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Review
. 2015 Feb;51(2):157-67.
doi: 10.1002/mus.24497. Epub 2014 Dec 16.

Spinal muscular atrophy: diagnosis and management in a new therapeutic era

W David Arnold  1 , Darine Kassar, John T Kissel
Affiliations
Review

Spinal muscular atrophy: diagnosis and management in a new therapeutic era

W David Arnold et al. Muscle Nerve. 2015 Feb.

Abstract

Spinal muscular atrophy (SMA) describes a group of disorders associated with spinal motor neuron loss. In this review we provide an update regarding the most common form of SMA, proximal or 5q-SMA, and discuss the contemporary approach to diagnosis and treatment. Electromyography and muscle biopsy features of denervation were once the basis for diagnosis, but molecular testing for homozygous deletion or mutation of the SMN1 gene allows efficient and specific diagnosis. In combination with loss of SMN1, patients retain variable numbers of copies of a second similar gene, SMN2, which produces reduced levels of the survival motor neuron (SMN) protein that are insufficient for normal motor neuron function. Despite the fact that understanding of how ubiquitous reduction of SMN protein leads to motor neuron loss remains incomplete, several promising therapeutics are now being tested in early-phase clinical trials.

Keywords: SMN1; antisense; electromyography; gene therapy; spinal muscular atrophy.

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Figures

Figure 1
Figure 1
Spinal muscular atrophy is caused by caused loss of the SMN1 gene and retention of the SMN2 gene, leading to low levels of full length SMN protein in all cell types. High levels of full length SMN protein are required in motor neurons, but the other cell types and tissues that require high levels of SMN remain to be determined.
Figure 2
Figure 2
Approach to molecular diagnosis of SMA.
See this image and copyright information in PMC

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