Shin Jung-Won, Yim Byeongsoo, Oh Seung Hun, Kim Nam Keun, Lee Sang Kun, Kim Ok-Joon
Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
Department of Biomedical Science, College of Life Science, CHA University, Seongnam, South Korea.
Clin Neurophysiol. 2017 May;128(5):756-762. doi: 10.1016/j.clinph.2017.01.019. Epub 2017 Feb 5.
We aimed to redefine various periodic patterns (PPs) observed on electroencephalography (EEG) in patients with sporadic Creutzfeldt-Jakob disease (sCJD) using the American Clinical Neurophysiology Society's (ACNS) Criteria.
We analyzed EEG data of 23 patients with sCJD were admitted to two university hospitals between August 2005 and September 2015.
We classified PPs on EEG data into three types: irregular periodic discharges (PDs) with superimposed rhythmic activities, appearing at a median of 8weeks after onset (w.a.o.); rhythmic sharp-and-wave, at a median of 11w.a.o.; and PDs with biphasic or triphasic morphology, at a median of 17w.a.o. Of 16 patients presenting with PPs, 14 had widespread lesions in both cortical and subcortical areas with clinical stage III at admission, and shorter time intervals for admission to hospital from disease onset than patients without PPs (Patients with PP, 11.6±12.2weeks; without PP, 18.2±8.3weeks; p=0.033).
PPs largely presented as three types at different stages of disease progression, and patients who had PPs had more wide spread lesions and rapid disease progression.
Our redefinition of PPs demonstrated on EEG using the ACNS criteria may contribute to further understanding of the pathological mechanisms of sCJD, and PPs might be a predictive factor of a rapid sCJD progression.
我们旨在使用美国临床神经生理学会(ACNS)的标准重新定义散发性克雅氏病(sCJD)患者脑电图(EEG)上观察到的各种周期性模式(PPs)。
我们分析了2005年8月至2015年9月期间入住两家大学医院的23例sCJD患者的EEG数据。
我们将EEG数据上的PPs分为三种类型:叠加有节律性活动的不规则周期性放电(PDs),出现在发病后中位数为8周(w.a.o.);节律性尖波和慢波,中位数为11w.a.o.;以及具有双相或三相形态的PDs,中位数为17w.a.o.。在出现PPs的16例患者中,14例在皮质和皮质下区域均有广泛病变,入院时临床分期为III期,且从发病到入院的时间间隔比无PPs的患者短(有PPs的患者,11.6±12.2周;无PPs的患者,18.2±8.3周;p = 0.033)。
PPs在疾病进展的不同阶段主要表现为三种类型,且有PPs的患者病变分布更广泛,疾病进展更快。
我们使用ACNS标准对EEG上显示的PPs进行的重新定义可能有助于进一步了解sCJD的病理机制,并且PPs可能是sCJD快速进展的预测因素。