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鲁宾斯坦-泰比综合征:多学科方法带来的神经放射学和神经精神病学新见解。

Rubinstein-Taybi syndrome: New neuroradiological and neuropsychiatric insights from a multidisciplinary approach.

作者信息

Ajmone Paola F, Avignone Sabrina, Gervasini Cristina, Giacobbe Antonella, Monti Fedrico, Costantino Antonella, Esposito Susanna, Marchisio Paola, Triulzi Fabio, Milani Donatella

机构信息

Child and Adolescent Neuropsychiatric Service (UONPIA) Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Department of Neuroradiology, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

出版信息

Am J Med Genet B Neuropsychiatr Genet. 2018 Jun;177(4):406-415. doi: 10.1002/ajmg.b.32628. Epub 2018 Apr 10.

DOI:10.1002/ajmg.b.32628
PMID:29637745
Abstract

Rubinstein-Taybi syndrome is a rare, autosomal dominant, plurimalformative disorder that is clinically characterized by intellectual disability and a wide spectrum of congenital anomalies; facial dysmorphisms are typical, and broad thumbs and great toes are particularly distinctive. Its genetic basis is only partially known, with a detection rate of approximately 65-70%; specifically, microdeletions or mutations in the CREBBP or EP300 genes can be found. Much is known about its clinical features and health-care protocols, but some areas of clinical knowledge are currently unsolved. In particular, few efforts have been made until now to understand the variability in the neuropsychological and neurobehavioral profile and to deepen knowledge of the neuroradiological malformative pattern. Consequently, little is known about the possible genotype-phenotype correlations of these issues. Here, we report clinical and genetic data from a cohort of 23 RSTS Italian patients. The most common features in brain magnetic resonance imaging (MRI) were dysmorphic aspects of the corpus callosum (73.6%) with or without minor dysmorphisms of cerebellar vermis, periventricular posterior white matter hyperintensity, and other less common anomalies. The most interesting feature on the whole spine MRI scans was the tendency for a low-lying conus medullaris without terminal filum thickening. These data will help to improve neuropsychiatric and neuroradiological knowledge and highlight specific genotype-phenotype correlations.

摘要

鲁宾斯坦-泰比综合征是一种罕见的常染色体显性多系统发育障碍疾病,临床特征为智力残疾和多种先天性异常;面部畸形较为典型,宽拇指和宽大脚趾尤为明显。其遗传基础仅部分为人所知,检测率约为65%-70%;具体而言,可发现CREBBP或EP300基因的微缺失或突变。关于其临床特征和医疗保健方案已有很多了解,但目前临床知识的某些领域仍未解决。特别是,迄今为止,在了解神经心理学和神经行为特征的变异性以及加深对神经放射学畸形模式的认识方面所做的努力很少。因此,对于这些问题可能的基因型-表型相关性知之甚少。在此,我们报告了一组23例意大利鲁宾斯坦-泰比综合征患者的临床和遗传数据。脑磁共振成像(MRI)最常见的特征是胼胝体畸形(73.6%),伴有或不伴有小脑蚓部轻度畸形、脑室周围后白质高信号以及其他较不常见的异常。全脊柱MRI扫描最有趣的特征是脊髓圆锥低位且终丝不增厚的倾向。这些数据将有助于增进神经精神病学和神经放射学知识,并突出特定的基因型-表型相关性。

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