Extended Observation Period Research Articles

Two- Versus Four-Narrow-Implant-Retained Dentures With Immediate-Loaded Anterior Implants: 9 Years Randomized Clinical Trial.

In many clinical cases, anatomical conditions such as an atrophied alveolar ridge do not allow insertion of normal diameter implants. At this point, narrow dental implants may provide an effective option to avoid complex surgical treatments. The aim of this trial was to evaluate long-term survival, prosthetic and biological complications, and OHRQoL for two-piece narrow dental implants supporting overdentures with Locator-attachments. Twenty-five patients with edentulous mandibles received four narrow dental implants and retained dentures with Locator attachments. Following successful implantation, immediate loading of anterior implants with Locator attachments was performed, while posterior implants underwent a conventional healing procedure. Follow-up examinations included documentation of implant and denture-related complications, modified gingiva index, modified plaque index, OHIP-G, and radiographic measurements of bone loss. Up to 9 years after restoration, 18 patients with 72 implants were available for the follow-up. During the observation period, one implant was lost in the immediate loading group. Implant survival was 98% and 100%. The outcomes of mPI and mGI for the 18 patients hardly differed between the groups. During the observation period, 136 prosthetic complications occurred. Scores for the different OHIP-G domains at the last follow-ups were stable over the years. Throughout an extended period of observation, we found stable implant survival rates, good maintenance of oral hygiene, and manageable prosthetic complications. The OHRQoL was satisfying over the years, suggesting that this treatment option could be favorable for older individuals. https://drks.de/search/en/trial/DRKS00005497.

Enhancing psychological health and cognitive inhibition in college students: insights from mindfulness training and high-intensity interval training

BackgroundThis study aimed to examine the effects of mindfulness training (MT) and high-intensity interval training (HIIT) on enhancing psychological health and cognitive inhibition in college students.MethodsA total of 132 undergraduates were recruited and randomly assigned to three groups: MT group, HIIT group, and control group. Both the MT and HIIT groups received training twice a week for 6 weeks, with each session lasting 1 h. The control group did not undergo MT or HIIT training during the experimental period. The Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Stop Signal tasks, and Flanker tasks were assessed at baseline, at 6 weeks (post-test), and 6 weeks after the end of the intervention (follow-up).ResultsBoth MT and HIIT were effective in alleviating depression and anxiety in college students, with MT showing a significant improvement in psychological health after intervention. Both MT and HIIT effectively improved the response inhibition accuracy of college students, with similar effects. However, neither MT nor HIIT affected the response inhibition reaction time. MT was more effective than HIIT in improving interference inhibition accuracy, but neither MT nor HIIT had an effect on the interference inhibition reaction time.ConclusionWithin-group analyses demonstrated significant pre-post reductions in depression and anxiety scores following both MT and HIIT interventions. While between-group comparisons suggested a trend toward greater symptom improvement in the MT group at post-test, the differences did not reach statistical significance at follow-up, possibly due to the limited sample size and intervention duration. These preliminary findings warrant replication in larger-scale trials with extended observation periods.

Histomorphometric and microtomographic evaluation of hydroxyapatite coated implants and L-PRF in over drilled bone sites in sheep

Hydroxyapatite used as a coating for titanium dental implants reduces the time required for osseointegration. Platelet-rich fibrin (L-PRF) releases growth factors and cytokines, enhancing tissue healing and bone regeneration. This study aimed to evaluate histologically, histomorphometrically, and by microcomputed tomography an implant surface coated with nanostructured hydroxyapatite (HAnano), in comparison with a double acid-etched (DAA) surface, both with and without peri-implant grafting with L-PRF, installed in over-instrumented sites in a low-density bone. Five adult sheep (2–4 years old) received twenty 3.5 × 10 mm implants in the iliac crest. Bone-to-implant contact (BIC) and bone-occupied area fraction (BAFo) were evaluated histomorphometrically after an 8-week experimental period. Brown-Forsyth analysis of variance (ANOVA) and Welch’s ANOVA test did not identify significant differences between the experimental groups. On average, BIC ranged from 44% (HAnano + L-PRF) to 63% (DAA + L-PRF). µCT analysis revealed that bone volume density in the peri-implant region ranged from 26% (HAnano + L-PRF) to 39% (DAA). No statistically significant differences were observed between the groups. Both implant surfaces studied allowed osseointegration in low bone density sites, independently of peri-implant grafting with L-PRF, after 8 weeks of implantation. While this model provided controlled conditions for evaluating early-stage osseointegration, the absence of functional loading and the relatively short follow-up period should be considered when extrapolating the findings to clinical applications. Future studies should assess these variables under load-bearing conditions with extended observation periods. All the sheep in this study remained alive.

