Facioscapulohumeral Muscular Dystrophy Society

FSH Watch

Vol. 1 No. 1, Spring 1994
A publication of the FacioScapuloHumeral Society
Provided by the FSH Society, Inc.

Inside ...



Perez Gives Testimony Before Congressional Committees


The FSH Society successfully launched its Washington agenda on February 1 with the testimony of FSH President Daniel Perez before the U.S. House of Representatives Appropriations Committee, Subcommittee on Labor, Health and Human Services, Education and Related Agencies which sets the funding for biomedical research. In an eloquent statement, Mr. Perez described what it is like to live with the FSH disorder. His testimony included a description of FSH, a summary of current research and a description of achievable research goals. This information was supplied by the newly formed FSH Society Scientific Advisory Board, in particular Dr. Theodore Munsat and Dr. Paul Schultz.
Mr. Perez pointed out that NIH has funded very little research into FSH. Now, with the genetic research moving ahead, he said it was time for NIH to accelerate the research with a small portfolio of grants. William Natcher (D-KY), Chairman of the subcommittee thanked Mr. Perez for his "fine statement" and for taking the time to inform the committee of the research that is needed.
The day before Mr. Perez testified he and Morgan Downey, General Counsel to the FSH Society, met with Dr. Patricia Grady, Acting Director of the National Institute of Neurological Disorders and Stroke (NINDS), Dr. Floyd J. Brinley, Director of the Division of Convulsive, Developmental and Neuromuscular Disorders, and Dr. Phillip Sheridan, Special Assistant to the Director of NINDS. They discussed the role of the Neurology Institute and the current lack of research going on in FSH. The officials of the Institute expressed interest in meeting with FSH researchers to refine research needs and work with them to improve the likelihood of their grants obtaining funding.
A second meeting was held with Dr. Richard W. Lymm, Director, Muscle Biology Branch of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Lymm expressed his interest in the FSH disorder and explained the different emphases between the Arthritis Institute and the Neurology Institute. Briefly, the Arthritis Institute would become involved in a research grant on FSH if it focused on muscle metabolism. The Neurology Institute, on the other hand, would take up research projects which would focus on central nervous system involvement.
Representatives of both Institutes were extremely supportive of the establishment of the FSH Society and had numerous suggestions for areas of future cooperation. "This was the first time that a patient representing FSH has talked to Congress and the National Institutes of Health about funding more research," said Daniel Perez. "It was an exciting opportunity but only one step. These institutions need constant pressure from patients if they are to do more research," he concluded.
On March 3, Daniel Perez testified before the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies chaired by Tom Harkin (D-IA). Herbert Kohl (D-WI) thanked Mr. Perez for his "excellent and moving testimony." This completes the testimonies needed for the budget year 1995.
Following is the recorded transcript of that testimony:
"Mr. Chairman, it is a great pleasure to appear before you today.
"My name is Daniel Paul Perez of Lexington, Massachusetts and I am here before you today as President of the Facioscapulohumeral Society and as an individual who has this rare disorder.
"In the written testimony you will see that we have assembled a prestigious national Scientific Advisory Board, comprised of the leading researchers and medical professionals in the field of neuromuscular disorders. Serving on our Scientific Advisory Board we have Dr. Theodore Munsat, who is past president of the American Academy of Neurology, and Dr. Louis Kunkel and Dr. Robert Brown who have cloned the genes for other major inherited neuromuscular disorders.
"My testimony today is about the profound and devastating effects of a disease known as Facioscapulohumeral Disease which is also known as FSH Muscular Dystrophy or FSHD, and the urgent need for NIH funding for research on this disorder. According to our research little, if any, work is going on in either the National Institute of Neurological Disorders and Stroke or the National Institute of Arthritis, Musculo-skelatal and Skin Diseases.
"The major consequence of inheriting this disease is that of a progressive loss of skeletal muscle, with a usual pattern of initial noticeable weakness of facial, scapular and upper arm muscles and subsequent developing weaknesses of other muscles of the torso and lower limbs. Early facial weakness often provides a clue that FSH is present.
"The age of onset is variable as is the eventual extent and degree of muscle loss, but noticeable muscle weaknesses are usually present by the age of twenty. The progression of FSH begins between the first and second decades of life for men and between the second and third decades of life for women. Life expectancy is normal in many, but many, if not most, patients become significantly incapacitated in the prime of life. There is an infantile form of FSH which is extremely severe and may result in an early death.
"The prognosis of FSH includes both a loss of muscular strength that limits personal and occupational activities, and a total loss of mobility in perhaps twenty percent of the cases. Hearing loss and retinal abnormalities have been associated with FSHD.
"I was born to a family that already experienced the extraordinary difficulty of receiving a proper diagnosis for FSH. In the first few years of my life I had been diagnosed as having FSH and a severe hearing loss which, in the past three years, I have come to find out is part of FSH.
"At 31 years of age I consider myself a life long survivor of the severe trauma and tension of FSH, and I do not say this lightly. I have dealt with the continuing, unrelenting and unending loss caused by FSH from the first second, into the first minute, hour, day, week, over the months and through the years. Not for a moment is there a reprieve from continual loss of my physical ability, not for a moment is there a time for me to mourn; not for a moment is there relief from the physical and mental pain that is a result of this disease. There is no known treatment and no known cause for this disease.
"FSH has insidiously and systematically deprived me of my childhood, my adolescence, and the full range of choices in life. FSH affects the way you walk, the way you dress, the way you work, the way you wash, the way you sleep, the way you relate, the way you parent, the way you love, the way and where you live, and the way people perceive and treat you. I can not smile, I can no longer hold a baby in my arms, I can not close my eyes to sleep, I can no longer run or walk on the beach or climb stairs. Every day I am aware of the things that I may not be able to do tomorrow. This is the reality for the ten to twenty-five thousand people living with FSH.
"I sincerely hope that I will not have to live the rest of my days managing my way through decline with this disease. This is the United States of America, and in a country as great as ours with all of its technical means and ability I should not be asked to sit idly by while this disease takes its course.
"I reiterate that it is absolutely clear, if not completely black and white, that the number one priority for individuals with FSH and the one absolutely commanding imperative for the federal government is to initiate and accelerate, in any way possible, research on FSH. With modest funding and a clear direction from Congress to the NIH to support research, significant progress can be made in conquering, and perhaps eliminating, this devastating disease.
"Mr. Chairman, again, thank you for providing this opportunity to testify before your subcommittee."

