Section of Genetics and Inherited Metabolic Disease, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Campus, Aurora, Colorado, USA.
RTI International, North Carolina, USA.
Am J Med Genet A. 2022 May;188(5):1457-1463. doi: 10.1002/ajmg.a.62662. Epub 2022 Jan 30.
Prader-Willi syndrome (PWS) is a genetic disorder characterized by hypotonia and poor feeding in infancy which progresses to hyperphagia in early-mid childhood, as well as developmental delays, a spectrum of behavioral and psychiatric concerns, endocrinopathies, orthopedic issues, and less commonly, seizures, sleep apnea, and narcolepsy with or without cataplexy. This study used data in the Global PWS Registry (N = 893) to explore the onset and severity over time of the neuropsychiatric features reported in individuals with PWS and explored its associations with sleep disorders, seizures, and psychiatric symptoms. Results demonstrate that seizures are more common in the deletion subtype and that narcolepsy and cataplexy are more common in individuals who have sleep-related seizures. Finally, this work shows that anxiety and compulsive behaviors are persistent features of PWS that may arise early in childhood, and that anxiety is associated with higher frequency of other comorbid psychiatric diagnoses. In conclusion, this study is one of the largest to date characterizing sleep disorders and neuropsychiatric characteristics of individuals with PWS and reports on the novel association between sleep disorders and seizures. This study is also one of the first to offer details on the nature of the progression of these features in individuals with PWS.
普拉德-威利综合征(PWS)是一种遗传性疾病,其特征为婴儿期出现低张力和喂养不良,随后在幼儿期中期出现食欲过盛,以及发育迟缓、一系列行为和精神健康问题、内分泌疾病、骨科问题,以及较少见的癫痫发作、睡眠呼吸暂停和伴有或不伴有猝倒的发作性睡病。本研究使用全球 PWS 登记处(N=893)的数据,探讨了报告的 PWS 个体的神经精神特征随时间的发生和严重程度,并探讨了其与睡眠障碍、癫痫发作和精神症状的关联。结果表明,癫痫发作在缺失型中更为常见,而伴有睡眠相关癫痫发作的个体中更常见发作性睡病和猝倒。最后,这项工作表明,焦虑和强迫行为是 PWS 的持续特征,可能在儿童早期出现,并且焦虑与其他共患精神疾病诊断的更高频率相关。总之,这项研究是迄今为止描述 PWS 个体的睡眠障碍和神经精神特征的最大规模研究之一,并报告了睡眠障碍和癫痫发作之间的新关联。这项研究也是第一个详细描述 PWS 个体中这些特征进展情况的研究之一。