Yardeni Maya, Weisman Omri, Mandel Hanna, Weinberger Ronnie, Quarta Giovanni, Salazar-Mendiguchía Joel, Garcia-Pavia Pablo, Lobato-Rodríguez Maria José, Simon Lourdes Fajardo, Dov Freimark, Arad Michael, Gothelf Doron
The Behavioral Neurogenetics Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.
Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
Am J Med Genet A. 2017 Sep;173(9):2461-2466. doi: 10.1002/ajmg.a.38320. Epub 2017 Jun 19.
Danon disease (DD) is a rare X-linked disorder caused by loss-of-function mutations in the LAMP2 gene, which encodes lysosome-associated membrane protein. It is characterized by the triad of hypertrophic cardiomyopathy, myopathy, and intellectual disability. Whereas the molecular and pathophysiological mechanisms underlying this disorder have been previously reported and continue to be explored, the cognitive deficits and psychiatric comorbidities manifested in DD remain an understudied topic. We systematically assessed cognitive abilities and psychiatric comorbidities in 13 males and females. Most of the participants in our cohort (n = 9; 75%) had an IQ score within the normal range, while only one participant had intellectual disability. Participants' performance on the Cognitive Neuropsychiatric Battery (CNB) showed only mildly impaired cognitive abilities in most modules, except in the executive functioning test, which was low compared to healthy controls. Of note, 69% of the participants met criteria for at least one psychiatric disorder, mainly mood and anxiety disorders, occurring alone or in combination in the same patient. The results of the present study challenge earlier reports suggesting that mental retardation is a core constituent in DD. Of importance, it underscores the need to refer Danon patients to psychiatric assessment.
丹侬病(DD)是一种罕见的X连锁疾病,由LAMP2基因的功能丧失性突变引起,该基因编码溶酶体相关膜蛋白。其特征为肥厚型心肌病、肌病和智力残疾三联征。尽管此前已报道并仍在探索该疾病的分子和病理生理机制,但丹侬病所表现出的认知缺陷和精神共病仍是一个研究不足的课题。我们系统评估了13名男性和女性的认知能力及精神共病情况。我们队列中的大多数参与者(n = 9;75%)智商得分在正常范围内,只有一名参与者有智力残疾。参与者在认知神经精神量表(CNB)上的表现显示,除执行功能测试外,大多数模块的认知能力仅轻度受损,与健康对照组相比,执行功能测试得分较低。值得注意的是,69%的参与者符合至少一种精神障碍的标准,主要是情绪和焦虑障碍,单独或同时出现在同一患者身上。本研究结果对早期认为智力迟钝是丹侬病核心组成部分的报告提出了挑战。重要的是,它强调了将丹侬病患者转诊进行精神评估的必要性。