2011, Número 2
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Rev Mex Neuroci 2011; 12 (2)
Manifestaciones disautonómicas en sujetos presintomáticos y enfermos de ataxia espinocerebelosa tipo 2
Montes BJ, Estévez BM, Almaguer MLE
Idioma: Español
Referencias bibliográficas: 52
Paginas: 76-81
Archivo PDF: 184.64 Kb.
RESUMEN
Introducción: Los enfermos de ataxia espinocerebelosa
tipo 2 (E-SCA2) manifiestan a menudo trastornos del
sistema nervioso autónomo (SNA). Aún no está bien
definido si estos pacientes presentan alteraciones del
SNA durante la fase presintomática de la enfermedad
(PS-SCA2).
Objetivo: Determinar la presencia de
disfunción autonómica en los sujetos PS-SCA2 y E-SCA2.
Nuestra hipótesis es que los sujetos portadores de la
mutación SCA2 presentan mayor frecuencia de síntomas
que sus controles sanos.
Pacientes y métodos: A
97 E-SCA2 y 48 PS-SCA2 molecularmente diagnosticados
se les exploró la presencia de síntomas autonómicos
mediante la escala SCOPA-AUT. Los indicadores
considerados fueron comparados con un grupo de
sujetos controles pareado por edad y sexo (p < 0.05).
Resultados: Los pacientes y sujetos presintomáticos
mostraron mayor frecuencia y severidad de síntomas
disautonómicos que el grupo control, con predominio
de los síntomas relacionados con el sistema urinario
(39.7%) y gastrointestinal (30.6%), donde el estreñimiento
(19.3%) y la poliaquiuria (17.7%) fueron más
frecuentes en los PS-SCA2, y la poliaquiuria (19%),
nicturia (12.7%) y disfagia (12.1%) en los E-SCA2. Veintitrés
(47.9%) PS-SCA2 y 32 (33%) E-SCA2 no mostraron
síntomas autonómicos. Se encontraron correlaciones.
REFERENCIAS (EN ESTE ARTÍCULO)
Brusco A, Gellera C, Cagnoli C, Saluto A, Castucci A, Michielotto C. Molecular genetics of hereditary spinocerebellar ataxia: mutation analysis of spinocerebellar ataxia genes and CAG/CTG repeat expansion detection in 225 Italian families. Arch Neurol 2004; 61(5): 727-33.
Klockgether T. Ataxias. Diagnostic procedure and treatment. Nervenarzt 2005; 76(10): 1275-83.
Dur A. Autosomal dominant cerebellar ataxias: polyglutamine expansions and beyond. Lancet Neurol 2010; 9: 885-94.
Veláquez L, Sánchez G, Santos N, Almaguer L, Escalona K, Rodríquez R, et al. Molecular epidemiology of spinocerebellar ataxias in Cuba: Insights into SCA2 founder effect in Holquin. Neuroscience Letter 2009; 454: 157-60.
Velázquez-Pérez L, Sánchez-Cruz G, Canales-Ochoa N, Rodríguez-Labrada R, Rodríguez-Díaz J, Almaguer-Mederos L, et al. Electrophysiological features in patients and presymptomatic relatives with spinocerebellar ataxia type 2. J Neurol Sci 2007; 263: 158-64.
Velazquez PL, Seifried C, Santos-Falcon N, Abele M, Ziemann U. Saccade velocity is controlled by polyglutamine size in spinocerebellar ataxia 2. Ann Neurol. 2004; 56: 444-7.
Velázquez PL, Medina EE. Caracterización electrofisiológica en familiares asintomáticos de enfermos con ataxia espinocerebelosa tipo 2. Rev Neurol 1998; 27: 921-6.
Trouillas PTT, Hallett M, Currier RD, Subramony SH, Wesse K, et al. International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome. J Neurol Sci 1997; 145: 205-11.
Visser M, Marinus J, Stiggelbout AM, Jacobus J, Hilten V. Assessment of autonomic dysfunction in Parkinsons disease: The SCOPA-AUT. The Movement Disorders. 2004; 19(11): 1306-12.
Martí-Martínez S, Monge-Argilés JA, Sánchez-Payá J, Turpín-Fenoll L, Martín-Estefanía C, Leiva-Santana C. Versión española del test perfil de síntomas autonómicos. Rev Neurol 2009; 49(11): 577-80.
Suárez G, Opfer-Gehrking T, Offord K, Atkinson E, OBrien P, Low P. The Autonomic Symptom Profile. A new instrument to assess autonomic symptoms. Neurology 1999; 52: 523-8.
