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Long-tract signs

MedGen UID:
356397
Concept ID:
C1865903
Finding
Synonym: Long tract signs
 
HPO: HP:0002423

Definition

Long-tract signs refer to symptoms that are attributable to the involvement of the long fiber tracts in the spinal cord, which connect the spinal cord to the brain and mediate spinal and motor functions. [from HPO]

Conditions with this feature

Spinocerebellar ataxia type 29
MedGen UID:
350085
Concept ID:
C1861732
Disease or Syndrome
Spinocerebellar ataxia-29 (SCA29) is an autosomal dominant neurologic disorder characterized by onset in infancy of delayed motor development and mild cognitive delay. Affected individuals develop a very slowly progressive or nonprogressive gait and limb ataxia associated with cerebellar atrophy on brain imaging. Additional variable features include nystagmus, dysarthria, and tremor (summary by Huang et al., 2012). For a general discussion of autosomal dominant spinocerebellar ataxia, see SCA1 (164400).
Alzheimer disease 2
MedGen UID:
400197
Concept ID:
C1863051
Disease or Syndrome
Alzheimer's disease can be classified as early-onset or late-onset. The signs and symptoms of the early-onset form appear between a person's thirties and mid-sixties, while the late-onset form appears during or after a person's mid-sixties. The early-onset form of Alzheimer's disease is much less common than the late-onset form, accounting for less than 10 percent of all cases of Alzheimer's disease.\n\nIndividuals with Alzheimer's disease usually survive 8 to 10 years after the appearance of symptoms, but the course of the disease can range from 1 to 25 years. Survival is usually shorter in individuals diagnosed after age 80 than in those diagnosed at a younger age. In Alzheimer's disease, death usually results from pneumonia, malnutrition, or general body wasting (inanition).\n\nAs the disorder progresses, some people with Alzheimer's disease experience personality and behavioral changes and have trouble interacting in a socially appropriate manner. Other common symptoms include agitation, restlessness, withdrawal, and loss of language skills. People with Alzheimer's disease usually require total care during the advanced stages of the disease.\n\nMemory loss is the most common sign of Alzheimer's disease. Forgetfulness may be subtle at first, but the loss of memory worsens over time until it interferes with most aspects of daily living. Even in familiar settings, a person with Alzheimer's disease may get lost or become confused. Routine tasks such as preparing meals, doing laundry, and performing other household chores can be challenging. Additionally, it may become difficult to recognize people and name objects. Affected people increasingly require help with dressing, eating, and personal care.\n\nAlzheimer's disease is a degenerative disease of the brain that causes dementia, which is a gradual loss of memory, judgment, and ability to function. This disorder usually appears in people older than age 65, but less common forms of the disease appear earlier in adulthood.
Alzheimer disease type 1
MedGen UID:
354892
Concept ID:
C1863052
Disease or Syndrome
Alzheimer disease is the most common form of progressive dementia in the elderly. It is a neurodegenerative disorder characterized by the neuropathologic findings of intracellular neurofibrillary tangles (NFT) and extracellular amyloid plaques that accumulate in vulnerable brain regions (Sennvik et al., 2000). Terry and Davies (1980) pointed out that the 'presenile' form, with onset before age 65, is identical to the most common form of late-onset or 'senile' dementia, and suggested the term 'senile dementia of the Alzheimer type' (SDAT). Haines (1991) reviewed the genetics of AD. Selkoe (1996) reviewed the pathophysiology, chromosomal loci, and pathogenetic mechanisms of Alzheimer disease. Theuns and Van Broeckhoven (2000) reviewed the transcriptional regulation of the genes involved in Alzheimer disease. Genetic Heterogeneity of Alzheimer Disease Alzheimer disease is a genetically heterogeneous disorder. See also AD2 (104310), associated with the APOE*4 allele (107741) on chromosome 19; AD3 (607822), caused by mutation in the presenilin-1 gene (PSEN1; 104311) on 14q; and AD4 (606889), caused by mutation in the PSEN2 gene (600759) on 1q31. There is evidence for additional AD loci on other chromosomes; see AD5 (602096) on 12p11; AD6 (605526) on 10q24; AD7 (606187) on 10p13; AD8 (607116) on 20p; AD9 (608907), associated with variation in the ABCA7 gene (605414) on 19p13; AD10 (609636) on 7q36; AD11 (609790) on 9q22; AD12 (611073) on 8p12-q22; AD13 (611152) on 1q21; AD14 (611154) on 1q25; AD15 (604154) on 3q22-q24; AD16 (300756) on Xq21.3; AD17 (615080) on 6p21.2; and AD18 (615590), associated with variation in the ADAM10 gene (602192) on 15q21. Evidence also suggests that mitochondrial DNA polymorphisms may be risk factors in Alzheimer disease (502500). Finally, there have been associations between AD and various polymorphisms in other genes, including alpha-2-macroglobulin (A2M; 103950.0005), low density lipoprotein-related protein-1 (LRP1; 107770), the transferrin gene (TF; 190000), the hemochromatosis gene (HFE; 613609), the NOS3 gene (163729), the vascular endothelial growth factor gene (VEGF; 192240), the ABCA2 gene (600047), and the TNF gene (191160) (see MOLECULAR GENETICS).
Paget disease of bone 2, early-onset
MedGen UID:
899166
Concept ID:
C4085251
Disease or Syndrome
Paget disease (PDB) is a metabolic bone disease characterized by focal abnormalities of increased bone turnover affecting one or more sites throughout the skeleton, primarily the axial skeleton. Bone lesions in this disorder show evidence of increased osteoclastic bone resorption and disorganized bone structure. See reviews by Ralston et al. (2008) and Ralston and Albagha (2014). For a discussion of genetic heterogeneity of Paget disease of bone, see 167250.
Trichothiodystrophy 6, nonphotosensitive
MedGen UID:
934752
Concept ID:
C4310785
Disease or Syndrome
About half of all people with trichothiodystrophy have a photosensitive form of the disorder, which causes them to be extremely sensitive to ultraviolet (UV) rays from sunlight. They develop a severe sunburn after spending just a few minutes in the sun. However, for reasons that are unclear, they do not develop other sun-related problems such as excessive freckling of the skin or an increased risk of skin cancer. Many people with trichothiodystrophy report that they do not sweat.\n\nIntellectual disability and delayed development are common in people with trichothiodystrophy, although most affected individuals are highly social with an outgoing and engaging personality. Some people with trichothiodystrophy have brain abnormalities that can be seen with imaging tests. A common neurological feature of this disorder is impaired myelin production (dysmyelination). Myelin is a fatty substance that insulates nerve cells and promotes the rapid transmission of nerve impulses.\n\nMothers of children with trichothiodystrophy may experience problems during pregnancy including pregnancy-induced high blood pressure (preeclampsia) and a related condition called HELLP syndrome that can damage the liver. Babies with trichothiodystrophy are at increased risk of premature birth, low birth weight, and slow growth. Most children with trichothiodystrophy have short stature compared to others their age. \n\nThe signs and symptoms of trichothiodystrophy vary widely. Mild cases may involve only the hair. More severe cases also cause delayed development, significant intellectual disability, and recurrent infections; severely affected individuals may survive only into infancy or early childhood.\n\nTrichothiodystrophy is also associated with recurrent infections, particularly respiratory infections, which can be life-threatening. People with trichothiodystrophy may have abnormal red blood cells, including red blood cells that are smaller than normal. They may also have elevated levels of a type of hemoglobin called A2, which is a protein found in red blood cells. Other features of trichothiodystrophy can include dry, scaly skin (ichthyosis); abnormalities of the fingernails and toenails; clouding of the lens in both eyes from birth (congenital cataracts); poor coordination; and skeletal abnormalities including degeneration of both hips at an early age.\n\nIn people with trichothiodystrophy, tests show that the hair is lacking sulfur-containing proteins that normally gives hair its strength. A cross section of a cut hair shows alternating light and dark banding that has been described as a "tiger tail."\n\nTrichothiodystrophy, commonly called TTD, is a rare inherited condition that affects many parts of the body. The hallmark of this condition is hair that is sparse and easily broken. 

