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探索1型Chiari畸形的发病机制、患病率及基因关联:当代视角

Exploring pathogenesis, prevalence, and genetic associations in Chiari malformation type 1: a contemporary perspective.

作者信息

Mohd Rosdi Siti Nornazihah, Omar Suzuanhafizan, Mohamad Ghazali Mazira, Ghani Ab Rahman Izaini, Mohamed Yusoff Abdul Aziz

机构信息

Department of Neurosciences, School of Medical Sciences, University Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia.

出版信息

Asian Biomed (Res Rev News). 2024 Sep 20;18(4):148-156. doi: 10.2478/abm-2024-0021. eCollection 2024 Aug.

Abstract

Chiari malformation type 1 (CM 1) entails a structural defect in the cerebellum, involving the herniation of cerebellar tonsils toward the foramen magnum. The symptomatic or asymptomatic nature of CM 1 is contingent upon the condition of malformation in the spinal cord. This review presents an updated perspective on the prevalence of CM 1, its pathogenesis, genetic associations, and treatment. CM 1 exhibits a higher prevalence in adult females than males. Despite the incomplete understanding of the exact cause of CM 1, recent research suggests the involvement of both genetic and environmental factors in its development. One of the reasons for the occurrence of CM 1 in individuals is the smaller posterior cranial fossa, which manifests as typical morphological features. Additionally, environmental factors can potentially interact with genetic factors, modifying the observable characteristics of the disease and affecting the symptoms, severity, and development of the condition. Notably, headaches, neck pain, dizziness, and neurological deficits may be exhibited by individuals with CM 1, highlighting the importance of early diagnosis. Magnetic resonance imaging (MRI) serves as an alternative diagnostic technique for monitoring the symptoms of CM 1. Multiple genetic factors are likely to contribute to a cascade of abnormalities in CM 1. Early studies provided evidence, including clustering within families, bone development, and co-segregation with known genetic syndromes, establishing CM 1's association with a genetic basis. Furthermore, surgery is the only available treatment option to alleviate symptoms or hinder the progression of damage to the central nervous system (CNS) in CM 1 cases.

摘要

1型 Chiari 畸形(CM 1)是小脑的一种结构缺陷,涉及小脑扁桃体向枕骨大孔的疝出。CM 1的症状性或无症状性取决于脊髓的畸形状况。本综述呈现了关于CM 1的患病率、发病机制、基因关联及治疗的最新观点。CM 1在成年女性中的患病率高于男性。尽管对CM 1的确切病因尚不完全了解,但最近的研究表明其发病涉及遗传和环境因素。个体发生CM 1的原因之一是后颅窝较小,表现为典型的形态学特征。此外,环境因素可能与遗传因素相互作用,改变疾病的可观察特征,并影响症状、严重程度及病情发展。值得注意的是,CM 1患者可能会出现头痛、颈部疼痛、头晕和神经功能缺损,这凸显了早期诊断的重要性。磁共振成像(MRI)是监测CM 1症状的一种替代诊断技术。多种遗传因素可能导致CM 1出现一系列异常。早期研究提供了证据,包括家族内聚集、骨骼发育以及与已知遗传综合征的共分离,确立了CM 1与遗传基础的关联。此外,手术是缓解CM 1病例症状或阻止中枢神经系统(CNS)损伤进展的唯一可用治疗选择。

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本文引用的文献

1
Human genetics and molecular genomics of Chiari malformation type 1.Chiari 畸形 1 型的人类遗传学和分子基因组学。
Trends Mol Med. 2023 Dec;29(12):1059-1075. doi: 10.1016/j.molmed.2023.08.013. Epub 2023 Oct 4.
7
Elucidating the Genetic Basis of Chiari I Malformation.阐明 Chiari I 畸形的遗传基础。
Neurosurg Clin N Am. 2023 Jan;34(1):55-60. doi: 10.1016/j.nec.2022.07.001.

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