Kuriyama N, Mizuno T, Lida A, Watanabe Y, Nakagawa M. Autonomic nervous evaluation in the early stage of olivopontocerebellar atrophy. Auton Neurosci 2005; 123: 87-93.
Kuroiwa Y, Shimada Y, Toyokura Y. Postural hypotension and low R-R interval variability in parkinsonism, spinocerebellar degeneration, and Shy-Drager syndrome. Neurology 1983; 33(4): 463-7.
Yeh T, Lu CS, Wu Chou YH, Chong CC, Wu T, Han NH. Autonomic Dysfuntion in Machado-Joseph Disease. Arch Neurol 2005; 62: 630-6.
Sanchez-Cruz G, Velazquez-Perez L, Gomez-Pena L, Martinez-Gongora E, Castellano-Sanchez G, Santos-Falcon N. Dysautonomic features in patients with Cuban type 2 spinocerebellar ataxia. Rev Neurol 2001; 33(5): 428-33.
Pradhan C, Yashavantha BS, Pal PK, Sathyaprabha TN. Spinocerebellar ataxias type 1, 2 and 3: a study of heart rate variability. Acta Neurol Scand 2007;117: 337-42.
De Joanna G, De Rosa A, Salvatore E, Castaldo I, De Luca N, Izzo R, et al. Autonomic nervous system abnormalities in spinocerebellar ataxia type 2: A cardiovascular neurophysiologic study. J Neurol Sci 2008; 275: 60-3.
Orozco D, Nodarse FA, Cordovés SR, Auburger G. Autosomal dominant cerebellar ataxia: Clinical analysis of 263 patients from a homogeneous population in Holguín, Cuba. Neurology 1990; 40: 1369-75.
Oka H, Yoshioka M, Onouchi K MM, Mochio S, Suzuk Mi, Hirai T, et al. Characteristics of orthostatic hypotension in Parkinsons disease. Brain 2007; 130: 2425-32.
20 Netravathi M, Sathyaprabha TN, Jayalaxmi K, Datta P, Nirmala M, Pal PK. A comparative study of cardiac dysautonomia in autosomal dominant spinocerebellar ataxias and idiopathic sporadic ataxias. Acta Neurol Scand 2009; 120(3): 204-9.
Low PA, Ángstrom JW. Trastorno del Sistema Nervioso Autónomo. En: Harrison Principios de Medicina Interna. Mexico: McGraw Hill; 2006, p. 2673-9.
Boulton A, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, Malik RA. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care 2005; 28: 956-62.
Montes-Brown J, Sánchez-Cruz G, García AM, Báez ME, Velázquez- Pérez L. Heart rate variability in type 2 spinocerebellar ataxia. Acta Neurol Scand 2010, DOI: 10.1111/j.1600-0404.2009.01320.x.
Ewing DJ, Martyn CN, Young RJ, Clarke BF. The value of cardiovascular autonomic function tests: 10 years experience in diabetes. Diabetes Care 1985; 8(5): 491-8.
Vinick A, Ziegler D. Diabetic Cardiovascular Autonomic Neuropathy. Circulation 2007; 115: 387-97.
Low PA. Composite Autonomic Scoring Scale for Laboratory Quantification of Generalize Autonomic Failure. Mayo Clin Proc 1993; 68: 748-52.
Brusco A, Gellera C, Cagnoli C, Saluto A, Castucci A, Michielotto C. Molecular genetics of hereditary spinocerebellar ataxia: mutation analysis of spinocerebellar ataxia genes and CAG/CTG repeat expansion detection in 225 Italian families. Arch Neurol 2004; 61(5): 727-33.
Klockgether T. Ataxias. Diagnostic procedure and treatment. Nervenarzt 2005; 76(10): 1275-83.
Dur A. Autosomal dominant cerebellar ataxias: polyglutamine expansions and beyond. Lancet Neurol 2010; 9: 885-94.
Veláquez L, Sánchez G, Santos N, Almaguer L, Escalona K, Rodríquez R, et al. Molecular epidemiology of spinocerebellar ataxias in Cuba: Insights into SCA2 founder effect in Holquin. Neuroscience Letter 2009; 454: 157-60.
Velázquez-Pérez L, Sánchez-Cruz G, Canales-Ochoa N, Rodríguez-Labrada R, Rodríguez-Díaz J, Almaguer-Mederos L, et al. Electrophysiological features in patients and presymptomatic relatives with spinocerebellar ataxia type 2. J Neurol Sci 2007; 263: 158-64.
