A cytogenetic study of mentally retarded school children in taiwan with special reference to the fragile X chromosome

Summary A cytogenetic study was made on 341 mentally retarded children in the Provincial Nantou Rehabilitation Center for the Mentally Retarded and the St. Raphael Opportunity Center in Tainan. Of the 89 mentally retarded children with chromosomal abnormalities, 63 had Down syndrome, 13 had the fragile X [fra(X)] syndrome, and the remaining had other aneuploid constitutions. Family studies were possible for 2 of the 13 fra(X) probands. The results of this study illustrate the contribution of chromosomal abnormalities to the pathogenesis of mental retardation in children.     

A Survey of Toxoplasmosis Among Mentally Retarded Children

To determine what role, if any, toxoplasmosis plays in the mental retardation of children, sera from 345 mentally retarded children were tested for the presence of antibodies to Toxoplasma gondii. The serological tests employed were the complement-fixation, the Sabin-Feldman dye test and the immunofluorescence test. The donors were also skin-tested with toxoplasmin.Of 345 mentally retarded donors nine gave a positive skin reaction, 15 possessed complement-fixing antibodies, 21 had immunofluorescent antibodies and 45 had dye test antibodies to T. gondii.The incidence of antibodies to T. gondii in the mentally retarded group was approximately the same as in the normal control group of the same age, and less than in the group suspected of having toxoplasmosis. It is concluded that in the children in this study toxoplasmosis played little or no role as a predisposing factor in the occurrence of congenital mental deficiency.     

Observations on Community School Facilities for the Mentally Retarded and Admissions to Institutions in Ontario, 1954-63

The relationship between community school facilities and first admissions of mentally retarded children to Ontario Institutions was investigated for the period 1954-1963. The number of educable (I.Q. 50-75) mentally retarded children aged 6-16 years in community schools rose consistently (92.1/100,000 population in 1954 to 190.1 in 1963), while first admissions of educable mentally retarded persons aged 5-19 years to Ontario Hospital Schools showed no consistent trend (2.0/100,000 in 1954 and 2.0 in 1963). The number of trainable (I.Q. 20-50) mentally retarded children aged 5-18 years in community retarded children''s schools rose steadily (10.9/100,000 population in 1954 to 42.8 in 1963), while first admissions in this category aged 5-19 years demonstrated no consistent trend (2.6/100,000 in 1954 and 2.2 in 1963).No indication was found that the age distribution of these first admissions had changed from 1954 to 1963. Any effect that increased school facilities might have had in reducing first admissions may have been nullified by the very large demand for a limited number of beds.     

Prevalence of the fragile X syndrome in four birth cohorts of children of school age

Summary The prevalence of the fragile X syndrome among 12,882 children (6594 boys and 6288 girls) born during the years 1969–1972 in Kuopio province in eastern central Finland has been studied retrospectively. Mentally retarded children were selected from normal schools by using school achievement tests and from registers of mentally retarded individuals. In the present study fragile X syndrome was found in 6/111 mentally retarded children (5.4%), in 4/61 boys and in 2/50 girls, respectively. It was not detected in the control group of 85 healthy children. The corrected prevalence of fragile X syndrome among boys in four successive birth cohorts was estimated to the 1 in 1210 or 0.8/1000, and that among girls, 1 in 2418 or 0.4/1000. The overall prevalence was calculated to be 1 in 1612 or 0.6/1000 children.     

Mental retardation associated with "balanced" chromosome rearrangements.

Balanced chromosome rearrangements were found in seven of 455 retarded children vs. four of 1,679 nonretarded, psychiatric children (P less than .05). The combined incidence of non-Robertsonian balanced rearrangements from this and reported surveys of the mentally retarded was five times greater than that from newborn surveys, whereas Robertsonian translocations were not increased among the retarded. The combined data show an increase in de novo rather than familial rearrangements among the retarded; the increase in de novo rearrangements is specifically for non-Robertsonian translocation.     

