Winawer M R, Marini C, Grinton B E, Rabinowitz D, Berkovic S F, Scheffer I E, Ottman R
G.H. Sergievsky Center, Columbia University, New York, NY 10032, USA.
Neurology. 2005 Aug 23;65(4):523-8. doi: 10.1212/01.wnl.0000172920.34994.63.
To examine the genetic relationships among epilepsies with different seizure types--myoclonic, absence, and generalized tonic-clonic--within the idiopathic generalized epilepsies (IGEs).
Careful phenotype definition in the epilepsies may allow division into groups that share susceptibility genes. Examination of seizure type, a phenotypic characteristic less complex than IGE syndrome, may help to define more homogeneous subgroups.
Using the approach that found evidence of distinct genetic effects on myoclonic vs absence seizures in families from the Epilepsy Family Study of Columbia University, the authors examined an independent sample of families from Australia and Israel. They also examined the familial clustering of generalized tonic-clonic seizures (GTCs) within the IGEs in two combined data sets. Families were defined as concordant if all affected members had the same type of seizure or IGE syndrome, as appropriate for the analysis performed.
The proportion of families concordant for myoclonic vs absence seizures was greater than expected by chance in the Australian families. In addition, GTCs clustered in families with IGEs to a degree greater than expected by chance.
These results provide additional evidence for distinct genetic effects on myoclonic vs absence seizures in an independent set of families and suggest that there is a genetic influence on the occurrence of generalized tonic-clonic seizures within the idiopathic generalized epilepsies.
研究特发性全身性癫痫(IGEs)中不同发作类型(肌阵挛性、失神性和全身性强直-阵挛性)癫痫之间的遗传关系。
对癫痫进行仔细的表型定义可能有助于将其分为共享易感基因的组。研究发作类型这一比IGE综合征更简单的表型特征,可能有助于定义更同质的亚组。
采用在哥伦比亚大学癫痫家系研究中发现的对肌阵挛性发作与失神性发作有不同遗传效应证据的方法,作者对来自澳大利亚和以色列的独立家系样本进行了研究。他们还在两个合并数据集中研究了IGEs中全身性强直-阵挛性发作(GTCs)的家族聚集性。如果所有受影响成员具有相同类型的发作或IGE综合征(视所进行的分析而定),则将家系定义为一致。
在澳大利亚家系中,肌阵挛性发作与失神性发作一致的家系比例高于偶然预期。此外,GTCs在IGEs家系中的聚集程度高于偶然预期。
这些结果为在另一组独立家系中肌阵挛性发作与失神性发作存在不同遗传效应提供了额外证据,并表明在特发性全身性癫痫中全身性强直-阵挛性发作的发生存在遗传影响。