Division of Child Neurology, Helsinki University Hospital, Helsinki, Finland.
Institute of Biochemistry, Medical Faculty, University of Giessen, Giessen, Germany.
J Inherit Metab Dis. 2020 Mar;43(2):318-325. doi: 10.1002/jimd.12159. Epub 2019 Sep 8.
Aspartylglucosaminuria (AGU) is a rare, recessively inherited lysosomal disease with relatively high prevalence in Finnish population. This progressive disease has a vast impact on patient's cognition and physical health, leading to intellectual disability and shorter life expectancy. Cognitive functions of 21 7- to 14-year-old children with AGU were studied cross-sectionally using Wechsler's Intelligence Scale for Children IV and the results were compared with a standardized Finnish sample. In addition to overall cognitive performance, abilities in discrete cognitive domains, including verbal comprehension, perceptual reasoning, working memory, and processing speed, were examined. The results showed that despite the very low overall level of cognitive performance, there were notable differences between individuals. All those children whose performance was closer to their own age level were 7 to 10 years old. Processing speed appeared more compromised, as compared with verbal comprehension. Furthermore, examining the subtest raw scores, there were no significant positive correlations between age and subtest scores, suggesting that the developmental level of AGU children could be rather stable throughout ages 7 to 14. This study gives insight to the severe nature of AGU disease. Since younger children performed better compared to their age norms than older children, the results raise a question whether the highest peak in cognitive functions is reached at an earlier age than previously thought.
天冬氨酰葡糖胺尿症(AGU)是一种罕见的、隐性遗传的溶酶体疾病,在芬兰人群中发病率相对较高。这种进行性疾病对患者的认知和身体健康有很大影响,导致智力残疾和预期寿命缩短。本研究采用韦氏儿童智力量表第四版对 21 名 7-14 岁的 AGU 患儿进行了横断面研究,并与标准化的芬兰样本进行了比较。除了总体认知表现外,还检查了离散认知领域的能力,包括言语理解、知觉推理、工作记忆和加工速度。结果表明,尽管认知表现总体水平非常低,但个体之间存在显著差异。所有表现接近自己年龄水平的患儿均为 7-10 岁。与言语理解相比,加工速度的损害更为明显。此外,对各分量表原始分数进行检验,发现年龄与分量表分数之间无显著正相关,提示 AGU 患儿的发育水平在 7-14 岁期间可能相当稳定。本研究深入了解了 AGU 疾病的严重程度。由于与年龄规范相比,年龄较小的患儿表现更好,因此结果提出了一个问题,即认知功能的最高峰值是否比以前认为的更早达到。