Predictors of whole exome sequencing in dystonic cerebral palsy and cerebral palsy-like disorders

Pavelekova, P.; Necpal, J.; Jech, R.; Havrankova, P.; Svantnerova, J.; Jurkova, V.; Gdovinova, Z.; Lackova, A.; Han, V.; Winkelmann, J.; Zech, M. und Skorvanek, M. (2023): Predictors of whole exome sequencing in dystonic cerebral palsy and cerebral palsy-like disorders. In: Parkinsonism & Related Disorders, Bd. 111, 105352

Abstract

Introduction: Cerebral palsy (CP) is a group of permanent disorders attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. Cerebral palsy-like (CP-like) disorders may clinically resemble CP but do not fulfill CP criteria and have often a progressive course and/or neurodevelopmental regression. To assess which patients with dystonic CP and dystonic CP-like disorder should undergo Whole Exome Sequencing (WES), we compared the rate of likely causative variants in individuals regarding their clinical picture, co-morbidities, and environmental risk factors.Method: Individuals with early onset neurodevelopmental disorder (ND) manifesting with dystonia as a core feature were divided into CP or CP-like cohorts based on their clinical picture and disease course. Detailed clinical picture, co-morbidities, and environmental risk factors including prematurity, asphyxia, SIRS, IRDS, and cerebral bleeding were evaluated.Results: A total of 122 patients were included and divided into the CP group with 70 subjects (30 males;mean age 18y5m & PLUSMN;16y6m, mean GMFCS score 3.3 & PLUSMN;1.4), and the CP-like group with 52 subjects (29 males;mean age 17y7m & PLUSMN;1y,6 m, mean GMFCS score 2,6 & PLUSMN;1,5). The WES-based diagnosis was present in 19 (27.1%) CP patients and 30 CP-like patients (57.7%) with genetic conditions overlap in both groups. We found significant differences in diagnostic rate in CP individuals with vs. without risk factors (13.9% vs. 43.3%);Fisher's exact p = 0.0065. We did not observe the same tendency in CP-like (45.5% vs 58.5%);Fisher's exact p = 0.5.Conclusion: WES is a useful diagnostic method for patients with dystonic ND, regardless of their presentation as a CP or CP-like phenotype.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Munich Cluster for Systems Neurology (SyNergy)
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Sprache: Englisch
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 390857198