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与17号染色体节段性重复相关的夏科-马里-图斯多发性神经病的神经传导研究

Nerve conduction studies in Charcot-Marie-Tooth polyneuropathy associated with a segmental duplication of chromosome 17.

作者信息

Kaku D A, Parry G J, Malamut R, Lupski J R, Garcia C A

机构信息

Department of Neurology, Louisiana State University School of Medicine, New Orleans 70112-2822.

出版信息

Neurology. 1993 Sep;43(9):1806-8. doi: 10.1212/wnl.43.9.1806.

Abstract

We evaluated motor conduction velocities in a large group of patients and their unaffected kin from five families in which a segmental duplication of chromosome 17p has shown complete linkage to Charcot-Marie-Tooth disease type 1 (CMT1A). Slowing of conduction was completely concordant with the presence of the segmental duplication; two clinically normal patients had slowed conduction. Nonetheless, among the patients with the CMT1A duplication, conduction velocities varied widely, by > 30 m/sec overall, by > 20 m/sec within families, and often by more than 10 m/sec between siblings and between parents and children. One patient was homozygous for the chromosome 17p duplication and had the slowest conduction velocity observed. Conduction slowing was not age-dependent and was present early in childhood. Our findings demonstrate complete penetrance at an early age of the electrophysiologic phenotype associated with the chromosome 17p duplication and confirm the reliability of nerve conduction studies in establishing the affection status in CMT1A. The great variation in conduction velocity among CMT1A patients emphasizes the influence of factors apart from the shared genetic mutation on phenotypic expression.

摘要

我们评估了来自五个家族的一大群患者及其未受影响的亲属的运动传导速度,在这些家族中,17号染色体短臂的节段性重复已显示与1型遗传性运动感觉神经病(CMT1A)完全连锁。传导速度减慢与节段性重复的存在完全一致;两名临床正常的患者传导速度减慢。尽管如此,在患有CMT1A重复的患者中,传导速度差异很大,总体差异超过30米/秒,家族内差异超过20米/秒,兄弟姐妹之间以及父母与子女之间的差异通常超过10米/秒。一名患者为17号染色体短臂重复的纯合子,其传导速度是观察到的最慢的。传导速度减慢与年龄无关,在儿童早期就已出现。我们的研究结果表明,与17号染色体短臂重复相关的电生理表型在早年具有完全外显率,并证实了神经传导研究在确定CMT1A患病状态方面的可靠性。CMT1A患者之间传导速度的巨大差异强调了除共享基因突变外的其他因素对表型表达的影响。

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