Velazquez PL, Seifried C, Santos-Falcon N, Abele M, Ziemann U. Saccade velocity is controlled by polyglutamine size in spinocerebellar ataxia 2. Ann Neurol. 2004; 56: 444-7.
Velázquez PL, Medina EE. Caracterización electrofisiológica en familiares asintomáticos de enfermos con ataxia espinocerebelosa tipo 2. Rev Neurol 1998; 27: 921-6.
Trouillas PTT, Hallett M, Currier RD, Subramony SH, Wesse K, et al. International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome. J Neurol Sci 1997; 145: 205-11.
Visser M, Marinus J, Stiggelbout AM, Jacobus J, Hilten V. Assessment of autonomic dysfunction in Parkinsons disease: The SCOPA-AUT. The Movement Disorders. 2004; 19(11): 1306-12.
Martí-Martínez S, Monge-Argilés JA, Sánchez-Payá J, Turpín-Fenoll L, Martín-Estefanía C, Leiva-Santana C. Versión española del test perfil de síntomas autonómicos. Rev Neurol 2009; 49(11): 577-80.
Suárez G, Opfer-Gehrking T, Offord K, Atkinson E, OBrien P, Low P. The Autonomic Symptom Profile. A new instrument to assess autonomic symptoms. Neurology 1999; 52: 523-8.
Kuriyama N, Mizuno T, Lida A, Watanabe Y, Nakagawa M. Autonomic nervous evaluation in the early stage of olivopontocerebellar atrophy. Auton Neurosci 2005; 123: 87-93.
Kuroiwa Y, Shimada Y, Toyokura Y. Postural hypotension and low R-R interval variability in parkinsonism, spinocerebellar degeneration, and Shy-Drager syndrome. Neurology 1983; 33(4): 463-7.
Yeh T, Lu CS, Wu Chou YH, Chong CC, Wu T, Han NH. Autonomic Dysfuntion in Machado-Joseph Disease. Arch Neurol 2005; 62: 630-6.
Sanchez-Cruz G, Velazquez-Perez L, Gomez-Pena L, Martinez-Gongora E, Castellano-Sanchez G, Santos-Falcon N. Dysautonomic features in patients with Cuban type 2 spinocerebellar ataxia. Rev Neurol 2001; 33(5): 428-33.
Pradhan C, Yashavantha BS, Pal PK, Sathyaprabha TN. Spinocerebellar ataxias type 1, 2 and 3: a study of heart rate variability. Acta Neurol Scand 2007;117: 337-42.
De Joanna G, De Rosa A, Salvatore E, Castaldo I, De Luca N, Izzo R, et al. Autonomic nervous system abnormalities in spinocerebellar ataxia type 2: A cardiovascular neurophysiologic study. J Neurol Sci 2008; 275: 60-3.
Orozco D, Nodarse FA, Cordovés SR, Auburger G. Autosomal dominant cerebellar ataxia: Clinical analysis of 263 patients from a homogeneous population in Holguín, Cuba. Neurology 1990; 40: 1369-75.
Oka H, Yoshioka M, Onouchi K MM, Mochio S, Suzuk Mi, Hirai T, et al. Characteristics of orthostatic hypotension in Parkinsons disease. Brain 2007; 130: 2425-32.
20 Netravathi M, Sathyaprabha TN, Jayalaxmi K, Datta P, Nirmala M, Pal PK. A comparative study of cardiac dysautonomia in autosomal dominant spinocerebellar ataxias and idiopathic sporadic ataxias. Acta Neurol Scand 2009; 120(3): 204-9.
Low PA, Ángstrom JW. Trastorno del Sistema Nervioso Autónomo. En: Harrison Principios de Medicina Interna. Mexico: McGraw Hill; 2006, p. 2673-9.
Boulton A, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, Malik RA. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care 2005; 28: 956-62.
Montes-Brown J, Sánchez-Cruz G, García AM, Báez ME, Velázquez- Pérez L. Heart rate variability in type 2 spinocerebellar ataxia. Acta Neurol Scand 2010, DOI: 10.1111/j.1600-0404.2009.01320.x.
Ewing DJ, Martyn CN, Young RJ, Clarke BF. The value of cardiovascular autonomic function tests: 10 years experience in diabetes. Diabetes Care 1985; 8(5): 491-8.
Vinick A, Ziegler D. Diabetic Cardiovascular Autonomic Neuropathy. Circulation 2007; 115: 387-97.
Low PA. Composite Autonomic Scoring Scale for Laboratory Quantification of Generalize Autonomic Failure. Mayo Clin Proc 1993; 68: 748-52.