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台湾队列中亨廷顿舞蹈症患者的临床、影像学和遗传学特征。

Clinical, radiological, and genetic characteristics in patients with Huntington's disease in a Taiwanese cohort.

作者信息

Chen Szu-Ju, Lee Bo-Chin, Lee Ni-Chung, Chien Yin-Hsiu, Hwu Wuh-Liang, Lin Chin-Hsien

机构信息

Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.

Department of Neurology, National Taiwan University Bei-Hu Branch, Taipei, Taiwan.

出版信息

Am J Med Genet B Neuropsychiatr Genet. 2020 Sep;183(6):352-359. doi: 10.1002/ajmg.b.32810. Epub 2020 Jul 9.

Abstract

Characteristics of Huntington's disease (HD) differ among various ethnicities. Few studies have explored the relationship between phenotypes and genotypes of HD in Asians. We evaluated the relationship between integrated clinical and imaging phenotypes and genotypes in a Taiwanese HD cohort, enrolling 123 HD patients genetically diagnosed between August 1994 and February 2019. The clinical presentations and brain magnetic resonance imaging characteristics were analyzed from 67 patients and examined the correlation with genetic findings. Chorea was the most common initial manifestation (66.1%), especially in patients with late-onset disease (onset age > 60 years old), followed by psychiatric symptoms (25%) and cognitive impairment (14.3%). Compared to patients with adult-onset HD, the prevalence of parkinsonism was significantly higher in juvenile-onset HD patients (onset age < 20 years old, p = .007). Disease burden, which was measured by CAG repeats and age, was significantly associated with atrophy in caudate nucleus (p = .004), followed by putamen (p = .029), nucleus accumbens (p = .002), thalamus (p = .003), and total cortical volume (p = .001) after correcting for total intracranial volume. Our findings, that provided the first series of Taiwanese HD patients, delineated the clinical, radiological, and genetic characteristics in Asian HD patients.

摘要

亨廷顿舞蹈症(HD)的特征在不同种族之间存在差异。很少有研究探讨亚洲人中HD的表型与基因型之间的关系。我们评估了台湾HD队列中综合临床和影像学表型与基因型之间的关系,纳入了1994年8月至2019年2月期间基因诊断的123例HD患者。分析了67例患者的临床表现和脑磁共振成像特征,并检查了与基因结果的相关性。舞蹈症是最常见的初始表现(66.1%),尤其是在晚发性疾病(发病年龄>60岁)患者中,其次是精神症状(25%)和认知障碍(14.3%)。与成年发病的HD患者相比,青少年发病的HD患者(发病年龄<20岁,p = 0.007)帕金森症的患病率显著更高。通过CAG重复序列和年龄衡量的疾病负担与尾状核萎缩显著相关(p = 0.004),校正总颅内体积后,其次是壳核(p = 0.029)、伏隔核(p = 0.002)、丘脑(p = 0.003)和总皮质体积(p = 0.001)。我们的研究结果提供了首批台湾HD患者系列,描绘了亚洲HD患者的临床、放射学和遗传学特征。

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