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一名携带小扩张等位基因脊髓小脑共济失调17型的患者出现孤立性全身性舞蹈症。

Isolated Generalized Chorea in a Patient with Small-Expanded Allele Spinocerebellar Ataxia 17.

作者信息

Paparella Giulia, De Riggi Martina, Aloisio Simone, Martini Adriana, Angelini Luca, Birreci Daniele, Costa Davide, Cannavacciuolo Antonio, Griguoli Anna Maria, Gambardella Stefano, Bologna Matteo

机构信息

Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.

IRCCS Neuromed, Pozzilli (IS), Italy.

出版信息

Cerebellum. 2025 Jun 6;24(4):110. doi: 10.1007/s12311-025-01868-1.

DOI:10.1007/s12311-025-01868-1
PMID:40478462
Abstract

BACKGROUND

Spinocerebellar ataxia type 17 (SCA17) is an autosomal dominant disease caused by a polyglutamine-encoding CAG/CAA repeat expansion within the TATA box-binding protein (TBP) gene. It is characterized by a markedly heterogeneous phenomenology and complex genotype-phenotype relationships.

CASE DESCRIPTION

We describe the clinical, neuropsychological, and neuroimaging findings of a 73-year-old patient who presented a 10-year history of generalized hyperkinetic movements and depressive symptoms. The patient's family history was unremarkable. Neurological examination revealed choreic movements affecting the upper and lower limbs, the face and the trunk with no additional neurological signs. Blood sample analysis, brain imaging, and neuropsychological evaluation revealed normal results. Genetic analysis identified, in the TBP gene, the 41-CAG pathological allele with reduced penetrance.

CONCLUSION

The present case report provides further insight into the small-expanded allele SCA17-associated phenotype, supporting the recently updated genotype-phenotype assessment for SCA17.

摘要

背景

17型脊髓小脑共济失调(SCA17)是一种常染色体显性疾病,由TATA盒结合蛋白(TBP)基因内编码多聚谷氨酰胺的CAG/CAA重复序列扩增引起。其特点是临床表现明显异质性,基因型与表型关系复杂。

病例描述

我们描述了一名73岁患者的临床、神经心理学和神经影像学检查结果,该患者有10年的全身性运动过多和抑郁症状病史。患者家族史无异常。神经系统检查发现肢体、面部和躯干出现舞蹈样动作,无其他神经系统体征。血液样本分析、脑部成像和神经心理学评估结果均正常。基因分析在TBP基因中鉴定出41-CAG病理性等位基因,其外显率降低。

结论

本病例报告进一步深入了解了小扩增等位基因SCA17相关表型,支持了最近更新的SCA17基因型-表型评估。

相似文献

1
Isolated Generalized Chorea in a Patient with Small-Expanded Allele Spinocerebellar Ataxia 17.一名携带小扩张等位基因脊髓小脑共济失调17型的患者出现孤立性全身性舞蹈症。
Cerebellum. 2025 Jun 6;24(4):110. doi: 10.1007/s12311-025-01868-1.
2
Genotype-Phenotype Correlations for ATX-TBP (SCA17): MDSGene Systematic Review.ATX-TBP(SCA17)的基因型-表型相关性:MDSGene 系统评价。
Mov Disord. 2023 Mar;38(3):368-377. doi: 10.1002/mds.29278. Epub 2022 Nov 14.
3
Spinocerebellar ataxia type 17: report of a family with reduced penetrance of an unstable Gln49 TBP allele, haplotype analysis supporting a founder effect for unstable alleles and comparative analysis of SCA17 genotypes.17型脊髓小脑共济失调:一个携带不稳定Gln49 TBP等位基因且外显率降低的家系报告、支持不稳定等位基因存在奠基者效应的单倍型分析以及SCA17基因型的比较分析
BMC Med Genet. 2005 Jul 1;6:27. doi: 10.1186/1471-2350-6-27.
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Possible reduced penetrance of expansion of 44 to 47 CAG/CAA repeats in the TATA-binding protein gene in spinocerebellar ataxia type 17.17型脊髓小脑共济失调中TATA结合蛋白基因中44至47个CAG/CAA重复序列扩增的可能降低的外显率。
Arch Neurol. 2004 Feb;61(2):209-12. doi: 10.1001/archneur.61.2.209.
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Small-expanded allele spinocerebellar ataxia 17: imaging and phenotypic variability.小扩展等位基因脊髓小脑共济失调 17:影像学表现和表型变异性。
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Spinocerebellar Ataxia Type 17 (SCA17).脊髓小脑性共济失调 17 型(SCA17)。
Adv Exp Med Biol. 2018;1049:219-231. doi: 10.1007/978-3-319-71779-1_10.
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Phenotypical variability of expanded alleles in the TATA-binding protein gene. Reduced penetrance in SCA17?TATA结合蛋白基因中扩增等位基因的表型变异性。SCA17中存在外显率降低的情况?
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Digenic inheritance of STUB1 variants and TBP polyglutamine expansions explains the incomplete penetrance of SCA17 and SCA48.STUB1 变异和 TBP 多聚谷氨酰胺扩展的双基因遗传解释了 SCA17 和 SCA48 的不完全外显率。
Genet Med. 2022 Jan;24(1):29-40. doi: 10.1016/j.gim.2021.08.003. Epub 2021 Nov 30.
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Spinocerebellar ataxia type 17 associated with an expansion of 42 glutamine residues in TATA-box binding protein gene.脊髓小脑性共济失调 17 型与 TATA 框结合蛋白基因中 42 个谷氨酰胺残基的扩展有关。
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本文引用的文献

