of spinal muscular atrophy. Am J Hum Genet 70:2 (2002), 358–368 Feb.
Wirth, B., Brichta, L., Schrank, B., Lochmüller, H., Blick, S., Baasner, A., et al. Mildly affected patients with spinal muscular atrophy are partially protected by an increased SMN2 copy number. Hum Genet 119:4 (2006), 422–428 May.
Calucho, M., Bernal, S., Alías, L., March, F., Venceslá, A., Rodríguez-Álvarez, F.J., et al. Correlation between SMA type and SMN2 copy number revisited: an analysis of 625 unrelated Spanish patients and a compilation of 2834 reported cases. Neuromuscul Disord 28:3 (2018), 208–215.
Wadman, R.I., Jansen, M.D., Stam, M., Wijngaarde, C.A., Curial, C.A.D., Medic, J., et al. Intragenic and structural variation in the SMN locus and clinical variability in spinal muscular atrophy. Brain Commun, 2(2), 2020 fcaa075.
Blasco-Pérez, L., Paramonov, I., Leno, J., Bernal, S., Alias, L., Fuentes-Prior, P., et al. Beyond copy number: a new, rapid, and versatile method for sequencing the entire SMN2 gene in SMA patients. Hum Mutat 42:6 (2021), 787–795.
Costa-Roger, M., Blasco-Pérez, L., Cuscó, I., Tizzano, E.F, The Importance of digging into the genetics of SMN genes in the therapeutic scenario of spinal muscular atrophy. Int J Mol Sci, 22(16), 2021, 9029.
Dubowitz, V., Chaos in the classification of SMA: a possible resolution. Neuromuscul Disord 5:1 (1995), 3–5.
Main, M., Kairon, H., Mercuri, E., Muntoni, F., The Hammersmith functional motor scale for children with spinal muscular atrophy: a scale to test ability and monitor progress in children with limited ambulation. Eur J Paediatr Neurol 7:4 (2003), 155–159.
Mercuri, E., Finkel, R.S., Muntoni, F., Wirth, B., Montes, J., Main, M., et al. Diagnosis and management of spinal muscular atrophy: part 1: recommendations for diagnosis, rehabilitation, orthopedic and nutritional care. Neuromuscul Disord 28:2 (2018), 103–115.
Mercuri, E., Pera, M.C., Scoto, M., Finkel, R., Muntoni, F., Spinal muscular atrophy - insights and challenges in the treatment era. Nat Rev Neurol 16:12 (2020), 706–715.
Crawford, T.O., Swoboda, K.J., De Vivo, D.C., Bertini, E., Hwu, W.L., Finkel, R.S., et al. Continued benefit of nusinersen initiated in the presymptomatic stage of spinal muscular atrophy: 5-year update of the NURTURE study. Muscle Nerve 68:2 (2023), 157–170.
Aragon-Gawinska, K., Mouraux, C., Dangouloff, T., Servais, L, Spinal muscular atrophy treatment in patients identified by newborn screening-a systematic review. Genes, 14(7), 2023, 1377 Jun 29.
Dangouloff, T., Burghes, A., Tizzano, E.F., Servais, L., NBS SMA Study Group. 244th ENMC international workshop: newborn screening in spinal muscular atrophy May 10-12, 2019, Hoofdorp, The Netherlands. Neuromuscul Disord 30:1 (2020), 93–103.
Dangouloff, T., Vrščaj, E., Servais, L., Osredkar, D., SMA NBS World Study Group. Newborn screening programs for spinal muscular atrophy worldwide: where we stand and where to go. Neuromuscul Disord 31:6 (2021), 574–582.
Schorling, D.C., Becker, J., Pechmann, A., Langer, T., Wirth, B., Kirschner, J., Discrepancy in redetermination of SMN2 copy numbers in children with SMA. Neurology 93:6 (2019), 267–269.
