痉挛性截瘫4型(SPG4)是常染色体遗传性痉挛截瘫疾病中最常见的类型，主要临床特征为典型的单纯型遗传性痉挛性截瘫，神经功能损害仅限于下肢痉挛无力、高渗性膀胱障碍和下肢振动觉轻度减弱，不伴随出现神经萎缩、共济失调、认知障碍、癫痫发作和肌张力障碍等特征。SPAST是引起SPG4的主要致病基因，现已发现多种不同的SPAST致病变异体。该疾病存在高度临床异质性，相同致病变异体在不同患者间甚至在同一家系间也可表现出发病年龄与严重程度的差异。关于SPG4基因型和表型的相关性缺乏系统的研究，致病机制目前尚存在争议。本文对该疾病的临床特征、致病基因特点、基因型与表型的相关性、致病机理等进行了综述，以期为该疾病的临床诊疗提供参考。 Spastic paraplegia type 4 (SPG4) is the most common type of autosomally inherited spastic paraplegia. Its main clinical features include typical simple hereditary spastic paraplegia, with neurological impairments limited to lower limb spasticity, hypertonic bladder dysfunction, and mild weakening of lower limb vibration sensation, without accompanying features such as nerve atrophy, ataxia, cognitive impairment, seizures, and muscle tone disorders. SPAST is the main pathogenic gene underlying SPG4, and various pathogenic SPAST variants have been discovered. This disease has featured a high degree of clinical heterogeneity, and the same pathogenic variant can have different age of onset and severity among patients and even within the same family. There is a lack of systematic research on the correlation between the genotype and phenotype of SPG4, and the pathogenic mechanism has remained controversial. This article has provided a review for the clinical characteristics, pathogenic gene characteristics, correlation between the genotype and phenotype, and pathogenic mechanism of this disease, with an aim to provide reference for its clinical diagnosis and treatment.
Advance of research on Hereditary spastic paraplegia type 4
Spastic paraplegia type 4 (SPG4) is the most common type of autosomally inherited spastic paraplegia. Its main clinical features include typical simple hereditary spastic paraplegia, with neurological impairments limited to lower limb spasticity, hypertonic bladder dysfunction, and mild weakening of lower limb vibration sensation, without accompanying features such as nerve atrophy, ataxia, cognitive impairment, seizures, and muscle tone disorders. SPAST is the main pathogenic gene underlying SPG4, and various pathogenic SPAST variants have been discovered. This disease has featured a high degree of clinical heterogeneity, and the same pathogenic variant can have different age of onset and severity among patients and even within the same family. There is a lack of systematic research on the correlation between the genotype and phenotype of SPG4, and the pathogenic mechanism has remained controversial. This article has provided a review for the clinical characteristics, pathogenic gene characteristics, correlation between the genotype and phenotype, and pathogenic mechanism of this disease, with an aim to provide reference for its clinical diagnosis and treatment.
Neurodegenerative diseaseHereditary spastic paraplegia type 4SPAST geneClinical heterogeneity
万方数据
