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We profiled four muscle-specific miRNAs (myomiRs), ten bioinformatically predicted mRNA targets, two functionally associated lncRNAs, and\n                    <jats:italic>SMN<\/jats:italic>\n                    transcripts in whole blood from 50 adults with SMA types II\u2013IV. Using RT-qPCR, we assessed associations between baseline RNA expression and demographic and clinical parameters, including SMA type, ambulatory status, motor and respiratory function, and explored longitudinal changes during nusinersen (24 months) and risdiplam (6\/12 months) treatment. At baseline, miR-206 was higher in type III than in type II and in ambulatory compared to non-ambulatory patients, while it correlated positively with motor and respiratory function and with\n                    <jats:italic>SMN<\/jats:italic>\n                    mRNA variants (total, FL, and \u22067).\n                    <jats:italic>SMN<\/jats:italic>\n                    transcript levels were higher in patients with more\n                    <jats:italic>SMN2<\/jats:italic>\n                    copies and in ambulatory patients and showed positive correlations with motor and respiratory function. miR-133a-3p and miR-133b correlated negatively with upper limb and respiratory function, and sex-related differences were observed for miR-133a-3p,\n                    <jats:italic>FGFR1<\/jats:italic>\n                    ,\n                    <jats:italic>ANXA2<\/jats:italic>\n                    , and\n                    <jats:italic>LINCMD1<\/jats:italic>\n                    . During nusinersen treatment, we observed a decrease in miR-206,\n                    <jats:italic>LINCMD1<\/jats:italic>\n                    , and\n                    <jats:italic>lnc-GJA1-2<\/jats:italic>\n                    , alongside modest reductions in\n                    <jats:italic>SMN<\/jats:italic>\n                    -\u22067 and total\n                    <jats:italic>SMN<\/jats:italic>\n                    . In contrast, risdiplam induced a peripheral splicing shift:\n                    <jats:italic>SMN<\/jats:italic>\n                    -FL and the FL\/\u22067 ratio increased, while\n                    <jats:italic>SMN<\/jats:italic>\n                    -\u22067 decreased; miR-133a-3p also decreased at 6 months. By integrating muscle-derived RNAs, particularly miR-206, with blood\n                    <jats:italic>SMN2<\/jats:italic>\n                    splicing changes, we propose a composite, blood-based biomarker approach for assessing SMA status and treatment-associated molecular changes and highlight myomiR-lncRNA-mRNA networks that suggest disease-relevant mechanisms.\n                  <\/jats:p>","DOI":"10.1007\/s12035-026-05862-4","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:29:44Z","timestamp":1777588184000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MyomiR Networks in Spinal Muscular Atrophy: Associations With Clinical Severity and Treatment Response"],"prefix":"10.1007","volume":"63","author":[{"given":"Maru\u0161a","family":"Barbo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bla\u017e","family":"Koritnik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Leonardis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vita","family":"Dol\u017ean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Metka","family":"Ravnik-Glava\u010d","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"issue":"3","key":"5862_CR1","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/S0960-8966(97)00459-8","volume":"7","author":"K Zerres","year":"1997","unstructured":"Zerres K, Wirth B, Rudnik-Sch\u00f6neborn S (1997) Spinal muscular atrophy\u2013clinical and genetic correlations. 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