In this project, Dr Jarod Wong and his team will investigate changes in bone development in Duchenne muscular dystrophy using MRI and build on work being done by Dr Shuko Joseph in her clinical research and training fellowship. Specifically, they will extend the work from the fellowship to allow the study of muscle and bone in a larger number of boys with Duchenne muscular dystrophy and perform follow-up studies to see how bone health changes over time.
High resolution MRI assessment of bone in DMD gives very detailed information of bone health which current clinical assessments are unable to provide. It may also be an important outcome in future clinical trials.
What are the aims of this project?
Poor bone health and fractures are very common in individuals with Duchenne muscular dystrophy. Long-term steroid therapy is often given to slow down muscle damage in Duchenne muscular dystrophy and decreases inflammation. Steroids can also have a detrimental effect on bones and their use is associated with an increased risk of fractures. There is also some evidence to suggest that Duchenne muscular dystrophy itself can have a detrimental effect on bones as muscle and bone are very closely related. Therefore, people with Duchenne muscular dystrophy may be more susceptible to bone and muscle abnormalities, whether they are taking steroids or not.
A better understanding of the effects of Duchenne muscular dystrophy on muscle and bone is needed, using better tools for measuring these changes. This project will use innovative, non-invasive techniques (magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS)) to examine changes in bone health and investigate how they relate to muscle development in individuals with Duchenne muscular dystrophy. The aim is to improve our knowledge of bone health in the condition and explore whether these techniques could be used as accurate, non-invasive ways of measuring its progression.
Building on Dr Joseph’s clinical research and training fellowship, this 12 month project will allow 14 more boys aged 8-18 with Duchenne muscular dystrophy, and 14 more healthy boys to participate (making a total of 36 boys in each category). It will also allow the investigators to repeat the MRI assessments of bone and muscle after 12-18 months.
Why is this research important?
This research will give a comprehensive understanding of bone health in Duchenne muscular dystrophy. A thorough and detailed understanding of the underlying bone defect in Duchenne muscular dystrophy is important as this may allow doctors to select drugs to target the specific bone defect. MRI evaluation of bone provides very detailed assessment which current clinical methods of assessing bone health are unable to provide.
Gathering this information over a period of time (12-18 months) will also be particularly useful, adding to our knowledge of how the condition progresses over time, the natural history.
This research will also indicate if MRI and/or MRS measurements are useful indicators of the progression of Duchenne muscular dystrophy, in which case they could be used as outcome measures in future clinical trials.
How will the outcomes of this research benefit people with Duchenne muscular dystrophy?
This research could result in bone changes being more effectively monitored and treated and fractures being more easily predicted and prevented in people with Duchenne muscular dystrophy.
Less invasive outcome measures in future clinical trials could also be beneficial.
How might this research impact on other neuromuscular conditions?
There has been little research into bone health in neuromuscular conditions. This project will increase our knowledge of muscle and bone function, which could be useful for our understanding of other neuromuscular conditions as well as Duchenne muscular dystrophy.
Project leader: Dr Jarod Wong
Institute: University of Glasgow
Conditions: Duchenne muscular dystrophy
Duration: One year, starting 2017
Total cost (£): 24,138
Official title: Bone-muscle assessment using 3T MRI in boys with Duchenne muscular dystrophy
If you’re interested in taking part in the study, please email Dr Jarod Wong at email@example.com
Read about our other Duchenne muscular dystrophy research projects
Read our factsheet on steroids and Duchenne muscular dystrophy
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