Department of Anatomy and Neurobiology, University of California, Irvine, Orange, California, USA.
Curr Opin Neurol. 2012 Dec;25(6):682-8. doi: 10.1097/WCO.0b013e32835a360a.
The fields of clinical genetics and pharmacogenetics are rapidly expanding. Genetic factors have numerous associations with injury and with treatment effects in the setting of neural plasticity and recovery.
Evidence is reviewed that established genetic variants, as well as some more recently described variants, are related to outcome after neural injury and in some cases are useful for predicting clinical course. In many cases, the interaction of genetics with clinical factors such as experience and therapy may be important. As an extension of this, genetic factors have been associated with differential response to a number of forms of therapy, including pharmacological, brain stimulation, psychotherapy, and meditation. Genetic variation might also have a significant effect on plasticity and recovery through key covariates such as depression or stress. A key point is that genetic associations might be most accurately identified when studied in relation to distinct forms of a disorder rather than in relation to broad clinical syndromes.
Understanding genetic variation gives clinicians a biological signal that could be used to predict who is most likely to recover from neural injury, to choose the optimal treatment for a patient, or to supplement rehabilitation therapy.
临床遗传学和药物遗传学领域正在迅速发展。遗传因素与神经可塑性和恢复过程中的损伤以及治疗效果有许多关联。
有证据表明，已确定的遗传变异体以及一些最近描述的变异体与神经损伤后的结果有关，在某些情况下，它们可用于预测临床病程。在许多情况下，遗传与经验和治疗等临床因素的相互作用可能很重要。在此基础上，遗传因素与多种形式的治疗反应相关，包括药物治疗、脑刺激、心理治疗和冥想。遗传变异通过关键的协变量（如抑郁或压力）也可能对可塑性和恢复产生重大影响。关键点是，当与特定形式的疾病而不是广泛的临床综合征相关联进行研究时，遗传关联可能最准确地确定。
了解遗传变异为临床医生提供了生物学信号，可用于预测谁最有可能从神经损伤中恢复，为患者选择最佳治疗方法，或补充康复治疗。
