Aspects of the disclosure relate to methods of reducing fatigue in a subject having
myotonic dystrophy type 1 (DM1). Aspects of the disclosure relate to methods of treating one or more symptoms assessable by the MDHI (e.g., a GI symptom,
myotonia, upper extremity function impairment, fatigue, mobility impairment, impairment in the ability to perform activities, pain, vision impairment, communication impairment, sleep impairment, emotional issues,
cognitive impairment, social satisfaction impairment, social performance impairment,
breathing impairment,
swallowing impairment, and / or hearing impairment) in a subject having
myotonic dystrophy type 1 (DM1). In some embodiments, the methods comprise administering to the subject a composition comprising complexes (e.g.,
muscle targeting complexes) comprising an
oligonucleotide (e.g., a DMPK- targeting
oligonucleotide) covalently linked to an
antibody (e.g., anti-TfRl
antibody).