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Abstract Details

Does Change in Neuromuscular Jitter Predict or Correlate with Clinical Change in Myasthenia Gravis?
Muscle Disease/Neuromuscular Junction
P02 - (-)
204
BACKGROUND: Jitter measured by SFEMG has been recommended as a biomarker of disease severity in clinical trials of MG.
DESIGN/METHODS: We reviewed jitter measurements and outcome data from patients in the Duke MG Registry who had at least two jitter measurements in the extensor digitorum (ED) (n=227) or frontalis (n=51) muscle.
RESULTS: The best positive and negative predictive values (PPV & NPV) for improvement were found when the proportion of fiber pairs in the ED with normal jitter had increased by 15%: PPV=89%, NPV=74%. Fifteen percent of patients were misclassified as improved or not by this change in jitter. The predictive value of jitter change was slightly less in the frontalis and when the change in mean jitter was used to predict improvement in either muscle. Change in the percentage of blocking fibers was less predictive of improvement in both muscles.
CONCLUSIONS: Jitter measured by SFEMG is a sensitive and specific measure of disease severity in MG and has a potential role as a biomarker in clinical trials and to monitor disease severity in the clinic. In clinical trials it is important to measure jitter in a muscle most likely to demonstrate improvement in the individual patient. Change in the proportion of muscle fibers with normal jitter seems to be the best jitter parameter to follow. Jitter measured by other electrodes may not be as reliable in assessing neuromuscular junction abnormality.
Authors/Disclosures
Donald B. Sanders, MD, FAAN (Duke University Medical Center)
PRESENTER 		Dr. Sanders has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Accordant Health Services. Dr. Sanders has received personal compensation in the range of $0-$499 for serving as a Consultant for Cabaletta BIO. Dr. Sanders has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kashiv Biosciences. Dr. Sanders has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Momenta Pharmaceuticals. Dr. Sanders has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen RnD. Dr. Sanders has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-aventis. Dr. Sanders has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for VielaBio. Dr. Sanders has received publishing royalties from a publication relating to health care.
Janice M. Massey, MD, FAAN (Duke University Medical Center) Dr. Massey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenix. Dr. Massey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Revance Therapeutics. Dr. Massey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Momenta. The institution of Dr. Massey has received research support from Revance .
Teneille Gofton, MD (London Health Sciences Centre) The institution of Dr. Gofton has received research support from Government of Canada. The institution of Dr. Gofton has received research support from Canadian Institutes of Health Research. The institution of Dr. Gofton has received research support from Academic Medical Organisation of Southwestern Ontario. The institution of Dr. Gofton has received research support from Lawson Health Research Institute. Dr. Gofton has a non-compensated relationship as a Medical Advisory Board Member with NORSE Institute that is relevant to AAN interests or activities.