应用多聚酶链式反应快速分析FMR-1基因突变

为了建立一种在先天性智力低下患儿中快速分析脆性X综合征智力低下基因1(Fragile X mental retardation gene 1.FMR-1)突变的方法,对先天性智力低下儿童进行脆性X综合征的大面积筛查和诊断,应用复式多聚酶链式反应一次性扩增FMR-1基因的(CGG)n的重复区,分析CGG重复序列的大小,判断FMR-1基因状态(正常、突变前、突变后),对脆性X综合征可疑患儿快速筛查,在113倒不明原因的先天性智力低下患儿中,分析有脆性X综合征携带者(FMR-1基因前突变者)7例(2男5女),脆性X综合征患者(FMR-1基因突变者)5例,应用多聚酶链式反应可以对脆性X综合征可疑患儿进行大面积初筛,确定携带者和患者。     

High prevalence of aspartylglycosaminuria among school-age children in eastern Finland

Summary A high prevalence of the lysosomal storage disease aspartylglycosaminuria was found in a study of four birth cohorts of 12882 children in eastern Finland. Using school achievement tests and registers of mentally retarded individuals, 178 mentally retarded children were identified. Randomized urine samples from 151 of the 178 retarded children and from 101 healthy children were analyzed quantitatively for aspartylglucosamine by high-performance liquid chromatography. The results identified three affected individuals in the retarded group indicating an exceptionally high prevalence of aspartylglycosaminuria (1:3643) in the study population, consistent with a carrier frequency of 1:30. The 95% confidence limits for the prevalence are 1:4 352-1:16389. This is the highest prevalence described for any glycoproteinosis in any population and comparable to the incidence figures of the most common lysosomal storage diseases, Gaucher disease type I and Tay-Sachs disease among Ashkenazi Jews. In the study group, aspartylglycosaminuria was, after trisomy 21 (n = 19) and the fragile X syndrome (n = 6), the most common genetic cause for mental retardation.     

The frequency of X-linked mental retardation

600 mentally retarded children, 339 boys and 261 girls aged 5-9 years were examined. Boys to girls ratio (B:G) was found in the total group to be 1.3. Among 257 children with mental retardation of confirmed genetic origin B:G = 1.4, in 129 children with confirmed exogenous defects B:G = 1.04. The significant prevalence of boys over girls was characteristic of children with monogenic forms. The frequency of X-linked mental retardation in the total group, in all mentally retarded boys and in boys with genetic forms was 12.5 +/- 1.3%, 22.1 +/- 2.2% and 28.5 +/- 2.8%, respectively. The frequency of X-linked mental retardation was higher in boys with genetic forms of imbecility.     

Carotenemia in mentally retarded children I. Incidence and etiology

The incidence and etiology of carotenemia in mentally retarded children were examined. Fasting serum carotenoid and vitamin A levels were measured in 77 profoundly mentally retarded children aged 3 to 19 years who were receiving a standard diet containing 2000 IU of carotene (expressed in terms of vitamin A activity) and supplemented by 2000 IU of vitamin A daily. Seventeen of the 77 patients had serum carotenoid levels of more than 300 μg./ml. The particulate size of food had a significant inverse relationship to serum carotenoid levels and was an important factor in determining carotenemia. The serum vitamin A level was also higher in children on homogenized diet than in those on pureed feeds, while the lowest level was noted among patients on a chopped diet. Besides particulate size of food, other factors may also be operative in determining carotenemia.     

Dicarboxylic aminoaciduria associated with mental retardation

Summary Five hundred mentally retarded children (of both sexes and under 15 years of age) referred to our institute were screened for aminoacid disorders. One case of dicarboxylic aminoaciduria was found in a girl.     

Fluorometric assay of erythrocyte protoporphyrin: simple screening test for lead poisoning and iron deficiency.