Effect of Huatuo Zaizao Pill on Neurological Function and Limb Motor Recovery in Ischemic Stroke Patients During Convalescence: An Open-Labelled, Randomized Controlled Trial.

To evaluate the effects of Chinese patent medicine Huatuo Zaizao Pill (HTZZ) on neurological function and limb motor in ischemic stroke (IS) patients during convalescence. This is a prospective, open-labelled, randomized controlled trial. Patients with IS were recruited from the Neurology Department of Xiyuan Hospital of China Academy of Chinese Medical Sciences from May 2021 to June 2023. Eligible participants were randomly assigned to the HTZZ (40 cases) or control group (40 cases) at a ratio of 1:1. The HTZZ group was treated with oral HTZZ (8 g, thrice daily) combined with conventional treatment, while the control group received only conventional treatment. The treatment duration was 12 weeks. The primary outcome was the change in Modified Ashworth Scale (MAS) score from baseline to week 6 and 12. Secondary outcomes included changes in scores of National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FM), and Barthel Index (BI) from baseline to week 6 and 12, as well as lipid indices after 12 weeks. All adverse events (AEs) were recorded and liver and kidney indices were evaluated. A total of 72 patients completed the study (38 in the HTZZ group and 34 in the control group). Compared with the control group, the HTZZ group demonstrated significant improvements in MAS, NIHSS, FM, and BI scores following 6 and 12 weeks of treatment in both intent-to-treat and per-protocol analyses (all P<0.05). No significant differences were noted between groups in lipid indices, AEs, and liver and kidney dysfunction after 12 weeks (P>0.05). HTZZ alleviated spasticity and enhanced neurological function and prognosis of IS patients during convalescence. However, further evaluation of HTZZ's effect on IS outcomes is warranted in clinical trials with larger sample sizes and extended observation periods. (Trial registration No. NCT04910256).

A machine learning-based nomogram for predicting graft survival in allograft kidney transplant recipients: a 20-year follow-up study.

Kidney transplantation is the optimal form of renal replacement therapy, but the long-term survival rate of kidney graft has not improved significantly. Currently, no well-validated model exists for predicting long-term kidney graft survival over an extended observation period. Recipients undergoing allograft kidney transplantation at the Organ Transplantation Center of the First Affiliated Hospital of Kunming Medical University from 1 August 2003 to 31 July 2023 were selected as study subjects. A nomogram model was constructed based on least absolute selection and shrinkage operator (LASSO) regression, random survival forest, and Cox regression analysis. Model performance was assessed by the C-index, area under the curve of the time-dependent receiver operating characteristic curve, and calibration curve. Decision curve analysis (DCA) was utilized to estimate the net clinical benefit. The machine learning-based nomogram included cardiovascular disease in recipients, delayed graft function in recipients, serum phosphorus in recipients, age of donors, serum creatinine in donors, and donation after cardiac death for kidney donation. It demonstrated excellent discrimination with a consistency index of 0.827. The calibration curves demonstrated that the model calibrated well. The DCA indicated a good clinical applicability of the model. This study constructed a nomogram for predicting the 20-year survival rate of kidney graft after allograft kidney transplantation using six factors, which may help clinicians assess kidney transplant recipients individually and intervene.

