Fernandez Thomas V, State Matthew W, Pittenger Christopher
Child Study Center, Yale School of Medicine, New Haven, CT, United States.
Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States.
Handb Clin Neurol. 2018;147:343-354. doi: 10.1016/B978-0-444-63233-3.00023-3.
Tourette disorder is a developmental neuropsychiatric condition characterized by vocal and motor tics that can range in severity from mild to disabling. It represents one end of a spectrum of tic disorders and is estimated to affect 0.5-0.7% of the population. Accumulated evidence supports a substantial genetic contribution to disease risk, but the identification of genetic variants that confer risk has been challenging. Positive findings in candidate gene association studies have not replicated, and genomewide association studies have not generated signals of genomewide significance, in large part because of inadequate sample sizes. Rare mutations in several genes have been identified, but their causality is difficult to establish. As in other complex neuropsychiatric disorders, it is likely that Tourette disorder risk involves a combination of common, low-effect and rare, larger-effect variants in multiple genes acting together with environmental factors. With the ongoing collection of larger patient cohorts and the emergence of affordable high-throughput genomewide sequencing, progress is expected to accelerate in coming years.
抽动秽语综合征是一种发育性神经精神疾病,其特征为发声和运动抽动,严重程度从轻到致残不等。它代表了抽动障碍谱系的一端,据估计影响着0.5 - 0.7%的人群。越来越多的证据支持基因在疾病风险中起着重要作用,但确定导致风险的基因变异一直具有挑战性。候选基因关联研究中的阳性结果未能重复出现,全基因组关联研究也未产生全基因组显著信号,这在很大程度上是由于样本量不足。已鉴定出多个基因中的罕见突变,但其因果关系难以确定。与其他复杂的神经精神疾病一样,抽动秽语综合征的风险可能涉及多个基因中常见的、低效应和罕见的、高效应变异与环境因素共同作用。随着更大规模患者队列的持续收集以及经济实惠的高通量全基因组测序的出现,预计未来几年会加速取得进展。