Jang Dae-Hyun, Kim Jaewon, Schwabe Aloysia Leisanne, Lotze Timothy Edward
Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Medical Genetics/Rare Disease Center, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ann Rehabil Med. 2024 Dec;48(6):369-376. doi: 10.5535/arm.240081. Epub 2024 Dec 23.
Cerebral palsy (CP) is the most common motor disability in children, characterized by diverse clinical manifestations and often uncertain etiology, which has spurred increasing interest in genetic diagnostics. This review synthesizes findings from various studies to enhance understanding of CP's genetic underpinnings. The discussion is structured around five key areas: monogenic causes and copy number variants directly linked to CP, differential genetic disorders including atypical CP and mimics, ambiguous genetic influences, co-occurrence with other neurodevelopmental disorders, and polygenic risk factors. Case studies illustrate the clinical application of these genetic insights, underscoring the complexity of diagnosing CP due to the phenotypic overlap with other conditions and the potential for misdiagnosis. The review highlights the significant role of advanced genetic testing in distinguishing CP from similar neurodevelopmental disorders and assessing cases with unclear clinical presentations. Furthermore, it addresses the ongoing challenges in establishing a consensus on genetic contributors to CP, the need for comprehensive patient phenotyping, and the integration of rigorous genetic and functional studies to validate findings. This comprehensive examination of CP genetics aims to pave the way for more precise diagnostics and personalized treatment plans, urging continued research to overcome the current limitations and refine diagnostic criteria within this field.
脑瘫(CP)是儿童中最常见的运动障碍,其临床表现多样,病因往往不明,这激发了人们对基因诊断的日益浓厚的兴趣。本综述综合了各项研究的结果,以增进对脑瘫基因基础的理解。讨论围绕五个关键领域展开:与脑瘫直接相关的单基因病因和拷贝数变异、包括非典型脑瘫及相似病症在内的不同遗传疾病、模糊的遗传影响、与其他神经发育障碍的共病情况以及多基因风险因素。案例研究说明了这些基因见解的临床应用,强调了由于与其他病症存在表型重叠以及误诊可能性,脑瘫诊断具有复杂性。该综述强调了先进基因检测在区分脑瘫与相似神经发育障碍以及评估临床表现不明确的病例方面的重要作用。此外,它还探讨了在就脑瘫的遗传因素达成共识方面持续存在的挑战、全面患者表型分析的必要性,以及整合严谨的基因和功能研究以验证研究结果的需求。对脑瘫遗传学的这一全面审视旨在为更精确的诊断和个性化治疗方案铺平道路,促使持续开展研究以克服当前的局限性并完善该领域的诊断标准。