Olfactory Pathology in Central Nervous System Demyelinating Diseases
Olfactory Pathology in Central Nervous System Demyelinating Diseases
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DOI：
10.1111/bpa.12209
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发表时间：
2015-09-01
期刊：
影响因子：
6.4
通讯作者：
Esiri, Margaret M.
中科院分区：
文献类型：
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作者：
DeLuca, Gabriele C.;Joseph, Albert;Esiri, Margaret M.
嗅觉功能障碍在多发性硬化症（MS）中很常见。MS和其他脱髓鞘疾病中的嗅球和嗅束病理学仍未探索。一组病理证实的脱髓鞘疾病的人类尸检病例（MS; n = 17）、视神经肌病[（NMO）; n = 3]和急性播散性脑脊髓炎[（ADEM）; n = 7]与神经炎性[单纯疱疹病毒脑炎（HSE）; n = 3]、神经变性[阿尔茨海默病（AD; n = 4]和非神经系统（n = 8）对照。对于每种情况，嗅球和/或嗅束进行髓鞘，轴突和炎症染色。在MS和ADEM病例的一个子集中，对下额叶皮质和海马进行髓鞘染色。嗅球/嗅束脱髓鞘在所有脱髓鞘疾病中常见[MS 12/17（70.6%）; ADEM 3/7（42.9%）; NMO 2/3（66.7%）]，但在HSE、AD和非神经系统对照中不存在。与非神经系统对照组相比，脱髓鞘疾病组的炎症反应更严重。嗅球/嗅束轴突丢失在MS中最为严重，其与脱髓鞘（r = 0.610，P = 0.009）和实质炎症（r = 0.681，P = 0.003）的程度显著相关。嗅球/嗅束脱髓鞘的程度与相邻的下额叶皮质相关，但与海马无关。我们提供了明确的证据，嗅球/道脱髓鞘是频繁的，可以发生在早期，是高度炎症，是特定的脱髓鞘疾病。
Olfactory dysfunction is common in multiple sclerosis (MS). Olfactory bulb and tract pathology in MS and other demyelinating diseases remain unexplored. A human autopsy cohort of pathologically confirmed cases encompassing the spectrum of demyelinating disease (MS; n = 17), neuromyelitis optica [(NMO); n = 3] and acute disseminated encephalomyelitis [(ADEM); n = 7] was compared to neuroinflammatory [herpes simplex virus encephalitis (HSE); n = 3], neurodegenerative [Alzheimer's disease (AD); n = 4] and non-neurologic (n = 8) controls. For each case, olfactory bulbs and/or tracts were stained for myelin, axons and inflammation. Inferior frontal cortex and hippocampus were stained for myelin in a subset of MS and ADEM cases. Olfactory bulb/tract demyelination was frequent in all demyelinating diseases [MS 12/17 (70.6%); ADEM 3/7 (42.9%); NMO 2/3 (66.7%)] but was absent in HSE, AD and non-neurologic controls. Inflammation was greater in the demyelinating diseases compared to non-neurologic controls. Olfactory bulb/tract axonal loss was most severe in MS where it correlated significantly with the extent of demyelination (r = 0.610, P = 0.009) and parenchymal inflammation (r = 0.681, P = 0.003). The extent of olfactory bulb/tract demyelination correlated with that found in the adjacent inferior frontal cortex but not hippocampus. We provide unequivocal evidence that olfactory bulb/tract demyelination is frequent, can occur early and is highly inflammatory, and is specific to demyelinating disease.