Professional guidelines

PubMed

Ahmed S, Abdullah M, Khan MAA, Resham S, Qureshi BM, Mushtaq N
Childs Nerv Syst 2024 Nov;40(11):3537-3544. Epub 2024 Sep 30 doi: 10.1007/s00381-024-06637-9. PMID: 39349775
Fadil H, Kelley RE, Gonzalez-Toledo E
Int Rev Neurobiol 2007;79:393-422. doi: 10.1016/S0074-7742(07)79018-9. PMID: 17531852

Recent clinical studies

Etiology

Dudoit T, Balossier A, Reyes-Botero G, Laigle-Donadey F, Emery E, Blond S, Carluer L, Lechapt-Zalcman E, Delattre JY, Guillamo JS
Rev Neurol (Paris) 2021 Dec;177(10):1276-1282. Epub 2021 Jul 14 doi: 10.1016/j.neurol.2021.03.006. PMID: 34272066
Grimm SA, Chamberlain MC
Curr Neurol Neurosci Rep 2013 May;13(5):346. doi: 10.1007/s11910-013-0346-3. PMID: 23512689
Menon U, Kelley RE
Int Rev Neurobiol 2009;84:21-33. doi: 10.1016/S0074-7742(09)00402-4. PMID: 19501711
Hammack J, Kotanides H, Rosenblum MK, Posner JB
Neurology 1992 Oct;42(10):1938-43. doi: 10.1212/wnl.42.10.1938. PMID: 1407576
Harwick RD, Miller AS
Am J Surg 1979 Oct;138(4):512-6. doi: 10.1016/0002-9610(79)90410-0. PMID: 114069

