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认知概况与日常生活活动:35例α-甘露糖苷贮积症患者

Cognitive profile and activities of daily living: 35 patients with alpha-mannosidosis.

作者信息

Borgwardt L, Thuesen A M, Olsen K J, Fogh J, Dali C I, Lund A M

机构信息

Department of Clinical Genetics, Centre for Inherited Metabolic Diseases, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen, Denmark.

Psykolog 2, Virum, Denmark.

出版信息

J Inherit Metab Dis. 2015 Nov;38(6):1119-27. doi: 10.1007/s10545-015-9862-4. Epub 2015 May 28.

Abstract

BACKGROUND

Alpha-mannosidosis (OMIM 248500) (AM) is a rare lysosomal storage disease caused by a deficiency of the alpha-mannosidase enzyme. The typical signs consist of hearing impairment, intellectual disabilities, coarse facial features and motor function disturbances. We report on the cognitive function and activities of daily living in patients with AM.

METHODS

Thirty five AM patients, age 6-35 years, were included in the study. As a cognitive function test, we used the Leiter international performance scale-revised (Leiter-R), which consists of two batteries: the visual function and reasoning battery and the memory and attention battery, the latter including a memory screening. Additional two questionnaires, The Childhood Health Assessment Questionnaire (CHAQ) and EQ-5D-5 L, were filled out.

RESULTS

We found IQ in the range of 30-81 in our cohort. The total equivalent age (mental age) was significantly reduced, between 3-9 years old for the visual function and reasoning battery, between 2.3-10.2 years for the memory screening. Data suggested a specific developmental profile for AM with a positive intellectual development until the chronological age 10-12 years, followed by a static or slightly increasing intellectual level. All patients were to varying degrees socially and practically dependent and unable to take care of themselves in daily life.

CONCLUSIONS

Intellectual disability is a consistent finding in patients with alpha-mannosidosis but with extensive variation. We assess that this group of patients has, despite their intellectual disabilities, a potential for continuous cognitive development, especially during childhood and early teenage years. This should be included and supported in the individual educational planning.

摘要

背景

α-甘露糖苷贮积症(OMIM 248500)(AM)是一种由α-甘露糖苷酶缺乏引起的罕见溶酶体贮积病。典型症状包括听力障碍、智力残疾、面部特征粗糙和运动功能障碍。我们报告了AM患者的认知功能和日常生活活动情况。

方法

35名年龄在6至35岁之间的AM患者纳入本研究。作为认知功能测试,我们使用了修订版的莱特国际操作量表(Leiter-R),该量表由两个部分组成:视觉功能与推理部分以及记忆与注意力部分,后者包括一项记忆筛查。另外还填写了两份问卷,即儿童健康评估问卷(CHAQ)和EQ-5D-5L。

结果

我们发现队列中患者的智商在30至81之间。总等效年龄(心理年龄)显著降低,视觉功能与推理部分为3至9岁,记忆筛查为2.3至10.2岁。数据表明AM具有特定的发育模式,在实际年龄10至12岁之前智力呈正向发育,之后智力水平保持稳定或略有上升。所有患者在社交和实际生活中都存在不同程度的依赖,日常生活中无法自理。

结论

智力残疾是α-甘露糖苷贮积症患者的一个常见表现,但存在很大差异。我们评估,尽管这群患者存在智力残疾,但仍有持续认知发展的潜力,尤其是在儿童期和青少年早期。这一点应纳入个人教育规划并给予支持。

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