Schwartz, O., Kölbel, H., Blaschek, A., Gläser, D., Burggraf, S., Röschinger, W., et al. Spinal muscular atrophy - is newborn screening too late for children with two SMN2 copies?. J Neuromuscul Dis 9:3 (2022), 389–396.
Vrščaj E, Dangouloff T, Osredkar D, Servais L. Newborn screening programs for spinal muscular atrophy worldwide: second edition. Eur J Paediatr Neurol. In press.
Müller-Felber, W., Blaschek, A., Schwartz, O., Gläser, D., Nennstiel, U., Brockow, I., et al. Newborn screening SMA - from pilot project to nationwide screening in Germany. J Neuromuscul Dis 10 (2023), 55–65.
Strunk, A., Abbes, A., Stuitje, A.R., Hettinga, C., Sepers, E.M., Snetselaar, R., et al. Validation of a fast, robust, inexpensive, two-tiered neonatal screening test algorithm on dried blood spots for spinal muscular atrophy. Int J Neonatal Screen, 5(2), 2019, 21.
Abiusi, E., Vaisfeld, A., Fiori, S., Novelli, A., Spartano, S., Faggiano, M.V., et al. Experience of a 2-year spinal muscular atrophy NBS pilot study in Italy: towards specific guidelines and standard operating procedures for the molecular diagnosis. J Med Genet 60:7 (2023), 697–705.
Pane, M., Donati, M.A., Cutrona, C., De Sanctis, R., Pirinu, M., Coratti, G., et al. Neurological assessment of newborns with spinal muscular atrophy identified through neonatal screening. Eur J Pediatr 181:7 (2022), 2821–2829.
Vezain, M., Saugier-Veber, P., Goina, E., Touraine, R., Manel, V., Toutain, A., et al. A rare SMN2 variant in a previously unrecognized composite splicing regulatory element induces exon 7 inclusion and reduces the clinical severity of spinal muscular atrophy. Hum Mutat 31 (2010), E1110–E1125.
Boemer, F., Caberg, J.H., Dideberg, V., Beckers, P., Marie, S., Marcelis, L., et al. (S)un (M)ay (A)rise on SMA: the hope of a region without spinal muscular atrophy. Rev Med Liege 74:9 (2019), 461–464.
Boemer, F., Caberg, J.H., Dideberg, V., Dardenne, D., Bours, V., Hiligsmann, M., et al. Newborn screening for SMA in Southern Belgium. Neuromuscul Disord 29:5 (2019), 343–349.
Boemer, F., Caberg, J.H., Beckers, P., Dideberg, V., di Fiore, S., Bours, V., et al. Three years pilot of spinal muscular atrophy newborn screening turned into official program in Southern Belgium. Sci Rep, 11(1), 2021, 19922.
König, K., Pechmann, A., Thiele, S., Walter, M.C., Schorling, D., Tassoni, A., et al. De-duplicating patient records from three independent data sources reveals the incidence of rare neuromuscular disorders in Germany. Orphanet J Rare Dis, 14, 2019, 152.
Kölbel, H., Modler, L., Blaschek, A., Schara-Schmidt, U., Vill, K., Schwartz, O., et al. Parental burden and quality of life in 5q-SMA diagnosed by newborn screening. Children, 9, 2022.
Pechmann, A., Behrens, M., Dörnbrack, K., Tassoni, A., Stein, S., Vogt, S., et al. Effect of nusinersen on motor, respiratory and bulbar function in early-onset spinal muscular atrophy. Brain 146:2 (2023), 668–677.
Pechmann, A., Behrens, M., Dörnbrack, K., Tassoni, A., Wenzel, F., Stein, S., et al. Improved upper limb function in non-ambulant children with SMA type 2 and 3 during nusinersen treatment: a prospective 3-years SMArtCARE registry study. Orphanet J Rare Dis, 17(1), 2022, 384.
