The Etiologies of Chronic Progressive Cerebellar Ataxia in a Korean Population
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Background and Purpose The etiologies and frequencies of cerebellar ataxias vary between countries. Our primary aim was to determine the frequency of each diagnostic group of cerebellar ataxia patients in a Korean population. Methods We reviewed the medical records of patients who were being followed up between November 1994 and February 2016. We divided patients with cerebellar ataxias into familial and non-familial groups and analyzed the frequency of each etiology. Finally, we categorized patients into genetic, sporadic, secondary, and suspected genetic, but undetermined ataxia. Results A total of 820 patients were included in the study, among whom 136 (16.6%) familial patients and 684 (83.4%) non-familial cases were identified. Genetic diagnoses confirmed 98/136 (72%) familial and 72/684 (11%) nonfamilial patients. The overall etiologies of progressive ataxias comprised 170 (20.7%) genetic, 516 (62.9%) sporadic, 43 (5.2%) secondary, and 91 (11.1%) undetermined ataxia. The most common cause of ataxia was multiple-system atrophy (57.3%). In the genetic group, the most common etiology was spinocerebellar ataxia (152/170, 89.4%) and the most common subtype was spinocerebellar ataxia-3.38 of 136 familial and 53 of 684 sporadic cases (91/820, 11.1%) were undetermined ataxia. Conclusions This is the largest epidemiological study to analyze the frequencies of various cerebellar ataxias in a Korean population based on the large database of a tertiary hospital movement- disorders clinic in South Korea. These data would be helpful for clinicians in constructing diagnostic strategies and counseling for patients with cerebellar ataxias.
Abstract
Background and Purpose The etiologies and frequencies of cerebellar ataxias vary between countries. Our primary aim was to determine the frequency of each diagnostic group of cerebellar ataxia patients in a Korean population. Methods We reviewed the medical records of patients who were being followed up between November 1994 and February 2016. We divided patients with cerebellar ataxias into familial and non-familial groups and analyzed the frequency of each etiology. Finally, we categorized patients into genetic, sporadic, secondary, and suspected genetic, but undetermined ataxia. Results A total of 820 patients were included in the study, among whom 136 (16.6%) familial patients and 684 (83.4%) non-familial cases were identified. Genetic diagnoses confirmed 98/136 (72%) familial and 72/684 (11%) nonfamilial patients. The overall etiologies of progressive ataxias comprised 170 (20.7%) genetic, 516 (62.9%) sporadic, 43 (5.2%) secondary, and 91 (11.1%) undetermined ataxia. The most common cause of ataxia was multiple-system atrophy (57.3%). In the genetic group, the most common etiology was spinocerebellar ataxia (152/170, 89.4%) and the most common subtype was spinocerebellar ataxia-3.38 of 136 familial and 53 of 684 sporadic cases (91/820, 11.1%) were undetermined ataxia. Conclusions This is the largest epidemiological study to analyze the frequencies of various cerebellar ataxias in a Korean population based on the large database of a tertiary hospital movement- disorders clinic in South Korea. These data would be helpful for clinicians in constructing diagnostic strategies and counseling for patients with cerebellar ataxias.
참고문헌 (30)
- Brusse E, "Diagnosis and management of early- and late-onset cerebellar ataxia", Clin Genet, 71, pp.12~24 (2007)
- Fogel BL, "Clinical features and molecular genetics of autosomal recessive cerebellar ataxias", Lancet Neurol, 6, pp.245~257 (2007)[DOI]
- Klockgether T, "Sporadic ataxia with adult onset: classification and diagnostic criteria", Lancet Neurol, 9, pp.94~104 (2010)[DOI]
- Fogel BL, "An approach to the patient with late-onset cerebellar ataxia", Nat Clin Pract Neurol, 2, pp.629~635 (2006)[DOI]
- Kim JS, "Hereditary cerebellar ataxias: a Korean perspective", J Mov Disord, 8, pp.67~75 (2015)[DOI]
