日本人clinically isolated syndrome患者の脳MRI所見
日本人clinically isolated syndrome患者の脳MRI所見
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日本临床孤立综合征患者的脑部MRI表现
DOI：
10.5692/clinicalneurol.52.725
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Keiko Tanaka
中科院分区：
文献类型：
--
作者：
Masami Tanaka;R. Motoyama;M. Tahara;Keiko Tanaka
使用包括干扰素β在内的疾病改善药物治疗临床孤立综合征（CIS）患者可延迟转化为临床明确的多发性硬化症（MS）。然而，CIS患者即使在20年后也不一定会发展为MS。CIS患者需要脑MRI病变纳入临床试验，如CHAMPS研究和BENEFIT研究。在西方国家，CIS患者的脑MRI病变与多发性硬化症相符，被认为是转化为多发性硬化症的高风险。之前我们报道了9/23（39.1%）的MS患者在前一年至少复发一次或前2年至少复发两次的患者中发现无症状增强脑病变（AEBLs），每次扫描AEBLs的数量为0.37，提示日本MS患者疾病活动性低。我们检查了日本CIS患者的脑MRI结果，并与首次呈现的日本MS患者进行了比较。我们回顾了2007年12月至2010年10月来我们诊所就诊的23例符合Kappos等人（2006）和Dalton等人（2002）提出的标准的CIS患者的脑部MRI。32例临床明确的MS （CDMS）患者符合Polman等人（2005）提出的第一个McDonald标准（两次或两次以上发作，有两个或两个以上病变的客观临床证据）。排除视神经脊髓炎（NMO）患者和Wingerchuk et al.（2006）和Wingerchuk et al.（2007）提出的NMO谱患者。抗水通道蛋白4抗体或MRI上连续脊髓病变超过三个椎节的患者也被排除在外。11例CDMS患者由于病程较长，未行MRI检查，2例CIS患者和13例CDMS患者未行MRI检查。因此，我们在首次报告时使用party标准和Barkhof标准检查了21例CIS和8例CDMS患者。11例CIS患者不符合任何Barkhof标准。7例和3例CIS患者分别满足Barkhof标准中的1项和2项。没有CIS患者符合Barkhof标准中的3项以上。8名CDMS患者中有7名在首次报告时表现出超过一项Barkhof标准，然而，只有1名CDMS患者在发病时满足3项以上的Barkhof标准。日本的CIS患者似乎比西方国家的患者表现出更少的脑损伤。
Treatment of patients with clinically isolated syndrome (CIS) with disease modifying drugs including interferon β delays conversion to clinically definite multiple sclerosis (MS). However, CIS patients do not necessarily develop MS even after 20 years. Brain MRI lesions were required for CIS patients to include in clinical trials such as CHAMPS study and BENEFIT study. CIS patients with brain MRI lesions compatible to MS were considered as high risk to convert to MS in western countries. Previously we reported that asymptomatic enhancing brain lesions (AEBLs) were found in 9/23 (39.1%) of MS patients who had suffered at least one relapse in the preceding year or two relapses in the preceding 2 years, and the number of AEBLs per scan was 0.37, suggesting low disease activity of Japanese MS patients. We examined brain MRI findings in Japanese CIS patients and compared with those of Japanese MS patients at the first presentation. We reviewed brain MRI of 23 CIS visited our clinic from December 2007 to October 2010 who fulfilled the criteria proposed by Kappos et al. (2006) and Dalton et al (2002). Thirty two clinically definite MS (CDMS) patients fulfilled the first McDonald criteria (two or more attacks and objective clinical evidence of two or more lesions) proposed by Polman et al. (2005). Patients with neuromyelitis optica (NMO) and patients with NMO spectrum proposed by Wingerchuk et al. (2006) and Wingerchuk et al. (2007), respectively, were excluded. Patients with anti-aquaporin4 antibodies or with contiguous spinal cord lesion extending over three vertebral segments on MRI were also excluded. We could not obtain MRI of 11 patients with CDMS because of very long disease course, and 2 CIS and 13 CDMS patients had not been examined with MRI. So we examined 21 CIS and 8 CDMS patients at the first presentation using Paty criteria and Barkhof criteria. Eleven CIS patients did not meet any of the Barkhof criteria. Seven and 3 CIS patients met one and two of Barkhof criteria, respectively. No CIS patients showed fulfilled more than 3 of Barkhof criteria. Seven of eight CDMS patients at the first presentation showed more than one of the Barkhof criteria, however, only one CDMS patient at the onset fulfilled more than 3 of the Barkhof criteria. Japanese CIS patients seemed to show less brain lesions than those in western countries.
影响因子：
3.3
作者：
Nakashima, I;Fujihara, K;Itoyama, Y
通讯作者：
Itoyama, Y