From the President


Nobel laureate Carlos Fuentes once said to me: "If you had left at daybreak, you would have been there by now." I feel that the progress made on FSH in the last forty years is deeply reflected in this statement. Paul Cohen, an individual with FSH, set out at daybreak forty years ago when he founded the Muscular Dystrophy Association of America. There is a deep sense of irony in the fact that the FSH population has been one of the last to organize and is one of the last of the dystrophies seeking recognition at the national and international level.
Until 1987, no major genetic work was being conducted on FSH in the United States. It was at this point that Stephen J. Jacobsen Ph.D.--another individual with FSH--realized that numerous advances in research and clinical medicine were being made in other neuromuscular disorders and no major work could even begin without the formation of a genetic cell bank. In 1987, Dr. Jacobsen set up the first FSH cell bank at the University of California, San Diego. Again, another individual with FSH realized that the day was progressing, the journey had been interrupted, and that there was a long way to go before the FSH community could arrive at its final destination. These words are an appropriate metaphor for the arrival of the FSH Society. The FSH community had left at daybreak and although we should have arrived by now, the day is progressing and we have a long way to go.
The FSH Society's origins are directly traceable to Dr. Jacobsen's pioneering efforts to establish a national FSH cell bank with funding from the Muscular Dystrophy Association. We are deeply in debt to Dr. Jacobsen and the Muscular Dystrophy Association for their work and their efforts to raise awareness of the FSH population. I feel very strongly that we would not be here today if it were not for Dr. Jacobsen's work and commitment to the FSH cause.
Dr. Jacobsen was the second person with FSH that I ever met. During my visit to Dr. Jacobsen's lab in San Diego in 1989, I could not help but feel that the FSH population had finally found a home. Our hope for a permanent home is realized now with the formation of the FSH Society.
In 1990, I wrote the following objectives with the mindset that the FSH population needed organization, representation and advocacy in all forums. These objectives and purposes try to cover all of the necessary corporate mechanics and legal means for achieving a better quality of life for those involved with FSH. The FSH Society was created because of a need for a comprehensive resource for FSH individuals and families. The purposes of the organization are:
1. to create a clearinghouse for information on the FSH disorder, and drugs and devices for the treatment of same, and to foster communication among individuals, families, caregivers, charitable organizations, government agencies, industry, scientific researchers, academic institutions, and interested individuals;
2. to accumulate and disseminate information about FSH;
3. to encourage and promote increased scientific and clinical research and development on the causes, alleviation of suffering and the cure of FSH, including without limitation, the promotion of research and development for the treatment of FSH for which funding may not otherwise be generally available;
4. to solicit grants and contributions from private foundations, the pharmaceutical industry and others to support such research and development;
5. to make grants and awards to qualified applicants so that such applicants may accomplish such research and development;
6. to act as a liaison among consumers and government and industry concerning research and development with respect to drugs and devices for FSH;
7. to represent individuals and families with FSH not otherwise represented by effective organizations and to work cooperatively and collegially with related organizations, including but not limited to the Muscular Dystrophy Association and the National Organization of Rare Disorders; and
8. to educate the general public, relevant governmental bodies, and the medical profession about the existence, diagnosis and treatment of the FSH disorder, a disease for which funding for research and development concerning diagnosis and treatment may not be generally available.
The FSH Society is a voluntary health organization created by individuals with FSH for individuals involved with FSH. Our national Scientific Advisory Board is comprised of the leading researchers and medical professionals in the field of neuromuscular disorders. Serving on our Scientific Advisory Board we have Dr. Theodore Munsat, who is past president of the American Academy of Neurology, and Dr. Louis Kunkel and Dr. Robert Brown who have cloned the genes for other major inherited neuromuscular disorders (Duchene, Becker and familial ALS) and many other extremely talented individuals. In addition, the FSH Society has retained the finest and most experienced legislative and legal expert in the field of neurological disorders, R. Morgan Downey of Hoffheimer & Downey. All Board members are serving as unpaid volunteers and we rely on the contributions of time and money from all individuals.
The FSH Society is a membership organization and relies heavily if not solely on the support of its members. In short, this is an opportunity to empower yourself by being a concerned and active member in the Society. It is extremely imperative that each individual realize that if we are to arrive at our destination we must come together as a cohesive whole. Please do not be lulled into a false sense of security by thinking that other people are taking care of your problem. Lastly, please realize that this is a rare opportunity to take control of what happens with FSH and please consider this opportunity very seriously as the day is getting long and time is moving on.
--Daniel Paul Perez, President
Facioscapulohumeral Society, Inc.

