{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T21:55:44Z","timestamp":1781474144336,"version":"3.54.1"},"reference-count":43,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100003975","name":"Myotonic Dystrophy Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100003975","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Wyck Foundation"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["NIAMS R01 AR076060-01A1"],"award-info":[{"award-number":["NIAMS R01 AR076060-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["NIAMS and NINDS R01 AR056973"],"award-info":[{"award-number":["NIAMS and NINDS R01 AR056973"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Science Foundation Cooperative Agreement","award":["DMR-11570490"],"award-info":[{"award-number":["DMR-11570490"]}]},{"name":"National Science Foundation Cooperative Agreement","award":["DMR-1644779"],"award-info":[{"award-number":["DMR-1644779"]}]},{"DOI":"10.13039\/100023043","name":"State of Florida","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100023043","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Introduction: Myotonic dystrophy type 1 is the most prevalent muscular dystrophy in adults, characterized by weakness, impaired functional abilities, and myotonia. However, little is known about the relationship between quantitative MRI measures (fat fraction and T2 relaxation time) and clinical findings of the upper extremity. This study assessed forearm muscle structure in patients with myotonic dystrophy using quantitative MRI and correlated these measures with strength, function, and handgrip myotonia. Materials and Methods: Eighteen adults with myotonic dystrophy type 1 underwent MRI using three-point Dixon and T2 spin echo imaging of the forearm. Results: The average fat fraction and T2 relaxation time were greatest in the flexor digitorum profundus (26.7% and 55.6 ms, respectively). Correlations were found between quantitative MRI values and clinical tests of strength (r = \u22120.61 to \u22120.92, p &lt; 0.01), function (r = \u22120.64 to \u22120.83, p &lt; 0.01), and handgrip myotonia (r = 0.48, p &lt; 0.05). Overall, the anterior forearm fat fraction values showed higher correlations with strength and function compared to those of the posterior forearm. Discussion: Our results support the use of quantitative MRI measures to assess forearm disease pathology and show potential to monitor the effectiveness of therapeutic treatments in patients with myotonic dystrophy type 1.<\/jats:p>","DOI":"10.3390\/tomography11120136","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T10:50:38Z","timestamp":1764931838000},"page":"136","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Quantitative Magnetic Resonance Imaging of the Forearm in Myotonic Dystrophy Type 1"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5778-1245","authenticated-orcid":false,"given":"Sydney","family":"Eierle","sequence":"first","affiliation":[{"name":"Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Taivassalo","sequence":"additional","affiliation":[{"name":"Department of Physiology & Aging, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunjun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korey D.","family":"Cooke","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Moslemi","sequence":"additional","affiliation":[{"name":"Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean C.","family":"Forbes","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn A.","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Physiology & Aging, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Vandenborne","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. H.","family":"Subramony","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donovan J.","family":"Lott","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"ref_1","unstructured":"Adam, M.P., Bick, S., Mirzaa, G.M., Pagon, R.A., Wallace, S.E., and Amemiya, A. (1999). Myotonic Dystrophy Type 1. GeneReviews\u00ae, University of Washington."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.bbadis.2014.05.019","article-title":"Myotonic dystrophies: An update on clinical aspects, genetic, pathology, and molecular pathomechanisms","volume":"1852","author":"Meola","year":"2015","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Tom\u00e9, S., and Gourdon, G. (2020). DM1 Phenotype Variability and Triplet Repeat Instability: Challenges in the Development of New Therapies. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21020457"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1002\/acn3.496","article-title":"Relationships between grip strength, myotonia, and CTG expansion in myotonic dystrophy type 1","volume":"4","author":"Hogrel","year":"2017","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Sugie, K., Sugie, M., Taoka, T., Tonomura, Y., Kumazawa, A., Izumi, T., Kichikawa, K., and Ueno, S. (2015). Characteristic MRI Findings of upper Limb Muscle Involvement in Myotonic Dystrophy Type 1. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0125051"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1159\/000448328","article-title":"Muscle MRI of the Upper Extremity in the Myotonic Dystrophy Type 1","volume":"76","author":"Hayashi","year":"2016","journal-title":"Eur. