Long-term remyelination after optic neuritis - A 2-year visual evoked potential and psychophysical serial study
Long-term remyelination after optic neuritis - A 2-year visual evoked potential and psychophysical serial study
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DOI：
10.1093/brain/124.3.468
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发表时间：
2001-03-01
期刊：
影响因子：
14.5
通讯作者：
Plant, GT
中科院分区：
文献类型：
--
作者：
Brusa, A;Jones, SJ;Plant, GT
31例患者在视神经炎发作后，第一年每隔3个月随访一次，第二年每隔6个月随访一次。目的是确认先前关于视觉诱发电位（VEP）潜伏期进行性缩短的证据，并确定这是否与临床眼科检查、视野或对比敏感度的任何变化有关。VEP潜伏期在第一年和第二年（不太明显）显著下降，最显著的变化发生在3到6个月之间，对比敏感度在前9个月有所改善，但随后趋于（不显著）恶化。在临床明显多发性硬化症患者亚组中，中心视野敏感度也出现了类似的短暂改善。VEP参数或功能指标未见明显变化，该研究结果扩展了先前的研究结果，该研究显示VEP潜伏期在6个月至3年之间显着缩短，而功能未见明显改善。在此期间，无症状的眼睛VEP潜伏期显着延长，并伴有对比敏感度下降。这两项研究表明，包括髓鞘再生或离子通道重组在内的恢复过程至少持续2年。隐性脱髓鞘和/或轴突变性（也发生在视神经同伴）的并发影响最初被恢复过程所掩盖，但逐渐变得更加明显。长期恢复过程的功能益处相对较小，通常在几年内逆转。长期髓鞘再生可能在保护脱髓鞘轴突免受退化方面发挥重要作用，了解促进长期髓鞘再生的因素可能对多发性硬化症的治疗具有重要意义。
Thirty-one patients were followed-up, at 3-month intervals for the first year and at 6-month intervals for the second year, after an episode of optic neuritis, The object was to confirm previous evidence for a progressive shortening of visual evoked potential (VEP) latencies and to determine whether this is associated with any change in the clinical ocular examination, visual fields or contrast sensitivity, VEP latencies were found to decrease significantly during both the first and (less strikingly) the second year, the most marked changes occurring between 3 and 6 months, Contrast sensitivity improved during the first 9 months, but subsequently tended (non-significantly) to deteriorate, A similarly transient improvement in central visual field sensitivity was seen in a subgroup of patients with clinically overt multiple sclerosis, In the data from the acutely unaffected fellow eyes, no significant changes in VEP parameters or functional indices were observed, The findings extend those of a previous study which showed significant shortening of VEP latencies between 6 months and 3 years without significant functional improvement, Over this period, a significant prolongation of VEP latencies occurred in the asymptomatic fellow eye, accompanied by contrast sensitivity deterioration, Taken in conjunction, the two studies suggest that recovery processes involving remyelination or, possibly, ion channel reorganization proceed for at least 2 years, The concurrent effects of insidious demyelination and/or axonal degeneration (also occurring in the fellow optic nerve) are initially masked by the recovery process, but gradually become more evident, The functional benefits of the longterm recovery process are relatively minor and are usually reversed within a few years, Nevertheless, it is suggested that long-term remyelination may perform an important role in protecting demyelinated axons from degeneration, Understanding the factors which promote long-term remyelination may have significant implications for therapy in multiple sclerosis.