Jalnapurkar Isha, Cochran David M, Frazier Jean A
Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA.
Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA.
Curr Treat Options Neurol. 2019 Feb 27;21(3):12. doi: 10.1007/s11940-019-0551-8.
The purpose of this review is to provide an overview of current research and clinical practice guidelines in fragile X syndrome (FXS) with regard to therapeutic approaches in the management of this condition. The authors summarize and discuss findings from relevant preclinical studies and results from clinical trials in human subjects with FXS. Additionally, we provide an outline of the basic framework for understanding and providing educational and psychosocial supports for these individuals.
Current treatments in FXS are largely symptom based and focused on managing associated psychiatric and behavioral co-morbidities. While data from animal studies has been promising in providing targeted treatments to correct the underlying deficits at the cellular level, there have not been as robust findings in human trials. There are several targeted treatments for FXS currently under development. Individuals with FXS present with several behavioral challenges including anxiety, social withdrawal, ADHD, hyperarousal, self-injury, and aggression. Therapeutic services are often necessary, such as behavioral intervention, speech and language therapy, occupational therapy, and individualized educational support; adjunctive psychopharmacologic treatment is often helpful as well. It is important to address these symptoms and weigh the evidence for the use of medications that target the underlying neurobiology and pathophysiology of the syndrome.
本综述旨在概述脆性X综合征(FXS)当前在该病症管理中的治疗方法方面的研究和临床实践指南。作者总结并讨论了相关临床前研究的结果以及针对FXS人类受试者的临床试验结果。此外,我们还提供了一个基本框架概述,用于理解并为这些个体提供教育和心理社会支持。
目前对FXS的治疗主要基于症状,侧重于管理相关的精神和行为共病。虽然动物研究的数据在提供靶向治疗以纠正细胞水平的潜在缺陷方面很有前景,但在人体试验中尚未有同样有力的发现。目前有几种针对FXS的靶向治疗正在研发中。FXS个体存在多种行为挑战,包括焦虑、社交退缩、注意力缺陷多动障碍、过度觉醒、自我伤害和攻击行为。通常需要治疗服务,如行为干预、言语和语言治疗、职业治疗以及个性化教育支持;辅助性心理药物治疗通常也很有帮助。重要的是要解决这些症状,并权衡使用针对该综合征潜在神经生物学和病理生理学的药物的证据。