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日本普拉德-威利综合征患者的自闭症谱系障碍及多动/冲动行为:母源单亲二倍体与缺失病例的比较

Autism spectrum disorders and hyperactive/impulsive behaviors in Japanese patients with Prader-Willi syndrome: a comparison between maternal uniparental disomy and deletion cases.

作者信息

Ogata Hiroyuki, Ihara Hiroshi, Murakami Nobuyuki, Gito Masao, Kido Yasuhiro, Nagai Toshiro

机构信息

Department of Psychiatry, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.

出版信息

Am J Med Genet A. 2014 Sep;164A(9):2180-6. doi: 10.1002/ajmg.a.36615. Epub 2014 May 21.

Abstract

This study aims to compare maternal uniparental disomy 15 (mUPD) and a paternal deletion of 15q11-13 (DEL) of Prader-Willi syndrome (PWS) in regard to autism spectrum disorders (ASD). Forty-five Japanese individuals with PWS were recruited from a single recruitment center. The participants consisted of 22 children (aged from 6 to 12) and 23 adolescents (aged from 13 to 19). Six children and seven adolescents were confirmed as having mUPD. Sixteen children and 16 adolescents were confirmed as having DEL. Under blindness to the participants' genotypes, a single psychologist carried out behavioral and psychological assessments, including the Wechsler Intelligence Scales, Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS), and ADHD-Rating Scale-IV (ADHD-RS-IV). Two comparisons were made: one between mUPD and DEL children and another between mUPD and DEL adolescents. In children, no significant differences were found between mUPD and DEL participants in terms of autistic (PARS childhood, P = 0.657) and impulsive behaviors (ADHD-RS-IV hyperactive/impulsive, P = 0.275). In adolescents, mUPD patients showed significantly more autistic symptomatology (PARS adolescent, P = 0.027) and significantly more impulsive behavior (ADHD-RS-IV hyperactive/impulsive, P = 0.01) than DEL patients. Our findings about Japanese PWS patients were consistent with previous researches from western countries not focused on Asian patients, indicating that mUPD cases would be more prone to ASD than DEL cases, regardless of ethnoregional differences. In addition, our data suggested that the behavioral difference between mUPD and DEL cases in terms of autistic and impulsive symptoms tend to be unrecognizable in their childhood.

摘要

本研究旨在比较普拉德-威利综合征(PWS)中母源性单亲二体15(mUPD)和父源性15q11-13缺失(DEL)与自闭症谱系障碍(ASD)的关系。从单一招募中心招募了45名日本PWS患者。参与者包括22名儿童(6至12岁)和23名青少年(13至19岁)。6名儿童和7名青少年被确诊为mUPD。16名儿童和16名青少年被确诊为DEL。在对参与者基因型不知情的情况下,由一名心理学家进行行为和心理评估,包括韦氏智力量表、日本自闭症协会广泛性发育障碍评定量表(PARS)和注意缺陷多动障碍评定量表-IV(ADHD-RS-IV)。进行了两项比较:一项是mUPD儿童与DEL儿童之间的比较,另一项是mUPD青少年与DEL青少年之间的比较。在儿童中,mUPD和DEL参与者在自闭症(PARS儿童版,P = 0.657)和冲动行为(ADHD-RS-IV多动/冲动,P = 0.275)方面未发现显著差异。在青少年中,mUPD患者比DEL患者表现出明显更多的自闭症症状(PARS青少年版,P = 0.027)和明显更多的冲动行为(ADHD-RS-IV多动/冲动,P = 0.01)。我们关于日本PWS患者的研究结果与之前西方国家未关注亚洲患者的研究一致,表明无论种族区域差异如何,mUPD病例比DEL病例更容易患ASD。此外,我们的数据表明,mUPD和DEL病例在自闭症和冲动症状方面的行为差异在儿童期往往难以识别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa64/4278412/8a763cd33de4/ajmg0164-2180-f1.jpg

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