Neurogenic Muscle Biopsy Findings Are Common in Mitochondrial Myopathy

Mitochondrial diseases (MIDs) involve peripheral nerves and skeletal muscle, but the prevalence of mitochondrial neuropathy is still unclear. Mitochondrial neuropathy has been found to correlate with muscle weakness that may be due to myopathic and/or neurogenic myopathy in patients with MIDs. We examined vastus lateralis muscle biopsies of 58 consecutive patients with mitochondrial myopathy (MM), compared with 204 consecutive non-MM patients. Muscle fiber denervation atrophy was found in 39/58 (67%) of MM patients, significantly more than 41/204 (20%) of non-MM patients and 20/58 (34%) of clinically diagnosed neuropathy. Fiber type grouping was noted in 15/58 (26%) of MM patients, significantly more than 15/204 (7%) of non-MM patients. Type 2 fiber predominance (T2FP) was identified in 7/58 (12%) of MM patients, significantly more than 1/204 (0.5%) of non-MM patients. After dividing patients into age groups, muscle fiber denervation atrophy was significantly more in MM patients aged >50 years than MM patients aged ≤50 years, without differences from all MM patients; there were no differences in fiber type grouping or T2FP between the 2 age groups. Finally, electron microscopy demonstrated MM ultrastructural changes in the neuromuscular junctions. Our findings suggest that a neurogenic component in MM is common.