Etemadifar Masoud, Afshar Farshid, Nasr Zahra, Kheradmand Mohsen
Department of Neurology, School of Medicine, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Medical Sciences, School of Medicine, Medical Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Neurol. 2014 Apr 3;13(2):88-93.
Multiple sclerosis (MS) is an autoimmune inflammatory disease that affects the central nervous system. Except tremor, other movement disorders such as Parkinsonism are less frequent in MS. However, some investigations have shown inflammatory and autoimmune aspects of Parkinson's disease. In this study, we report eight new cases of MS who present Parkinson's disease.
This retrospective population-based study was carried out on Isfahan MS society between April 2003 and July 2012. A total of 3792 patients with MS were surveyed for Parkinson's disease. Parkinson's disease was approved according to "UK Parkinson disease Brain Bank" criteria. Eligible cases were invited to have an interview with a neurologist. MRI was carried out according to the baseline.
We identified eight patients (three men and five women) who present MS and Parkinson's disease. The mean (±SD) age of onset was 33.3 ± 6.5 (range: 24-42) years for MS and 39.5 ± 8.6 (range: 30-55) years for Parkinson's disease patients. In all patients, MS was preceded Parkinson's disease. Parkinson's disease was developed within mean duration of 6.1 ± 3.4 (range 2-13) years after MS. Focal lesions was shown in six cases, lesions of basal ganglia (BG) in four, lesions of the thalamus in two and lesions of mid-brain in five of cases. In four cases, Parkinsonism occurred before age 40 that is considered as Young-Onset Parkinson's disease.
We reported eight patients with MS and Parkinson's disease. To the best of our knowledge, 34 cases of Parkinsonism associating with MS are reported so far. Parkinsonism is a movement disorder, defines as deep gray matter disorder which lead to dopamine deficiency in BG. Investigations have shown that MS could affect deep gray matter structures. Demyelinated lesions in MS and consequence axonal loss in BG and/or nigrostriatal pathway may be responsible for Parkinsonism manifestations in such cases.
多发性硬化症（MS）是一种影响中枢神经系统的自身免疫性炎症性疾病。除震颤外，帕金森氏症等其他运动障碍在MS中较少见。然而，一些研究表明帕金森病存在炎症和自身免疫方面的问题。在本研究中，我们报告了8例出现帕金森病的新发MS病例。
这项基于人群的回顾性研究于2003年4月至2012年7月在伊斯法罕MS协会进行。共对3792例MS患者进行了帕金森病调查。帕金森病根据“英国帕金森病脑库”标准确诊。符合条件的病例被邀请接受神经科医生的访谈。根据基线进行MRI检查。
我们确定了8例同时患有MS和帕金森病的患者（3名男性和5名女性）。MS患者的平均（±标准差）发病年龄为33.3±6.5（范围：24 - 42）岁，帕金森病患者为39.5±8.6（范围：30 - 55）岁。在所有患者中，MS先于帕金森病出现。帕金森病在MS发病后的平均6.1±3.4（范围2 - 13）年出现。6例显示局灶性病变，4例有基底神经节（BG）病变，2例有丘脑病变，5例有中脑病变。4例帕金森氏症在40岁之前出现，即早发性帕金森病。
我们报告了8例患有MS和帕金森病的患者。据我们所知，目前已报告34例与MS相关的帕金森氏症病例。帕金森氏症是一种运动障碍，定义为导致BG中多巴胺缺乏的深部灰质疾病。研究表明MS可能影响深部灰质结构。MS中的脱髓鞘病变以及BG和/或黑质纹状体通路中随之而来的轴突损失可能是此类病例中帕金森氏症表现的原因。