- Gebus O, "Deciphering the causes of sporadic late-onset cerebellar ataxias: a prospective study with implications for diagnostic work", J Neurol, 264, pp.1118~1126 (2017)[DOI]
- Hadjivassiliou M, "Causes of progressive cerebellar ataxia: prospective evaluation of 1500 patients", J Neurol Neurosurg Psychiatry, 88, pp.301~309 (2017)[DOI]
- Basu P, "Analysis of CAG repeats in SCA1, SCA2, SCA3, SCA6, SCA7 and DRPLA loci in spinocerebellar ataxia patients and distribution of CAG repeats at the SCA1, SCA2 and SCA6 loci in nine ethnic populations of eastern India", Hum Genet, 106, pp.597~604 (2000)[DOI]
- Maruyama H, "Difference in disease-free survival curve and regional distribution according to subtype of spinocerebellar ataxia: a study of 1,286 Japanese patients", Am J Med Genet, 114, pp.578~583 (2002)[DOI]
- Nagaoka U, "Regional differences in genetic subgroup frequency in hereditary cerebellar ataxia, and a morphometrical study of brain MR images in SCA1, MJD and SCA6", J Neurol Sci, 164, pp.187~194 (1999)[DOI]
- Pujana MA, "Spinocerebellar ataxias in Spanish patients: genetic analysis of familial and sporadic cases. The Ataxia Study Group", Hum Genet, 104, pp.516~522 (1999)[DOI]
- Ranum LP, "Spinocerebellar ataxia type 1 and Machado-Joseph disease: incidence of CAG expansions among adult-onset ataxia patients from 311 families with dominant, recessive, or sporadic ataxia", Am J Hum Genet, 57, pp.603~608 (1995)
- Gilman S, "Second consensus statement on the diagnosis of multiple system atrophy", Neurology, 71, pp.670~676 (2008)[DOI]
- Abele M, "The aetiology of sporadic adult-onset ataxia", Brain, 125, pp.961~968 (2002)[DOI]
- Klockgether T, "The natural history of degenerative ataxia: a retrospective study in 466 patients", Brain, 121, pp.589~600 (1998)[DOI]
- Jamora RD, "Clinical characteristics of patients with multiple system atrophy in Singapore", Ann Acad Med Singapore, 34, pp.553~557 (2005)
- Ota S, "Distribution of cerebello-olivary degeneration in idiopathic late cortical cerebellar atrophy: clinicopathological study of four autopsy cases", Neuropathology, 28, pp.43~50 (2008)[DOI]
- Muzaimi MB, "Population based study of late onset cerebellar ataxia in south east Wales", J Neurol Neurosurg Psychiatry, 75, pp.1129~1134 (2004)[DOI]
- Schols L, "Autosomal dominant cerebellar ataxias: clinical features, genetics, and pathogenesis", Lancet Neurol, 3, pp.291~304 (2004)[DOI]
- Silveira I, "Trinucleotide repeats in 202 families with ataxia: a small expanded (CAG)n allele at the SCA17 locus", Arch Neurol, 59, pp.623~629 (2002)[DOI]
- Tang B, "Frequency of SCA1, SCA2, SCA3", MJD, SCA6, SCA7, and DRPLA CAG trinucleotide repeat expansion in patients with hereditary spinocerebellar ataxia from Chinese kindreds, 2000, pp.57, 540~544
- Jin DK, "Frequency of spinocerebellar ataxia types 1,2,3,6,7 and dentatorubral pallidoluysian atrophy mutations in Korean patients with spinocerebellar ataxia", J Neurol, 246, pp.207~210 (1999)[DOI]
- Lee WY, "Frequency analysis and clinical characterization of spinocerebellar ataxia types 1, 2, 3, 6, and 7 in Korean patients", Arch Neurol, 60, pp.858~863 (2003)[DOI]
- Kim HJ, "SCA in Korea and its regional distribution: a multicenter analysis", Parkinsonism Relat Disord, 17, pp.72~75 (2011)[DOI]
- Kim JY, "Molecular analysis of spinocerebellar ataxias in Koreans: frequencies and reference ranges of SCA1, SCA2, SCA3, SCA6, and SCA7", Mol Cells, 12, pp.336~341 (2001)
- 허희재, "Identification of ATM Mutations in Korean Siblings with Ataxia-Telangiectasia", Annals of Laboratory Medicine, 33(3), pp.217~220 (2013), 대한진단검사의학회
- Schols L, "Genetic background of apparently idiopathic sporadic cerebellar ataxia", Hum Genet, 107, pp.132~137 (2000)[DOI]
- Shizuka M, "Molecular analysis of a de novo mutation for spinocerebellar ataxia type 6 and (CAG)n repeat units in normal elder controls", J Neurol Sci, 161, pp.85~87 (1998)[DOI]
- Laffita-Mesa JM, "De novo mutations in ataxin-2 gene and ALS risk", PLoS One, 8, pp.e70560~ (2013)[DOI]
- Lee YC, "Comparison of cerebellar ataxias: a three-year prospective longitudinal assessment", Mov Disord, 26, pp.2081~2087 (2011)[DOI]
