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CompletedNCT07331025FACIAL-FSHDUpdated Jan 9, 2026

Ultrasound Detection of Early Facial Muscle Changes in FSHD: Thickness and Echo Intensity Findings

An observational study in Facioscapulohumeral Muscular Dystrophy, Facioscapulohumeral Muscular Dystrophy 1 and Neuromuscular Disease, sponsored by Koç University. Completed at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 55 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-01-09.

Sponsored by Koç University · Observational

Study type
Observational
Model
Other
Time perspective
Prospective
Enrollment
39
Ages
18 Years to 55 Years
Sex
All
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Study summary

Facioscapulohumeral muscular dystrophy (FSHD) is characterized by early and significant involvement of facial muscles; however, objective imaging data focusing on facial muscles are limited. Facial ultrasound can serve as a sensitive imaging biomarker and outcome measure by capturing regional structural changes in facial muscles associated with disease progression in FSHD patients.

The aim of this study is to compare facial muscle thickness and echo density between FSHD patients and healthy controls using ultrasound and to examine the relationships between ultrasound findings and clinical parameters.

This study will include 20 patients with genetically confirmed FSHD1 diagnosis and 19 age- and sex-matched healthy controls. Using musculoskeletal ultrasound, bilateral evaluation of selected facial muscles (Orbicularis oculi, orbicularis oris, zygomaticus major, and buccinator) will be performed by two different researchers, and muscle thickness and muscle echo density will be recorded. Inter-rater reliability will be assessed using intraclass correlation coefficients. Group comparisons and correlation analyses will be performed with clinical scores, symptom duration, and D4Z4 repeat size.

The results will evaluate whether ultrasound can reliably detect structural changes in FSHD that cannot be captured by traditional clinical assessments, and if significant, will suggest that ultrasound can serve as a sensitive imaging biomarker for early and region-specific facial muscle involvement in FSHD.

Read the detailed description

Facioscapulohumeral muscular dystrophy (FSHD) is a hereditary neuromuscular disorder characterized by progressive muscle weakness, showing early and significant involvement of facial muscles. Despite their diagnostic and functional importance, facial muscles are often underrepresented in imaging-based assessments of disease involvement. This observational, cross-sectional study was designed to compare structural changes in selected facial muscles of individuals with genetically confirmed FSHD with healthy controls using musculoskeletal ultrasound. The study focuses on the quantitative assessment of muscle thickness and the qualitative assessment of muscle echo density as indicators of atrophy and fat infiltration. Bilateral ultrasound examinations will be performed on facial muscles, including the orbicularis oculi, orbicularis oris, zygomaticus major, and buccinator muscles, which play a role in facial expression and oral function. Imaging findings will be evaluated in relation to clinical features to investigate whether facial muscle ultrasound can provide region-specific information not captured by global disease severity scores. This study aims to characterize facial muscle involvement using a non-invasive and accessible imaging method, contribute to the understanding of early and subclinical facial muscle changes in FSHD, and support the potential role of ultrasound as an imaging biomarker in neuromuscular disorders.

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Conditions studied

  • Facioscapulohumeral Muscular Dystrophy
  • Facioscapulohumeral Muscular Dystrophy 1
  • Neuromuscular Disease

Keywords

  • facioscapulohumeral muscular dystrophy
  • facial muscles
  • muscle ultrasound
  • muscle echogenicity
  • muscle thickness
  • imaging biomarker
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In context

Muscular Dystrophy, Facioscapulohumeral

74 studies on the registry are indexed under Muscular Dystrophy, Facioscapulohumeral; 25 are open to participants now.

This study's enrollment of 39 is below the median of 80 across 29 observational studies indexed under Muscular Dystrophy, Facioscapulohumeral.

Browse Muscular Dystrophy, Facioscapulohumeral studies →

Lead sponsor

Koç University is the lead sponsor of 106 studies on the registry; 36 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

The study population consisted of adults with genetically confirmed facioscapulohumeral muscular dystrophy type 1 and age- and sex-matched healthy volunteers. Participants were recruited from a tertiary neuromuscular disease center and underwent a single-session bilateral facial muscle ultrasound assessment.

Inclusion criteria

  • Adults aged 18-55 years
  • Genetically confirmed facioscapulohumeral muscular dystrophy type 1 (FSHD1) (patient group)
  • Age- and sex-matched healthy volunteers without neuromuscular disease (control group)
  • Ability to provide written informed consent

Exclusion criteria

Exclusion Criteria:

  • Presence of other neurological or neuromuscular disorders
  • History of facial palsy or facial trauma
  • Botulinum toxin injection to facial muscles within the last 6 months
  • Inability to cooperate with ultrasound assessment
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Study design

Observational model
Other
Time perspective
Prospective
Enrollment
39 participants (actual)
Patient registry
No

Groups and cohorts

  • FSHD patients

    Individuals with genetically confirmed facioscapulohumeral muscular dystrophy type 1 who underwent bilateral facial muscle ultrasound assessment. No intervention was applied.

  • Healthy Controls

    Age- and sex-matched healthy volunteers without neuromuscular disease.

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What researchers measure

Primary outcomes

  1. Facial muscle thickness measured by ultrasound

    Bilateral thickness (in millimeters) of the orbicularis oculi, orbicularis oris (superficial and deep layers), zygomaticus major, and buccinator muscles measured using B-mode musculoskeletal ultrasound at standardized anatomical reference points.

    Time frame: Baseline

  2. Facial muscle echo intensity

    Muscle echogenicity of the same facial muscles assessed bilaterally using the Modified Heckmatt Scale (grades 1-4) to evaluate structural changes and fatty infiltration on B-mode ultrasound images.

    Time frame: Baseline

Secondary outcomes

  1. Inter-rater reliability of facial muscle ultrasound measurements

    Agreement between independent raters assessed using intraclass correlation coefficients for facial muscle thickness and echo intensity measurements.

    Time frame: Baseline

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Study locations

1 site
  • Koç University Hospital
    Istanbul, Istanbul 34010, Turkey (Türkiye)
08

References and documents

Individual participant data

Plan to share: No — Individual participant data will not be shared due to the small sample size, the rare disease nature of the study population, and the potential risk of participant re-identification. In addition, specific informed consent for public data sharing was not obtained.

No publications or documents are linked to this record.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 9, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07331025
Lead sponsor
Koç University
Responsible party
Havvanur Albayrak (Physical Medicine and Rehabilitation Specialist, Koç University) — Principal investigator
First posted
Jan 9, 2026
Start date
Sep 1, 2023
Primary completion
Dec 20, 2023
Completion
Feb 15, 2024
Last update
Jan 9, 2026

Study contacts

Havvanur Albayrak
principal investigator · Koç University School of Medicine

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.

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