Annals of Clinical and Translational Neurology (Aug 2023)

Newborn screening for Duchenne muscular dystrophy: A two‐year pilot study

  • Norma P. Tavakoli,
  • Dorota Gruber,
  • Niki Armstrong,
  • Wendy K. Chung,
  • Breanne Maloney,
  • Sunju Park,
  • Julia Wynn,
  • Carrie Koval‐Burt,
  • Lorraine Verdade,
  • David H. Tegay,
  • Lilian L. Cohen,
  • Natasha Shapiro,
  • Annie Kennedy,
  • Garey Noritz,
  • Emma Ciafaloni,
  • Barry Weinberger,
  • Marty Ellington Jr,
  • Charles Schleien,
  • Regina Spinazzola,
  • Sunil Sood,
  • Amy Brower,
  • Michele Lloyd‐Puryear,
  • Michele Caggana,
  • the Duchenne Muscular Dystrophy Pilot Study Group

DOI
https://doi.org/10.1002/acn3.51829
Journal volume & issue
Vol. 10, no. 8
pp. 1383 – 1396

Abstract

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Abstract Objective Duchenne muscular dystrophy (DMD) is an X‐linked disorder resulting in progressive muscle weakness and atrophy, cardiomyopathy, and in late stages, cardiorespiratory impairment, and death. As treatments for DMD have expanded, a DMD newborn screening (NBS) pilot study was conducted in New York State to evaluate the feasibility and benefit of NBS for DMD and to provide an early pre‐symptomatic diagnosis. Methods At participating hospitals, newborns were recruited to the pilot study, and consent was obtained to screen the newborn for DMD. The first‐tier screen measured creatine kinase‐MM (CK‐MM) in dried blood spot specimens submitted for routine NBS. Newborns with elevated CK‐MM were referred for genetic counseling and genetic testing. The latter included deletion/duplication analysis and next‐generation sequencing (NGS) of the DMD gene followed by NGS for a panel of neuromuscular conditions if no pathogenic variants were detected in the DMD gene. Results In the two‐year pilot study, 36,781 newborns were screened with CK‐MM. Forty‐two newborns (25 male and 17 female) were screen positive and referred for genetic testing. Deletions or duplications in the DMD gene were detected in four male infants consistent with DMD or Becker muscular dystrophy. One female DMD carrier was identified. Interpretation This study demonstrated that the state NBS program infrastructure and screening technologies we used are feasible to perform NBS for DMD. With an increasing number of treatment options, the clinical utility of early identification for affected newborns and their families lends support for NBS for this severe disease.