Erythrocyte protoporphyrin levels are high in lead poisoning, iron deficiency and erythropoietic porphyria. On-site fluorometric assay was used to screen for raised blood levels in three groups of children in one city: 166 who were severely mentally retarded and lived in an institution, 88 who were moderately to severely mentally retarded and attending special schools but lived at home, and 128 who were of normal intelligence and attended a regular school. High erythrocyte protoporphyrin levels (40 micrograms/dl [0.7 mumol/l] or greater) were found in 14 of the children, each of whom was tested for further evidence of lead poisoning and iron deficiency. The two children found to have high blood lead levels (above 30 micrograms/dl [1.5 mumol/l]) were both living in the institution, were ambulatory and had pica. Of the other 12 children 8 had evidence of iron deficiency, though in 4 the probability of a true deficiency was low. The fluorometric assay of erythrocyte protoporphyrin may prove to be a simple method of screening for lead poisoning and iron deficiency.     

Aerobic work capacity of mentally retarded boys and girls in junior high schools.

The maximal oxygen uptake (Vo2 max) and ergometer load at a heart rate of 170 beats/min (PWC170) were determined in mentally retarded children (74 boys and 53 girls) of ages 12-15, whose IQ ranged from 36 to 91, and the results were compared with those for normal children. Mentally retarded boys and girls showed significantly inferior body height and weight, but no significant difference was found in skinfold thickness. The mean value of PWC170 for boys and girls was 14.34 kpm/kg/min and 11.31 kpm/kg/min, respectively, significantly less than that of the normal group. The mentally retarded boys had mean VO2 max per unit body weight of 42.4 ml/kg/min, which was significantly less than the 51.2 ml/kg/min of normal boys. The mentally retarded girls had a mean of 33.1 ml/kg/min which was also less than the 41.3 ml/kg/min of normal girls. The correlation coefficient between body weight and PWC170 (kpm/min) was 0.711 and 0.720 for boys and girls, respectively, while that between body weight and VO2 max (liter/min) was 0.641 for boys and 0.656 for girls. No significant correlation was found between IQ and PWC170 (kpm/kg/min) nor between IQ and VO2 max (ml/kg/min) both for boys and for girls. Similarly, no significant correlation was found between mental age and the VO2 max value (ml/kg/min).     

Mentally retarded children of eastern India: A biosocial study

Abstract

Biosocial characteristics of 265 mentally retarded and 253 nonretarded children comprising 518 handicapped children from eastern India were studied to discern characteristics significantly associated with the retardates. The children studied were consecutive referrals between January 1977 and April 1981 to the Centre for Handicapped Children, Institute of Child Health, Calcutta. Comparison of retarded and nonretarded children showed the incidence of mental retardation to be significantly associated with age of children, age of mothers, parents’ socioeconomic class, family size, birth order, tempo of motor development, and family history of psychiatric illness. The proportion of retardates was higher among the handicapped girls than among boys, and the level of retardation was significantly associated with sex. Implications of findings are discussed.     

Population cytogenetics of folate-sensitive fragile sites

Summary The frequencies of folate-sensitive autosomal rare fragile sites (ARFS) were compared in populations of mentally retarded, mentally subnormal, and mentally normal children and of patients referred for diagnostic chromosome study. The frequencies did not differ significantly. Altogether, an autosomal rare fragile site was found in 16 of 1445 individuals (1 in 90). Of six different folate-sensitive ARFS detected, the most common one was FRA9A, with a frequency of 1 in 241 individuals. In addition, FRA17A, classified as a distamycin A-inducible fragile site, was found with a frequency of 1 in 206. It was regarded as a spontaneously expressive fragile site. In 19 families in which transmission of an autosomal rare fragile site was studied, the mother was the carrier in 16 families and the father, in one family. The mean percentage (±SD) of cells expressing ARFS in 55 individuals was 19% (±11.4). The age did not affect the rate of expression. When the rate of expression was calculated separately in a group of mentally retarded (mean=23.4%) and in a group of mentally normal individuals (mean=16.0%), the difference was statistically significant.     

