A long-term neuropsychological evaluation in Fabry disease
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ORIGINAL ARTICLE
A long‑term neuropsychological evaluation in Fabry disease G. Loret1 · M. Miatton1 · G. Vingerhoets2 · B. Poppe3 · D. Hemelsoet1 Received: 9 August 2020 / Accepted: 24 August 2020 © Belgian Neurological Society 2020
Abstract Fabry disease (FD) is a X-linked multi-systemic metabolic disorder with mainly renal, cardiac and neurological dysfunction. The neuropsychological impact is still unclear, with previous study results ranging from disturbance of speed of information processing and executive functions to a normal cognitive profile. The aim of our study was to gain further insight into the neuropsychological involvement of FD. Patients with genetically proven FD were enrolled at the Ghent University Hospital by their treating neurologist. We evaluated the cognitive status of each patient by a thorough neuropsychological test battery and these exact same neuropsychological assessments were repeated after a follow-up period of 2–4 years and at a second follow-up moment 1–4 years after the first follow-up. Thirteen patients with FD were included (8 female) with mean age of 41.5 years (SD ± 13.9) at baseline. All patients had normal neuropsychological test results on the subtests included in the cognitive battery at baseline, according to age-, gender- and education matched normative data. At the first followup moment (2–4 years after baseline), six patients were included (3 male), mean age 45.3 years. At the second follow-up (1–4 years after first follow-up), four patients (2 male) were included, with mean age 45 years. Both at the first and second follow-up moments, all patients obtained normal scores on the subtests. The cognitive functioning appeared to be in the normal range at baseline and did not decline over a follow-up period of 3–8 years, suggesting that cognition in FD patients may be well-preserved in time. Keywords Fabry disease · Cognition · Memory · Neuropsychology
Introduction Fabry disease (FD) is an X-linked multi-systemic metabolic disorder with pathological lysosomal storage due to a deficiency in the alpha-galactosidase A enzyme leading to accumulation of neutral glycosphingolipids, mainly globotriaosylceramide (Gb3) and multiple organ involvement. Eventually, severe complications due to renal, cardiac and cerebrovascular involvement occur, but also gastro-intestinal, pulmonary, ocular, skin and peripheral nerve symptoms are * G. Loret [email protected] * D. Hemelsoet [email protected] 1
Department of Neurology, Ghent University Hospital, Ghent, Belgium
2
Department of Experimental Psychology, Ghent University, Ghent, Belgium
3
Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
part of the heterogeneous phenotype. A classical full-blown phenotype appears in hemizygous men, while heterozygous women usually present with a more attenuated phenotype and later onset due to X-chromosome inactivation. However, atypical and pauci-symptomatic presentations are also well known, even in men [1]. Neurological involvement in FD already
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