Below is an instruction from Human. Write a response.
    ### Instruction:
    What are the genetic changes related to tibial muscular dystrophy ?
    ### Response:
    Mutations in the TTN gene cause tibial muscular dystrophy. This gene provides instructions for making a protein called titin. Titin plays an important role in muscles the body uses for movement (skeletal muscles) and in heart (cardiac) muscle.  Within muscle cells, titin is an essential component of structures called sarcomeres.
    