Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA.
Mol Genet Genomic Med. 2022 Aug;10(8):e2001. doi: 10.1002/mgg3.2001. Epub 2022 Jul 18.
Fragile X syndrome is characterized by a myriad of physical features, behavioral features, and medical problems. Commonly found behavioral features are hyperactivity, anxiety, socialization difficulties, and ASD. There is also a higher incidence than in the general population of strabismus, otitis media, and mitral valve prolapse. In addition, one of the most common medical problems associated with FXS is an increased risk of seizures. A subset of individuals carrying the full mutation of the FMR1 gene and diagnosed with fragile X syndrome (FXS) are reported to experience seizures, mostly during the first 10 years of their life span.
As part of a larger project to identify genetic variants that modify the risk of seizures, we collected clinical information from 49 carriers with FXS who experienced seizures and 46 without seizures. We compared seizure type and comorbid conditions based on the source of data as well as family history of seizures.
We found that the concordance of seizure types observed by parents and medical specialists varied by type of seizure. The most common comorbid condition among those with seizures was autism spectrum disorder (47% per medical records vs. 33% per parent report compared with 19% among those without seizures per parent report); the frequency of other comorbid conditions did not differ among groups. We found a slightly higher frequency of family members who experienced seizures among the seizure group compared with the nonseizure group.
This study confirms previously reported features of seizures in FXS, supports additional genetic factors, and highlights the importance of information sources, altogether contributing to a better understanding of seizures in FXS.
脆性 X 综合征的特征是存在多种身体特征、行为特征和医疗问题。常见的行为特征包括多动、焦虑、社交困难和 ASD。斜视、中耳炎和二尖瓣脱垂的发病率也高于普通人群。此外,与 FXS 相关的最常见的医疗问题之一是癫痫发作的风险增加。据报道,携带完整 FMR1 基因突变并被诊断为脆性 X 综合征(FXS)的一部分个体会出现癫痫发作,主要发生在他们的生命跨度的前 10 年。
作为确定可改变癫痫发作风险的遗传变异的更大项目的一部分,我们从 49 名患有 FXS 并经历过癫痫发作的携带者和 46 名没有癫痫发作的携带者中收集了临床信息。我们根据数据来源以及癫痫发作的家族史比较了癫痫发作类型和合并症。
我们发现,父母和医学专家观察到的癫痫发作类型的一致性因发作类型而异。在有癫痫发作的患者中最常见的合并症是自闭症谱系障碍(47% 根据医疗记录,33% 根据父母报告,而根据父母报告,无癫痫发作的患者中为 19%);其他合并症的频率在各组之间没有差异。与无癫痫发作组相比,癫痫发作组中家庭成员有癫痫发作的频率略高。
本研究证实了先前报道的 FXS 癫痫发作的特征,支持了其他遗传因素,并强调了信息来源的重要性,共同有助于更好地了解 FXS 中的癫痫发作。