1
Antisaccades in Spinocerebellar Ataxia Type 17 With Middle Cerebellar Peduncle Hyperintensities Without Hot-Cross-Bun Sign.伴有小脑中脚高信号且无“热十字面包征”的17型脊髓小脑共济失调中的反扫视眼运动
J Clin Neurol. 2024 May;20(3):342-344. doi: 10.3988/jcn.2023.0397.
2
Cognitive dysfunction, social behavior disorder, cerebellar ataxia, and atypical brain FDG-PET presentation in spinocerebellar ataxia 17: a case report.脊髓小脑共济失调 17 型:认知功能障碍、社会行为障碍、小脑性共济失调和非典型脑部 FDG-PET 表现:病例报告。
Neurol Sci. 2024 Jun;45(6):2877-2880. doi: 10.1007/s10072-024-07453-4. Epub 2024 Mar 18.
3
Genotype-Phenotype Correlations for ATX-TBP (SCA17): MDSGene Systematic Review.
ATX-TBP(SCA17)的基因型-表型相关性:MDSGene 系统评价。
Mov Disord. 2023 Mar;38(3):368-377. doi: 10.1002/mds.29278. Epub 2022 Nov 14.
4
Small-expanded allele spinocerebellar ataxia 17: imaging and phenotypic variability.小扩展等位基因脊髓小脑共济失调 17:影像学表现和表型变异性。
Neurol Sci. 2021 Oct;42(10):4309-4315. doi: 10.1007/s10072-021-05313-z. Epub 2021 May 24.
5
Spinocerebellar ataxia 17: full phenotype in a 41 CAG/CAA repeats carrier.脊髓小脑共济失调17型:41个CAG/CAA重复序列携带者的完整表型。
Cerebellum Ataxias. 2018 Mar 14;5:7. doi: 10.1186/s40673-018-0086-x. eCollection 2018.
6
A patient with 41 CAG repeats in SCA17 presenting with parkinsonism and chorea.一名患有SCA17基因中41个CAG重复序列的患者,表现为帕金森症和舞蹈症。
Parkinsonism Relat Disord. 2016 Jan;22:106-7. doi: 10.1016/j.parkreldis.2015.11.011. Epub 2015 Nov 14.
7
Psychiatric onset and late chorea in a patient with 41 CAG repeats in the TATA-binding protein gene.一名TATA结合蛋白基因中有41个CAG重复序列的患者出现精神症状及迟发性舞蹈症。
Parkinsonism Relat Disord. 2014 Jun;20(6):678-9. doi: 10.1016/j.parkreldis.2014.03.007. Epub 2014 Mar 21.
8
Late onset ataxia: MSA-C or SCA 17? A gene penetrance dilemma.迟发性共济失调:多系统萎缩-C型还是17型脊髓小脑共济失调?基因外显率难题。
Mov Disord. 2014 Jan;29(1):36-8. doi: 10.1002/mds.25770. Epub 2013 Dec 16.
9
Consensus and controversies in best practices for molecular genetic testing of spinocerebellar ataxias.脊髓小脑共济失调分子遗传学检测最佳实践的共识与争议。
Eur J Hum Genet. 2010 Nov;18(11):1188-95. doi: 10.1038/ejhg.2010.10. Epub 2010 Feb 24.
10
Case of spinocerebellar ataxia type 17 (SCA17) associated with only 41 repeats of the TATA-binding protein (TBP) gene.仅伴有41次TATA结合蛋白(TBP)基因重复序列的17型脊髓小脑共济失调(SCA17)病例。
Mov Disord. 2007 Feb 15;22(3):436. doi: 10.1002/mds.21275.