FSH Society Statement


Facioscapulohumeral Dystrophy (FSHD) is a muscle disease with a frequency in the population of between 4 and 10 per 100,000. The disease is inheritable; the responsible gene is located on chromosome 4. The expression of symptoms requires inheritance of the defective gene from only one affected parent. An individual of either sex has a fifty percent chance of inheriting the gene from that affected parent.
The disease pathology includes a progressive loss of skeletal muscle with a usual pattern of initial noticeable weakness of facial, scapular and upper arm muscles and subsequent developing weaknesses of other muscles of the torso and lower limbs. Early facial weaknesses distinguish this disease from other neuromuscular diseases that can be similar in appearance. The age of onset is variable, as is the eventual extent and degree of muscle loss, but noticeable muscle weaknesses are usually present by the age of twenty and are recognizable in all but a small percentage of adults who carry the gene.
The prognosis includes both a loss of muscular strength that limits personal and occupational activities of most FSHD individuals, and a loss of mobility in perhaps twenty percent of the cases. Hearing loss and retinal abnormalities associated with FSHD have been reported, but the frequency of these effects and their relationship, if any, to the causative gene for the muscle defect are uncertain.
The Facioscapulohumeral Society (FSH Society) is an independent, non-profit and tax-exempt U.S. corporation organized to address issues and needs specifically related to Facioscapulohumeral Muscular Dystrophy (FSHD). Papers certifying its incorporation, bylaws and tax-exempt status are deposited at the corporation's east and west coast offices and the office of its General Counsel in Washington, D.C.
The FSH Society was created because of a need for a comprehensive resource for FSHD individuals and families. Purposes of the organization are:
  • to encourage and promote scientific and clinical research and development through education of the general public, government bodies and the medical profession,
  • to support such research and development through solicitation of grants and contributions from private foundations, the pharmaceutical industry and others,
  • to accumulate and disseminate information about FSHD,
  • to actively cooperate with related organizations and foster communication among all interested parties, and
  • to represent individuals and families with FSHD.
    The Society invites contact from any interested individuals, families, physicians, caregivers, charitable organizations, government agencies, industry, scientific researchers and academic institutions. Any inquiries regarding membership, charitable donations, purposes and goals or other issues pertaining to the Society and FSHD, should be addressed to the east or west coast offices.

    Current Happenings in Research


    Since the gene for FSHD was mapped to one end of chromosome 4, research groups in the United States and Europe have worked to narrow the region in which the gene maps to identify the FSHD disease causing gene. In the past two years, several important findings have been published.
    A group of researchers at Duke University led by Dr. Margaret Pericak-Vance have found that more than one gene can cause FSHD. The Duke group reported that they have several FSHD families where the gene for FSHD does not map to chromosome 4. These researchers are currently searching for the chromosomal location of this other FSHD gene. This finding has important implications for families who would like pre-symptomatic or prenatal testing for FSHD. Since the chromosome 4 gene for FSHD has not yet been identified, one would have to determine whether the family has an alteration in the chromosome 4-linked FSHD gene or another FSHD gene before one proceeds with testing. To determine whether the disease maps to chromosome 4, participation of a large family is necessary. At this time, no group is offering diagnostic testing for FSHD families.
    Researchers at the University of Iowa led by Dr. Kathy Mathews are interested in mouse models for FSHD. This group is studying a mouse strain that has a mutation resulting in symptoms that are similar to those seen in FSHD humans. The mdx mouse, a strain with mouse Duchenne muscular dystrophy, has been important in testing different therapies such as gene replacement and myoblast transfer. Similarly, the identification of a mouse model for FSHD would speed the study of therapies and therapeutics for this disease.
    Although the FSHD gene that maps to chromosome 4 has not yet been identified, the work of several groups has narrowed the location of the gene. Groups in Leiden led by Dr. Rune Frants and in London led by Dr. Jane Hewitt have detected rearrangements that are associated with FSHD. These arrangements are seen in affected individuals and appear to be the result of a large deletion of DNA. Whether these rearrangements are directly responsible for the disease is unclear. Dr. Weiffenbach (Collaborative Research, Waltham, MA), Drs. Griggs and Tawil (University of Rochester, N.Y.), and Dr. Meena Upadhyaya (University of Cardiff, U.K.) have found affected individuals that do not contain the rearrangements. However, it is clear that the discovery of the FSHD-associated rearrangements is important and will lead to the discovery of the FSHD gene.
    Several research groups are actively searching for the FSHD gene by identifying and studying genes that map near the FSHD-associated rearrangements. They include: Dr. Michael Altherr (Los Alamos National Laboratory), Dr. Denise Figlewicz (University of Rochester), Dr. Rune Frants (University of Leiden, The Netherlands), Dr. Jane Hewitt (University of Manchester, U.K.), Dr. Kathy Mathews (University of Iowa), Dr. Meena Upadhyaya (University of Cardiff, U.K.), and Dr. Barbara Weiffenbach (Collaborative Research, Waltham, MA).

    Rochester Research Update


    The University of Rochester research project involving FSHD is now in its fifth year of clinical study. Our accession of new families continues at a comfortable rate. We have screened 69 families with 34 individuals being followed in the Quantitative Natural History (QNH) phase of the study. We have also tested 69 normal volunteers (NV) on the Quantitative Myometry (QMT) system. The NV population includes family members and friends of individuals affected with FSH and other neuromuscular diseases being studied at the University of Rochester, and staff from the Department of Neurology.
    We are now actively recruiting patients for the prednisone treatment trial. Four persons have already been enrolled in the study. The prednisone trial is no longer restricted to people outside the QNH study. Anyone interested in participating in the prednisone study is urged to call Lynn Cos at (716) 275-2559.

    Researchers


    Los Alamos, NV
    Michael R. Altherr
    Life Sciences
    Group LS 2, M880
    Los Alamos National Laboratory
    Los Alamos, New Mexico 87545
    Interest(s): Molecular genetics
    This group has developed hybrid cell lines (hamster cells with small pieces of chromosome 4). These cell line facilitate mapping and isolation of new probes. Lab is analyzing transcripts in the FSH region.

    Tokyo, Japan
    Kiichi Arahata
    Hideo Sugita
    J.H. Lee
    Department of Neuromuscular Research
    National Institute of Neuroscience, NCNP
    4-1-1 Ogawa-higashi, Kodiara
    Tokyo, 187, Japan
    Interest(s): Molecular genetics and clinical

    Waltham, MA
    Barbara Weiffenbach
    Susan Manning
    Richa Saxena
    Collaborative Research, Inc.
    1365 Main Street
    Waltham, Massachusetts 02154
    Interest(s): Molecular genetics

    Paris, France
    Michael Fardeau
    Institut National de La Sante et
    de le Recherche Medicale
    17 Rue du Fer-a-Moulin
    75005 Paris
    France
    Interest(s): Clinical

    Leiden, Netherlands
    Nijmegen, Netherlands
    O. F. Brouwer
    Department of Neurology
    University Hospital Leiden
    P.O. Box 9600
    2300 RC Leiden
    The Netherlands

