Faculty of Medicine, Institute of Human Genetics, Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Neurol Res. 2021 Apr;43(4):321-326. doi: 10.1080/01616412.2020.1863697. Epub 2021 Jan 6.
: Although one of the most common monogenic late-onset neurodegenerative disorders, fragile-X-associated tremor/ataxia syndrome (FXTAS) is still underdiagnosed. The aim of the present study was to estimate the frequency of premutation carriers in patients with unexplained degenerative ataxias, action tremor or parkinsonism, and action tremor with or without associated cognitive impairment.: The study comprised 100 consecutive patients with the disease onset >49 years who had any form of unexplained action tremor, cerebellar ataxia, followed by parkinsonism with or without incipient dementia, and in whom the repeats size was determined.: Premutation in the was identified in two patients (2%): the first, male patient had 83 CGG repeats and the second, female patient had 32 and 58 CGG repeats.: FXTAS was relatively rare among older patients with unexplained ataxia and action tremor, with or without parkinsonism and/or cognitive impairment. Tremor and ataxia were major clinical features in our two patients, although parkinsonism, autonomic dysfunction and psychiatric problems might be an important part of the spectrum. Probable FXTAS should be considered in the differential diagnosis of patients with unexplained action tremor and ataxia, and undetermined parkinsonism, especially when there was a positive family history for involuntary movement disorders in other family members and/or autism spectrum disorders in younger cousins.
虽然脆性 X 相关震颤共济失调综合征 (FXTAS) 是最常见的单基因迟发性神经退行性疾病之一,但仍存在漏诊的情况。本研究旨在评估不明原因退行性共济失调、动作性震颤或帕金森病以及伴有或不伴有认知障碍的动作性震颤患者中前突变携带者的频率。
该研究纳入了 100 例发病年龄>49 岁的连续患者,这些患者存在任何形式的不明原因动作性震颤、小脑共济失调,随后出现帕金森病伴或不伴轻度痴呆,并且已经确定了 重复次数。
在两名患者(2%)中发现了 前突变:第一例男性患者有 83 个 CGG 重复,第二例女性患者有 32 个和 58 个 CGG 重复。
在不明原因的动作性震颤和共济失调、伴或不伴帕金森病和/或认知障碍的老年患者中,FXTAS 相对较为罕见。在我们的两名患者中,震颤和共济失调是主要的临床特征,尽管帕金森病、自主神经功能障碍和精神问题可能是其谱系的重要组成部分。对于不明原因的动作性震颤和共济失调以及未确定的帕金森病患者,尤其是在其他家族成员中存在不自主运动障碍阳性家族史和/或年轻表亲中有自闭症谱系障碍的情况下,应考虑可能的 FXTAS 进行鉴别诊断。