Comparison of Core Features in Four Developmental Encephalopathies in the Rett Natural History Study.


Journal

Annals of neurology
ISSN: 1531-8249
Titre abrégé: Ann Neurol
Pays: United States
ID NLM: 7707449

Informations de publication

Date de publication:
08 2020
Historique:
received: 13 03 2019
revised: 20 05 2020
accepted: 21 05 2020
pubmed: 31 5 2020
medline: 15 12 2020
entrez: 31 5 2020
Statut: ppublish

Résumé

Rett syndrome, CDKL5-deficiency disorder, FOXG1 disorder, and MECP2 duplication disorder are developmental encephalopathies with shared and distinct features. Although they are historically linked, no direct comparison has been performed. The first head-to-head comparison of clinical features in these conditions is presented. Comprehensive clinical information was collected from 793 individuals enrolled in the Rett and Rett-Related Disorders Natural History Study. Clinical features including clinical severity, regression, and seizures were cross-sectionally compared between diagnoses to test the hypothesis that these are 4 distinct disorders. Distinct patterns of clinical severity, seizure onset age, and regression were present. Individuals with CDKL5-deficency disorder were the most severely affected and had the youngest age at seizure onset (2 months), whereas children with MECP2 duplication syndrome had the oldest median age at seizure onset (64 months) and lowest severity scores. Rett syndrome and FOGX1 were intermediate in both features. Smaller head circumference correlates with increased severity in all disorders and earlier age at seizure onset in MECP2 duplication syndrome. Developmental regression occurred in all Rett syndrome participants (median = 18 months) but only 23 to 34% of the other disorders. Seizure incidence prior to the baseline visit was highest for CDKL5 deficiency disorder (96.2%) and lowest for Rett syndrome (47.5%). Other clinical features including seizure types and frequency differed among groups. Although these developmental encephalopathies share many clinical features, clear differences in severity, regression, and seizures warrant considering them as unique disorders. These results will aid in the development of disease-specific severity scales, precise therapeutics, and future clinical trials. ANN NEUROL 2020;88:396-406.

Identifiants

pubmed: 32472944
doi: 10.1002/ana.25797
pmc: PMC8882337
mid: NIHMS1775196
doi:

Substances chimiques

FOXG1 protein, human 0
Forkhead Transcription Factors 0
Nerve Tissue Proteins 0

Types de publication

Clinical Trial Comparative Study Journal Article Multicenter Study Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

396-406

Subventions

Organisme : NICHD NIH HHS
ID : U54 HD083211
Pays : United States
Organisme : NICHD NIH HHS
ID : U54 HD061222
Pays : United States
Organisme : Vanderbilt Intellectual and Developmental Disabilities Research Center
ID : U54HD083211
Pays : International
Organisme : NIH National Institutes of Child Health and Disease
ID : 3 U54-HD061222-14S1
Pays : International
Organisme : NICHD NIH HHS
ID : U54 HD086984
Pays : United States

Informations de copyright

© 2020 American Neurological Association.

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Auteurs

Clare Cutri-French (C)

Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Dallas Armstrong (D)

Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Joni Saby (J)

Division of Radiology Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Casey Gorman (C)

Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Jane Lane (J)

Department of Pediatrics, Civitan International Research Center, University of Alabama at Birmingham, Birmingham, Alabama.

Cary Fu (C)

Department of Pediatrics, Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee.

Sarika U Peters (SU)

Department of Pediatrics, Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee.

Alan Percy (A)

Department of Pediatrics, Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee.

Jeffrey L Neul (JL)

Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Eric D Marsh (ED)

Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

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