Pechmann, A., Behrens, M., Dörnbrack, K., Tassoni, A., Wenzel, F., Stein, S., et al. Improvements in walking distance during nusinersen treatment – a prospective 3-year SMArtCARE registry study. J Neuromuscul Dis 10:1 (2023), 29–40.
Fang, P., Li, L., Zeng, J., Zhou, W.J., Wu, W.Q., Zhong, Z.Y., et al. Molecular characterization and copy number of SMN1, SMN2 and NAIP in Chinese patients with spinal muscular atrophy and unrelated healthy controls. BMC Musculoskelet Disord, 16(1), 2015, 11.
Ogino, S., Gao, S., Leonard, D.G., Paessler, M., Wilson, R.B., Inverse correlation between SMN1 and SMN2 copy numbers: evidence for gene conversion from SMN2 to SMN1. Eur J Hum Genet, 11(9), 2003, 723.
Vijzelaar, R., Snetselaar, R., Clausen, M., Mason, A.G., Rinsma, M., Zegers, M., Molleman, N., The frequency of SMN gene variants lacking exon 7 and 8 is highly population dependent. PLoS One, 14(7), 2019, e0220211.
Niba, E.T.E., Nishio, H., Wijaya, Y.O.S., Lai, P.S., Tozawa, T., Chiyonobu, T., et al. Clinical phenotypes of spinal muscular atrophy patients with hybrid SMN gene. Brain Dev 43:2 (2021), 294–302.
Hauke, J., Riessland, M., Lunke, S., Eyüpoglu, I.Y., Blümcke, I., El-Osta, A., et al. Survival motor neuron gene 2 silencing by DNA methylation correlates with spinal muscular atrophy disease severity and can be bypassed by histone deacetylase inhibition. Hum Mol Genet 18:2 (2009), 304–317.
Cuscó, I., Bernal, S., Blasco-Pérez, L., Calucho, M., Alias, L., Fuentes-Prior, P., et al. Practical guidelines to manage discordant situations of SMN2 copy number in patients with spinal muscular atrophy. Neurol Genet, 6(6), 2020, e530.
Blasco-Pérez, L., Costa-Roger, M., Leno-Colorado, J., Bernal, S., Alias, L., Codina-Solà, M., et al. Deep molecular characterization of milder spinal muscular atrophy patients carrying the c.859G>C variant in SMN2. Int J Mol Sci, 23(15), 2022, 8289.
Vollger, M.R., Guitart, X., Dishuck, P.C., Mercuri, L., Harvey, W.T., Gershman, A., et al. Segmental duplications and their variation in a complete human genome. Science, 376(6588), 2022, eabj6965.
Nurk, S., Koren, S., Rhie, A., Rautiainen, M., Bzikadze, A.V., Mikheenko, A., et al. The complete sequence of a human genome. Science 376:6588 (2022), 44–53.
Ruhno, C., McGovern, V.L., Avenarius, M.R., Snyder, P.J., Prior, T.W., Nery, F.C., et al. Complete sequencing of the SMN2 gene in SMA patients detects SMN gene deletion junctions and variants in SMN2 that modify the SMA phenotype. Hum Genet 138:3 (2019), 241–256.
Jones, C.C., Cook, S.F., Jarecki, J., Belter, L., Reyna, S.P., Staropoli, J., et al. Spinal Muscular Atrophy (SMA) subtype concordance in siblings: findings from the cure SMA cohort. J Neuromuscul Dis 7:1 (2020), 33–40.
Helmken, C., Hofmann, Y., Schoenen, F., Oprea, G., Raschke, H., Rudnik-Schöneborn, S., et al. Evidence for modifying pathway in SMA discordant families: reduced SMN level decreases the amount of its interacting partners and Htra2-beta1. Hum Genet 114 (2003), 11–21.
Oprea, G.E., Kröber, S., McWhorter, M.L., Rossoll, W., Müller, S., Krawczak, M., et al. Plastin 3 is a protective modifier of autosomal recessive spinal muscular atrophy. Science 320 (2008), 524–527.
