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Phelan-McDermid 综合征的感觉处理和适应行为:一项横断面研究。

Sensory processing and adaptive behavior in Phelan-McDermid syndrome: a cross-sectional study.

机构信息

Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Avenida de Atenas s/n. CP.28922, Rey Juan Carlos University, Alcorcón, Madrid, Spain.

Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.

出版信息

Eur J Pediatr. 2022 Aug;181(8):3141-3152. doi: 10.1007/s00431-022-04564-y. Epub 2022 Jul 15.

Abstract

UNLABELLED

Phelan-McDermid syndrome (PMS) is a genetic disorder caused by a mutation or deletion of the SHANK3 gene (chromosome 22q13.3), characterized by different sensory processing anomalies. The objective of this study is to expand and provide a detailed definition of the sensory profile of patients with PMS. The secondary objective was to examine the relationship between sensory patterns and adaptive behavior. A cross-sectional study was carried out among 51 Spanish patients with a confirmed genetic diagnosis of PMS. All the participants' parents completed the Short Sensory Profile-Spanish (SSP-S) and the Adaptive Behavior Assessment System II (ABAS-II). Correlational, multiple regression and hierarchical cluster analyses were performed. An atypical sensory profile was identified in almost 75% of PMS patients. Definite differences were found among scores; nonetheless, sub-threshold values were observed in tactile sensitivity, underresponsive/seeks sensation, auditory filtering, and low energy/weak sensory categories. Conceptual, social, and practical domains, as well as the General Adaptive Composite (GAC) of the ABAS-II showed extremely low scores (i.e., <70). Significant correlations were found (p<0.005) between SSP-S scores and the conceptual, social, practical, and GAC index of the ABAS-II, whereby higher SSP-S scores were associated with better skills and higher adaptive performance. The cluster analysis indicated that the group with the largest mutation size (7.23 Mb) showed the greatest sensory processing difficulties and very low adaptive skills.

CONCLUSIONS

Patients with PMS show an atypical sensory profile, which correlates with limitations in general adaptive behaviors.

WHAT IS KNOWN

• PMS sensory processing difficulties were associated with a pattern of underresponsive/seeks sensation, low energy/weak, and tactile hyporeactivity. • Sensory processing difficulties have been associated with limitations in the development of appropriate adaptive communication and interaction behaviors.

WHAT IS NEW

• Sensory definite differences associated with tactile hyperreactivity, as well as significant effects of underresponsiveness/seeks sensation and auditory filtering categories on the adaptive abilities were found in SHANK3 patients. • Cluster analysis suggests that smaller mutation sizes were related to better sensory processing and higher adaptive skills, while patients with larger deletion sizes have greater adaptive difficulties and worse sensory processing skills.

摘要

目的

扩展并提供 Phelan-McDermid 综合征(PMS)患者感觉特征的详细定义。次要目的是检查感觉模式与适应行为之间的关系。

方法

对 51 名经基因证实患有 PMS 的西班牙患者进行了横断面研究。所有参与者的父母均完成了短感觉量表-西班牙语版(SSP-S)和适应行为评估系统 II(ABAS-II)。进行了相关分析、多元回归和层次聚类分析。

结果

在近 75%的 PMS 患者中确定了非典型感觉特征。尽管存在触觉敏感性、反应迟钝/寻求感觉、听觉过滤和低能量/弱感觉等方面的亚阈值值,但在分数上仍存在明显差异。ABAS-II 的概念、社会和实践领域以及一般适应综合指数(GAC)的得分极低(即<70)。在 SSP-S 分数与 ABAS-II 的概念、社会、实践和 GAC 指数之间发现了显著相关性(p<0.005),即 SSP-S 分数越高,技能越好,适应表现越高。聚类分析表明,具有最大突变大小(7.23 Mb)的组显示出最大的感觉处理困难和非常低的适应技能。

结论

PMS 患者表现出非典型的感觉特征,与一般适应行为的局限性相关。

已知

• PMS 感觉处理困难与反应迟钝/寻求感觉、低能量/弱和触觉低反应性模式相关。• 感觉处理困难与适当的适应交流和互动行为的发展受限有关。

新发现

• 在 SHANK3 患者中发现了与触觉高反应性相关的感觉明确差异,以及与反应迟钝/寻求感觉和听觉过滤类别的显著影响对适应能力的影响。• 聚类分析表明,较小的突变大小与更好的感觉处理和更高的适应技能相关,而具有较大缺失大小的患者则具有更大的适应困难和更差的感觉处理技能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dbf/9352617/b29fb3c397a9/431_2022_4564_Fig1_HTML.jpg

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