Natural History of Limb Girdle Muscular Dystrophy D1 (LGMDD1): A GRASP-LGMD Consortium Study.
8 affiliations
- 1Department of Neurology, Washington University School of Medicine, St. Louis, MO.
- 2Department of Neurology, Virginia Commonwealth University, Richmond.
- 3Department of Neurology, University of Kansas Medical Center.
- 4Department of Neurology, The University of Colorado-Anschutz, Aurora.
- 5Department of Neurology, University of Texas at San Antonio.
- 6Center for Genetic Muscle Disorders, Kennedy Krieger Institute, Baltimore, MD.
- 7Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH; and.
- 8The Ohio State University College of Medicine, Columbus.
Abstract
Limb-girdle muscular dystrophy type D1 (LGMDD1) is caused by dominantly inherited pathogenic variants in DNAJB6, a cochaperone of HSP70. Prior work has described the clinical spectrum of LGMDD1, including genotype-phenotype correlations and cross-sectional functional impairments, but prospective longitudinal data remain limited. The primary objective of this study was to identify outcome assessments that reliably measure disease progression in LGMDD1 and are most suitable for use as end points in future natural history and interventional studies. As part of the Genetic Resolution and Assessments Solving Phenotypes in LGMD (GRASP-LGMD) study, participants with genetically confirmed LGMDD1 were enrolled across 11 sites and completed 2 consecutive baseline visits and a 12-month follow-up. Clinical outcome assessments (COAs) included the North Star Assessment for Limb Girdle‑Type Dystrophies (NSAD), several timed mobility tests, Performance of the Upper Limb (PUL), handheld dynamometry (HHD), pulmonary function tests, and multiple patient-reported outcome measures. Test-retest reliability was calculated for COAs. Twelve-month change, responsiveness, and anchor-based minimal clinically important difference (MCID) values were assessed, and distribution-based thresholds were used to contextualize detectability. Fifteen participants enrolled; 13 completed baseline and 12-month visits. Functional COAs and HHD showed high test-retest reliability. Significant 12-month decline was detected in the Disability of the Arm, Shoulder and Hand (DASH), NSAD, the NSAD-10-m walk/run (NSAD-10M), and NSAD-rise from floor (NSAD-RFF). NSAD-10M, DASH, NSAD, NSAD-RFF, hip abduction, and deltoid strength were the most responsive. MCID values were interpreted alongside average annual change and distribution-based detectability. NSAD-10M, NSAD-RFF, NSAD, PUL, DASH, and LGMD-Health Index demonstrated the most feasible and consistent MCID profiles. A focused set of outcome assessments-particularly NSAD-10M, NSAD-RFF, NSAD, PUL, and DASH-demonstrated robust measurement characteristics over 12 months across the LGMDD1 severity spectrum and represent promising end points for future LGMDD1 natural history studies and interventional trials. NCT03981289, prospectively registered, observational. First registered: 2019-06-03. Actual study start date: 2019-06-14 clinicaltrials.gov/study/NCT03981289?term=GRASP-LGMD&rank=1&tab=study.
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BibTeX
@article{findlay2026natural,
title = {{Natural History of Limb Girdle Muscular Dystrophy D1 (LGMDD1): A GRASP-LGMD Consortium Study.}},
author = {Andrew R Findlay and Stephanie M Hunn and Aileen S Jones and Amanda Butler and Sandhya Sasidharan and Melissa Hayes and Jeffrey M Statland and Talia Strahler and Robert Will and Matthew P Wicklund and Stacy E Dixon and Nikia S Stinson and Doris G Leung and Amanda R Clause and Lindsay N Alfano and Conrad Weihl and Nicholas E Johnson and as the GRASP-LGMD Consortium},
journal = {Neurology. Genetics},
year = {2026},
month = nov,
doi = {10.1212/nxg.0000000000200448},
url = {https://europepmc.org/article/MED/42997910},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Natural History of Limb Girdle Muscular Dystrophy D1 (LGMDD1): A GRASP-LGMD Consortium Study.
AU - Andrew R Findlay
AU - Stephanie M Hunn
AU - Aileen S Jones
AU - Amanda Butler
AU - Sandhya Sasidharan
AU - Melissa Hayes
AU - Jeffrey M Statland
AU - Talia Strahler
AU - Robert Will
AU - Matthew P Wicklund
AU - Stacy E Dixon
AU - Nikia S Stinson
AU - Doris G Leung
AU - Amanda R Clause
AU - Lindsay N Alfano
AU - Conrad Weihl
AU - Nicholas E Johnson
AU - as the GRASP-LGMD Consortium
PY - 2026
DA - 2026/11/05
JO - Neurology. Genetics
DO - 10.1212/nxg.0000000000200448
UR - https://europepmc.org/article/MED/42997910
AB - Limb-girdle muscular dystrophy type D1 (LGMDD1) is caused by dominantly inherited pathogenic variants in DNAJB6, a cochaperone of HSP70. Prior work has described the clinical spectrum of LGMDD1, including genotype-phenotype correlations and cross-sectional functional impairments, but prospective longitudinal data remain limited. The primary objective of this study was to identify outcome assessments that reliably measure disease progression in LGMDD1 and are most suitable for use as end points in future natural history and interventional studies. As part of the Genetic Resolution and Assessments Solving Phenotypes in LGMD (GRASP-LGMD) study, participants with genetically confirmed LGMDD1 were enrolled across 11 sites and completed 2 consecutive baseline visits and a 12-month follow-up. Clinical outcome assessments (COAs) included the North Star Assessment for Limb Girdle‑Type Dystrophies (NSAD), several timed mobility tests, Performance of the Upper Limb (PUL), handheld dynamometry (HHD), pulmonary function tests, and multiple patient-reported outcome measures. Test-retest reliability was calculated for COAs. Twelve-month change, responsiveness, and anchor-based minimal clinically important difference (MCID) values were assessed, and distribution-based thresholds were used to contextualize detectability. Fifteen participants enrolled; 13 completed baseline and 12-month visits. Functional COAs and HHD showed high test-retest reliability. Significant 12-month decline was detected in the Disability of the Arm, Shoulder and Hand (DASH), NSAD, the NSAD-10-m walk/run (NSAD-10M), and NSAD-rise from floor (NSAD-RFF). NSAD-10M, DASH, NSAD, NSAD-RFF, hip abduction, and deltoid strength were the most responsive. MCID values were interpreted alongside average annual change and distribution-based detectability. NSAD-10M, NSAD-RFF, NSAD, PUL, DASH, and LGMD-Health Index demonstrated the most feasible and consistent MCID profiles. A focused set of outcome assessments-particularly NSAD-10M, NSAD-RFF, NSAD, PUL, and DASH-demonstrated robust measurement characteristics over 12 months across the LGMDD1 severity spectrum and represent promising end points for future LGMDD1 natural history studies and interventional trials. NCT03981289, prospectively registered, observational. First registered: 2019-06-03. Actual study start date: 2019-06-14 clinicaltrials.gov/study/NCT03981289?term=GRASP-LGMD&rank=1&tab=study.
SN - 2376-7839
ER -