Jędrzejowska, M., Borkowska, J., Zimowski, J., Kostera-Pruszczyk, A., Milewski, M., Jurek, M., et al. Unaffected patients with a homozygous absence of the SMN1 gene. Eur J Hum Genet 16:8 (2008), 930–934.
Bernal, S., Also-Rallo, E., Martínez-Hernández, R., Alías, L., Rodríguez-Alvarez, F.J., Millán, J.M., et al. Plastin 3 expression in discordant spinal muscular atrophy (SMA) siblings. Neuromuscul Disord 21:6 (2011), 413–419.
Prior, T.W., Swoboda, K.J., Scott, H.D., Hejmanowski, A.Q., Homozygous SMN1 deletions in unaffected family members and modification of the phenotype by SMN2. Am J Med Genet 130A (2004), 307–310.
Wang, C.H., Xu, J., Carter, T.A., Ross, B.M., Dominski, M.K., Bellcross, C.A., et al. Characterization of survival motor neuron (SMNT) gene deletions in asymptomatic carriers of spinal muscular atrophy. Hum Mol Genet 5:3 (1996), 359–365.
Su, Y.N., Hung, C.C., Lin, S.Y., Chen, F.Y., Chern, J.P., Tsai, C., et al. Carrier screening for spinal muscular atrophy (SMA) in 107,611 pregnant women during the period 2005-2009: a prospective population-based cohort study. PLoS One, 6(2), 2011.
Sugarman, E.A., Nagan, N., Zhu, H., Akmaev, V.R., Zhou, Z., Rohlfs, E.M., et al. Pan-ethnic carrier screening and prenatal diagnosis for spinal muscular atrophy: clinical laboratory analysis of >72,400 specimens. Eur J Hum Genet 20:1 (2012), 27–32.
Pane, M., Lapenta, L., Abiusi, E., de Sanctis, R., Luigetti, M., Palermo, C., et al. Longitudinal assessments in discordant twins with SMA. Neuromuscul Disord 27:10 (2017), 890–893.
Riessland, M., Kaczmarek, A., Schneider, S., Swoboda, K.J., Löhr, H., Bradler, C., et al. Neurocalcin delta suppression protects against spinal muscular atrophy in humans and across species by restoring impaired endocytosis. Am J Hum Genet 100:2 (2017), 297–315.
Wolff, L., Strathmann, E.A., Müller, I., Mählich, D., Veltman, C., Niehoff, A., et al. Plastin 3 in health and disease: a matter of balance. Cell Mol Life Sci 78:13 (2021), 5275–5301.
Strathmann, E.A., Hölker, I., Tschernoster, N., Hosseinibarkooie, S., Come, J., Martinat, C., et al. Epigenetic regulation of plastin 3 expression by the macrosatellite DXZ4 and the transcriptional regulator CHD4. Am J Hum Genet 110:3 (2023), 442–459.
Muiños-Bühl, A., Rombo, R., Ling, K.K., Zilio, E., Rigo, F., Bennett, C.F., et al. Long-term SMN- and Ncald-ASO combinatorial therapy in SMA Mice and NCALD-ASO treatment in hiPSC-derived motor neurons show protective effects. Int J Mol Sci, 24(4), 2023, 4198.
Tiziano, F.D., Lomastro, R., Abiusi, E., Pasanisi, M.B., Di Pietro, L., Fiori, S., et al. Longitudinal evaluation of SMN levels as biomarker for spinal muscular atrophy: results of a phase IIb double-blind study of salbutamol. J Med Genet 56:5 (2019), 293–300.
Baranello, G., Darras, B.T., Day, J.W., Deconinck, N., Klein, A., Masson, R., et al. Risdiplam in type 1 spinal muscular atrophy. N Engl J Med 384:10 (2021), 915–923.
