{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:59:24Z","timestamp":1790852364925,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2004,10,7]],"date-time":"2004-10-07T00:00:00Z","timestamp":1097107200000},"content-version":"vor","delay-in-days":9138,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[1979,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A quantitative assessment of the pathological changes in extraocular muscle is presented in 8 patients with chronic progressive external ophthalmoplegia (CPEO). Serial cross\u2010sections of extraocular muscle were stained with a battery of histochemical and immunohistochemical techniques and compared with 36 normal extraocular muscles and 1 muscle from a patient who had longstanding third nerve palsy with anomalous reinnervation.<\/jats:p><jats:p>Several of the patient had a striking increase in the number of ragged\u2010red fibers in extraocular muscle, particularly if frequent ragged\u2010red fibers also were found on limb muscle biopsy. One patient demonstrated extrajunctional acetylcholine receptor (AChR) in a small percentage of fibers, although this finding was not present in the reinnervated muscle. Numerous darkly staining central regions were noted in the ocular muscle fibers of a patient with Stephens syndrome (CPEO, peripheral neuropathy, and cerebellar disease) and in the reinnervated muscle. A patient with myotubular myopathy had single central nuclei in both limb and ocular muscle. All patients demonstrated in their extraocular muscles variation in both the size and distribution of each of the three histochemical fiber types.<\/jats:p><jats:p>Extraocular muscule biopsy proved to be a safe, reliable technique. As a similar quantitative analysis is applied to the study of further patients, a better understanding of the pathogenesis of CPEO should be possible.<\/jats:p>","DOI":"10.1002\/ana.410060406","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T16:55:21Z","timestamp":1104598521000},"page":"326-339","source":"Crossref","is-referenced-by-count":26,"title":["Extraocular muscle biopsy in chronic progressive external ophthalmoplegia"],"prefix":"10.1002","volume":"6","author":[{"given":"Steven P.","family":"Ringel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Wilson","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Barden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,7]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-92920-5_14"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410010104"},{"key":"e_1_2_1_4_2","first-page":"42","article-title":"Pathology of abiotrophic ophthalmoplegia externa","volume":"111","author":"Cogan DO","year":"1962","journal-title":"Bull Johns Hopkins Hosp"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1977.tb05638.x"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/98.3.473"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.16.2_Part_1.161"},{"key":"e_1_2_1_8_2","volume-title":"Handbook of Clinical Neurology","author":"DiMauro S"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1973.00490270052008"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1968.00470360076008"},{"key":"e_1_2_1_11_2","first-page":"203","volume-title":"Handbook of Clinical Neurology","author":"Drachman DA","year":"1975"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1969.00480140070007"},{"key":"e_1_2_1_13_2","volume-title":"Muscle Biopsy: A Modern Approach","author":"Dubowitz V","year":"1973"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(67)90016-2"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1970.50.1.40"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(73)90158-5"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1958.00940080296016"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00688678"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(75)90204-X"},{"key":"e_1_2_1_20_2","first-page":"392","article-title":"Chronisch\u2010progressive ocularen Muskeldystrophie in electronemikroskopischen Bilde","volume":"62","author":"Movert E","year":"1959","journal-title":"Ber Dtsch Ophthalmol Ges"},{"key":"e_1_2_1_21_2","first-page":"227","article-title":"The fine structures of the human extraocular muscles: 1.A \u201claminated structure\u201d in the muscle fibers","volume":"15","author":"Mukuno K","year":"1966","journal-title":"J Electron Microsc (Tokyo)"},{"key":"e_1_2_1_22_2","first-page":"111","article-title":"The fine structures of the human extraocular muscles: 2 The classification of muscle fibers","volume":"12","author":"Mukuno K","year":"1968","journal-title":"Jpn J Ophthalmol"},{"key":"e_1_2_1_23_2","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1111\/j.1755-3768.1976.tb01285.x","article-title":"Progressive external ophthalmoplegia. Evidence for a generalized mitochondrial diesease with a defect in pyruvate metabolism","volume":"54","author":"Reske\u2010Nielsen E","year":"1976","journal-title":"Acta Ophthalmol (Kbh)"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1976.00500110019004"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/255730a0"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.28.1.55"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1978.03910050587020"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1968.00480040028002"},{"key":"e_1_2_1_29_2","first-page":"177","volume-title":"Handbook of Clinical Neurology","author":"Rowland LP","year":"1975"},{"key":"e_1_2_1_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-197801000-00001"},{"key":"e_1_2_1_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(73)90054-3"},{"key":"e_1_2_1_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1976.00500070017003"},{"key":"e_1_2_1_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/ar.1091560305"},{"key":"e_1_2_1_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1966.00470070005001"},{"key":"e_1_2_1_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/81.4.556"},{"key":"e_1_2_1_36_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196212202672501"}],"container-title":["Annals of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fana.410060406","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ana.410060406","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T21:52:56Z","timestamp":1705528376000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ana.410060406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1979,10]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1979,10]]}},"alternative-id":["10.1002\/ana.410060406"],"URL":"https:\/\/doi.org\/10.1002\/ana.410060406","archive":["Portico"],"relation":{},"ISSN":["0364-5134","1531-8249"],"issn-type":[{"value":"0364-5134","type":"print"},{"value":"1531-8249","type":"electronic"}],"subject":[],"published":{"date-parts":[[1979,10]]}}}