The experience of living with Niemann–Pick type C: a patient and caregiver perspective

Orphanet Journal of Rare Diseases

Research

Emma Golden¹  Amanda Cao¹  Mariesa Cay¹  Raquel van Gool²  Jaymin Upadhyay³  Benjamin Goodlett⁴  Walla Al-Hertani⁴ 

[1] Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, 02115, Boston, MA, USA;Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, 02115, Boston, MA, USA;Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, The Netherlands;Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, 02115, Boston, MA, USA;Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA;Division of Genetics and Genomics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA;

关键词: Niemann–Pick disease type C;    Central nervous system;    Cognition;    Motor;    Caregiver;    Focus group;   

DOI  :  10.1186/s13023-023-02741-2

 received in 2022-12-18, accepted in 2023-05-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundNiemann–Pick disease type C (NPC) is a rare inherited lysosomal storage disease typified by accumulation of cholesterol and other lipids in late endosomes/lysosomes, thereby resulting in a spectrum of neurological, psychiatric, and systemic symptoms (notably liver disease). Though it is well-known that NPC exacts a physical and emotional toll on both patients and caregivers, the burden of NPC can vary between patients, while the challenges of living with NPC can evolve over time (i.e., from time of diagnosis to the present day). To further grasp patient and caregiver perceptions and experiences with NPC, we carried out focus group discussions with pediatric and adult individuals with NPC (N = 19), with partial or full representation of the patient by their caregiver. Furthermore, we utilized our NPC focus group discussion to provide guidance on study design parameters and feasibility of prospective investigations aiming to characterize the central manifestations of NPC using neuroimaging, specifically, magnetic resonance imaging (MRI) methodology.ResultsFocus group discussions revealed that neurological signs, including declining cognition, memory loss, and psychiatric symptoms, as well as increasingly impaired mobility and motor function, are among the most pressing past and current concerns for patients and caregivers. Moreover, several participants also expressed concern over a loss of independence, social exclusion, and uncertainty for what the future holds. Caregivers described the challenges that participation in research poses, which included logistical difficulties mainly due to traveling with medical equipment and the need for sedation in a minority of patients when undergoing MRI.ConclusionsThe findings derived from focus group discussions highlight the outstanding challenges that NPC patients and their caregivers face daily, while also providing direction on the potential scope and feasibility of future studies focusing on the central phenotypes of NPC.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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