    Rune R. Frantz
    Nicole Datson
    Cisca Wijmenga*
    Institute for Anthropogenetica
    Wassenaarseweg 72
    2333 AL Leiden,
    The Netherlands

    George W.A.M. Padberg
    University Hospital Nijmegen St Radboud
    Department of Neurology
    P.O. Box 9101
    6500 HB Nijmegen,
    The Netherlands
    Interest(s): Molecular genetics and clinical

    *Cisca Wijmenga is currently with The National Center for Human Genome Research, Laboratory of Gene Transfer, National Institutes of Health, Building 4G, Room 3A14, 9000 Rockville Pike, Bethesda, MD 20892

    Marburg, West Germany
    Manuela Koch
    Institut for Humangenetic der Philipps-Universitat
    Bahnhofstr. 7A
    D-3550 Marburg
    West Germany
    Interest(s): Molecular genetics

    Rochester, NY
    Robert Griggs
    Rabi Tawil
    Denise Figlewicz
    Lynn Cos
    James Forrester
    Michael McDermott
    University of Rochester School of Medicine
    Department of Neurology
    601 Elmwood Avenue
    P.O. Box 673
    Rochester, New York 14642
    Interest(s): Molecular genetic and clinical
    Actively recruiting patients for a prednisone treatment trial. Contact Lynn Cos at (716) 275-2559 if interested in participating in the prednisone study.
    The University of Rochester research project involving Facioscapulohumeral Muscular Dystrophy is now in its fifth year of study.
    UR and Ohio State have jointly screened 69 families with 34 individuals being followed in the Quantitative Natural History (QNH) phase of the study. UR has also tested 69 normal volunteers (NV) on the Quantitative Myometry (QMT) system.
    UR has three sets of identical twins in its QNH study. In the two sets of sisters, both are affected in each set. In the set of brothers only one is affected.

    Iowa City, IA
    Katherine Matthews
    Brian Shute
    Kate Mills
    Julie Fedderson
    Holly Bailey
    Jeff Murray
    Department of Pediatrics
    216 MRC
    University of Iowa Hospitals and Clinics
    Iowa City, Iowa 52242
    Interest(s): Molecular genetics and clinical
    Group has a mouse mutant that may be a mouse version of FSHD.

    Manchester, England
    London, England
    Jane Hewitt
    Laboratory of Human Molecular Genetics
    Department of Cell and Structural Biology
    Stopford Building
    Manchester University
    Oxford Road
    Manchester M13 3PT
    England

    R. Williamson
    Tracy Wright
    Department of Biochemistry and Molecular Genetics
    St. Mary's Hospital Medical School
    Imperial College of Science, Tech., & Medicine
    Norfolk Place
    London, W21PG
    England
    Interest(s): Molecular genetics


    Cardiff, England
    Bristol, England
    Peter Lunt
    Peter Harper
    Meena Upadhyaya
    Institute of Medical Genetics
    University of Wales College of Medicine
    Heath Park
    Cardiff CF4 4XN
    England

    Philip Jardine
    Institute of Child Health
    Bristol Royal Hospital for Sick Children
    St. Michael's Hill
    Bristol BS2 8BJ
    England
    Interest(s): Molecular genetics and clinical

    Columbus, OH
    Jerry Mendell
    Department of Neurology
    Ohio State University
    Columbus, Ohio 43210
    Interest(s): Clinical


    San Francisco, CA
    Robert Miller
    University of California, San Francisco
    3700 California Street
    P.O. Box 3805
    San Francisco, California 94119
    Interest(s): Clinical


    Sao Paulo, Brazil
    M. Rita Passos-Bueno
    Departmento de Biologia
    Instituto de Biociencias
    Universidade de Sao Paulo
    Sao Paulo, C.P. 11461
    CEP 05422-970 S.P. Brazil
    Interest(s): Clinical and Occupational


    Irvine, CA
    Sara T. Winokur
    Ulla Bengtsson
    Rachelle Markovitch
    John Wasmuth
    Michael Altherr*
    Department of Biological Chemistry
    University of California, Irvine
    Irvine, CA
    Interest(s): Molecular genetics

    *Michael Altherr is currently with the Genomics and Structural Biology Group, LANL, Los Alamos, NM

    St. Petersburg, Russia
    V.M. Kazakov
    Address: Unknown at press time
    Interest(s): Clinical

    Davis, CA
    M. Brewer
    D.D. Kilmer
    R. T. Abresch
    S.G. Aitkens
    G.T. Carter
    W.M. Fowler
    E.R. Johnson
    C.M. McDonald
    N.J. Wright
    Research and Training Center on Neuromuscular Disease
    Department of Physical Medicine and Rehabilitation
    University of California, Davis
    TB 191
    Davis, CA 95616-8665
    Interest(s): Rehabilitation, Occupational and Clinical

    The research is being conducted by the Research and Training Center on Neuromuscular Disease and the National Institute on Disability & Rehabilitation Research.

    Durham, NC
    Margaret Pericak-Vance
    John R. Gilbert
    Duke University Medical Center
    227D Bryan Research Building
    P.O. Box 2900
    Durham, North Carolina 27710
    Interest(s): Molecular genetics

    Italy
    L. Felicetti
    Intituto de Biologia Cellulare, CNR
    Interest(s): Molecular genetics

