Weakness of the diaphragm and other breathing muscles can lead to problems getting enough oxygen when a person is asleep, even if they do not have any symptoms of breathing difficulty while awake. However, in DM1, respiratory muscle weakness can affect lung function and deprive the body of needed oxygen. Respiratory muscle weakness does not appear to be a common feature of DM2. To learn more, read The Brain in DM (cognitive and emotional aspects of DM1) and Excessive Daytime Sleepiness Can Be 'Debilitating' in DM1 and DM2 (complex effects of DM on the brain's sleep-wake cycles and respiratory muscles). Thus, cognitive problems do not show the same degree of deterioration over time that is typical of muscle dysfunction in DM1.Īlthough not as much is known about the effects of DM2 on personality, cognition, and sleepiness as with DM1, it appears that people with DM2 can have some of the same difficulties in these areas but to a lesser degree. In both classic DM1 and DM2, frontal lobe cognitive impairment (attention deficit) worsens over time but does not extend to other areas of cognition. Also, in patients with DM1, cognitive skills are diminished, and the IQ has been shown to be lower with younger age of onset. In some people, there is a kind of overall "apathy" that may be due to changes in the brain related to DM1.
Research suggests that, in DM1, there may be abnormalities in the parts of the brain that determine the rhythm of sleeping and waking, making excessive daytime sleepiness a barrier to full participation in work, school, or social life for many adults with the disorder. In most cases, weakness predominantly involves the proximal muscles, particularly the hip girdle muscles.
In general, DM2 is a less severe disease than classic DM1. Onset for DM2 ranges from the second to the seventh decade of life, often presenting with myotonia, weakness, or cataracts. The CTG repeat size is usually in the range of 50 to 150. Age at onset is between 20 and 70 years (typically onset occurs after age 40), and life expectancy is normal. The mild form of DM1 is characterized by mild weakness, myotonia, and cataracts. The CTG repeat size in adult onset is generally in the range of 50 to 1,000. Patients diagnosed with DM1 have multiple sets of DNA bases repeats in their genome (known as the CTG repeats). In these patients, average lifespan is reduced. The classic form of DM1 becomes symptomatic between the second and fourth decades of life.
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