Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
J Neurol Neurosurg Psychiatry. 2011 Oct;82(10):1174-7. doi: 10.1136/jnnp.2010.210708. Epub 2010 Nov 11.
Previous studies have shown that anti-GQ1b antibodies induce massive neuromuscular blocking. If anti-GM1 and -GD1a antibodies have similar effects on the neuromuscular junction (NMJ) in human limb muscles, this may explain selective motor involvement in axonal Guillain--Barré syndrome (GBS).
Axonal-stimulating single-fibre electromyography was performed in the extensor digitorum communis muscle of 23 patients with GBS, including 13 with the axonal form whose sera had a high titre of serum IgG anti-GM1 or -GD1a antibodies.
All patients with axonal or demyelinating GBS showed normal or near-normal jitter, and no blocking.
In both axonal and demyelinating GBS, neuromuscular transmission is not impaired. Our results failed to support the hypothesis that anti-GM1 or -GD1a antibody affects the NMJ. In GBS, impulse transmission is presumably impaired in the motor nerve terminal axons proximal to the NMJ.
先前的研究表明，抗-GQ1b 抗体可导致大量的神经肌肉阻滞。如果抗-GM1 和抗-GD1a 抗体对人类肢体肌肉的神经肌肉接头（NMJ）有类似的影响，这可能解释了轴索性吉兰-巴雷综合征（GBS）中选择性运动受累的原因。
对 23 例 GBS 患者的伸指总肌进行了轴突刺激单纤维肌电图检查，其中包括 13 例血清 IgG 抗-GM1 或抗-GD1a 抗体滴度较高的轴索性 GBS 患者。
所有轴索性或脱髓鞘性 GBS 患者的抖动均正常或接近正常，且无阻滞。
在轴索性和脱髓鞘性 GBS 中，神经肌肉传递均未受损。我们的结果未能支持抗-GM1 或抗-GD1a 抗体影响 NMJ 的假说。在 GBS 中，冲动传递可能在 NMJ 近端的运动神经末梢轴突中受损。