TWO-YEAR RESULTS OF SUBCUTANEOUS INFLIXIMAB (CT-P13 SC) DOSE ESCALATION THERAPY - FROM LIBERTY-CD AND LIBERTY-UC

Abstract INTRODUCTION Dose escalation (DE) of subcutaneous (SC) infliximab from 120 mg to 240 mg every 2 weeks (Q2W) showed restoring efficacy in the 54-week LIBERTY-CD and LIBERTY-UC studies, and safety profiles were generally comparable between patients with or without DE. Both two studies included an extension phase through Week (W) 102, and we present post-hoc long-term efficacy and safety results of DE in patients who treated in extension phase in two studies. AIMS &amp; METHODS Patients with moderately to severely active CD and UC were treated with 3 doses of infliximab IV 5 mg/kg as induction therapy (Weeks 0, 2 and 6). Clinical responders at W10 were randomized (2:1) to receive either CT-P13 SC 120 mg or placebo Q2W as maintenance therapy up to W54. Patients who would benefit from continued treatment entered open-label extension study from W56 to W102 by the opinion of the investigator received CT-P13 SC 120 mg regardless of previously assigned arm. From W22, the patients who met loss of response criteria were permitted to escalate the dose to CT-P13 SC 240 mg Q2W through W102 for both arms. The results from CT-P13 SC arm treated in extension phase are analyzed. RESULTS A total of 192 and 237 patients were analyzed in CD and UC study, each. Among them, DE from CT-P13 SC 120 mg to CT-P13 SC 240 mg prior to W102 was more common in UC than CD (30.0% [71/237] vs 21.9% [42/192]). Patients showed improvement in clinical remission at W102 (both CD and UC) or endoscopic response at W102 (CD) after DE. Also, patients showed improvement in other efficacy endpoints after DE (Table 1). Most patients with DE regained clinical remission and clinical response within 8 weeks after DE (Table 2). For UC, endpoints were defined by modified Mayo score in Table 1, partial Mayo score in Table 2, respectively. The incidence rate of treatment-emergent adverse events (TEAEs) and &amp;#x2028;treatment-emergent serious adverse events (TESAEs) in the pooled safety data (CD+UC) across maintenance and extension phase were comparable between patients with and without DE (85.2% [98/115] vs 78.8% [256/325] for TEAEs, 13.0% [15/115] vs 10.5% [34/325] for TESAEs). The incidence rate of TEAEs of infection for patients with and without DE was 45.2% [52/115] vs 43.4% [141/325]. The incidence rate of TEAEs of systemic injection reaction for patients with and without DE was 4.3% [5/115] vs 2.8% [9/325]. CONCLUSION DE of CT-P13 SC from 120 mg to 240 mg Q2W in patients who initially respond but subsequently lose response, shows improving clinical efficacy over an extended observation period of 102 weeks. Most patients with DE regained response promptly within 8 weeks after DE. Safety profiles were generally comparable between patients with or without DE, and no new safety concerns were found after DE as well in long term treatment.

Participant-Centered Engagement for Sustained Adherence to Smartwatches: A 12-Month Prospective Decentralized Digital Health Study.

Adherence in digital health studies with extended observation periods (≥ 12 months) is limited, and participant retention considerably reduces with time. The US Food and Drug Administration has issued guidelines for improving participant engagement, adherence, and diversity in digital health studies combined with decentralized procedures. A decentralized digital health study on well-being was designed with protocolized procedures to study the feasibility of participant engagement and technology support to facilitate adherence (wearing the smartwatch ≥ 70% of time) sustained over a 12-month period. At the end of the study, participants were asked about their ease of participation and free-response questions about how wearing the smartwatches impacted their physical wellness. An inductive thematic analysis (ITA) was performed to assess themes of those responses and association with adherence. A total of 298 participants were recruited between 2022 and 2023 (n = 129 in Cohort A in October 22, n = 169 in Cohort B in April 23), with 23% non-white participants accrued. Among the 298 participants accrued, 273 (92% of accrued participants) completed the 12-month study with an average overall adherence of 77.4% (SD = 32.64) wear-time across 12 months. Median adherence of participants whose responses exemplified an ITA theme encompassing perceived behavior changes in sleep and physical activity was higher than those who did not have a response exemplifying that theme. Conversely, those expressing perceived discomfort or intrusiveness of the smartwatch had a statistically lower adherence. These results highlight the crucial roles of technology support and robust engagement efforts to enable sustained adherence over extended follow-up periods in decentralized digital health studies.

Exploring the impact of xenobiotic drugs on forensic entomology for accurate post-mortem interval estimation.

Forensic entomotoxicology is an emerging field within forensic entomology that investigates the effects of chemicals, drugs, and toxins on insect development and their implications for postmortem interval (PMI) estimation. This systematic overview delves into the influence of drugs such as Morphine, heroin, Opiates, and cocaine on the variables affecting the use of forensically significant insects as evidence tools. Notably, it has been observed that the presence of drugs does not appear to alter the progression of the lifecycle from the first instar to the emergence of flies, indicating that PMI estimations based on fly emergence remain unaffected by drugs. However, larvae treated with drugs frequently show delayed pupation, suggesting the need for further research into the impact of different compounds on various insect species over more extended observation periods. Additionally, conflicting results have been noted regarding how toxins can influence the developmental process in larvae, underscoring the necessity to assess the effect of different classes of compounds on other insect species. The study also recommends exploring factors such as the samples' collection site and the drugs' pathological implications to inspire future research. Furthermore, the paper underscores the potential for varying drug effects across insect species, emphasizing the complexity of interpreting drug impacts on PMI estimations. This systematic review was conducted by the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.

