Axonal and perikaryal involvement in chronic inflammatory demyelinating polyneuropathy

被引:57
作者
Nagamatsu, M
Terao, S
Misu, K
Li, M
Hattori, N
Ichimura, M
Sakai, M
Yamamoto, H
Watanabe, H
Riku, S
Ikeda, E
Hata, J
Oda, M
Satake, M
Nakamura, N
Matsuya, S
Hashizume, Y
Sobue, G
机构
[1] Nagoya Univ, Sch Med, Dept Neurol, Showa Ku, Nagoya, Aichi 4668550, Japan
[2] Aichi Med Univ, Dept Internal Med 4, Aichi, Japan
[3] Fujita Hlth Univ, Sch Med, Dept Neurol, Toyoake, Aichi 47011, Japan
[4] Chukyo Hosp, Dept Neurol, Nagoya, Aichi, Japan
[5] Keio Univ, Sch Med, Dept Pathol, Tokyo 160, Japan
[6] Tokyo Metropolitan Neurol Hosp, Dept Pathol, Tokyo, Japan
关键词
chronic inflammatory demyelinating polyneuropathy; axon loss; spinal motor neuron;
D O I
10.1136/jnnp.66.6.727
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives-To assess the extent of loss of myelinated nerve fibres and spinal motor neuron loss in chronic inflammatory demyelinating polyneuropathy (CIDP), a clinicopathological study was conducted on biopsied sural nerves and necropsied spinal cords from patients with CIDP. Methods-The myelinated fibre pathology of 71 biopsied sural nerves and motor neuron pathology of nine necropsied spinal cords at L4 levels in patients with CIDP were quantitatively and immunohistochemically assessed. Results-Myelinated nerve fibre density was significantly diminished to 65.4% of the control values (p <0.0001), correlating inversely with the extent of segmental demyelination and remyelination (r = -0.43, p < 0.0005) and duration of illness (r = -0.31, p < 0.01). Numbers of large spinal motor neurons in CIDP were variably but significantly diminished (range from 46.0 to 97.6% of the age matched control value (p < 0.005)), and reactive astrogliosis was evident in the ventral horn in CIDP. The frequency of ventral horn neurons exhibiting central chromatolysis and the accumulation of phosphorylated high molecular weight neurofilament protein was significantly higher in CIDP than in controls (p<0.01 and p<0.05). Conclusions-The loss of nerve axons and spinal motor neurons is common in CIDP, and extensive in some cases. These neuronal and axonal losses may influence the functional prognosis in CIDP.
引用
收藏
页码:727 / 733
页数:7
相关论文
共 47 条
[1]   CHRONIC EXPERIMENTAL ALLERGIC NEURITIS IN LEWIS RATS [J].
ADAM, AM ;
ATKINSON, PF ;
HALL, SM ;
HUGHES, RAC ;
TAYLOR, WA .
NEUROPATHOLOGY AND APPLIED NEUROBIOLOGY, 1989, 15 (03) :249-264
[2]  
ARANSON BGW, 1993, PERIPHERAL NEUROPATH, P1437
[3]   CHRONIC INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY - CLINICAL CHARACTERISTICS, COURSE, AND RECOMMENDATIONS FOR DIAGNOSTIC-CRITERIA [J].
BAROHN, RJ ;
KISSEL, JT ;
WARMOLTS, JR ;
MENDELL, JR .
ARCHIVES OF NEUROLOGY, 1989, 46 (08) :878-884
[4]   MORPHOMETRIC MEASUREMENTS AND RNA-CONTENT OF AXOTOMIZED FELINE CERVICAL MOTO-NEURONS [J].
BARRON, KD ;
COVA, J ;
SCHEIBLY, ME ;
KOHBERGER, R .
JOURNAL OF NEUROCYTOLOGY, 1982, 11 (05) :707-720
[5]  
CAMPBELL B, 1946, P SOC EXP BIOL MED, V61, P425
[6]  
CORNBLATH DR, 1991, NEUROLOGY, V41, P617
[7]   IMMUNOGLOBULIN AND COMPLEMENT DEPOSITS IN NERVES OF PATIENTS WITH CHRONIC RELAPSING POLYNEUROPATHY [J].
DALAKAS, MC ;
ENGEL, WK .
ARCHIVES OF NEUROLOGY, 1980, 37 (10) :637-640
[8]   LOCAL MODULATION OF NEUROFILAMENT PHOSPHORYLATION, AXONAL CALIBER, AND SLOW AXONAL-TRANSPORT BY MYELINATING SCHWANN-CELLS [J].
DEWAEGH, SM ;
LEE, VMY ;
BRADY, ST .
CELL, 1992, 68 (03) :451-463
[9]  
DYCK PJ, 1970, MAYO CLIN PROC, V45, P286
[10]  
DYCK PJ, 1975, MAYO CLIN PROC, V50, P621