Frontiers in Genetics (Feb 2024)

Brain function in classic galactosemia, a galactosemia network (GalNet) members review

  • Bianca Panis,
  • Bianca Panis,
  • Bianca Panis,
  • E. Naomi Vos,
  • E. Naomi Vos,
  • E. Naomi Vos,
  • E. Naomi Vos,
  • E. Naomi Vos,
  • Ivo Barić,
  • Annet M. Bosch,
  • Annet M. Bosch,
  • Annet M. Bosch,
  • Martijn C. G. J. Brouwers,
  • Martijn C. G. J. Brouwers,
  • Alberto Burlina,
  • Alberto Burlina,
  • David Cassiman,
  • David J. Coman,
  • María L. Couce,
  • María L. Couce,
  • Anibh M. Das,
  • Anibh M. Das,
  • Didem Demirbas,
  • Aurélie Empain,
  • Aurélie Empain,
  • Matthias Gautschi,
  • Olga Grafakou,
  • Olga Grafakou,
  • Stephanie Grunewald,
  • Sandra D. K. Kingma,
  • Sandra D. K. Kingma,
  • Ina Knerr,
  • Elisa Leão-Teles,
  • Elisa Leão-Teles,
  • Dorothea Möslinger,
  • Dorothea Möslinger,
  • Elaine Murphy,
  • Katrin Õunap,
  • Katrin Õunap,
  • Adriana Pané,
  • Adriana Pané,
  • Sabrina Paci,
  • Sabrina Paci,
  • Rossella Parini,
  • Rossella Parini,
  • Isabel A. Rivera,
  • Sabine Scholl-Bürgi,
  • Ida V. D. Schwartz,
  • Triantafyllia Sdogou,
  • Triantafyllia Sdogou,
  • Loai A. Shakerdi,
  • Anastasia Skouma,
  • Anastasia Skouma,
  • Karolina M. Stepien,
  • Eileen P. Treacy,
  • Susan Waisbren,
  • Gerard T. Berry,
  • M. Estela Rubio-Gozalbo,
  • M. Estela Rubio-Gozalbo,
  • M. Estela Rubio-Gozalbo,
  • M. Estela Rubio-Gozalbo,
  • M. Estela Rubio-Gozalbo

DOI
https://doi.org/10.3389/fgene.2024.1355962
Journal volume & issue
Vol. 15

Abstract

Read online

Classic galactosemia (CG, OMIM #230400, ORPHA: 79,239) is a hereditary disorder of galactose metabolism that, despite treatment with galactose restriction, affects brain function in 85% of the patients. Problems with cognitive function, neuropsychological/social emotional difficulties, neurological symptoms, and abnormalities in neuroimaging and electrophysiological assessments are frequently reported in this group of patients, with an enormous individual variability. In this review, we describe the role of impaired galactose metabolism on brain dysfunction based on state of the art knowledge. Several proposed disease mechanisms are discussed, as well as the time of damage and potential treatment options. Furthermore, we combine data from longitudinal, cross-sectional and retrospective studies with the observations of specialist teams treating this disease to depict the brain disease course over time. Based on current data and insights, the majority of patients do not exhibit cognitive decline. A subset of patients, often with early onset cerebral and cerebellar volume loss, can nevertheless experience neurological worsening. While a large number of patients with CG suffer from anxiety and depression, the increased complaints about memory loss, anxiety and depression at an older age are likely multifactorial in origin.

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