- 17番染色体に連鎖しパーキンソニズムを伴う前頭側頭型認知症
- 関
- frontotemporal dementia and parkinsonism linked to chromosome 17
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2016/07/25 05:22:14」(JST)
[Wiki ja表示]
FTDP-17あるいは17番染色体に連鎖する家族性前頭側頭型認知症パーキンソニズムとは65歳未満で発症することが多い遺伝性の神経変性疾患であり認知症、行動異常、性格変化、パーキンソン症候群を中心とする運動障害と広い臨床スペクトラムを有する疾患である。タウ遺伝子(microtubule-assositated protein tau、MAPT)に変異を有するFTDP-17(MAPT)とプログラニュリン遺伝子(progranulin、RPGN)遺伝子に変異を認めるFTDP-17(RPGN)が知られている。臨床像では両者を区別できないがFTDP-17(MAPT)はタウオパチーの代表疾患であり、FTDP-17(RPGN)はTDP-43 proteinopathyである。
症状
発症年齢は比較的若く65歳未満で40~50歳代が中心である。遺伝子変異部位によって臨床表現形がかなり異なる。性格変化、行動異常、認知障害、パーキンソン症候群など運動障害が特徴である。若年発症で家族歴がある場合は特に疑われる。FTDP-17(MAPT)とFTDP-17(RPGN)は臨床像からは区別できない。
診断
診断は遺伝子診断で行う。7番染色体でMAPTとRPGNは非常に近くに位置する。
病理
肉眼的病理として前頭側頭葉の萎縮を認めるがその程度は一様ではない。
参考文献
- clinical Neuroscience 2009 vol.27 タウオパチー ISSN 02890585
[Wiki en表示]
Frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17) is an autosomal dominant neurodegenerative disorder and Parkinson plus syndrome,[1] which has three cardinal features: behavioral and personality changes, cognitive impairment, and motor symptoms. FTDP-17 was defined during the International Consensus Conference in Ann Arbor, Michigan, in 1996.
Contents
- 1 Pathophysiology
- 2 Diagnosis
- 3 Management
- 4 Prognosis
- 5 Epidemiology
- 6 References
- 7 Further reading
- 8 External links
Pathophysiology
The pathogenetic mechanisms underlying the disorder are thought to be related to the altered proportion of tau isoforms or to the ability of tau to bind microtubules and to promote microtubule assembly.
Diagnosis
Definitive diagnosis of FTDP-17 requires a combination of characteristic clinical and pathological features and molecular genetic analysis. Genetic counseling should be offered to affected and at-risk individuals; for most subtypes, penetrance is incomplete.
Management
Currently, treatment for FTDP-17 is only symptomatic and supportive.
Prognosis
The prognosis and rate of the diseases progression vary considerably among individual patients and genetic kindreds, ranging from life expectancies of several months to several years, and, in exceptional cases, as long as two decades.
Epidemiology
The prevalence and incidence remain unknown but FTDP-17 is an extremely rare condition. It is caused by mutations in the MAPT gene, which encodes a microtubule-binding protein. Over 100 families with 38 different mutations in the tau gene have been identified worldwide. The phenotype of FTDP-17 varies not only between families carrying different mutations but also between and within families carrying the same mutations.
References
- ^ Mitra K, Gangopadhaya PK, Das SK. (Jun 2003). "Parkinsonism plus syndrome--a review". Neurology India 51 (2): 183–8. PMID 14570999.
Further reading
- Zbigniew K Wszolek, Yoshio Tsuboi, Bernardino Ghetti, Stuart Pickering-Brown, Yasuhiko Baba and William P Cheshire Orphanet Journal of Rare Diseases 2006, 1:30 doi:10.1186/1750-1172-1-30
External links
- Luc Buée; André Delacourte (1999). "Comparative Biochemistry of Tau in Progressive Supranuclear Palsy, Corticobasal Degeneration, FTDP-17 and Pick's Disease" (PDF). Brain Pathology 9 (4): 681–693. doi:10.1111/j.1750-3639.1999.tb00550.x. PMID 10517507.
UpToDate Contents
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English Journal
- Motor function and behaviour across the ALS-FTD spectrum.
- De Silva D1,2, Hsieh S3, Caga J3, Leslie FV1,2,4, Kiernan MC1,3, Hodges JR1,2,4, Mioshi E5, Burrell JR1,2,4.
- Acta neurologica Scandinavica.Acta Neurol Scand.2016 May;133(5):367-72. doi: 10.1111/ane.12471. Epub 2015 Jul 30.
- BACKGROUND: Behavioural/functional disturbances, characteristic of frontotemporal dementia (FTD), are also a feature of amyotrophic lateral sclerosis (ALS) and patients with combined ALS and FTD (FTD-ALS).AIM OF THE STUDY: To investigate the progression of behavioural disturbances in ALS and FTD usi
- PMID 26223148
- Omega-3 fatty acids for the treatment of dementia.
- Burckhardt M1, Herke M, Wustmann T, Watzke S, Langer G, Fink A.
- The Cochrane database of systematic reviews.Cochrane Database Syst Rev.2016 Apr 11;4:CD009002. [Epub ahead of print]
- BACKGROUND: Omega-3 polyunsaturated fatty acids (omega-3 PUFAs) from fish and plant sources are commonly considered as a promising non-medical alternative to improve brain functions and slow down the progression of dementia. This assumption is mostly based on findings of preclinical studies and epid
- PMID 27063583
- Dominant hemisphere lateralization of cortical parasympathetic control as revealed by frontotemporal dementia.
- Guo CC1, Sturm VE2, Zhou J3, Gennatas ED4, Trujillo AJ2, Hua AY2, Crawford R2, Stables L2, Kramer JH2, Rankin K2, Levenson RW5, Rosen HJ2, Miller BL2, Seeley WW6.
- Proceedings of the National Academy of Sciences of the United States of America.Proc Natl Acad Sci U S A.2016 Apr 11. pii: 201509184. [Epub ahead of print]
- The brain continuously influences and perceives the physiological condition of the body. Related cortical representations have been proposed to shape emotional experience and guide behavior. Although previous studies have identified brain regions recruited during autonomic processing, neurological l
- PMID 27071080
Japanese Journal
- Systematic review and meta-analysis of Japanese familial Alzheimer's disease and FTDP-17
- 症例報告 健忘症状で気づかれた17番染色体に連鎖したタウ遺伝子変異による家族性前頭側頭型認知症パーキンソニズムの1家系
Related Links
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17番染色体に連鎖しパーキンソニズムを伴う前頭側頭型認知症
- 関
- FTDP-17
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