Developmental Neurology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Alta Intensità di Cura, Milan, Italy.
Am J Med Genet A. 2020 Oct;182(10):2317-2324. doi: 10.1002/ajmg.a.61789. Epub 2020 Aug 15.
Potocki-Lupski syndrome is a condition mainly characterized by infantile hypotonia, developmental delay/intellectual disability (DD/ID), and congenital anomalies, caused by duplications of the 17p11.2 region, encompassing RAI1 gene. Its clinical presentation is extremely variable, especially for what concerns the cognitive level and the behavioral phenotype. Such aspects, as well as the dysmorphic/malformative ones, have been covered by previous studies; otherwise neurological features have never been systematically described. In order to delineate the neurological phenotype of Potocki-Lupski Syndrome, we collect an 8-patients cohort. Developmental milestones are delayed and a mild to moderate cognitive impairment is present in all patients, variably associated with features of autism spectrum disorder, behavioral disturb, and sleep disturb. Hypotonia appears a less frequent finding than what previously reported, while motor clumsiness/coordination impairment is frequent. EGG registration demonstrated a common pattern with excess of diffuse rhythmic activity in sleep phases or while the patient is falling asleep. Brain MRI did not reveal common anomalies, although unspecific white matter changes may be present. We discuss such findings and compare them to literature data, offering an overview on the neurological and cognitive-behavioral presentation of the syndrome.
波托茨基-卢普斯基综合征主要表现为婴儿型张力减退、发育迟缓/智力残疾(DD/ID)和先天性异常,由 17p11.2 区域的重复引起,包括 RAI1 基因。其临床表现非常多样化,尤其是认知水平和行为表型。这些方面,以及畸形/形态异常,已经被之前的研究涵盖;然而,神经学特征从未被系统地描述过。为了描绘波托茨基-卢普斯基综合征的神经表型,我们收集了一个 8 例患者的队列。所有患者的发育里程碑都延迟,存在轻度至中度认知障碍,不同程度地伴有自闭症谱系障碍、行为障碍和睡眠障碍的特征。与之前的报道相比,张力减退的发生率较低,而运动笨拙/协调障碍则较为常见。脑电图(EEG)记录显示一种常见的模式,即在睡眠阶段或入睡时,弥漫性节律性活动增加。脑 MRI 未显示出常见异常,尽管可能存在非特异性的白质改变。我们讨论了这些发现,并与文献数据进行了比较,概述了该综合征的神经学和认知行为表现。