Neurophysiological evidence for long-term repair of MS lesions: implications for axon protection
Neurophysiological evidence for long-term repair of MS lesions: implications for axon protection
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DOI：
10.1016/s0022-510x(02)00428-8
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发表时间：
2003-02-15
影响因子：
4.4
通讯作者：
Brusa, A
中科院分区：
文献类型：
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作者：
Jones, SJ;Brusa, A
从视神经炎急性期恢复后，通常观察到视觉诱发电位（VEP）的潜伏期明显延长。我们进行了三项研究（一项横断面研究，两项前瞻性研究），旨在阐明VEP潜伏期的逐渐缩短，这在随后的几个月或几年内经常发生。这已被证明是一个渐进的过程，在患者人群中是一种普遍的趋势，持续超过2年，尽管事实上在最初几个月后视力的功能改善很少。我们认为，修复的基本过程是最有可能涉及脱髓鞘视神经轴突髓鞘再生。而不是恢复视觉功能（这可能是几乎完全后，短短3个月），长期髓鞘修复过程的主要重要性可能在于保护脱髓鞘轴突从随后的，永久性的退化。在急性未受影响的对侧眼的VEP中，随访超过3年，我们观察到无症状的恶化，可能是由于脱髓鞘和/或轴突变性的潜伏过程。因此，即使在MS的复发/缓解阶段，也有临床无症状轴突参与的电生理学证据，在后期阶段，可能表现为进行性功能恶化。(C)2002 Elsevier Science B. V.保留所有权利。
After recovery from the acute stage of optic neuritis, a marked prolongation in the latencies of visual evoked potentials (VEPs) is typically observed. We have conducted three studies (one cross-sectional, two prospective), aimed at elucidating the progressive shortening of VEP latency, which frequently ensues over the following months or years. This has been shown to be a progressive process and a prevalent tendency in the patient population, proceeding for more than 2 years in spite of the fact that very little functional improvement in vision occurs after the first few months. We argue that the underlying process of repair is most likely to involve remyelination of demyelinated optic nerve axons. Rather than restoration of visual function (which may be virtually complete after as short a period as 3 months), the main importance of the long-term myelin repair process may consist in protecting demyelinated axons from subsequent, permanent de generation. In the VEPs of the acutely unaffected fellow eyes followed up over 3 years, we observed an asymptomatic deterioration, possibly due to insidious processes of demyelination and/or axonal degeneration. Even in the relapsing/remitting stage of MS, therefore, there is electropbysiological evidence for involvement of clinically asymptomatic axons, which, in the later stages, may be manifested as progressive functional deterioration. (C) 2002 Elsevier Science B.V. All rights reserved.