    Research Bibliography


    1991 n n n
    Padberg GW, Lunt PW, Koch M, Fardeau M, (1991). Diagnostic criteria for facioscapulohumeral muscular dystrophy. Neuromuscul Disord. 1(4):231-4.
    Molnar M, Dioszeghy P, Mechler F, (1991). Inflammatory changes in facioscapulohumeral muscular dystrophy. Eur Arch Psychiatry Clin Neurosci 241(2):105-8.
    Yamakage M, Iwasaki H, Kawana S, Ishima T, Namiki A, (1991). [A case report of monitoring neuro-muscular blockade during anesthesia in a patient with facioscapulohumeral muscle dystrophy]. Masui 40(1):105-8 (Published in Japanese).
    Slipetz DM, Aprille JR, Goodyer PR, Rozen R, (1991). Deficiency of complex III of the mitochondrial respiratory chain in a patient with facioscapulohumeral disease. Am J Hum Genet 48(3):502-10.
    Passos-Bueno MR, Byth B, Love D, Terwilliger J, Ott J, Rapaport D, Valnzof M, Zatz M, Davies KE, (1991). Exclusion of the gene responsible for facioscapulohumeral muscular dystrophy (FSH) at 6q23-q27. J Neurol Sci 102(2):206-8.
    Shimizu T, Miyamoto K, Hayashi H, Nagashima T, Hirose K, Tanabe H, (1991). [Congenital facioscapulohumeral muscular dystrophy associated with tongue atrophy and sensorineural hearing disturbance]. Rinsho Shinkeigaku 31(4):433-8.
    Wijmenga C, Padberg GW, Moerer P, Wiegant J, Liem L, Brouwer OF, Milner EC, Weber JL, van Ommen GB, Sandkuyl LA, et al. (1991). Mapping of facioscapulohumeral muscular dystrophy gene to chromosome 4q35-qter by multipoint linkage analysis and in situ hybridization. Genomics 9(4):570-5.
    Ohno Y, Nakata Y, Sumiyoshi M, Hisaoka T, Ogura S, Nakazato Y, Yamaguchi H, (1991). [A case of facioscapulohumeral muscular dystrophy complicated with complete A-V block]. Kokyu To Junkan 39(5):491-5.
    Akiyama C, Suzuki H., Nonaka I, (1991). [A case of facioscapulohumeral muscular dystrophy with infantile spasms, sensorineural deafness and retinal vessel abnormality]. No To Hattatsu 23(4):395-9.
    Shapiro F, Specht L, Korf BR, (1991). Locomotor problems in infantile facioscapulo-humeral muscular dystrophy. Retrospective study of 9 patients. Acta Orthop Scand 62(4):367-71.
    Lin MY, Nonaka I, (1991.) Facioscapulohumeral muscular dystrophy: muscle fiber type analysis with particular reference to small angular fibers. Brain Dev 13(5):331-8.
    Lunt PW, Harper PS, (1991). Genetic counseling in facioscapulohumeral muscular dystrophy. J Med Genet 28(10):655-64.
    Shen EN, Madsen T, (1991). Facioscapulohumeral muscular dystrophy and recurrent pacemaker lead dislodgement. Am Heart J 122(4 Pt 1):1167-9.
    Upadhyaya M, Lunt PW, Sarfarazi M, Broadhead W, Daniels J, Owen M, Harper PS, (1991). A closely linked DNA marker for facioscapulohumeral disease on chromosome 4q. J Med Genet 28(10):665-71.
    Brouwer OF, Padberg GW, Ruys CJ, Brand R, de Laat JA, Grote JJ, (1991). Hearing loss in facioscapulohumeral muscular dystrophy. Neurology 41(12):1878-81.
    1992 n n n
    Weiffenbach B, Bagley RG, Falls K, Dubois J, Hyser C, Storvick D, Schultz P, Mendell JR, Milner EC, Jacobsen SJ, et al, (1992). Framework multipoint map of the long arm of human chromosome 4 and telomeric localization of the gene for FSHD. Mamm Genome 3(3):143-50.
    Padberg GW, (1992). Why cells die in facioscapulohumeral muscular dystrophy. Clin Neurol Neurosurg 94 Suppl:S21-4.
    Badalian LO, Temin PA, Mukhin Klu Bulaeva NBV, Zavadenko NN, Nikanorova Mlu Shnaidman RV, Lysov VL, (1992). [Infantile facioscapulohumeral muscular dystrophy] Infantil'naia litse-lopatochno-plechevaia myshechnaia distrofiia. Zh Nevropatol Psikhiatr 92(3):28-30.
    Pauleikhoff D, Bornfeld N, Bird AC, Wessing A, (1992). Severe visual loss associated with retinal telangiectasis and facioscapulohumeral muscular dystrophy. Graefes Arch Clin Exp Ophthalmol 230(4):362-5.
    de Visser M, de Voogt WG, la Riviere GV, (1992). The heart in Becker muscular dystrophy, facioscapulohumeral dystrophy, and Bethlem myopathy. Muscle Nerve 15(5):591-6.
    Gilbert JR, Stajich JM, Speer MC, Vance JM, Stewart CS, Yamaoka LH, Samson F, Fardeau M, Potter TG, Roses AD, et al, (1992). Linkage studies in facioscapulohumeral muscular dystrophy (FSHD). Am J Hum Genet 51(2):424-7.
    Mathews KD, Mills KA, Bosch EP, Lonasescu VV, Wiles KR, Buetow KH, Murray JC, (1992). Linkage localization of facioscapulohumeral muscular dystrophy (FSHD) in 4q35. Am J Hum Genet 51(2):428-31.
    Mills KA, Buetow KH, Xu Y, Ritty TM, Mathews KD, Bodrug SE, Wijmenga C, Balazs I, Murray JC, (1992). Genetic and physical mapping on chromosome 4 narrows the localization of the gene for facioscapulohumeral muscular dystrophy (FSHD). Am J. Hum Genet Aug 51(2):432-9.
    Sarfarazi M, Wijmenga C, Upadhyaya M, Weiffenbach B, Hyser C, Mathews K, Murray J, Gilbert J, Pericak-Vance M, Lunt P, et al, (1992). Regional mapping of facioscapulohumeral muscular dystrophy gene on 4q35: combined analysis of an international consortium. Am J Hum Genet 51(2):396-403.
    Upadhyaya M, Lunt P, Sarfarazi M, Broadhead W, Farnham J, Harper PS, (1992). The mapping of chromosome 4q markers in relation to facioscapulohumeral muscular dystrophy (FSHD). Am J Hum Genet 51(2):404-10.
    Weiffenbach B, Bagley R, Falls K, Hyser C, Storvick D, Jacobsen SJ, Schultz P, Mendell J, Willems van Dijk K, Milner EC, et al, (1992). Linkage analysis of five chromosome 4 markers localizes the facioscapulohumeral muscular dystrophy (FSHD) gene to distal 4q35. Am J Hum Genet 51(2):416-23.
    Wijmenga C, Sandkuijl LA, Moerer P, van der Boorn N, Bodrug SE, Ray PN, Brouwer OF, Murray JC, van Ommen GJ, Padberg GW, et al, (1992). Genetic linkage map of facioscapulohumeral muscular dystrophy and five polymorphic loci on chromosome 4q35-qter. Am J Hum Genet 51(2):411-5.
    Fischbeck KH, Garbern JY, (1992). Facioscapulohumeral muscular dystrophy defect identified. Nature Genet 2:3-4.
    Wijmenga C, Hewitt JE, Sandkuijl LA, Clark LN, Wright TJ, Dauwerse HG, Gruter AM, Hofker MH, Moerer P, Williamson R, et al, (1992.) Chromosome 4q DNA rearrangements associated with facioscapulohumeral muscular dystrophy. Nat Genet 2(1):26-30.
    Wijmenga C, Brouwer OF, Padberg GW, Frants RR, (1992). Transmission of de-novo mutation associated with facioscapulohumeral muscular dystrophy. [letter] Lancet 17 340(8825): 985-6.
    Brouwer OF, Padberg GW, van der Ploeg RJ, Ruys CJ, Brand R, (1992). The influence of handedness on the distribution of muscular weakness of the arm in facioscapulohumeral muscular dystrophy. Brain 115 (Pt 5):1587-98.
    Horikawa H, Takahashi K, Nishio H, Mano Y, Takayanagi T, (1992). [X-ray computed tomographic scans of lower limb and trunk muscles in facioscapulohumeral muscular dystrophy] Rinsho Shinkeigaku 32(10):1061-6.
    Ville I, Ravaud JF, Marchal F, Paicheler H, Fardeau M, (1992). Social identity and the International Classification of Handicaps: an evaluation of the consequences of facioscapulohumeral muscular dystrophy. Disabil Rehabil 14(4):168-75.

