Fukui Yusuke, Hishikawa Nozomi, Shang Jingwei, Sato Kota, Nakano Yumiko, Morihara Ryuta, Ohta Yasuyuki, Yamashita Toru, Abe Koji
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
J Neurol Sci. 2016 Jul 15;366:94-99. doi: 10.1016/j.jns.2016.04.042. Epub 2016 Apr 28.
This study evaluates endothelial functions of neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and spinocerebellar ataxia (SCA). The reactive hyperemia index (RHI) of peripheral arterial tonometry and serological data were compared between age- and gender-matched normal controls (n=302) and five disease groups (ALS; n=75, PD; n=180, PSP; n=30, MSA; n=35, SCA; n=53). Correlation analyses were performed in ALS with functional rating scale-revised (FRS-R), and in PD with the Hehn-Yahr scale (H-Y) and a heart to mediastinum ratio using (123)I-MIBG scintigraphy (MIBG). The RHI of ALS and PD, but not of PSP, MSA or SCA, were significantly lower than normal controls (p<0.01). ALS showed a negative correlation of RHI with serum triglycerides (TG) and immunoreactive insulin (IRI) levels, but not with disease severity (FRS-R) or rates of disease progression (∆FRS-R). On the other hand, PD showed a negative correlation of RHI with a progressive disease severity (H-Y) and a positive correlation of RHI with early/delayed MIBG scintigraphy, but not with serological data. The present study demonstrated significant declines of peripheral arterial endothelial functions in ALS and PD. The RHI of ALS was more correlated with disease duration and serum parameters while the RHI of PD was more correlated with disease severity and MIBG, suggesting different mechanisms of endothelial dysfunction.
本研究评估了肌萎缩侧索硬化症（ALS）、帕金森病（PD）、进行性核上性麻痹（PSP）、多系统萎缩（MSA）和脊髓小脑共济失调（SCA）等神经退行性疾病的内皮功能。比较了年龄和性别匹配的正常对照组（n = 302）与五个疾病组（ALS；n = 75、PD；n = 180、PSP；n = 30、MSA；n = 35、SCA；n = 53）的外周动脉张力测定的反应性充血指数（RHI）和血清学数据。在ALS中对功能评定量表修订版（FRS-R）进行相关性分析，在PD中对 Hoehn-Yahr 量表（H-Y）以及使用（123）I-MIBG 闪烁显像（MIBG）的心脏与纵隔比率进行相关性分析。ALS和PD的RHI显著低于正常对照组（p<0.01），而PSP、MSA或SCA则不然。ALS的RHI与血清甘油三酯（TG）和免疫反应性胰岛素（IRI）水平呈负相关，但与疾病严重程度（FRS-R）或疾病进展率（∆FRS-R）无关。另一方面,PD的RHI与疾病严重程度进展（H-Y）呈负相关，与早期/延迟MIBG闪烁显像呈正相关，但与血清学数据无关。本研究表明ALS和PD患者外周动脉内皮功能显著下降。ALS的RHI与疾病持续时间和血清参数的相关性更强，而PD的RHI与疾病严重程度和MIBG的相关性更强，提示内皮功能障碍的机制不同。
