Echaniz-Laguna Andoni, Rene Frédérique, Marcel Christophe, Bangratz Marie, Fontaine Bertrand, Loeffler Jean-Philippe, Nicole Sophie
Département de Neurologie, Hôpital Civil de Strasbourg, 1 Place de l'Hôpital, BP426, 67091 Strasbourg,France.
Muscle Nerve. 2009 Jul;40(1):55-61. doi: 10.1002/mus.21253.
Schwartz-Jampel syndrome (SJS) is an autosomal-recessive condition characterized by muscle stiffness and chondrodysplasia. It is due to loss-of-function hypomorphic mutations in the HSPG2 gene that encodes for perlecan, a proteoglycan secreted into the basement membrane. The origin of muscle stiffness in SJS is debated. To resolve this issue, we performed an electrophysiological investigation of an SJS mouse model with a missense mutation in the HSPG2 gene. Compound muscle action potential amplitudes, distal motor latencies, repetitive nerve stimulation tests, and sensory nerve conduction velocities of SJS mice were normal. On electromyography (EMG), neuromyotonic discharges, that is, bursts of motor unit action potentials firing at high rates (120-300 HZ), were constantly observed in SJS mice in all muscles, except in the diaphragm. Neuromyotonic discharges were not influenced by general anesthesia and disappeared with curare administration. They persisted after complete motor nerve section, terminating only with Wallerian degeneration. These results demonstrate that perlecan deficiency in SJS provokes a neuromyotonic syndrome. The findings further suggest a distal axonal localization of the generator of neuromyotonic discharges. SJS should now be considered as an inherited disorder with peripheral nerve hyperexcitability.
施瓦茨 - 扬佩尔综合征(SJS)是一种常染色体隐性疾病,其特征为肌肉僵硬和软骨发育异常。它是由编码基底膜中分泌的蛋白聚糖核心蛋白聚糖的HSPG2基因功能丧失型亚效突变引起的。SJS中肌肉僵硬的起源存在争议。为了解决这个问题,我们对具有HSPG2基因错义突变的SJS小鼠模型进行了电生理研究。SJS小鼠的复合肌肉动作电位幅度、远端运动潜伏期、重复神经刺激试验和感觉神经传导速度均正常。在肌电图(EMG)检查中,除膈肌外,在SJS小鼠的所有肌肉中均持续观察到神经肌强直放电,即运动单位动作电位以高频率(120 - 300赫兹)爆发。神经肌强直放电不受全身麻醉影响,给予箭毒后消失。在完全切断运动神经后仍持续存在,仅在沃勒变性时终止。这些结果表明,SJS中核心蛋白聚糖缺乏会引发神经肌强直综合征。研究结果进一步表明神经肌强直放电的起源位于轴突远端。现在应将SJS视为一种具有周围神经兴奋性过高的遗传性疾病。