The ability of new therapeutic options to reverse or lessen the degree of central nervous system dysfunctions should be a focus of future investigations.
Myotonic dystrophy type 1 is the most common form of muscular dystrophy

in adults with estimated prevalence of 1 to 35 patients on 100 000 inhabitants (1). It is an autosomal dominant disorder caused by expansion of Inhibitors,research,lifescience,medical unstable trinucleotide CTG repeats in DMPK gene on the long arm of the chromosome 19 (2). This mutation is responsible for premature aging of many organs and systems in DM1 (2). Endocrine disorders are common in DM1 (3). Hypogonadism is also described with affection of both interstitial and tubular gonadic function (4). Erectile dysfunction (ED) is defined as a persistent or recurrent inability to achieve and maintain a penile erection adequate for satisfactory sexual activity (5). It is reported that Inhibitors,research,lifescience,medical ED can be found among DM1 patients (6, 7), but there are not enough data about frequency and causes of this disorder. Also, effects of ED on personal and social life, as well as on quality of life (QoL) in DM1 men is still unclear. Aim of this study was to assess frequency of erectile dysfunction (ED) and hypogonadism, the correlation between them and the impact of ED on health-related QoL in patients with DM1. Material and methods The study Inhibitors,research,lifescience,medical included 25 men aged from 22 to 58

years which were consecutively recruited from the Inpatient and Outpatient Unit of Neurology Clinic, Clinical Center of Serbia, from October 1st 2011 until February 15th 2012. Genetic diagnosis of CTG repeat expansion was obtained for patients in addition to typical clinical and electromyographic data. Patients with congenital form of the disease, those with diabetes mellitus and with any other Inhibitors,research,lifescience,medical associated severe disease not related to DM1 were excluded from the study. Presence of depression was excluded by Hamilton depression scale applied by a trained physician. All patients gave informed consent to participate in the study and the study was approved by the Ethical Board of the Neurology Clinic. Severity of muscular involvement was assessed using the Muscular Impairment Rating Scale

Astemizole (MIRS) (8). The Inhibitors,research,lifescience,medical MIRS is an ordinal five-point rating scale, established in accordance with the clinically recognized distal to proximal progression of muscular involvement in DM1, and based partly on manual muscle testing of 11 muscle groups (8). Erectile function was assessed using the International Index of Erectile Function test (IIEF) (9). IIEF is multidimensional instrument for the evaluation of male sexual function that has been adopted as the gold standard measure and has been recomended as a primary endpoint for clinical trials of ED, as well as for the diagnostic evaluation of its severity (10). For purposes of this study, we used shorter Proteasome activity version of the questionary (IIEF-5), which was valideted and rated as simple method for evaluation of ED (11). The possible scores for IIEF-5 range from 5 to 25.