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7例22q13缺失综合征患者的神经精神病理学:双相情感障碍的存在及技能的逐渐丧失。

Neuropsychopathology in 7 Patients with the 22q13 Deletion Syndrome: Presence of Bipolar Disorder and Progressive Loss of Skills.

作者信息

Denayer A, Van Esch H, de Ravel T, Frijns J-P, Van Buggenhout G, Vogels A, Devriendt K, Geutjens J, Thiry P, Swillen A

机构信息

Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium.

出版信息

Mol Syndromol. 2012 Jun;3(1):14-20. doi: 10.1159/000339119. Epub 2012 May 16.

Abstract

The 22q13 deletion syndrome is characterised by intellectual disability (ID), delayed or absent speech, autistic-like behaviour and minor, nonspecific dysmorphic features. The deletion of the SHANK3 gene is thought to be responsible for these features. In this study, the clinical data of 7 patients with the 22q13 deletion syndrome are presented, obtained by clinical genetic examination, direct behavioural observation and by interview of family members and/or caregivers, complemented by behavioural questionnaires. The specific focus was on behaviour, psychopathology and the level of functioning during life course in order to determine common features that might contribute to the delineation of the syndrome. Major findings were a high incidence of psychiatric disorders, more in particular bipolar disorder (BPD) and attention deficit hyperactivity disorder (ADHD), and a sudden deterioration after acute events, in addition to a progressive loss of skills over years. Therefore, a deletion of SHANK3 may result in a dysfunctional nervous system, more susceptible to developmental problems and psychiatric disorders on the one hand, less able to recuperate after psychiatric and somatic events, and more vulnerable to degeneration at long term on the other hand. These results are exploratory and need to be confirmed in a larger sample.

摘要

22q13缺失综合征的特征包括智力残疾(ID)、言语发育迟缓或缺失、自闭症样行为以及轻微的非特异性畸形特征。SHANK3基因的缺失被认为是导致这些特征的原因。在本研究中,呈现了7例22q13缺失综合征患者的临床数据,这些数据通过临床基因检测、直接行为观察以及对家庭成员和/或照顾者的访谈获得,并辅以行为问卷。具体重点在于行为、精神病理学以及生命历程中的功能水平,以确定可能有助于该综合征描述的共同特征。主要发现包括精神障碍的高发病率,尤其是双相情感障碍(BPD)和注意力缺陷多动障碍(ADHD),以及急性事件后突然恶化,此外还存在多年来技能的逐渐丧失。因此,SHANK3的缺失可能导致神经系统功能失调,一方面更容易出现发育问题和精神障碍,另一方面在精神和躯体事件后恢复能力较差,长期来看更容易退化。这些结果具有探索性,需要在更大样本中得到证实。

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