NEURODEVELOPMENTAL DISORDERS IN PATIENTS WITH DUCHENNE AND BECKER MUSCULAR DYSTROPHY: NEW EVIDENCES FOR GENOTYPE-PHENOTYPE CORRELATION


Topic:

Translational Research

Poster Number: S121

Author(s):

Jonas Alex Morales Saute, PhD, Universidade Federal do Rio Grande do Sul, Fabrício Maciel Soares, MD, Universidade Federal do Rio Grande do Sul, Gabriela M Giordani, MD, Universidade Federal do Rio Grande do Sul, Bruna F ROSA, ROSA,, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, Ana Carolina Brusius-Facchin, PhD, Hospital de Clínicas de Porto Alegre, Michele Michelin Becker, MD, PhD, Child Neurology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

Neurodevelopmental disorders are frequently and heterogeneously diagnosed among patients with dystrophinopathies. Manifestation of intellectual developmental disorders are associated with the underlying DMD genotype, however correlation between others frequently diagnosed comorbidities and genotype is uncertain. We aimed to evaluate how the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD), Obsessive-Compulsive Disorder (OCD), or Autism Spectrum Disorder (ASD) and genotype are related, as well as whether the prevalence of these comorbidities differ among the studied genotypic subgroups. Childhood Autism Rating Scale (CARS), Yale-Brown Obsessive Compulsive Scale for Children (CY-BOCS), and Swanson, Nolan and Pelham IV (SNAP-IV) scale were applied to 50 participants and their caregivers, mainly from the Hospital de Clínicas de Porto Alegre (n=38) or other Brazilian centers (n=12). Participants were grouped according to their genotype and affected dystrophin isoforms. The overall diagnostic rate for ASD was 34%, similar to OCD (35.5%). Half of the patients (51.4%) were diagnosed with ADHD. Cerebral isoforms were affected in more than half of the participants (52%). The diagnosis of ASD, CARS scores, and diagnosis of OCD were associated with genotype and impairment of cerebral isoforms. ADHD diagnostic rates were elevated across all the genotypic groups and showed no association with muscular or cerebral isoforms. Our results show that patients with DMD and impairment of cerebral dystrophin isoforms have an increased risk for ASD and OCD, and the identification of a patient with a genotype that affects these isoforms should prompt neuropsychological assessment and multidisciplinary follow-up.