Positive impact of cladribine tablets on reducing brain atrophy in patients with relapsing-remitting multiple sclerosis: A longitudinal study.

Measuring brain volume changes over time is an objective and dependable surrogate marker for the pathological processes that damage the brain in relapsing-remitting multiple sclerosis (RRMS). These measures are particularly valuable for monitoring the long-term impact of immunomodulatory treatments such as cladribine. To evaluate the long-term impact of oral cladribine treatment on brain volume loss in patients with RRMS. This real-world study processed magnetic resonance imaging (MRI) scans using FreeSurfer's recon-all-clinical pipeline leveraging SynthSeg for brain segmentation. Piecewise linear regression was used to analyze brain atrophy changes over 4.5 years before and after cladribine treatment and estimate the time breakpoint of atrophy rate change. A total of 448 MRI exams from 102 RRMS patients were analyzed. Before the initiation of cladribine treatment, brain atrophy rates were significantly steep with an α1 slope between -1.27 and -0.62 for the Thalamus, DGM, Subcortical GM, Cerebral WM, and BP. Over 2 years after treatment, breakpoints marked a shift in atrophy rates, with post-breakpoint slopes (α2) becoming non-significant, reflecting stabilization of brain atrophy. Cladribine treatment in highly active RRMS patients protects the brain from atrophy, with stabilization occurring over 2 years after initiation. The extended observation period highlights its sustained benefits compared with shorter clinical trials.

Incidence of rheumatoid arthritis in Austria: a prospective population-based cohort study in a federal province

ObjectiveWhen it comes to prospective studies on the incidence of rheumatoid arthritis (RA), the Norfolk study from 1994 is still frequently cited as prospective incidence data by many countries lacking...

Precise Orbit Determination of Mars-crossing Asteroids

This study investigates the orbit determination of the Mars-crossing asteroids (MCAs) with a focus on the possibility of detecting their Yarkovsky signals. We analyze the influences of force model uncertainties on MCA orbits, including the uncertainty of the main asteroid belt, and the uncertainty of the major planets’ ephemeris. The main asteroid belt is modeled using 343 asteroids and a ring structure. The Yarkovsky effect’s quadratic nature allows it to dominate over extended observation periods. To address dynamical errors and potential interactions with the main asteroid belt, we employ not only a traditional seven-dimensional differential corrector but also a nine-dimensional differential corrector that considers radial, vertical, and transversal forces. Comparison shows that the latter approach enhances the fit to observational data. However, the reliability of the Yarkovsky parameter is not enhanced because the estimation of the radial component is physically unacceptable. Despite incorporating precise Gaia data, our analysis does not conclusively detect a Yarkovsky effect on MCAs due to uncertainties in the force model. Nevertheless, our research advances our understanding of MCA dynamics, identifying five potential candidates whose Yarkovsky effect may be observable.

Acupuncture Combined with Periocular Injection for Treatment of Hydroxychloroquine Retinopathy with Cystoid Macular Edema: A Case Report.

For HCQ retinopathy with CME, acupuncture combined with periocular injection can be used to improve the CME and protect the central vision. Subsequent research endeavors involving a more extensive cohort and extended observation periods are warranted to evaluate the effectiveness and safety profile of the intervention.

ESG Scores and Its Impact on Firm Performance: Study from Nifty100 Firms

The study examines how environmental, social and governance (ESG) scores impact the operational, financial and market performance of firms indexed in the Nifty 100 index for short and long observation periods. Return on assets (ROA), return on equity (ROE) and Tobin’s Q are employed as proxies to evaluate the firms’ performance. The longitudinal research design draws upon secondary data from Bloomberg for ESG scores and Prowess for Interactive Querying for performance indicators. It employs panel regression analysis, and the results indicate a significant difference in the short and long observation periods. ESG adversely affects firms’ operational and financial performance over an extended observation period and has insignificant effects over a short observation period. Conversely, it reports a statistically significant positive impact on market performance in short and long observation periods. It concludes by recognizing its limitations, discussing policy implications and sketching a roadmap for future research. JEL Classification: Q51, Q56

WMH Contributions to Cognitive Impairment: Rationale and Design of the Diverse VCID Study.

