Longitudinal assessment of natural disease progression in Brazilian children and adolescents with Charcot-Marie-Tooth disease

Soares, Bruno Alvarenga; Freitas, Camila Fernanda de; Cardoso, Juliana; Baptista, Cyntia Rogean de Jesus Alves de; Marques Junior, Wilson; Mattiello-Sverzut, Ana Claudia

doi:10.1055/s-0045-1811174

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Original Article • Arq. Neuro-Psiquiatr. 83 (8) • 2025 • https://doi.org/10.1055/s-0045-1811174 linkcopy

Longitudinal assessment of natural disease progression in Brazilian children and adolescents with Charcot-Marie-Tooth disease

Authorship SCIMAGO INSTITUTIONS RANKINGS

Background Charcot-Marie-Tooth disease (CMT) is a progressive neurological disorder that typically manifests in early childhood. The natural progression of CMT in Brazilian pediatric and adolescent populations remains unknown.

Objective To evaluate the natural disease progression in Brazilian children and adolescents with CMT using the Charcot-Marie-Tooth Pediatric Scale (CMTPedS).

Methods A longitudinal observational study was conducted to assess disease progression over a 2-year period through 3 evaluations, spaced 1 year apart, in children and adolescents aged 5 to 18 years with a confirmed CMT diagnosis. Height, weight, body mass index (BMI), fat-free mass, and functionality (assessed via the CMTPedS) were evaluated in each of the three sessions.

Results We included 30 participants of both sexes with a mean age of 11.1 ± 3.2 years. Significant increases in height, weight, and BMI were observed, alongside a decline in the percentage of lean body mass across evaluations. The total score on the CMTPedS increased by 4.5 points throughout 2 years, indicating disease progression, with notable deterioration in functional dexterity, pinprick and vibration sensations, and gait. Significant progression was evident within 1 year, with an average annual deterioration of 2.25 points. The subgroup with CMT type 1A (CMT1A) presented an increase of 4 points in the total score, corresponding to an average annual progression of 2 points. Unlike the overall CMT group, the CMT1 subgroup did not exhibit a decline in the pinprick sensation score.

Conclusion Children and adolescents with CMT exhibit significant disease progression within 2 years, with measurable deterioration observed as early as 1 year. The CMTPedS is a reliable tool to monitor CMT progression in this population.

Keywords
Charcot-Marie-Tooth Disease; Functional Status; Disability Evaluation; Child; Adolescent

	Evaluation 1 (n = 30)	Evaluation 2 (n = 26)	Evaluation 3 (n = 30)	p
Height (cm)	150.1 (144.0–156.3)	153.3 (147.6–158.9) #	155.7 (151.0–160.1) # $	< 0.0001
Weight (Kg)	48.3 (40.6–56.0)	51.4 (42.9–59.1) #	54.3 (46.1–61.6) # $	< 0.0001
Body Mass Index (kg/m²)	20.4 (17.8–21.3)	21.0 (19.3–24.7)	22.0 (20.2–25.5) #	0.033
Fat-free mass (%)	75.1 (66.2–84.0)	66.8 (60.8–79.9)	62.0 (56.3–67.7) #	0.039
Walker (n)	29	25	29	-
Wheelchair user (n)	1	1	1	-
Previous surgeries (n)	0	0	0	-
Rehabilitation (n)	7	6	10	-
Physical activity (n)	0	7	8	-
Other therapies (n)	0	0	0	-
Orthosis (n)	5	6	11	-
Insole (n)	3	6	4	-

	Evaluation 1 (n = 30)	Evaluation 2 (n = 26)	Evaluation 3 (n = 30)	p
Functional dexterity test	1.7 (1.1–2.3)	2.5 (1.9–3.1) #	2.6 (2.0–3.1) #	0.007
Nine-hole peg test	3.0 (2.5–3.4)	3.0 (2.5–3.4)	3.2 (2.8–3.6)	0.52
Hand grip strength	1.1 (0.5–1.8)	1.2 (0.5–1.8)	0.8 (0.2–1.4)	0.28
Dorsiflexor strength	2.6 (2.1–3.1)	2.9 (2.3–3.3)	2.9 (2.3–3.3)	0.52
Plantar flexor strength	2.4 (1.8–2.9)	2.7 (2.2–3.2)	2.5 (1.8–3.0)	0.50
Pinprick sensation	0.4 (0.0–0.8)	0.7 (0.2–1.2)	1.4 (0.8–1.8) #	0.019
Vibration sensation	0.5 (0.1–0.9)	0.6 (0.1–1.1)	1.5 (0.8–2.0) # $	0.004
Balance	1.8 (1.1–2.5)	1.8 (1.0–2.4)	2.0 (1.3–2.7)	0.59
Gait	1.9 (1.4–2.4)	2.4 (1.9–2.8)	2.8 (2.2–3.1) #	0.008
Long jump	2.4 (1.9–2.9)	2.5 (2.0–3.0)	2.5 (2.0–2.9)	0.89
6-minute walk test	2.5 (2.0–2.9)	2.7 (2.1–3.1)	2.7 (2.2–3.1)	0.63
Total score	20.1 (17.0–23.2)	22.6 (19.4–25.8) #	24.6 (21.1–28.2) # $	< 0.0001

	Evaluation 1 (n = 24)	Evaluation 2 (n = 22)	Evaluation 3 (n = 24)	p
Functional dexterity test	1.7 (1.0–2.4)	2.3 (1.6–3.0)#	2.4 (1.8–3.1)#	0.027
Nine-hole peg test	2.9 (2.4–3.3)	3.0 (2.4–3.5)	3.1 (2.7–3.5)	0.63
Hand grip strength	0.7 (0.1–1.2)	0.8 (0.1–1.4)	0.6 (0.2–1.0)	0.49
Dorsiflexor strength	2.3 (1.8–2.8)	2.6 (2.0–3.1)	2.7 (2.1–3.3)	0.52
Plantar flexor strength	2.1 (1.5–2.7)	2.6 (2.0–3.2)	2.3 (1.5–2.8)	0.28
Pinprick sensation	0.3 (0.0–0.7)	0.6 (0.1–1.0)	1.0 (0.5–1.5)	0.15
Vibration sensation	0.5 (0.1–1.0)	0.6 (0.1–1.2)	1.3 (0.7–1.9)# $	0.029
Balance	1.5 (0.8–2.3)	1.4 (0.6–2.1)	1.9 (1.1–2.7)	0.18
Gait	1.8 (1.3–2.3)	2.3 (1.7–2.7)	2.5 (1.9–3.0)#	0.029
Long jump	2.2 (1.7–2.8)	2.3 (1.9–2.8)	2.3 (1.8–2.7)	0.87
6-minute walk test	2.3 (1.7–2.7)	2.6 (2.0–3.1)	2.5 (1.9–3.0)	0.53
Total score	18.3 (15.4–21.7)	21.0 (18.1–23.8)#	22.3 (19.0–25.7)#	0.004

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[1] Notes:

[TFN1] ^#
Significant difference from evaluation 1;

[TFN2] ^$
significant difference from evaluation 2.