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西班牙常染色体显性遗传性小脑共济失调:分子与临床相关性、患病率估计及生存分析

Autosomal dominant cerebellar ataxias in Spain: molecular and clinical correlations, prevalence estimation and survival analysis.

作者信息

Infante J, Combarros O, Volpini V, Corral J, Llorca J, Berciano J

机构信息

Neurology Service, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.

出版信息

Acta Neurol Scand. 2005 Jun;111(6):391-9. doi: 10.1111/j.1600-0404.2005.00400.x.

Abstract

INTRODUCTION

The genetic and clinical profile of autosomal dominant cerebellar ataxias (ADCA) displays marked geographical and ethnical variability.

MATERIALS AND METHODS

We have analysed the molecular and clinical correlations in an ethnically homogeneous sample of 30 Spanish ADCA kindreds. Minimal point prevalence for the region of Cantabria was estimated.

RESULTS

Seventy per cent of the families harboured known mutations. Areflexia, slow saccades and hypopallesthesia predominated in SCA2; nystagmus, pyramidal signs or areflexia restricted to the legs in SCA 3; and retinal degeneration, pyramidal signs and slow saccades in SCA 7. Anticipation and intergenerational instability were greater in SCA 7. Length of expansions and age at onset were inversely correlated in all SCA subtypes. Larger expansions correlated with areflexia in SCA 2, with pyramidal signs in SCA 3 and with early visual impairment in SCA 7. Survival was similar among the different SCA subtypes. Prevalence of ADCA in Cantabria was 1.6 cases per 100,000 population.

CONCLUSIONS

This report shows the epidemiological, clinical and genetic profile of ADCA in Spain, providing additional data regarding the broad clinical heterogeneity of these disorders and the variability of the genotype-phenotype correlations.

摘要

引言

常染色体显性遗传性小脑共济失调(ADCA)的遗传和临床特征呈现出显著的地理和种族差异。

材料与方法

我们分析了30个西班牙ADCA家族的种族同质样本中的分子与临床相关性。估算了坎塔布里亚地区的最小点患病率。

结果

70%的家族携带已知突变。无反射、扫视缓慢和轻触觉减退在SCA2中占主导;眼球震颤、锥体束征或仅累及下肢的无反射在SCA3中出现;视网膜变性、锥体束征和扫视缓慢在SCA7中出现。SCA7中的遗传早现和代际不稳定性更为明显。在所有SCA亚型中,扩增长度与发病年龄呈负相关。较大的扩增与SCA2中的无反射、SCA3中的锥体束征以及SCA7中的早期视力损害相关。不同SCA亚型的生存率相似。坎塔布里亚地区ADCA的患病率为每10万人中有1.6例。

结论

本报告展示了西班牙ADCA的流行病学、临床和遗传特征,提供了有关这些疾病广泛临床异质性以及基因型-表型相关性变异性的更多数据。

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