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