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November 28, 2022Research Article

Patient-Reported Impact of Symptoms in Friedreich Ataxia

Jamison Seabury, Danae Alexandrou, Nuran Dilek, Brittany Cohen, John Heatwole, Jane Larkindale, View ORCID ProfileDavid R Lynch, Courtney Park, Spencer Rosero, View ORCID ProfileSub H Subramony, Anika Varma, Ellen Wagner, Susan Walther, Jennifer Weinstein, McKenzie Wells, Christine Zizzi, View ORCID ProfileChad Heatwole
First published November 28, 2022, DOI: https://doi.org/10.1212/WNL.0000000000201598
Jamison Seabury
1University of Rochester Center for Health + Technology (CHeT), Rochester, NY;
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Danae Alexandrou
2Loyola University Chicago Stritch School of Medicine, Chicago, IL
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Nuran Dilek
3University of Rochester Department of Neurology, Rochester, NY
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Brittany Cohen
1University of Rochester Center for Health + Technology (CHeT), Rochester, NY;
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John Heatwole
4Pittsford Sutherland High School, Pittsford, NY
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Jane Larkindale
5PepGen Inc., Boston, MA
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David R Lynch
6Children’s Hospital of Philadelphia (CHOP), Philadelphia, PA
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  • ORCID record for David R Lynch
Courtney Park
6Children’s Hospital of Philadelphia (CHOP), Philadelphia, PA
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Spencer Rosero
1University of Rochester Center for Health + Technology (CHeT), Rochester, NY;
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Sub H Subramony
7University of Florida College of Medicine, Gainesville, FL
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  • ORCID record for Sub H Subramony
Anika Varma
1University of Rochester Center for Health + Technology (CHeT), Rochester, NY;
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Ellen Wagner
1University of Rochester Center for Health + Technology (CHeT), Rochester, NY;
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Susan Walther
8Friedreich’s Ataxia Research Alliance (FARA), Downingtown, PA
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Jennifer Weinstein
1University of Rochester Center for Health + Technology (CHeT), Rochester, NY;
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McKenzie Wells
6Children’s Hospital of Philadelphia (CHOP), Philadelphia, PA
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Christine Zizzi
9Princeton University School of Public and International Affairs, Princeton, NJ
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Chad Heatwole
1University of Rochester Center for Health + Technology (CHeT), Rochester, NY;
3University of Rochester Department of Neurology, Rochester, NY
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  • For correspondence: chad_heatwole@urmc.rochester.edu
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Citation
Patient-Reported Impact of Symptoms in Friedreich Ataxia
Jamison Seabury, Danae Alexandrou, Nuran Dilek, Brittany Cohen, John Heatwole, Jane Larkindale, David R Lynch, Courtney Park, Spencer Rosero, Sub H Subramony, Anika Varma, Ellen Wagner, Susan Walther, Jennifer Weinstein, McKenzie Wells, Christine Zizzi, Chad Heatwole
Neurology Nov 2022, 10.1212/WNL.0000000000201598; DOI: 10.1212/WNL.0000000000201598

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Abstract

Objective: To determine the prevalence and relative importance of symptoms experienced by children and adults with Friedreich’s ataxia (FA) and to identify factors associated with a higher burden of disease.

Methods: We conducted qualitative interviews with individuals with FA and caregivers of pediatric individuals with FA to identify potential symptoms of importance to those living with FA. We subsequently performed a cross-sectional study to assess which symptoms have the highest prevalence and importance in FA and to determine which factors are associated with a higher burden of disease.

Results: Thirty-nine participants provided 2,527 quotes regarding the symptomatic burden of FA. Two-hundred and two individuals (153 with FA and 49 caregivers) participated in a subsequent cross-sectional study. Individuals with FA and caregivers identified impaired coordination, limitations with mobility and walking, inability to do activities, fatigue, and lower extremity weakness as the most prevalent and life altering symptomatic themes in FA. Muscle stiffness and functional staging for ataxia were associated with the prevalence of symptomatic themes in FA. In addition, the length of the smaller GAA expansion and the mean length of both GAA expansions were strongly associated with the onset of symptoms in FA.

Conclusions: There are a wide variety of symptoms that affect the lives of individuals with FA. These symptoms, many underrecognized, have different levels of importance and occur at different rates in the FA population. The most common and life altering of these symptoms represent potential targets for future therapeutic interventions.

  • Received May 23, 2022.
  • Accepted in final form October 6, 2022.
  • © 2022 American Academy of Neurology

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