The Development of a New Patient-Reported Outcome Measure in Recessive Ataxias: The Person-Reported Ataxia Impact Scale.

Autosomal recessive cerebellar ataxias (ARCAs) are inherited neurological disorders that can affect both the central and peripheral nervous systems. To assess the effects of interventions according to the perception of people affected, patient-reported outcome measures (PROMs) must be available. This paper presents the development process of the Person-Reported Ataxia Impact Scale (PRAIS), a new PROM in recessive ataxias, and the documentation of its content validity, interpretability, and construct validity (structural and discriminant). The development followed the PROMIS framework and the Food and Drug Administration guidelines. A mixed-method study design was used to develop the PROM. A systematic review of the literature, semistructured interviews, and discussion groups was conducted to constitute an item pool. Experts' consultation helped formulate items, and the questionnaire was sent online to be completed by people affected. Statistical analyses were performed to assess the structural and discriminant validity. A total of 125 people affected by recessive ataxia completed the questionnaire. The factor analysis confirmed the three components: physical functions and activities, mental functions, and social functions. The statistical analysis showed that it can discriminate between stages of mobility and level of autonomy. It showed very good levels of internal consistency (0.79 to 0.89). The Person-Reported Ataxia Impact Scale (PRAIS) is a 38-item questionnaire that assesses the manifestations and impacts of the disease according to the perception of people affected by recessive ataxia. It can be used in clinical and research settings.

Skin fibroblasts in vitro radiosensitivity can predict for late complications following AVM radiosurgery.

BACKGROUND AND PURPOSE: A small proportion of patients undergoing radiotherapy display heightened normal tissue reactions. We have set out to determine whether this sensitivity is genetic in nature and can be assessed using an in vitro skin fibroblast assay in order to predict and avoid excessive normal tissue complications. PATIENTS AND METHODS: In this study we compared five arteriovenous malformation (AVM) patients who were treated with radiotherapy and showed severe normal tissue reactions (necrosis) to two AVM patients who showed normal reactions. Fibroblasts taken from patients were cultured in vitro and irradiated. RESULTS: The results showed that the fibroblasts from the sensitive patients were also more radiosensitive in vitro than the cells from the normally responding patients. CONCLUSIONS: The results suggest underlying genetic radiosensitivity and that such an assay may be used for prediction of severe radiosensitivity in AVM patients.