    1993 n n n
    Tawil R, Storvick D, Feasby TE, Weiffenbach B, Griggs RC, (1993). Extreme variability of expression in monozygotic twins with FSH muscular dystrophy. Neurology 43(1):345-48.
    Wevers CW, Brouwer OF, Padberg GW, Nijboer ID, (1993). Job perspectives in facioscapulohumeral muscular dystrophy. Disabil Rehabil 15(1):24-8 93160515.
    Brouwer OF, Wijmenga C, Frants RR, Padberg GW, (1993). Facioscapulohumeral muscular dystrophy: the impact of genetic research. Clin Neurol Neurosurg 95(1):9-21.
    Bunch WH, Siegel IM, (1993). Scapulothoracic arthrodesis in facioscapulohumeral muscular dystrophy. Review of seventeen procedures with three to twenty-one year follow-up. J Bone Joint Surg Am 75(3):372-6.
    Haraguchi Y, Chung AB, Torroni A, Stepien G, Shoffner JM, Wasmuth JJ, Costigan DA, Polak M, Altherr MR, Winokur ST, et al, (1993). Genetic mapping of human heart-skeletal muscle adenine nucleotide translocator and its relationship to the facioscapulohumeral muscular dystrophy locus. Genomics 16(2):479-85.
    Passos-Bueno MR, Wijmenga C, Takata RE, Marie SK, Vainzof M, Pavanello RC, Hewitt JE, Bakker E, Carvalho A, Akiyama J, et al, (1993). No evidence of genetic heterogeneity in Brazilian facioscapulohumeral muscular dystrophy families (FSHD) with 4q markers. Hum Mol Genet 2(5):557-62.
    Weiffenbach B, Dubois J, Storvick D, Tawil R, Jacobsen SJ, Gilbert J, Wijmenga C, Mendell JR, Winokur S, Altherr MR, et al, (1993). Mapping the facioscapulohumeral muscular dystrophy gene is complicated by chromosome 4q35 recombination events. Nat Genet 4(2):165-9.
    Eggers S, Passos-Bueno MR, Zatz M, (1993). Facioscapulohumeral muscular dystrophy: aspects of genetic counseling, acceptance of preclinical diagnosis, and fitness. J Med Genet 30(7):589-92.
    Upadhyaya M, Jardine P, Maynard J, Farnham J, Sarfarazi M, Wijmenga C, Hewitt JE, Frants R, Harper PS, Lunt PW, (1993). Molecular analysis of British facioscapulohumeral dystrophy families for 4q DNA rearrangements. Hum Mol Genet 2(7):981-7.
    Gilbert JR, Stajich JM, Wall S, Carter SC, Qiu H, Vance JM, Stewart CS, Speer MC, Pufky J, Yamaoka LH, et al, (1993). Evidence for heterogeneity in facioscapulohumeral muscular dystrophy (FSHD). Am J Hum Genet 53(2):401-8.
    Wijmenga C, Winokur ST, Padberg GW, Skraastad MI, Altherr MR, Wasmuth JJ, Murray JC, Hofker MH, Frants RR, (1993). The human skeletal muscle adenine nucleotide translocator gene maps to chromosome 4q35 in the region of the facioscapulohumeral muscular dystrophy locus. Hum Genet 92(2):198-203.
    Jardine P, Jones M, Tyfield L, Upadhyaya M, Lunt P, (1993). De novo DNA rearrangement in atypical facioscapulohumeral muscular dystrophy [letter] In: Clin Genet 44(3):167.
    Wijmenga C, Wright TJ, Baan MJ, Padberg GW, Williamson R, van Ommen G-JB, Hewitt JE, Hofker MH, Frants RR, (1993). Physical mapping and YAC-cloning connects four genetically distinct 4qter loci (D4S163, D4S139, D4F35S1 and D4F104S1) in the FSHD gene-region. Hum Mol Genet 2(10):1667-72.
    Winokur ST, Schutte B, Weiffenbach B, Washington SS, McElligott D, Chakravarti A, Wasmuth JH, Altherr MR, (1993). A radiation hybrid map of 15 loci on the distal long arm of chromosome 4, the region containing the gene responsible for facioscapulohumeral muscular dystrophy (FSHD). Am J Hum Genet 53(4):874-80.
    Wright TJ, Wijmenga C, Clark LN, Frants RR, Williamson R, Hewitt JE, (1993). Fine mapping of the FSHD gene region orientates the rearranged fragment detected by the probe p13E-11. Hum Mol Genet 2(10):1673-78.
    Griggs RC, Tawil R, Storvick D, Mendell JR, Altherr MR, (1993). Genetics of facioscapulohumeral muscular dystrophy: new mutations in sporadic cases. Neurology 43(11):2369-72.
    Jakab E, Gledhill RB, (1993). Simplified technique for scapulocostal fusion in facioscapulohumeral dystrophy. In: J Pediatr Orthop 13(6):749-51.
    Tawil R, Storvick D, Weiffenbach B, Altherr MR, Feasby TE, Griggs RC, (1993). Chromosome 4q DNA Rearrangement in Monozygotic Twins Discordant for Facioscapulohumeral Muscular Dystrophy Human Mutations 2:492-94.

