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不同阿尔珀斯综合征基因型患者的临床特征及脑电图分析

Clinical Attributes and Electroencephalogram Analysis of Patients With Varying Alpers' Syndrome Genotypes.

作者信息

Li Hua, Wang Wei, Han Xiaodi, Zhang Yujia, Dai Lifang, Xu Manting, Deng Jie, Ding Changhong, Wang Xiaohui, Chen Chunhong, Yang Xiaofeng, Fang Fang

机构信息

Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center For Children's Health, Beijing, China.

Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China.

出版信息

Front Pharmacol. 2021 Oct 6;12:669516. doi: 10.3389/fphar.2021.669516. eCollection 2021.

Abstract

Alpers' syndrome is an early inceptive neurodegenerative disorder with a poor prognosis, characterized by developmental regression, intractable epilepsy, and hepatic dysfunction. Candidate genes, such as are distinguished and registered following research on large cohorts that portray the clinical phenotype in such patients using expanded access to whole-exome sequencing (WES). In this study, we aimed to better understand the electroencephalogram (EEG) characteristics and clinical phenotype of different genotypes of the Alpers' syndrome, which are currently insufficiently studied. We conducted a study on seven patients with Alpers' syndrome who received treatment in Beijing Children's Hospital and had a detailed clinical EEG. Furthermore, a substantial literature search of the Chinese Biomedical Literature Database, PubMed, and Cochrane Central Register of Controlled Trials EMBASE was also conducted, which revealed a total of 22 reported cases between January 2008 to January 2021. We analyzed 29 cases of Alpers' syndrome caused by different gene variants, of which 22 cases were related to gene mutation and 7 cases were related to gene mutation, and found that patients with distinctive pathogenic variants exhibited comparable phenotypes and similar EEG patterns. And we defined EEG characteristics found specifically in Alpers' syndrome. Rhythmic high-amplitude delta with superimposed (poly) spikes (RHADS) is a characteristic EEG finding in the early stages of Alpers' syndrome and is a kind of epileptic phenomenon, which can provide clues for the early diagnosis of the disease.

摘要

阿尔珀斯综合征是一种早期起病的神经退行性疾病,预后较差,其特征为发育倒退、难治性癫痫和肝功能障碍。通过扩大全外显子测序(WES)的应用,对大量描绘此类患者临床表型的队列进行研究后,鉴别并登记了诸如候选基因等。在本研究中,我们旨在更好地了解目前研究尚不充分的阿尔珀斯综合征不同基因型的脑电图(EEG)特征和临床表型。我们对在北京儿童医院接受治疗且有详细临床脑电图的7例阿尔珀斯综合征患者进行了研究。此外,还对中国生物医学文献数据库、PubMed以及考克兰系统评价数据库EMBASE进行了大量文献检索,结果显示在2008年1月至2021年1月期间共有22例报告病例。我们分析了29例由不同基因变异引起的阿尔珀斯综合征病例,其中22例与基因突变有关,7例与基因突变有关,发现具有独特致病变异的患者表现出可比的表型和相似的脑电图模式。并且我们明确了在阿尔珀斯综合征中特有的脑电图特征。节律性高波幅δ波伴叠加(多)棘波(RHADS)是阿尔珀斯综合征早期的特征性脑电图表现,是一种癫痫现象,可为该病的早期诊断提供线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d02/8526534/4bea761ab962/fphar-12-669516-g001.jpg

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