Subpial demyelination in the cerebral cortex of multiple sclerosis patients
Subpial demyelination in the cerebral cortex of multiple sclerosis patients
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DOI：
10.1093/jnen/62.7.723
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发表时间：
2003-07-01
影响因子：
3.2
通讯作者：
Mork, SJ
中科院分区：
文献类型：
--
作者：
Bo, L;Vedeler, CA;Mork, SJ
在20例多发性硬化症（MS）患者的78个脑组织块和7例无神经系统疾病的患者的28个脑组织块中确定了大脑皮质脱髓鞘的程度和模式。研究了4个预定区域（扣带回、额叶、顶叶和颞叶）的组织块，不考虑肉眼可见的MS斑块。所有组织块均含有大脑皮质和脑室周围和/或皮质下白色物质。在大脑皮质中检测到109个脱髓鞘病变，其中92个（84.4%）为纯皮质内病变，17个（15.6%）为累及白色和灰质区的病变。在20个MS脑中的5个中，在所研究的4个广泛间隔的皮质区域中广泛存在软膜下脱髓鞘，因此认为代表一般皮质软膜下脱髓鞘。大脑皮质中脱髓鞘区域的百分比（平均值26.5%，中位数14.1%）显著高于白色物质（平均值6.5%，中位数0%）（p = 0.001）。扣带回的灰质和白色物质脱髓鞘比其他检查区域更明显（p < 0.05）。这些结果表明，大脑皮质可能是多发性硬化病变的好发部位，并将一般皮质软膜下脱髓鞘确定为多发性硬化患者重要亚群中发生的独特模式。
The extent and pattern of demyelination in the cerebral cortex was determined in 78 tissue blocks from the brains of 20 multiple sclerosis (MS) patients and 28 tissue blocks from 7 patients without neurological disease. Tissue blocks from 4 predetermined areas (cingulate gyros, frontal, parietal, and temporal lobe) were studied, irrespective of macroscopically evident MS plaques. All tissue blocks contained cerebral cortex and periventricular and/or subcortical white matter. One hundred and nine demyelinating lesions were detected in the cerebral cortex, of which 92 (84.4%) were purely intracortical and 17 (15.6%) were lesions extending through both white and gray matter areas. In 5 of the 20 MS brains, subpial demyelination was extensive in the 4 widely spaced cortical areas studied, thus considered to represent a general cortical subpial demyelination. The percentage of demyelinated area was significantly higher in the cerebral cortex (mean 26.5%, median 14.1%) than in white matter (mean 6.5%, median 0%) (p = 0.001). Both gray and white matter demyelination was more prominent in the cingulate gyrus than in the other areas examined (p < 0.05). These results indicate that the cerebral cortex is likely to be a predilection site for MS lesions and identify general cortical subpial demyelination as a distinct pattern occurring in a significant subpopulation of MS patients.