    1994 n n n
    Winokur S, Bengtsson U, Feddersen J, Mathews K, Weiffenbach B, Bailey H, Markovich R, Murray J, Wasmuth J, Altherr M, Schutte B, (1994). The DNA rearrangement associated with facioscapulohumeral muscular dystrophy involves a heterochromatin-associated repetitive element: Implications for a role of chromatin structure in the pathogenesis of the disease. Chromosome Research 1994, 2.

    Meet the Board


    Robert H. Brown, Jr. M.D., D.Ph
    A member of our Scientific Advisory Board, Dr. Robert H. Brown is an associate neurologist at the Massachusetts General Hospital, associate professor of neurology at Harvard Medical School and Director of the Cecil B. Day Labor-atory for Neuromuscular Research. The focus of the Laboratory is the study of neuromuscular diseases including Lou Gehrig's disease. A recipient of many awards and honors, Dr. Brown has published extensively and most recently has been involved in major breakthroughs in ALS.

    Lady W. Hall
    Lady W. Hall is active in community and church affairs. A graduate of Louisiana State University, she lives in DeRidder, Louisiana. She is dedicated to informing the public on FSH issues as a concerned parent and FSH patient.

    William E. Hall, Jr., J.D.
    Judge William E. Hall, Jr. is a practicing attorney and Senior Partner with Hall, Lestage, and Landreneau in Louisiana. Active in pursuing solutions to FSHD, Judge Hall brings years of knowledge of the legislative process to our Society. A veteran of WW II, he retired as a city judge after 29 years.

    Stephen J. Jacobsen, Ph.D.
    Dr. Jacobsen is Vice President of our Society and a member of the Scientific Advisory Board. During his ten years as a researcher on FSHD, Dr. Jacobsen has published many papers while associated with the University of California at San Diego School of Medicine. As a result of his work in establishing a FSHD cell bank, Dr. Jacobsen recognized the need to network and create the Society which would advocate for FSHD resources. Dr. Jacobsen currently resides in San Diego where he is the Director of our West Coast office.

    Karen L. Johnsen
    Currently a continuing education college student, Ms. Johnsen has been the leader of the FSH Support Group in Maryland for the past five years. Ms. Johnsen is currently Miss Wheelchair Maryland which puts her in contact with the public on disability issues. Her mission in the FSH Society is to promote public awareness of FSH issues.

    Louis Kunkel, Ph.D.
    Dr. Kunkel is Chief of the Division of Genetics at The Children's Hospital, Boston. As investigator with the Howard Hughes Medical Institute, Dr. Kunkel is known for locating the DMD gene. Currently associated with Harvard Medical School, Dr. Kunkel continues his interest in research into neuromuscular diseases. Among other major honors, he is the recipient of the 1991 Silvio O. Conte Decade of the Brain Award .

    Richard A. Lefebvre, FHFMA
    As Secretary of the Society, Mr. Lefebvre is a seasoned health care professional with extensive operational experience in the health care industry in both the profit and nonprofit sectors. He is the Group Vice President for Quorum Health Resources the world's largest organization that manages and operates hospitals. As an FSH patient, he is interested in expediting a solution to the FSH problem.

    William R. Lewis, M.D.
    A member of our Scientific Advisory Board, Dr. Lewis, a practicing neurosurgeon in Monterey, CA has a special interest in FSH since he has children with this diagnosis.

    William R. Lewis III, M.D.
    A member of our Scientific Advisory Board, Dr. Lewis is an Assistant Professor of Cardiology at the University of California, Davis and has been doing research on myoblast transfer as a treatment for heart disease. As an individual with FSH, Dr. Lewis is committed to the activities of our Society.

    William G. Michael, C.P.A.
    As the elected Treasurer of the FSH Society, Mr. Michael brings his expertise as a Certified Public Accountant for nonprofits to our organization. A practicing CPA in Boston, Mr. Michael brings his commitment to our Society as a parent of an adult son with FSH.

    Theodore L. Munsat, M.D.
    A past president of the American Academy of Neurology, Dr. Munsat serves on our Scientific Advisory Board. He is Director of the Neuromuscular Research Group, Department of Neurology, New England Medical Center in Boston. Dr. Munsat is a professor of neurology and pharmacology at Tufts University. He is a leading researcher in the field of neuromuscular diseases.

    Daniel P. Perez
    Founder and President of the FSH Society, Daniel Perez is currently an associate director in the software division of a market research company in Massachusetts. Mr. Perez's dedication to founding the FSH Society began when he met Dr. Stephen Jacobsen in 1989. With Daniel Perez's hard work in developing the by-laws of the Society and incorporating our organization as a nonprofit corporation and organizing the Board of Directors, the FSH Society has become a viable force for information and advocacy on FSHD.

