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运动障碍遗传学与临床医生;该检测谁和什么?

Genetics of Movement Disorders and the Practicing Clinician; Who and What to Test for?

机构信息

IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Neurodegenerative disease center (CEMAND), Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy.

出版信息

Curr Neurol Neurosci Rep. 2018 May 23;18(7):37. doi: 10.1007/s11910-018-0847-1.

Abstract

PURPOSE OF REVIEW

This review aims to provide the basic knowledge on the genetics of hypokinetic and hyperkinetic movement disorders to guide clinicians in the decision of "who and what to test for?"

RECENT FINDINGS

In recent years, the identification of various genetic causes of hypokinetic and hyperkinetic movement disorders has had a great impact on a better definition of different clinical syndromes. Indeed, the advent of next-generation sequencing (NGS) techniques has provided an impressive step forward in the easy identification of genetic forms. However, this increased availability of genetic testing has challenges, including the ethical issue of genetic testing in unaffected family members, "commercially" available home testing kits and the increasing number and relevance of "variants of unknown significance." The emergent role of genetic factors has important implications on clinical practice and counseling. As a consequence, it is fundamental that practicing neurologists have a proper knowledge of the genetic background of the diseases and perform an accurate selection of who has to be tested and for which gene mutations.

摘要

目的综述

本文旨在介绍运动障碍的动力不足和动力过度的遗传学基础知识,以指导临床医生做出“针对谁和检测什么”的决策。

最近的发现

近年来,各种运动障碍的遗传学病因的确定对更好地定义不同的临床综合征产生了重大影响。事实上,下一代测序 (NGS) 技术的出现为基因形式的简便鉴定提供了令人瞩目的进步。然而,这种遗传检测的广泛应用带来了一些挑战,包括对无病家庭成员进行遗传检测的伦理问题、“商业化”可用的家庭检测试剂盒以及“意义不明的变异”的数量和相关性不断增加。遗传因素的出现对临床实践和咨询具有重要意义。因此,神经科医生必须对疾病的遗传背景有正确的认识,并准确选择需要检测的患者和基因变异。

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