Determinants of quality of life in Rett syndrome: new findings on associations with genotype

J Med Genet. 2021 Sep;58(9):637-644. doi: 10.1136/jmedgenet-2020-107120. Epub 2020 Aug 25.

Abstract

Background: Rett syndrome is a genetically caused neurodevelopmental disorder associated with functional deficits and comorbidities. This study investigated relationships between genotype, functional abilities and comorbidities and quality of life in Rett syndrome.

Methods: The International Rett Syndrome Database, InterRett, was used as a sampling frame for this observational study. Information was collected to describe functional abilities (walking and feeding), health (Sleep Disorder Scale for Children, the Rett Syndrome Behavioural Questionnaire), parental health (12-item Short Form Health Survey) sociodemographic factors (parental employment and education) and quality of life (Quality of Life Inventory-Disability) for 210 individuals with Rett syndrome. Univariate and multivariate regressions were used to analyse the relationships between the independent variables and quality of life.

Results: Compared with individuals with the p.Arg270* mutation, those with the p.Arg294* mutation type had the poorest quality of life (coeff -12.81, 95% CI -23.49 to 2.12), despite this being recognised as a clinically milder genotype. Overall better walking and feeding skills and seizure parameters were more associated with better quality of life and poor sleep and behavioural difficulties with poorer quality of life.

Conclusions: These findings suggest that genotype, functioning and health each have implications for quality of life and should be considered when counselling families and planning clinical and support management strategies.

Keywords: genotype; movement disorders; nervous system diseases; phenotype.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alleles
  • Amino Acid Substitution
  • Comorbidity
  • Databases, Factual
  • Genetic Predisposition to Disease
  • Genotype
  • Humans
  • Mutation
  • Phenotype
  • Public Health Surveillance
  • Quality of Life*
  • Rett Syndrome / diagnosis
  • Rett Syndrome / epidemiology*