    Paul Schultz, M.D.
    The Chairman of our Scientific Advisory Board, Dr. Schultz is the Director of the Muscle Disease Clinic of Children's Hospital, San Diego, CA. As clinical professor of neurosciences and pediatrics, Dr. Schultz has a strong interest in the clinical aspects of neuromuscular disease. Dr. Schultz has published research papers on FSHD with Dr. Jacobsen and Dr. Weiffenbach.

    R. Morgan Downey
    The general counsel to the FSH Society is R. Morgan Downey of Hoffheimer & Downey in Washington, D.C. Mr. Downey and his partner have been involved in advocacy work for neurological disorders for the past 17 years.


    Hoffheimer & Downey
    Hoffheimer & Downey, general counsel for the FSH Society, specializes in the provision of legal, legislative, consultative and management services to corporations, professional societies, voluntary health agencies, trade associations and universities involved in neuroscience, neurological disorders, communication sciences and disorders and neurocomputing and neurorehabilitation fields.
    Among the firm's clients are: The National Foundation for Brain Research, The International Neural Network Society, The National Coalition for Research in Neurological Disorders, The Academy for Neurologic Communication Disorders, and The National Association for Clinical NeuroServices (naCNS). The firm also represents a soon-to-be-announced university department of neuroscience and manages a university industry joint venture for technology transfer and drug development.
    Morgan Downey, partner in the firm, is a graduate of Georgetown University Law Center. His career includes working on the staff of a former member of the United States Senate, legislative advocacy for public interest organizations, and 11 years as director of governmental and legal affairs for the American Speech-Language-Hearing Association. He is a member of the Bar of the District of Columbia, the National Health Lawyers Association, the Computer Law Society and the American Bar Association, Section of Health Law and Section on Science and Technology.
    Lawrence S. Hoffheimer is a member of the bar of the District of Columbia and Virginia. He was a trial attorney in the Justice Department and has been in private practice since 1972. He has represented many health care clients including the Group Health Association and the National Multiple Sclerosis Society. Since 1977, he has been intensely involved in biomedical research and serves as the director of the National Coalition for Research on Neurological Disorders.

    FSH Groups Welcome New Members


    The New England FSHMD group and the Capitol FSHMD group are currently the only two groups in the United States offering the unique opportunity to meet others and share information and support on FSHMD issues. Regular meetings are held every two months covering topics specific to FSHMD. The groups are fortunate to have leading researchers and clinicians present the most current genetic and clinical information. A variety of other experts have addressed nutrition, exercise and coping strategies as they relate to FSHMD.
    Since 1989, Carol Perez has facilitated the New England group and Karen Johnsen has led the Capitol group which includes Maryland, Virginia, Washington D.C., Delaware and Pennsylvania. New members are always welcome to join the group and participate in these informational meetings.
    We are pleased to announce the opening of a third group in the Philadelphia area in June, 1994. This group will cover Pennsylvania, Delaware, southern New Jersey and is open to anyone who wishes to attend from any area. If you have any questions about the groups, please feel free to contact the following: Carol A. Perez, 3 Westwood Road, Lexington, MA 02420, (617) 860-0501 or Karen Johnsen, 12203 Foxhill Lane, Bowie, MD 20715, (301) 262-0701.

    History of the FSH Society


    The history of the FSH Society can be traced to the ongoing interests of Daniel Perez and Stephen Jacobsen to contribute to the progress of research in this disease. The two met in 1988 during Dr. Jacobsen's work in establishing a national FSHD cell bank. There was a mutual interest in establishing a national information network and educating affected individuals, and creating a mechanism that could enhance awareness of governmental and private sectors to meet the needs of the research and clinical communities.
    Dr. Jacobsen contacted affected individuals and families that were part of his studies and provided an opportunity for them to contact Daniel Perez and be part of an organization dedicated specifically for FSHD issues. A large number of individuals expressed interest and, subsequently, research updates were provided. Several FSHD support groups were established on the east and west coasts. Mr. Perez began work on creation of a tax-exempt charitable corporation. Through the firm of Hoffheimer and Downey in Washington, D.C., the corporation was established in June of 1991 and tax-exempt status was subsequently obtained.
    In July of 1992, a group of family members, physicians and businessmen met in San Diego to establish initial working priorities for the Society. Under the counsel of Mr. Downey, the Society embarked on the task of establishing a Board of Directors, soliciting donations and establishing an account. By late summer of 1993, these goals were accomplished through generous donations of time and money from many individuals of affected families and their friends.
    From its inception, the Society desired to work with other organizations in a positive fashion. Consequently, in October and November of 1993, the Society established contact and liaisons with medical and charitable organizations, basic research and clinical groups involved in the study of the disease, and similar FSHD support groups in Europe.
    --Stephen J. Jacobsen, Ph.D.

    East Coast Office Update


    It is with great pleasure that I introduce myself and the east coast office in this first edition of the FSH Watch. As one of the founders of the FSH Society, I am impressed by your overwhelming and positive response to our organization which is dedicated to the education and empowerment of those concerned with FSHD.
    As a volunteer, I administer the business office and east coast information, referral and resource center. Having more than twenty years experience in the area of human service administration and provision of rehabilitation services, I strongly support advocacy and networking to help individuals manage their way to maximizing their quality of life and health. Working together with the medical community and service providers, individuals and family members can make informed decisions and be proactive.
    I thoroughly enjoy meeting you by phone and mail and working jointly to accomplish our goals. After many years devoted to helping others, I look with satisfaction to using my experience to help ourselves know, to the fullest extent possible, the nature of our disorder and ensuring that information is made available to all.
    I welcome your calls and letters and look forward to an active and productive year.
    --Carol A. Perez, M.Ed., C.R.C

    West Coast Office Update


    The west coast office is available for your calls or correspondence concerning questions and needs regarding FSH. Please feel free to call anytime. I have a lifetime of experience with FSHD, many years of research regarding the disease and can help you with your questions or direct you to those who may be able to do so. Welcome to the FSH Society!
    --Stephen J. Jacobsen, Ph. D.