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16 个巴西家族的脊髓小脑共济失调 10 型的临床和遗传评估。

Clinical and Genetic Evaluation of Spinocerebellar Ataxia Type 10 in 16 Brazilian Families.

机构信息

Movement Disorders Unit, Neurology Service, Hospital de Clínicas, Federal University of Paraná, Rua General Carneiro 1103/102, Centro, Curitiba, PR, 80060-150, Brazil.

Department of Neurology, Baylor College of Medicine, Houston, TX, USA.

出版信息

Cerebellum. 2019 Oct;18(5):849-854. doi: 10.1007/s12311-019-01064-y.

Abstract

Spinocerebellar ataxia type 10 (SCA10) is an autosomal dominant disorder in which patients have a slowly progressive cerebellar ataxia, with dysarthria, dysphagia, and epilepsy. The aims of this study were to characterize the phenotypic expression of SCA10 and to examine its genotype-phenotype relationships. Ninety-one Brazilian patients with SCA10 from 16 families were selected. Clinical and epidemiological data were assessed by a standardized protocol, and severity of disease was measured by the Scale for the Assessment and Rating of Ataxia (SARA). The mean age of onset of symptoms was 34.8 ± 9.4 years. Sixty-two (68.2%) patients presented exclusively with pure cerebellar ataxia. Only 6 (6.6%) of the patients presented with epilepsy. Patients with epilepsy had a mean age of onset of symptoms lower than that of patients without epilepsy (23.5 ± 15.5 years vs 35.4 ± 8.7 years, p = 0.021, respectively). All cases of intention tremor were in women from one family. This family also had the lowest mean age of onset of symptoms, and a higher percentage of SCA10 cases in women. There was a positive correlation between duration of disease and severity of ataxia (rho = 0.272, p = 0.016), as quantified by SARA. We did not find a statistically significant correlation between age of onset of symptoms and expansion size (r = - 0.163, p = 0.185). The most common clinical presentation of SCA10 was pure cerebellar ataxia. Our data suggest that patients with epilepsy may have a lower age of onset of symptoms than those who do not have epilepsy. These findings and the description of a family with intention tremor in women with earlier onset of symptoms draw further attention to the phenotypic variability of SCA10.

摘要

脊髓小脑共济失调 10 型(SCA10)是一种常染色体显性遗传病,患者表现为进行性小脑共济失调,伴有构音障碍、吞咽困难和癫痫。本研究旨在描述 SCA10 的表型表达,并探讨其基因型-表型关系。我们选择了来自 16 个家族的 91 名巴西 SCA10 患者。通过标准化方案评估临床和流行病学数据,并使用共济失调评估和评分量表(SARA)测量疾病严重程度。症状发作的平均年龄为 34.8±9.4 岁。62 名(68.2%)患者仅表现为单纯小脑性共济失调。仅有 6 名(6.6%)患者出现癫痫。有癫痫的患者症状发作的平均年龄低于无癫痫的患者(分别为 23.5±15.5 岁和 35.4±8.7 岁,p=0.021)。一个家族的所有意向性震颤患者均为女性。该家族还具有最低的症状发作平均年龄,以及女性中 SCA10 病例的比例更高。疾病持续时间与共济失调严重程度呈正相关(rho=0.272,p=0.016),这可通过 SARA 进行量化。我们未发现症状发作年龄与扩展大小之间存在统计学显著相关性(r=-0.163,p=0.185)。SCA10 最常见的临床表现为单纯小脑性共济失调。我们的数据表明,有癫痫的患者可能比无癫痫的患者有更低的症状发作年龄。这些发现以及对一个家族的描述,该家族中的女性有震颤意向且发病年龄更早,这进一步引起了对 SCA10 表型变异性的关注。

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