An overview of inborn errors of metabolism affecting the brain: from neurodevelopment to neurodegenerative disorders.

Abstract:

:Inborn errors of metabolism (IEMs) are particularly frequent as diseases of the nervous system. In the pediatric neurologic presentations of IEMs neurodevelopment is constantly disturbed and in fact, as far as biochemistry is involved, any kind of monogenic disease can become an IEM. Clinical features are very diverse and may present as a neurodevelopmental disorder (antenatal or late-onset), as well as an intermittent, a fixed chronic, or a progressive and late-onset neurodegenerative disorder. This also occurs within the same disorder in which a continuum spectrum of severity is frequently observed. In general, the small molecule defects have screening metabolic markers and many are treatable. By contrast only a few complex molecules defects have metabolic markers and most of them are not treatable so far. Recent molecular techniques have considerably contributed in the description of many new diseases and unexpected phenotypes. This paper provides a comprehensive list of IEMs that affect neurodevelopment and may also present with neurodegeneration. :Las enfermedades hereditarias del metabolismo (EHM) afectan con gran frecuencia al sistema nervioso. En sus formas neuropediátricas el neurodesarrollo se encuentra siempre afectado. En realidad, cualquier enfermedad monogénica cuya fisiopatología implique una alteración bioquímica puede ser considerada como una EHM. Las presentaciones clínicas son muy diversas en forma de trastorno del desarrollo antenatal o tardío, o bien de una enfermedad neurodegenerativa a brotes intermitentes, de carácter crónico o progresivo de debut tardío. En una misma enfermedad pueden darse diferentes espectros de gravedad. En general, las EHM que afectan a las moléculas pequeñas tienen marcadores metabólicos diagnósticos y muchas de ellas son tratables. Por contra, las EHM de las moléculas complejas tienen raramente marcadores metabólicos conocidos y la mayoría no tienen un tratamiento a día de hoy. Las técnicas de secuenciación masiva han permitido la descripción de numerosas nuevas enfermedades y fenotipos inesperados. Este artículo ofrece una lista completa de EHM que afectan el neurodesarrollo y pueden presentarse también como enfermedades neurodegenerativas. :Les maladies héréditaires du métabolisme (MHM) affectent très fréquemment le système nerveux. Dans leurs formes neuropédiatriques, le neurodéveloppement est toujours perturbé et dès l'instant qu'elle implique un mécanisme biochimique, toute maladie monogénique peut devenir une MHM. Les présentations cliniques sont très diverses et peuvent s'exprimer sous la forme d'un trouble du neurodéveloppement (anténatal ou à début tardif) ou d'une maladie neurodégénérative intermittente, chronique stable ou progressive à début tardif. Ceci peut aussi s'observer au sein d'une même maladie, ou un continuum de sévérité est fréquemment constaté. En général, les MHM affectant les petites molécules biochimiques ont des marqueurs métaboliques de dépistage et beaucoup sont traitables. Au contraire, les MHM affectant les molécules biochimiques complexes ont rarement des marqueurs métaboliques et la plupart d'entre elles ne sont pas traitables jusqu'à présent. Les techniques moléculaires récentes ont permis la description de nombreuses nouvelles maladies et de phénotypes inattendus. Cet article donne une liste complète des MHM affectant le neurodéveloppement et pouvant aussi se présenter comme des maladies neurodégénératives.

authors

Saudubray JM,Garcia-Cazorla A

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

301-325

issue

4

eissn

1294-8322

issn

1958-5969

journal_volume

20

pub_type

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