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e2803","DOI":"10.1212\/WNL.0000000000007648","article-title":"Lower extremity muscle pathology in myotonic dystrophy type 1 assessed by quantitative MRI","volume":"92","author":"Heskamp","year":"2019","journal-title":"Neurology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1002\/jmri.22849","article-title":"Quantitative assessment of skeletal muscle degeneration in patients with myotonic dystrophy type 1 using MRI","volume":"35","author":"Hiba","year":"2012","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Wenninger, S., Montagnese, F., and Schoser, B. (2018). Core Clinical Phenotypes in Myotonic Dystrophies. Front. Neurol., 9.","DOI":"10.3389\/fneur.2018.00303"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1002\/mus.26420","article-title":"The myotonic dystrophy experience: A North American cross-sectional study","volume":"59","author":"Hagerman","year":"2019","journal-title":"Muscle Nerve"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1212\/WNL.0b013e318260cbe6","article-title":"Patient-reported impact of symptoms in myotonic dystrophy type 1 (PRISM-1)","volume":"79","author":"Heatwole","year":"2012","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1007\/s00415-017-8547-3","article-title":"Quantifying fat replacement of muscle by quantitative MRI in muscular dystrophy","volume":"264","author":"Burakiewicz","year":"2017","journal-title":"J. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"W207","DOI":"10.2214\/AJR.14.13754","article-title":"Quantitative Skeletal Muscle MRI: Part 1, Derived T2 Fat Map in Differentiation Between Boys with Duchenne Muscular Dystrophy and Healthy Boys","volume":"205","author":"Johnston","year":"2015","journal-title":"Am. J. Roentgenol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1002\/mus.24679","article-title":"T2 relaxation times are increased in Skeletal muscle of DMD but not BMD patients","volume":"53","author":"Wokke","year":"2016","journal-title":"Muscle Nerve"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1002\/mus.27174","article-title":"Quantitative muscle MRI as a sensitive marker of early muscle pathology in myotonic dystrophy type 1","volume":"63","author":"Gutmann","year":"2021","journal-title":"Muscle Nerve"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1148\/radiol.2020192518","article-title":"Quantitative Muscle MRI Depicts Increased Muscle Mass after a Behavioral Change in Myotonic Dystrophy Type 1","volume":"297","author":"Heskamp","year":"2020","journal-title":"Radiology"},{"key":"ref_17","first-page":"833","article-title":"18.3 Test\u2013retest reliability of strength measurements of the long finger flexors (LFF) in patients with myotonic dystrophy type 1","volume":"23","author":"Eichinger","year":"2017","journal-title":"Neuromuscul. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1002\/mus.24725","article-title":"Myotonic dystrophy health index: Correlations with clinical tests and patient function","volume":"53","author":"Heatwole","year":"2016","journal-title":"Muscle Nerve"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"P5.455","DOI":"10.1212\/WNL.90.15_supplement.P5.455","article-title":"Muscle Strength and Function Measures in a Multicenter Study of Myotonic Dystrophy Type 1 (DM1): Baseline Impairment and Test-Retest Agreement over 3 Months","volume":"90","author":"Eichinger","year":"2018","journal-title":"Neurology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"P05.188","DOI":"10.1212\/WNL.78.1_MeetingAbstracts.P05.188","article-title":"Video hand opening time (vHOT) in myotonic dystrophy type 1 (DM1) (P05.188)","volume":"78","author":"Puwanant","year":"2012","journal-title":"Neurology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1002\/mus.27559","article-title":"Remote assessment of myotonic dystrophy type 1: A feasibility study","volume":"66","author":"Hamel","year":"2022","journal-title":"Muscle Nerve"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1080\/09638288.2017.1300690","article-title":"The extremity function index (EFI), a disability severity measure for neuromuscular diseases: Psychometric evaluation","volume":"40","author":"Bos","year":"2018","journal-title":"Disabil. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4221","DOI":"10.1007\/s00415-021-10533-6","article-title":"Assessment of muscular strength and functional capacity in the juvenile and adult myotonic dystrophy type 1 population: A 3-year follow-up study","volume":"268","author":"Roussel","year":"2021","journal-title":"J. Neurol."},{"key":"ref_24","first-page":"69","article-title":"Grip and pinch strength: Normative data for adults","volume":"66","author":"Mathiowetz","year":"1985","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1212\/WNL.0000000000000775","article-title":"Examination of effects of corticosteroids on skeletal muscles of boys with DMD using MRI and MRS","volume":"83","author":"Arpan","year":"2014","journal-title":"Neurology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1007\/s00415-011-6393-2","article-title":"Quantitative MRI can detect subclinical disease progression in muscular dystrophy","volume":"259","author":"Fischmann","year":"2012","journal-title":"J. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/mrm.24917","article-title":"Chemical shift-based MRI to measure fat fractions in dystrophic skeletal muscle","volume":"72","author":"Triplett","year":"2014","journal-title":"Magn. Reson. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1002\/nbm.2851","article-title":"T2 mapping provides multiple approaches for the characterization of muscle involvement in neuromuscular diseases: A cross-sectional study of lower leg muscles in 5\u201315-year-old boys with Duchenne muscular dystrophy","volume":"26","author":"Arpan","year":"2013","journal-title":"NMR Biomed."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1002\/jmri.24972","article-title":"Fat quantification in skeletal muscle using multigradient-echo imaging: Comparison of fat and water references","volume":"43","author":"Peterson","year":"2016","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1589\/jpts.32.337","article-title":"Detection of muscle activity with forearm pronation exercise using T2-map MRI","volume":"32","author":"Takamori","year":"2020","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_31","first-page":"1897","article-title":"Magnetic resonance imaging criteria for distinguishing between inclusion body myositis and polymyositis","volume":"29","author":"Dion","year":"2002","journal-title":"J. Rheumatol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Willis, T.A., Hollingsworth, K.G., Coombs, A., Sveen, M.-L., Andersen, S., Stojkovic, T., Eagle, M., Mayhew, A., De Sousa, P.L., and Dewar, L. (2014). Quantitative magnetic resonance imaging in limb-girdle muscular dystrophy 2I: A multinational cross-sectional study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0090377"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Otto, L.A.M., van der Pol, W., Schlaffke, L., Wijngaarde, C.A., Stam, M., Wadman, R.I., Cuppen, I., van Eijk, R.P., Asselman, F., and Bartels, B. (2020). Quantitative MRI of skeletal muscle in a cross-sectional cohort of patients with spinal muscular atrophy types 2 and 3. NMR Biomed., 33.","DOI":"10.1002\/nbm.4357"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"407","DOI":"10.3233\/JND-190457","article-title":"Lower Extremity Muscle Involvement in the Intermediate and Bethlem Myopathy Forms of COL6-Related Dystrophy and Duchenne Muscular Dystrophy: A Cross-Sectional Study","volume":"7","author":"Batra","year":"2020","journal-title":"J. Neuromuscul. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1212\/WNL.0000000000004647","article-title":"Adding quantitative muscle MRI to the FSHD clinical trial toolbox","volume":"89","author":"Mul","year":"2017","journal-title":"Neurology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e1622","DOI":"10.1212\/WNL.0000000000009244","article-title":"Modeling disease trajectory in Duchenne muscular dystrophy","volume":"94","author":"Rooney","year":"2020","journal-title":"Neurology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e897","DOI":"10.1212\/WNL.0000000000009012","article-title":"MR biomarkers predict clinical function in Duchenne muscular dystrophy","volume":"94","author":"Barnard","year":"2020","journal-title":"Neurology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/S0960-8966(02)00023-8","article-title":"Clinical and imaging findings in six cases of congenital muscular dystrophy with rigid spine syndrome linked to chromosome 1p (RSMD1)","volume":"12","author":"Mercuri","year":"2002","journal-title":"Neuromuscul. Disord."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1212\/01.wnl.0000324927.28817.9b","article-title":"Distinct muscle imaging patterns in myofibrillar myopathies","volume":"71","author":"Fischer","year":"2008","journal-title":"Neurology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.ncl.2014.04.008","article-title":"A pattern recognition approach to patients with a suspected myopathy","volume":"32","author":"Barohn","year":"2014","journal-title":"Neurol. Clin."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1002\/mus.26914","article-title":"Myopathies with finger flexor weakness: Not only inclusion-body myositis","volume":"62","author":"Nicolau","year":"2020","journal-title":"Muscle Nerve"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1002\/oti.12","article-title":"Effects of a hand training programme in five patients with myotonic dystrophy type 1","volume":"12","author":"Aldehag","year":"2005","journal-title":"Occup. Ther. Int."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.3109\/09638288.2012.754952","article-title":"Effects of hand-training in persons with myotonic dystrophy type 1\u2014A randomised controlled cross-over pilot study","volume":"35","author":"Aldehag","year":"2013","journal-title":"Disabil. Rehabil."}],"container-title":["Tomography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2379-139X\/11\/12\/136\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T05:22:05Z","timestamp":1765084925000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2379-139X\/11\/12\/136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":43,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["tomography11120136"],"URL":"https:\/\/doi.org\/10.3390\/tomography11120136","relation":{},"ISSN":["2379-139X"],"issn-type":[{"value":"2379-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]}}}