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Clinical epidemiology and analysis of pathomechanisms of optic-spinal form of multiple sclerosis

视脊髓型多发性硬化症的临床流行病学及发病机制分析

基本信息

批准号：
09470150
负责人：
ITOYAMA Yasuto
金额：
$ 2.56万
依托单位：
Tohoku University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1998
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09470150/
关键词：
multiple sclerosis demyelinating disease MRI Motor evoked potentials 4-aminopyridine Parvovirus B19 Devic disease multiple sclerosis optic-spinal form anti-nuclear antibody ANCA myelitis anti-thyraid antibody anti-thyroid antibod

项目摘要

We studied clinical features and pathomechanisms of multiple sclerosis (MS) in Japan, especially optic-spinal form of MS (OSMS). (l)Eighty six cases of MS whose onset of disease were during 1970-1998 were clinically classified. Frequency of cases of MS with acute transverse myelitis (ATM) decreased in 1980s and 1990s compared with 1970s. In contrast, OSMS without ATM and conventinal MS increased in 1 980s. Changes of environmental factors might have caused these changes of clinical picture of MS in Japan. Brainstem and cerebellar symptoms and signs and MRI findings were analyzed in 66 consecutive cases of MS, and 65% had those symptoms and signs. Cerebellarsigns were seen in 30%. Moreover, cerebellar lesions on MRI were seen in only 6.4%, which was significantly lower than the figures in Western countries (50-90%). (2)4-aminopyridine (4-AP) relieves conductionlock in demyelinated nerves by blocking K channels. 4-AP was administered intravenously and motor evoked potentials (MEP) were recorded before and after 4-AP therapy. After 4-AP therapy, MEP amplitudes increased significantly and mean consecutive difference of MEP latency decreased significantly. 4-AP probably caused coordinated contraction of more muscle fibers. (3) Parvovirus 819 (B19) infection is associated with autoimmunity. B19 antibodies in sera and cerebrospinal fluid (CSF) and B19 DNA in CSF were studied in 46 MS patients. Frequency of B19 lgG in MS (65%) was significantly higher than that in controls (40%), but serum 819 lgM and B19 DNA in CSF were consistently negative in excerbation of MS.

我们研究了日本多发性硬化症（MS）的临床特征和病理机制，特别是光学脊髓型多发性硬化症（OSMS）。(1)对发病时间为1970 ~ 1998年的86例多发性硬化症进行临床分类。与20世纪70年代相比，20世纪80年代和90年代MS合并急性横贯脊髓炎（ATM）的发病率有所下降。相比之下，无ATM的OSMS和常规MS在20世纪80年代有所增加。环境因素的变化可能是造成日本多发性硬化症临床表现变化的原因。对66例MS患者的脑干和小脑症状、体征及MRI表现进行分析，65%的患者存在上述症状和体征。30%可见小脑征象。此外，MRI上小脑病变的发生率仅为6.4%，明显低于西方国家（50-90%）。(2)4-氨基吡啶（4-AP）通过阻断K通道缓解脱髓鞘神经的传导锁定。静脉给予4-AP治疗，记录4-AP治疗前后的运动诱发电位（MEP）。经4-AP治疗后，MEP振幅显著升高，MEP潜伏期平均连续差显著减小。4-AP可能引起更多肌肉纤维的协调收缩。细小病毒819 （B19）感染与自身免疫有关。对46例MS患者血清、脑脊液B19抗体及脑脊液B19 DNA进行了检测。MS患者血清B19 lgM和脑脊液B19 DNA的检出率（65%）明显高于对照组（40%），但MS患者血清819 lgM和脑脊液B19 DNA均呈阴性。