Quaio Caio Robledo D'Angioli Costa, Silva Thiago Yoshinaga Tonholo, Barsottini Orlando G, Camargos Sarah Teixeira, França Marcondes C, Saute Jonas A, Marques Wilson, Kok Fernando, Pedroso José Luiz
Hospital Israelita Albert Einstein, São Paulo SP, Brazil.
Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2025 Apr;83(4):1-14. doi: 10.1055/s-0045-1807715. Epub 2025 May 13.
Over the last decade, whole-exome sequencing (WES) has become a standard diagnostic tool, significantly transforming the landscape of clinical genetics and playing a pivotal role in the diagnosis of neurogenetic diseases. This revolutionary shift has left a lasting impact on the field of neurology in Brazil. The current review article examines key developments and milestones achieved in Brazil through the application of WES in neurology and discusses forthcoming challenges and essential steps to advance molecular diagnosis. Several studies report the use of WES to diagnose genetic disorders with neurological manifestations in Brazil, underscoring the growing importance of molecular diagnosis in neurogenetics. These studies often provide detailed phenotypic analyses and clinical descriptions, offering valuable insights into the genetic underpinnings of several neurological conditions. Many reports highlight the use of WES in the investigation of complex neurological conditions in Brazil, such as neurodevelopmental disorders, hereditary spastic paraplegia, movement disorders, and ataxia. The discovery of new genes implicated in monogenic diseases with neurological manifestations through WES was a significant breakthrough. Despite these advances, the availability of large cohort studies on rare diseases in Brazil remains limited, hindering the ability to generalize findings and explore the full spectrum of genetic diversity. However, a few larger cohort studies have substantially contributed to our understanding of rare diseases and specific neurological disorders.While WES has limitations and may eventually be supplanted by more advanced diagnostic tools, it left a permanent mark on the neurology field in Brazil. The field of neurogenetics is set to become increasingly important in the future.
在过去十年中,全外显子组测序(WES)已成为一种标准的诊断工具,极大地改变了临床遗传学的格局,并在神经遗传疾病的诊断中发挥了关键作用。这一革命性的转变给巴西的神经病学领域留下了持久的影响。当前的这篇综述文章审视了通过在神经病学中应用WES在巴西所取得的关键进展和里程碑事件,并讨论了未来的挑战以及推进分子诊断的必要步骤。多项研究报告了在巴西使用WES诊断具有神经学表现的遗传疾病,突显了分子诊断在神经遗传学中日益增长的重要性。这些研究通常提供详细的表型分析和临床描述,为几种神经疾病的遗传基础提供了有价值的见解。许多报告强调了在巴西使用WES对复杂神经疾病进行调查,如神经发育障碍、遗传性痉挛性截瘫、运动障碍和共济失调。通过WES发现与具有神经学表现的单基因疾病相关的新基因是一项重大突破。尽管取得了这些进展,但巴西关于罕见病的大型队列研究仍然有限,这阻碍了对研究结果进行推广以及探索遗传多样性全貌的能力。然而,一些较大规模的队列研究为我们对罕见病和特定神经疾病的理解做出了重大贡献。虽然WES有其局限性,最终可能会被更先进的诊断工具所取代,但它在巴西的神经病学领域留下了永久的印记。神经遗传学领域在未来将变得越来越重要。
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