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TATA 结合蛋白(TBP)基因突变分析在俄罗斯脊髓小脑共济失调和亨廷顿病样表型患者中的作用。

Mutation analysis of the TATA box-binding protein (TBP) gene in Russian patients with spinocerebellar ataxia and Huntington disease-like phenotype.

机构信息

Research Center of Neurology, 80 Volokolamskoe shosse, Moscow 125367, Russia.

Research Center of Neurology, 80 Volokolamskoe shosse, Moscow 125367, Russia.

出版信息

Clin Neurol Neurosurg. 2022 Nov;222:107473. doi: 10.1016/j.clineuro.2022.107473. Epub 2022 Oct 12.

Abstract

OBJECTIVE

We aimed to analyze the occurrence and clinical and genetic characteristics of spinocerebellar ataxia type 17 (SCA17) among Russian patients with progressive cerebellar ataxia or Huntington disease-like phenotype.

METHODS

Genetic analysis of CAG/CAA repeats in TBP gene was carried out in 217 patients, including 153 patients with progressive unspecified ataxia and 64 patients with Huntington disease-like phenotype. SCA types 1, 2, 3, 6 and 8, Friedreich's ataxia, CANVAS and Huntington disease were preliminarily excluded.

RESULTS

Six unrelated patients with SCA17 (2.8 %) were identified (43-57 CAG/CAA repeats in TBP gene). Two patients had a positive family history. Age at the disease onset ranged from 15 to 47 years. The core clinical syndrome included progressive cerebellar ataxia, dysarthria, movement disorders, cognitive impairment, and psychiatric symptoms. One patient had epilepsy with rare generalized tonic-clonic seizures. Another patient with diffuse muscle atrophy and small expansion size (43 CAG/CAA repeats) had myopathic changes in skeletal muscles on EMG study. We also described a patient with a large expansion size of 57 CAA/CAG repeats with early onset and rapid disease progression.

CONCLUSION

SCA17 is a relatively rare cause of progressive disorders with ataxia and chorea, but it should be considered in the spectrum of differential diagnosis in such patients. Most of our SCA17 cases were sporadic which should be kept in mind when planning genetic testing in patients with spinocerebellar ataxia and chorea.

摘要

目的

我们旨在分析俄罗斯进行性小脑共济失调或亨廷顿病样表型患者中 17 型脊髓小脑共济失调(SCA17)的发生及临床和遗传特征。

方法

对 217 例患者(包括 153 例进行性未特指小脑共济失调和 64 例亨廷顿病样表型患者)的 TBP 基因 CAG/CAA 重复进行基因分析。初步排除 SCA 1 型、2 型、3 型、6 型和 8 型、弗里德里希共济失调、CANVAS 和亨廷顿病。

结果

发现 6 例(2.8%)不相关的 SCA17 患者(TBP 基因中有 43-57 个 CAG/CAA 重复)。2 例患者有阳性家族史。发病年龄为 15-47 岁。主要临床综合征包括进行性小脑共济失调、构音障碍、运动障碍、认知障碍和精神症状。1 例患者有癫痫,表现为罕见的全身性强直阵挛发作。另 1 例患者有弥漫性肌肉萎缩和较小的扩展大小(43 CAG/CAA 重复),肌电图研究显示骨骼肌有肌病改变。我们还描述了 1 例患者有较大的扩展大小(57 CAA/CAG 重复),发病早,疾病进展迅速。

结论

SCA17 是一种相对罕见的进行性共济失调和舞蹈病的病因,但在这些患者的鉴别诊断谱中应考虑到这一点。我们的大多数 SCA17 病例为散发性,在计划对有脊髓小脑共济失调和舞蹈病的患者进行基因检测时应牢记这一点。

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