Sasaki H
Department of Neurology, Hokkaido University School of Medicine.
Rinsho Shinkeigaku. 1993 Dec;33(12):1285-7.
To study gene loci and disease phenotypes, 18 families with dominant OPCA were subjected for linkage analysis to SCA1- or SCA2-linked microsatellites. Total individuals consisted of 190. Among them, 77 were affected. Consequently, 10 families were 6p-linked, 7 were 12q-linked, and one was type-undetermined. These results indicate that the majority of dominant OPCA in Japan are composed with these two genotypes. Clinically, these two disorders show progressive ataxia, Babinski reflexes, and terminal amyotrophy. Other common features in SCA1 were hyperreflexia, spasticity, mild nystagmus at early stage, slow saccade, and external ophthalmoparesis (EOP) at advanced stage. In contrast SCA2 showed progressive hyporeflexia and slow saccade from early stage. Moreover, choreiform movement, tremor, and rhythmic myoclonus were more frequent in the latter. Neuropathologically, dentate nucleus, brainstem motor nuclei, spinocerebellar tract were involved more severely in SCA1 than SCA2. Degeneration of substantia nigra is more marked in SCA2 than SCA1. These observations strongly indicate that there are correlations between genotypes and phenotypes in dominant OPCAs. Conversely, it is possible to diagnose these two genetic disorders from the clinico-pathological findings.
为了研究基因位点与疾病表型,对18个显性橄榄桥脑小脑萎缩(OPCA)家族进行了与脊髓小脑共济失调1型(SCA1)或脊髓小脑共济失调2型(SCA2)相关的微卫星连锁分析。总共有190名个体,其中77名患病。结果显示,10个家族与6号染色体短臂(6p)连锁,7个与12号染色体长臂(12q)连锁,1个类型未确定。这些结果表明,日本的大多数显性OPCA由这两种基因型组成。临床上,这两种疾病均表现为进行性共济失调、巴宾斯基反射和晚期肌萎缩。SCA1的其他常见特征包括反射亢进、痉挛、早期轻度眼球震颤、扫视缓慢以及晚期外展神经麻痹(EOP)。相比之下,SCA2从早期就表现为进行性反射减退和扫视缓慢。此外,后者出现舞蹈样动作、震颤和节律性肌阵挛更为频繁。神经病理学上,SCA1中齿状核、脑干运动核、脊髓小脑束受累比SCA2更严重。SCA2中黑质变性比SCA1更明显。这些观察结果强烈表明,显性OPCA的基因型与表型之间存在相关性。相反,根据临床病理表现可以诊断这两种遗传性疾病。