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天使综合征的神经发育概况:不仅仅是低智商。

Neurodevelopmental profile in Angelman syndrome: more than low intelligence quotient.

作者信息

Micheletti S, Palestra F, Martelli P, Accorsi P, Galli J, Giordano L, Trebeschi V, Fazzi E

机构信息

Unit of Child Neuropsychiatry and Early Neurorehabilitation, ASST Spedali Civili, Piazzale Spedali, Civili 1, 25123, Brescia, Italy.

Cognition Psychology Neuroscience Lab, University of Pavia, Pavia, Italy.

出版信息

Ital J Pediatr. 2016 Oct 21;42(1):91. doi: 10.1186/s13052-016-0301-4.

Abstract

BACKGROUND

Angelman Syndrome (AS) is a rare neurodevelopment disorder resulting from deficient expression or function of the maternally inherited allele of UBE3A gene. The aim of the study is to attempt at providing a detailed definition of neurodevelopmental profile in AS, with particular regard to motor, cognitive, communicative, behavioural and neurovisual, features by using standardized instruments.

METHOD

A total of ten subjects aged from 5 to 11 years (4 males and 6 females) with molecular confirmed diagnosis of AS (7 15q11.2-q13 deletion and 3 UBE3A mutation) were enrolled in our study. All of them underwent an assessment protocol including neurological and neurovisual examination and the evaluation of motor (Gross Motor Function Measure Scale), cognitive (Griffiths Mental Development Scale and Uzgiris-Hunt Scale); adaptive (Vineland Adaptive Behavioural Scale); communication (MacArthur-Bates Communicative Development Inventory and video-recordings children's verbal expression), behavioural aspects (IPDDAG Scale) and neurovisual aspects.

RESULTS

All children presented motor function involvement. A severe cognitive impairment was detected with different profiles according to the test applied. In all cases, communicative disability (phonemic inventory, word/gesture comprehension and production) and symptoms of inattention disorder were revealed. Neurovisual impairment was characterized by refractive errors, fundus oculi anomalies, strabismus and/or oculomotor dysfunction.

CONCLUSION

AS presents a complex neurodevelopmental profile in which several aspects play a negative role in global development leading to a severe functional impairment. Intellectual disability is not the only component because neurovisual functions and behavioural disorders may worsen the global function and are needed of specific rehabilitation programs.

摘要

背景

天使综合征(AS)是一种罕见的神经发育障碍,由母系遗传的UBE3A基因等位基因表达或功能缺陷引起。本研究的目的是尝试通过使用标准化工具,详细定义AS的神经发育概况,特别是运动、认知、交流、行为和神经视觉特征。

方法

本研究共纳入10名年龄在5至11岁之间的受试者(4名男性和6名女性),他们经分子确诊为AS(7例15q11.2-q13缺失和3例UBE3A突变)。所有受试者均接受了评估方案,包括神经学和神经视觉检查以及运动(粗大运动功能测量量表)、认知(格里菲斯心理发展量表和乌兹吉里斯-亨特量表)、适应性(文兰适应行为量表)、交流(麦克阿瑟-贝茨交流发展量表和儿童言语表达录像)、行为方面(IPDDAG量表)和神经视觉方面的评估。

结果

所有儿童均存在运动功能受累。根据所应用的测试,检测到严重的认知障碍,表现形式各异。在所有病例中,均发现有交流障碍(音素清单、单词/手势理解和表达)以及注意力不集中障碍的症状。神经视觉障碍的特征为屈光不正、眼底异常、斜视和/或眼球运动功能障碍。

结论

AS呈现出复杂的神经发育概况,其中多个方面对整体发育产生负面影响,导致严重的功能障碍。智力残疾并非唯一组成部分,因为神经视觉功能和行为障碍可能会使整体功能恶化,需要特定的康复计划。

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