Patterns of urinary aminoacid excretion in exceptional children and patients with mental disorders in Costa Rica

The amino acid profile was studied in individual random samples of urine from 1147 normal schoolchildren and 1074 exceptional children: 628 with mental retardation, 332 with hearing and speech defects and 114 with visual defects as well as in 673 patients with mental disorders. Laboratory procedures included chemical tests and one-dimension paper- electro- and column-chromatography. Phenylketonuria was found in a mentally retarded girl and in one of her brothers; iminoglycinuria in a mentally retarded boy and heterozygote cystinuria in a man with manic-depressive psychosis. The percentage of high excretors of beta-aminoisobutyric acid (B-AIB) in the controls (4.88%) was similar to previous findings in the Caucasian race. The children with hearing and speech defects showed a number of high excretors of B-AIB significantly lower (X2 = 5.32; p less than 0.025) and the children with visual defects a number of hyperglycinurias significantly higher (X2 = 9.19; p less than 0.05). Previous non-consistent findings on the excess of high excretors of B-AIB in Down's syndrome were not confirmed in this study. These results suggest a relationship between transport defects in the plasma membrane and pathological disorders in some of the cases screened.     

On the nosology of moderate mental retardation with special attention to X-linked mental retardation. A diagnostic genetic survey of 274 institutionalized moderately mentally retarded men

In this paper we report the results of a genetic-diagnostic survey of 274 institutionalized moderately mentally retarded adult males and compare these data with those from our previous studies in the severely mentally retarded and from a comparable population of 262 institutionalized moderately mentally retarded males and females (The Borgenstein experience). Special attention is paid to the nosology of X-linked mental retardation and familial mental retardation in general.     

Peripheral and central 5-hydroxytryptamine in trisomy 21.

Peripheral and central metabolism of 5-hydroxytryptamine was studied in 16 patients with trisomy 21 and compared to that in 4 karyotypically normal mentally retarded children. Serum 5-hydroxytryptamine was markedly decreased in the trisomics whereas cerebrospinal fluid levels of 5-hydroxytryptamine and 5-hydroxyindole acetic acid were increased in the same groups. These results are discussed with respect to regulatory mechanisms of 5-HT metabolism.     

Minor chromosome variations and selected heteromorphisms in 200 unclassifiable mentally retarded patients and 200 normal controls

Summary Lymphocyte chromosome preparations from 200 mentally retarded children and 200 normal adult controls were analyzed by G-, Q-, and C-banding techniques for minor chromosome variations (G and Q) and selected heteromorphisms (G and C). Minor variations scored included inv(9), prominent or decreased short arms and/or satellite on acrocentric chromosomes, and 17ph. C heteromorphisms analyzed included those involving 1qh, 9qh, and 16qh regions. Length variations of Yq were scored on G-banded karyotypes. No significant differences in frequencies of scored minor variations or heteromorphisms were noted between the retarded and control populations.     

Population cytogenetics of folate-sensitive fragile sites

Summary The location and frequency of folate-sensitive common fragile sites (CFS) were studied in three populations: (1) 111 mentally retarded children of school age, (2) 240 mentally subnormal children attending special schools, and (3) 85 healthy children attending normal schools. Common fragile sites were found at 54 chromosomal bands including also the band Xq27, where gaps and breaks were detected in 4% of the children. The most frequent CFS were FRA3B (at 3p14.2), FRA6E (at 6q26), and FRA16D (at 16q23) seen in 73%, 65%, and 58% of the individuals totally studied. The frequencies of CFS-positive individuals did not differ among the populations. The variation found in the distribution of CFS among the populations was primarily assumed to be due to sampling differences and study method. The rate of expression of the most frequent CFS varied significantly among the individuals, seeming to suggest that polymorphism exists at those CFS.     

The Problem of Mental Retardation (A Tentative Working Hypothesis)

Within the general problem of mental retardation, the focus has traditionally been on the child's intellectual inadequacy, his feeblemindedness. This is entrenched in the very term used to designate these children, who are usually called feebleminded, or mentally retarded. All the other aspects of the personality of such a child are usually seen as phenomena arising secondarily as a function of the basic intellectual defect. Many investigators do not even see any essential affective and volitional differences between these children and normal children. …