对小脑桥发育不全患者的评估:一项全国性多中心研究

Dilek Cavusoglu, Gulten Ozturk, Dilsad Turkdogan, Semra Hiz Kurul, Uluc Yis, Mustafa Komur, Faruk Incecik, Bulent Kara, Turkan Sahin, Olcay Unver, Cengiz Dilber, Gulen Gul Mert, Cagatay Gunay, Gamze Sarikaya Uzan, Ozlem Ersoy, Yavuz Oktay, Serdar Mermer, Gokcen Oz Tuncer, Olcay Gungor, Gul Demet Kaya Ozcora, Ugur Gumus, Ozlem Sezer, Gokhan Ozan Cetin, Fatma Demir, Arzu Yilmaz, Gurkan Gurbuz, Meral Topcu, Haluk Topaloglu, Ahmet Cevdet Ceylan, Serdar Ceylaner, Joseph G. Gleeson, Dilara Fusun Icagasioglu, F. Mujgan Sonmez
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摘要

小脑桥脑发育不全症(PCH)是一组以小脑和脑桥发育不全和变性为特征的异质性神经退行性疾病。我们的目的是确定已确诊并进行了基因分析的 PCH 患者的临床、实验室和影像学结果。我们在对土耳其 64 名 PCH 患者进行的回顾性多中心全国研究中收集了可用的临床数据、实验室和影像学结果。基因分析包括全外显子组测序(WES)、靶向新一代测序(NGS)或单基因分析。64 名 PCH 患者中有 28 名女性(43.8%)和 36 名男性(56.3%)。89.1%的患者出现同基因突变,79.7%的患者为近亲结婚,85.2%的患者足月妊娠,91.3%的患者出现小头畸形,98.4%的患者出现精神运动发育迟缓,100%的患者出现神经系统异常,63.8%的患者出现癫痫发作,92.2%的患者生化和代谢检查正常,51.2%的患者出现畸形。在所有 PCH 患者中,错义突变是最常见的变异类型。由于 CLP1(n = 17)是最常见的 PCH 相关基因,因此它也被检测出来。在所有 CLP1 患者中都发现了同源错义变异 c.419G > A (p.Arg140His)。此外,在 TSEN54 组(n = 6)中,所有患者都出现了相同的同源错义变体 c.919G >T(p.A307S)。在土耳其,CLP1 被确定为最常见的致病基因,其相同变体为 c.419G > A; p.Arg140His。本研究证实,PCH 的基因型数据会导致广泛表型谱的表型变异。
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Evaluation of the Patients with the Diagnosis of Pontocerebellar Hypoplasia: A Multicenter National Study

Pontocerebellar hypoplasia (PCH) is a heterogeneous group of neurodegenerative disorders characterized by hypoplasia and degeneration of the cerebellum and pons. We aimed to identify the clinical, laboratory, and imaging findings of the patients with diagnosed PCH with confirmed genetic analysis. We collected available clinical data, laboratory, and imaging findings in our retrospective multicenter national study of 64 patients with PCH in Turkey. The genetic analysis included the whole-exome sequencing (WES), targeted next-generation sequencing (NGS), or single gene analysis. Sixty-four patients with PCH were 28 female (43.8%) and 36 (56.3%) male. The patients revealed homozygous mutation in 89.1%, consanguinity in 79.7%, pregnancy at term in 85.2%, microcephaly in 91.3%, psychomotor retardation in 98.4%, abnormal neurological findings in 100%, seizure in 63.8%, normal biochemistry and metabolic investigations in 92.2%, and dysmorphic findings in 51.2%. The missense mutation was found to be the most common variant type in all patients with PCH. It was detected as CLP1 (n = 17) was the most common PCH related gene. The homozygous missense variant c.419G > A (p.Arg140His) was identified in all patients with CLP1. Moreover, all patients showed the same homozygous missense variant c.919G > T (p.A307S) in TSEN54 group (n = 6). In Turkey, CLP1 was identified as the most common causative gene with the identical variant c.419G > A; p.Arg140His. The current study supports that genotype data on PCH leads to phenotypic variability over a wide phenotypic spectrum.

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