Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
Curr Opin Neurol. 2013 Apr;26(2):128-36. doi: 10.1097/WCO.0b013e32835f1a30.
Developmental disorders, including intellectual disability, autism and attention deficit hyperactivity disorder (ADHD), are neuropsychiatric disorders that manifest in early childhood as deviations from the normal development. At present, in the majority of cases a cause cannot be found. However, in the past 5 years major advances have been made in the identification of specific genetic causes of these disorders. Here, we review these findings and discuss possible implications for our current understanding of the cause of developmental disorders.
In addition to the disorders with known genetic cause that are associated with intellectual disability, autism and ADHD, an increasing number of novel recurrent structural variants are identified in association with these developmental disorders. These variants, as well as the genetic variants identified through sequencing approaches indicate the involvement of a large number of genes.
Similar to what is the case for intellectual disability, recent genetic studies indicate a large degree of genetic heterogeneity for autism and ADHD. Many of the disease risk variants display incomplete penetrance, indicating that additional genetic, and possibly nongenetic, factors are relevant. Despite the high number of causative or contributing genes, functional studies of these genes indicate a large degree of convergence into a smaller number of neurobiological pathways. Elucidating these shared biological mechanisms is a crucial step towards the rational development of novel therapeutic interventions.
目的综述:发育障碍包括智力障碍、自闭症和注意缺陷多动障碍(ADHD),是在儿童早期表现出的偏离正常发育的神经精神障碍。目前,大多数病例都找不到病因。然而,在过去的 5 年中,已经在确定这些疾病的特定遗传原因方面取得了重大进展。在这里,我们回顾这些发现,并讨论它们对我们目前对发育障碍病因的理解可能产生的影响。
最新发现:除了与智力障碍、自闭症和 ADHD 相关的已知遗传原因的疾病外,越来越多的新型重复结构变异也与这些发育障碍有关。这些变异以及通过测序方法确定的遗传变异表明,涉及大量基因。
总结:与智力障碍的情况类似,最近的遗传研究表明,自闭症和 ADHD 存在很大程度的遗传异质性。许多疾病风险变异显示不完全外显率,表明其他遗传和非遗传因素也很重要。尽管有大量的致病或致病基因,但这些基因的功能研究表明,它们在较小数量的神经生物学途径中存在很大程度的收敛。阐明这些共同的生物学机制是朝着合理开发新的治疗干预措施迈出的关键一步。