Axonal loss in multiple sclerosis: a pathological survey of the corticospinal and sensory tracts
Axonal loss in multiple sclerosis: a pathological survey of the corticospinal and sensory tracts
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DOI：
10.1093/brain/awh118
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发表时间：
2004-05-01
期刊：
影响因子：
14.5
通讯作者：
Esiri, MM
中科院分区：
文献类型：
--
作者：
DeLuca, GC;Ebers, GC;Esiri, MM
与髓磷脂相比，多发性硬化的临床、影像学和病理研究普遍强调轴突的相对保存。然而，最近的证据表明，轴突损失也很重要，影响长束，如皮质脊髓束和感觉束，并与功能残疾密切相关。因此，这种轴突损失的分布和程度是当前研究的重点。采用55例多发性硬化症患者和32例匹配对照的死后材料，定量检测从髓质到腰椎的皮质脊髓束和从腰椎到颈上脊髓的感觉束中的轴突数量。髓磷脂和轴突染色切片分别用于估计两个束的名义面积和轴突密度。我们的研究结果表明，与对照组相比，多发性硬化症患者皮质脊髓束的面积和轴突密度在所有水平上都显著减少。相比之下，多发性硬化症患者感觉束的面积和轴突密度仅在脊髓的上部区域显著减少。正如MRI斑块负荷和T2负荷所发现的那样，轴突损失与疾病持续时间的相关性不强。在多发性硬化症中失去的纤维中，我们发现小纤维(
Clinical, imaging, and pathological studies in multiple sclerosis have generally emphasized the relative preservation of axons in comparison with myelin. Recent evidence, however, demonstrates that axonal loss is also significant, affects long tracts such as the corticospinal and sensory tracts and relates closely to functional disability. Accordingly, the distribution and extent of this axonal loss is the focus of the current investigation. Post-mortem material of 55 multiple sclerosis patients and 32 matched controls was used to examine quantitatively the population of axons in the corticospinal tracts from the medulla to the lumbar spinal cord and the sensory tracts from the lumbar to the upper cervical spinal cord. Myelin- and axon-stained sections have been prepared to estimate the notional area and axon density, respectively of both tracts. Our results indicate that in the corticospinal tracts there is a significant reduction of the area and axon density at all levels investigated in multiple sclerosis cases when compared with controls. In contrast, the sensory tracts in multiple sclerosis cases showed a significant reduction in area and axon density only in the upper regions of the spinal cord. As has been found with MRI plaque load and T2 burden, correlations of axonal loss with duration of disease were not strong. Of the fibres lost in multiple sclerosis, we have found that small fibres (