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奥格登综合征的纵向适应性行为结局与癫痫发作状态和治疗干预有关。

Longitudinal adaptive behavioral outcomes in Ogden syndrome by seizure status and therapeutic intervention.

机构信息

Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, New York, New York, USA.

George A. Jervis Clinic, New York State Institute for Basic Research in Developmental Disabilities, New York, New York, USA.

出版信息

Am J Med Genet A. 2024 Sep;194(9):e63651. doi: 10.1002/ajmg.a.63651. Epub 2024 May 15.

Abstract

Ogden syndrome, also known as NAA10-related neurodevelopmental syndrome, is a rare genetic condition associated with pathogenic variants in the NAA10 N-terminal acetylation family of proteins. The condition was initially described in 2011 and is characterized by a range of neurologic symptoms, including intellectual disability and seizures, as well as developmental delays, psychiatric symptoms, congenital heart abnormalities, hypotonia, and others. Previously published articles have described the etiology and phenotype of Ogden syndrome, mostly with retrospective analyses; herein, we report prospective data concerning its progress over time. The current study involves a total of 58 distinct participants; of these, 43 caregivers were interviewed using the Vineland-3 and answered a survey regarding therapy and other questions, 10 of whom completed the Vineland-3 but did not answer the survey, and 5 participants who answered the survey but have not yet performed the Vineland-3 due to language constraints. The average age at the time of the most recent assessment was 12.4 years, with individuals ranging in age from 11 months to 40.2 years. Using Vineland-3 scores, we show decline in cognitive function over time in individuals with Ogden syndrome (n = 53). Sub-domain analysis found the decline to be present across all modalities. In addition, we describe the nature of seizures in this condition in greater detail, as well as investigate how already-available non-pharmaceutical therapies impact individuals with NAA10-related neurodevelopmental syndrome. Additional investigation between seizure and non-seizure groups showed no significant difference in adaptive behavior outcomes. A therapy investigation showed speech therapy to be the most commonly used therapy by individuals with NAA10-related neurodevelopmental syndrome, followed by occupational and physical therapy, with more severely affected individuals receiving more types of therapy than their less-severe counterparts. Early intervention analysis was only significantly effective for speech therapy, with analyses of all other therapies being non-significant. Our study portrays the decline in cognitive function over time of individuals within our cohort, independent of seizure status, and therapies being received, and highlights the urgent need for the development of effective treatments for Ogden syndrome.

摘要

奥格登综合征,也称为 NAA10 相关神经发育综合征,是一种罕见的遗传疾病,与 NAA10 N 端乙酰化蛋白家族的致病性变异有关。该病症最初于 2011 年描述,其特征是一系列神经系统症状,包括智力障碍和癫痫发作,以及发育迟缓、精神症状、先天性心脏异常、肌张力减退等。以前的文章已经描述了奥格登综合征的病因和表型,主要是回顾性分析;在这里,我们报告了随着时间推移的前瞻性数据。本研究共涉及 58 名不同的参与者;其中,43 名照顾者使用 Vineland-3 进行了访谈,并回答了有关治疗和其他问题的调查,其中 10 名完成了 Vineland-3 但未回答调查,5 名参与者回答了调查,但由于语言限制尚未完成 Vineland-3。最近一次评估时的平均年龄为 12.4 岁,年龄范围为 11 个月至 40.2 岁。使用 Vineland-3 评分,我们显示奥格登综合征患者的认知功能随时间下降(n=53)。子域分析发现所有模式均存在下降。此外,我们更详细地描述了这种情况下癫痫发作的性质,并研究了已经可用的非药物治疗如何影响 NAA10 相关神经发育综合征患者。对癫痫发作和非癫痫发作组之间的进一步调查显示,适应性行为结果没有显著差异。一项治疗调查显示,言语治疗是 NAA10 相关神经发育综合征患者最常用的治疗方法,其次是职业和物理治疗,受影响更严重的患者比病情较轻的患者接受的治疗类型更多。早期干预分析仅对言语治疗有效,而对所有其他治疗的分析均无统计学意义。我们的研究描述了我们队列中个体的认知功能随时间的下降,与癫痫发作状态和接受的治疗无关,并强调了迫切需要开发针对奥格登综合征的有效治疗方法。

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