Title:Respiratory Disorders in Rett Syndrome
Volume: 21
Issue: 1
Author(s): Giulia Spoto, Arianna Santina Accetta, Maria Grella, Irene Di Modica*Antonio Gennaro Nicotera
Affiliation:
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano
Barresi", University of Messina, Messina, Italy
Keywords:
Rett syndrome, respiratory disorders, MECP2, obstructive sleep apnea, breathing regulation, SUDEP.
Abstract: Rett Syndrome (RTT) is a rare and severe neurodevelopmental disorder affecting children
in the early stages of infancy and associated with a MECP2 mutation in 95-97% of individuals
with typical RTT. Nearly all of the patients show breathing abnormalities during their lifespan,
both in wake and sleep and respiratory illness represents an important cause of morbidity and mortality
in RTT. Pathogenic mechanisms underlying breath-holding and other breathing abnormalities
in RTT are mainly related to dysautonomia and an alteration in respiratory control at different
levels, including several regions of the central and peripheral nervous system. Pathogenic variants
in the MECP2 gene have been implicated in the dysfunction of respiratory pathways, affecting
chemosensitivity and the response to neurotransmitters. In addition, frequent comorbidities such
as scoliosis, dysphagia, sleep disorders, and epilepsy can further impair the respiratory function in
these patients.