As awareness of dementia increases, more individuals with minor cognitive complaints are requesting clinical assessment. Neuroimaging studies frequently identify incidental white matter hyperintensities, raising patient concerns about their brain health and future risk for dementia. Moreover, current US demographics indicate that ≈50% of these individuals will be from diverse backgrounds by 2060. Racial and ethnic minority populations bear a disproportionate burden of vascular risk factors magnifying dementia risk. Despite established associations between white matter hyperintensities and cognitive impairment, including dementia, no study has comprehensively and prospectively examined the impact of individual and combined magnetic resonance imaging measures of white matter injury, their risk factors, and comorbidities on cognitive performance among a diverse, nondemented, stroke-free population with cognitive complaints over an extended period of observation. The Diverse VCID (Diverse Vascular Cognitive Impairment and Dementia) study is designed to fill this knowledge gap through 3 assessments of clinical, behavioral, and risk factors; neurocognitive and magnetic resonance imaging measures; fluid biomarkers of Alzheimer disease, vascular inflammation, angiogenesis, and endothelial dysfunction; and measures of genetic risk collected prospectively over a minimum of 3 years in a cohort of 2250 individuals evenly distributed among Americans of Black/African, Latino/Hispanic, and non-Hispanic White backgrounds. The goal of this study is to investigate the basic mechanisms of small vessel cerebrovascular injury, emphasizing clinically relevant assessment tools and developing a risk score that will accurately identify at-risk individuals for possible treatment or clinical therapeutic trials, particularly individuals of diverse backgrounds where vascular risk factors and disease are more prevalent.

Fertilization with Olive Mill Pomace Compost Can Moderate Pest Damage in a Superintensive Olive Grove

Olive cultivation is a key agricultural activity in Spain, primarily for producing oil. The extraction process of olive oil from the drupe yields a by-product known as ‘alperujo’, which can be composted and utilized as fertilizer. This research examines the impact of composted ‘alperujo’ on arthropod assemblages in the tree canopy, comparing it to mineral fertilization over the years 2021 and 2022. The study was conducted in two olive groves with different management systems (superintensive and traditional). Two types of sampling methods were used for the canopy: visual survey and sweep net. Under superintensive management, the presence and damage of Eriophyidae (Acari; Trombidiformes) in the shoots was significantly lower in the compost treatment in 2022 (20% of the shoots were occupied/damaged) compared to the mineral treatment (60% of the shoots were occupied/damaged). Araneae abundance was significantly higher (p = 0.033) in the compost treatment compared to the mineral treatment. However, under traditional management, no clear effect on arthropod assemblage was observed. In conclusion, the addition of compost to the superintensive grove helped to limit the presence of some arthropod pests compared to mineral treatment, contributing to a more sustainable crop. Grove type management appeared to play a significant role in the arthropod assemblages and effect of compost addition, but future research utilizing a greater number of groves (replicates) and an extended observation period should be performed to confirm these results.

Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19

Few studies have investigated the association between COVID-19 and autoimmune and autoinflammatory connective tissue disorders; however, research with long-term observation remains insufficient. To investigate the long-term risk of autoimmune and autoinflammatory diseases after COVID-19 over an extended observation period. This retrospective nationwide population-based study investigated the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service (K-COV-N) cohort. Individuals with confirmed COVID-19 from October 8, 2020, to December 31, 2022, and controls identified among individuals who participated in the general health examination in 2018 were included in the analysis. Confirmed COVID-19. Incidence and risk of autoimmune and autoinflammatory connective tissue disorders in patients after COVID-19. Various covariates, such as demographic characteristics, general health data, socioeconomic status, and comorbidity profiles, were balanced using inverse probability weighting. A total of 6 912 427 participants (53.6% male; mean [SD] age, 53.39 [20.13] years) consisting of 3 145 388 with COVID-19 and 3 767 039 controls with an observational period of more than 180 days were included. Alopecia areata (adjusted hazard ratio [AHR], 1.11 [95% CI, 1.07-1.15]), alopecia totalis (AHR, 1.24 [95% CI, 1.09-1.42]), vitiligo (AHR, 1.11 [95% CI, 1.04-1.19]), Behçet disease (AHR, 1.45 [95% CI, 1.20-1.74]), Crohn disease (AHR, 1.35 [95% CI, 1.14-1.60]), ulcerative colitis (AHR, 1.15 [95% CI, 1.04-1.28]), rheumatoid arthritis (AHR, 1.09 [95% CI, 1.06-1.12]), systemic lupus erythematosus (AHR, 1.14 [95% CI, 1.01-1.28]), Sjögren syndrome (AHR, 1.13 [95% CI, 1.03-1.25]), ankylosing spondylitis (AHR, 1.11 [95% CI, 1.02-1.20]), and bullous pemphigoid (AHR, 1.62 [95% CI, 1.07-2.45]) were associated with higher risk in the COVID-19 group. Subgroup analyses revealed that demographic factors, including male and female sex, age younger than 40 years, and age 40 years and older, exhibited diverse associations with the risk of autoimmune and autoinflammatory outcomes. In addition, severe COVID-19 infection requiring intensive care unit admission, the Delta period, and not being vaccinated were associated with higher risk. This retrospective cohort study with an extended follow-up period found associations between COVID-19 and the long-term risk of various autoimmune and autoinflammatory connective tissue disorders. Long-term monitoring and care of patients is crucial after COVID-19, considering demographic factors, disease severity, and vaccination status, to mitigate these risks.

Temporal association between COVID-19 infection and subsequent new-onset dementia in older adults (aged 60 years and above): a systematic review and meta-analysis

Temporal association between COVID-19 infection and subsequent new-onset dementia in older adults (aged 60 years and above): a systematic review and meta-analysis

Human papillomavirus self-sampling and urine-sampling tests and the management and short-term outcomes of cervical intraepithelial neoplasia: A prospective observational study.

The importance of human papillomavirus (HPV) co-testing using physician-, self-, and urine-collected samples to predict cervical intraepithelial neoplasia (CIN) grade 1-2 prognoses has not been previously reported. Therefore, this study aimed to investigate outcomes of patients with CIN 1-2 who simultaneously underwent physician-, self-, and urine-collection sampling tests. This study was conducted in Japan between October 2019 and November 2022 and examined the proportion of cases with CIN 1-2 progressions, the percentage of cases with persistent CIN 1-2, and the outcome differences according to the results of physician-, self-, and urine-sampling tests. There were 105 and 59 CIN 1 and 2 cases, respectively, with progression or persistence in 27 (29.3%) and 21 (50.0%) cases, respectively. The median follow-up was 20 and 12 months, respectively. Progression and persistence of CIN 1 were significantly associated with HPV-positive physician- and self-collected samples. No significant difference was observed between cases with CIN 2 who had HPV-positive and HPV-negative results using any sampling method. Physician- and self-testing for HPV are crucial for predicting disease progression risk in CIN 1 cases. Future research with an extended observation period and consideration of the progression risks is warranted.

P19-54 Data from extended observation period to support evaluation of availability of the skin depot for absorption within in vitro dermal absorption studies

P19-54 Data from extended observation period to support evaluation of availability of the skin depot for absorption within in vitro dermal absorption studies

Nusinersen Improves Motor Function in Type 2 and 3 Spinal Muscular Atrophy Patients across Time.

Spinal muscular atrophy (SMA) is a genetic disorder primarily caused by mutations in the SMN1 gene, leading to motor neuron degeneration and muscle atrophy, affecting multiple organ systems. Nusinersen treatment targets gene expression and is expected to enhance the motor function of voluntary muscles in the limbs and trunk. Motor skills can be assessed through specific scales like the Revised Upper Limb Module Scale (RULM) and Hammersmith Functional Motor Scale Expanded (HFMSE). This study aims to evaluate the influence of nusinersen on the motor skills of patients with SMA Type 2 and 3 using real-world data collected over 54 months. A prospective longitudinal study was conducted on 37 SMA patients treated with nusinersen, analyzing data with R statistical software. The outcomes revealed significant improvements in motor functions, particularly in SMA Type 3 patients with higher RULM and HFSME scores. Additionally, GEE analysis identified time, type, age, and exon deletions as essential predictors of motor score improvements. The extended observation period is both a major strength and a limitation of this research, as the dropout rates could present challenges in interpretation. Variability in responses, influenced by genetic background, SMA type, and onset age, highlights the need for personalized treatment approaches.