Diagnosis

Williams J, D'Amore P, Redlich N, Darlow M, Suwak P, Sarkovich S, Bhandutia AK
Orthop Clin North Am 2022 Oct;53(4):509-521. Epub 2022 Sep 14 doi: 10.1016/j.ocl.2022.05.007. PMID: 36208893
Dudoit T, Balossier A, Reyes-Botero G, Laigle-Donadey F, Emery E, Blond S, Carluer L, Lechapt-Zalcman E, Delattre JY, Guillamo JS
Rev Neurol (Paris) 2021 Dec;177(10):1276-1282. Epub 2021 Jul 14 doi: 10.1016/j.neurol.2021.03.006. PMID: 34272066
Grimm SA, Chamberlain MC
Curr Neurol Neurosci Rep 2013 May;13(5):346. doi: 10.1007/s11910-013-0346-3. PMID: 23512689
Rennebohm R, Susac JO, Egan RA, Daroff RB
J Neurol Sci 2010 Dec 15;299(1-2):86-91. Epub 2010 Sep 19 doi: 10.1016/j.jns.2010.08.032. PMID: 20855088
Harwick RD, Miller AS
Am J Surg 1979 Oct;138(4):512-6. doi: 10.1016/0002-9610(79)90410-0. PMID: 114069

Therapy

Janssens GO, Jansen MH, Lauwers SJ, Nowak PJ, Oldenburger FR, Bouffet E, Saran F, Kamphuis-van Ulzen K, van Lindert EJ, Schieving JH, Boterberg T, Kaspers GJ, Span PN, Kaanders JH, Gidding CE, Hargrave D
Int J Radiat Oncol Biol Phys 2013 Feb 1;85(2):315-20. Epub 2012 Jun 9 doi: 10.1016/j.ijrobp.2012.04.006. PMID: 22682807
Rennebohm R, Susac JO, Egan RA, Daroff RB
J Neurol Sci 2010 Dec 15;299(1-2):86-91. Epub 2010 Sep 19 doi: 10.1016/j.jns.2010.08.032. PMID: 20855088
Hall WA, Doolittle ND, Daman M, Bruns PK, Muldoon L, Fortin D, Neuwelt EA
J Neurooncol 2006 May;77(3):279-84. Epub 2005 Nov 29 doi: 10.1007/s11060-005-9038-4. PMID: 16314949
Tenembaum S, Chamoles N, Fejerman N
Neurology 2002 Oct 22;59(8):1224-31. doi: 10.1212/wnl.59.8.1224. PMID: 12391351
Feinglass EJ, Arnett FC, Dorsch CA, Zizic TM, Stevens MB
Medicine (Baltimore) 1976 Jul;55(4):323-39. doi: 10.1097/00005792-197607000-00004. PMID: 781466

Prognosis

Kumar A, Behari S, Sardhara J, Mishra P, Singh V, Raiyani V, Bhaisora KS, Srivastava AK
Br J Neurosurg 2022 Dec;36(6):686-692. Epub 2022 Mar 7 doi: 10.1080/02688697.2022.2047155. PMID: 35254185
Dudoit T, Balossier A, Reyes-Botero G, Laigle-Donadey F, Emery E, Blond S, Carluer L, Lechapt-Zalcman E, Delattre JY, Guillamo JS
Rev Neurol (Paris) 2021 Dec;177(10):1276-1282. Epub 2021 Jul 14 doi: 10.1016/j.neurol.2021.03.006. PMID: 34272066
Hunter G, Young GB, Ang LC
Neurocrit Care 2012 Aug;17(1):102-6. doi: 10.1007/s12028-012-9691-3. PMID: 22622843
Fadil H, Kelley RE, Gonzalez-Toledo E
Int Rev Neurobiol 2007;79:393-422. doi: 10.1016/S0074-7742(07)79018-9. PMID: 17531852
Harwick RD, Miller AS
Am J Surg 1979 Oct;138(4):512-6. doi: 10.1016/0002-9610(79)90410-0. PMID: 114069

Clinical prediction guides

Batish A, Gupta SK, Mohanty M, Tripathi M, Salunke P, Aggarwal A
Neurol India 2022 May-Jun;70(3):897-904. doi: 10.4103/0028-3886.349614. PMID: 35864616
Kumar A, Behari S, Sardhara J, Mishra P, Singh V, Raiyani V, Bhaisora KS, Srivastava AK
Br J Neurosurg 2022 Dec;36(6):686-692. Epub 2022 Mar 7 doi: 10.1080/02688697.2022.2047155. PMID: 35254185
Schmahmann JD
Childs Nerv Syst 2020 Jun;36(6):1205-1214. Epub 2019 Jun 25 doi: 10.1007/s00381-019-04253-6. PMID: 31240391Free PMC Article
Preethish-Kumar V, Polavarapu K, Nashi S, Bhattacharya K, Saini J, Vengalil S, Pruthi N, Bhat DI, Nalini A
Neurol India 2018 Jul-Aug;66(4):1094-1099. doi: 10.4103/0028-3886.236966. PMID: 30038100
Orakcioglu B, Schramm P, Kohlhof P, Aschoff A, Unterberg A, Halatsch ME
J Neurosurg Spine 2009 Jan;10(1):54-9. doi: 10.3171/2008.10.SPI08311. PMID: 19119934

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