Nitz, E., Smitka, M., Schallner, J., Akgün, K., Ziemssen, T., von der Hagen, M., et al. Serum neurofilament light chain in pediatric spinal muscular atrophy patients and healthy children. Ann Clin Transl Neurol 8:10 (2021), 2013–2024.
Alves, C.R.R., Petrillo, M., Spellman, R., Garner, R., Zhang, R., Kiefer, M., et al. Implications of circulating neurofilaments for spinal muscular atrophy treatment early in life: a case series. Mol Ther Methods Clin Dev 23 (2021), 524–538.
Abiusi, E., Infante, P., Cagnoli, C., Lospinoso Severini, L., Pane, M., Coratti, G., et al. SMA-miRs (miR-181a-5p, -324-5p, and -451a) are overexpressed in spinal muscular atrophy skeletal muscle and serum samples. Elife, 10, 2021, e68054.
Zaharieva, I.T., Scoto, M., Aragon-Gawinska, K., Ridout, D., Doreste, B., Servais, L., et al. Response of plasma microRNAs to nusinersen treatment in patients with SMA. Ann Clin Transl Neurol 9:7 (2022), 1011–1026.
D'Silva, A.M., Kariyawasam, D., Venkat, P., Mayoh, C., Farrar, M.A, Identification of novel CSF-derived miRNAs in treated paediatric onset spinal muscular atrophy: an exploratory study. Pharmaceutics, 15(1), 2023, 170.
Magen, I., Aharoni, S., Yacovzada, N.S., Tokatly Latzer, I., Alves, C.R.R., Sagi, L., et al. Muscle microRNAs in the cerebrospinal fluid predict clinical response to nusinersen therapy in type II and type III spinal muscular atrophy patients. Eur J Neurol 29:8 (2022), 2420–2430.
Sprenger-Svačina, A., Haensch, J., Weiss, K., Große Hokamp, N., Maintz, D., Schlamann, M., et al. MRI correlates of motoneuron loss in SMA. J Neurol 270:1 (2023), 503–510.
Alves, C.R.R., Zhang, R., Johnstone, A.J., Garner, R., Nwe, P.H., Siranosian, J.J., et al. Serum creatinine is a biomarker of progressive denervation in spinal muscular atrophy. Neurology 94:9 (2020), e921–e931.
Freigang, M., Wurster, C.D., Hagenacker, T., Stolte, B., Weiler, M., Kamm, C., et al. Serum creatine kinase and creatinine in adult spinal muscular atrophy under nusinersen treatment. Ann Clin Transl Neurol 8:5 (2021), 1049–1063.
Glascock, J., Sampson, J., Haidet-Phillips, A., Connolly, A., Darras, B., Day, J., et al. Treatment algorithm for infants diagnosed with spinal muscular atrophy through newborn screening. J Neuromuscul Dis 5:2 (2018), 145–158.
Tiziano, F.D., Pinto, A.M., Fiori, S., Lomastro, R., Messina, S., Bruno, C., et al. SMN transcript levels in leukocytes of SMA patients determined by absolute real-time PCR. Eur J Hum Genet 18:1 (2010), 52–58.
Tan, C.A., Westbrook, M.J., Truty, R., Kvitek, D.J., Kennemer, M., Winder, T.L., et al. Incorporating spinal muscular atrophy analysis by next-generation sequencing into a comprehensive multigene panel for neuromuscular disorders. Genet Test Mol Biomarkers 24:10 (2020), 616–624.
Kumar, B., Barton, S., Kordowska, J., Eaton, R.B., Counihan, A.M., Hale, J.E., et al. Novel modification of a confirmatory SMA sequencing assay that can be used to determine SMN2 copy number. Int J Neonatal Screen, 7(3), 2021, 47.
Jin, W., Yang, Z., Tang, X., Wang, X., Huang, Y., Hui, C., et al. Simultaneous quantification of SMN1 and SMN2 copy numbers by MALDI-TOF mass spectrometry for spinal muscular atrophy genetic testing. Clin Chim Acta 532 (2022), 45–52.