MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK; Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff, UK.
Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK; Barts Health NHS Trust, London, UK.
Curr Opin Genet Dev. 2021 Jun;68:26-34. doi: 10.1016/j.gde.2020.12.012. Epub 2021 Jan 15.
Several copy number variants (CNVs) have been identified to confer high risk for a range of neuropsychiatric conditions. Because of advances in genetic testing within clinical settings, patients are increasingly receiving diagnoses of copy number variant genomic disorders. However, clinical guidelines surrounding assessment and management are limited. This review synthesises recent research and makes preliminary recommendations regarding the clinical evaluation of patients with neuropsychiatric risk CNVs. We recommend multi-system assessment beyond the initial referral reason, recognition of the potential need for co-ordinated multidisciplinary care, and that interventions take account of relevant multimorbidity. The frequently complex needs of patients with CNVs across the life-course pose challenges for many health care systems and may be best provided for by the establishment of specialist clinics.
已经鉴定出多个拷贝数变异 (CNV),这些变异可导致多种神经精神疾病的高风险。由于临床环境中的基因检测技术的进步,越来越多的患者被诊断为拷贝数变异基因组疾病。然而,围绕评估和管理的临床指南有限。本综述综合了最近的研究成果,并就具有神经精神风险 CNV 的患者的临床评估提出了初步建议。我们建议进行超出初始转诊原因的多系统评估,认识到可能需要协调多学科护理的必要性,并使干预措施考虑到相关的多病共存情况。在整个生命周期中,CNV 患者的需求常常很复杂,这给许多医疗保健系统带来了挑战,可能最好由专门诊所来提供服务。