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一组18号染色体异常患者的行为表型:一项回顾性观察研究。

The behavioral phenotype in a cohort of patients with chromosome 18 anomalies: a retrospective observational study.

作者信息

Allegri Beatrice, Ajmone Paola Francesca, Michelini Giovanni, Antonietti Virginia, Tornielli Silvia, Bruschi Fabio, Dall'Ara Francesca, Monti Federico, Milani Donatella, Vizziello Paola Giovanna, Costantino Maria Antonella

机构信息

Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico -SC, via Pace 9, Milan, 20122, Italy.

Child and Youth Lab, Sigmund Freud University of Milan, Via Ripa di Porta Ticinese 77, Milan, 20143, Italy.

出版信息

Ital J Pediatr. 2025 Feb 25;51(1):60. doi: 10.1186/s13052-025-01902-2.

Abstract

BACKGROUND

Genetic syndromes resulting from chromosome 18 structural abnormalities constitute a broad spectrum of conditions characterized by significant clinical heterogeneity. Most studies in the literature focus on case reports and clinical observations; the present study aims to assess the cognitive, communicative, behavioral, and adaptive abilities of different chromosome 18 abnormalities. In addition, this work aims to identify phenotype-genotype correlations by comparing individuals with 18p deletion, 18q deletion, and 18p tetrasomy.

METHODS

The sample included 24 patients with a definite genetic diagnosis of 18p deletion (N = 6), 18q deletion (N = 9), or 18p tetrasomy (N = 8). The assessment is provided by using a specific protocol based on direct and indirect clinical assessment of patients. Differences in IQ/GQ indexes, adaptive behavior, CARS scores, and CBCL internalizing and externalizing symptoms were assessed using ANCOVAs with age as covariate.

RESULTS

Our results showed more significant cognitive and behavioral impairment in tetrasomy 18 than in the other two conditions. Conversely, in 18p deletion group, we found greater behaviorally susceptibility to develop autistic traits.

CONCLUSION

These preliminary findings should raise clinicians' awareness of the strengths and weaknesses of patients with chromosome 18 alterations, paving the way to targeted and more appropriate management.

摘要

背景

由18号染色体结构异常导致的遗传综合征构成了一系列具有显著临床异质性的疾病。文献中的大多数研究集中在病例报告和临床观察上;本研究旨在评估不同18号染色体异常患者的认知、沟通、行为和适应能力。此外,这项工作旨在通过比较18p缺失、18q缺失和18p四体的个体来确定表型-基因型相关性。

方法

样本包括24例明确诊断为18p缺失(N = 6)、18q缺失(N = 9)或18p四体(N = 8)的患者。通过使用基于对患者直接和间接临床评估的特定方案进行评估。使用以年龄为协变量的协方差分析评估智商/发育商指数、适应行为、儿童孤独症评定量表(CARS)得分以及儿童行为检查表(CBCL)内化和外化症状的差异。

结果

我们的结果显示,与其他两种情况相比,18号染色体四体患者的认知和行为损害更严重。相反,在18p缺失组中,我们发现患者在行为上更容易出现孤独症特征。

结论

这些初步发现应提高临床医生对18号染色体改变患者优缺点的认识,为有针对性和更适当的管理铺平道路。

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本文引用的文献

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Tetrasomy 18p: case report and review of literature.18号染色体短臂四体综合征:病例报告及文献复习
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A review of 18p deletions.18号染色体短臂缺失的综述。
Am J Med Genet C Semin Med Genet. 2015 Sep;169(3):251-64. doi: 10.1002/ajmg.c.31445. Epub 2015 Aug 6.
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Consequences of chromsome18q deletions.18号染色体长臂缺失的后果。
Am J Med Genet C Semin Med Genet. 2015 Sep;169(3):265-80. doi: 10.1002/ajmg.c.31446. Epub 2015 Aug 3.
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Whole arm deletions of 18p: medical and developmental effects.18号染色体短臂的全臂缺失:医学和发育影响
Am J Med Genet A. 2015 Feb;167A(2):313-23. doi: 10.1002/ajmg.a.36880. Epub 2015 Jan 14.
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Mood disorders in individuals with distal 18q deletions.伴有远端 18q 缺失的个体的心境障碍。
Am J Med Genet B Neuropsychiatr Genet. 2013 Dec;162B(8):879-88. doi: 10.1002/ajmg.b.32197. Epub 2013 Sep 4.

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