Do Thi Thu Hang, Vu Diem My, Huynh Thi Thuy Kieu, Le Thi Khanh Van, Sohn Eun Hwa, Le Thieu Mai Thao, Ha Huu Hao, Bui Chi Bao
Research Center for Genetics and Reproductive Health, School of Medicine, Vietnam National University HCMC, Ho Chi Minh City, Vietnam.
Center for Molecular Biomedicine, University of Medicine and Pharmacy HCMC, Ho Chi Minh City, Vietnam.
J Clin Neurol. 2017 Jan;13(1):62-70. doi: 10.3988/jcn.2017.13.1.62.
Dravet syndrome is a rare and severe type of epilepsy in infants. The heterogeneity in the overall intellectual disability that these patients suffer from has been attributed to differences in genetic background and epilepsy severity.
Eighteen Vietnamese children diagnosed with Dravet syndrome were included in this study. SCN1A variants were screened by direct sequencing and multiplex ligation-dependent probe amplification. Adaptive functioning was assessed in all patients using the Vietnamese version of the Vineland Adaptive Behavior Scales, and the results were analyzed relative to the SCN1A variants and epilepsy severity.
We identified 13 pathogenic or likely pathogenic variants, including 6 that have not been reported previously. We found no correlations between the presence or type of SCN1A variants and the level of adaptive functioning impairment or severity of epilepsy. Only two of nine patients aged at least 5 years had an adaptive functioning score higher than 50. Both of these patients had a low frequency of convulsive seizures and no history of status epilepticus or prolonged seizures. The remaining seven had very low adaptive functioning scores (39 or less) despite the variability in the severity of their epilepsy confirming the involvement of factors other than the severity of epilepsy in determining the developmental outcome.
Our study expands the spectrum of known SCN1A variants and confirms the current understanding of the role of the genetic background and epilepsy severity in determining the developmental outcome of Dravet syndrome patients.
德雷维特综合征是一种罕见且严重的婴儿癫痫类型。这些患者所患的整体智力残疾的异质性归因于遗传背景和癫痫严重程度的差异。
本研究纳入了18名被诊断为德雷维特综合征的越南儿童。通过直接测序和多重连接依赖探针扩增对SCN1A基因变异进行筛查。使用越南版的文兰适应行为量表对所有患者的适应功能进行评估,并将结果相对于SCN1A基因变异和癫痫严重程度进行分析。
我们鉴定出13种致病或可能致病的变异,其中6种此前未曾报道过。我们发现SCN1A基因变异的存在或类型与适应功能损害水平或癫痫严重程度之间没有相关性。在9名至少5岁的患者中,只有2名患者的适应功能得分高于50。这两名患者惊厥发作频率较低,且无癫痫持续状态或长时间发作史。其余7名患者尽管癫痫严重程度存在差异,但其适应功能得分非常低(39分或更低),这证实了除癫痫严重程度外,其他因素也参与了决定发育结局。
我们的研究扩展了已知SCN1A基因变异的范围,并证实了目前对遗传背景和癫痫严重程度在决定德雷维特综合征患者发育结局中作用的理解。