Salcini Celal, Baştan Birgül, Sunter Gülin, Kahraman Koytak Pınar, Yilmaz Orhan, Tanridağ Tülin, Us Önder, Uluç Kayıhan
Department of Neurology, Marmara University School of Medicine, İstanbul, Turkey.
Department of Neurology, Üsküdar University, NPIstanbul Neuropsychiatry Hospital, İstanbul, Turkey.
Noro Psikiyatr Ars. 2017 Mar;54(1):78-81. doi: 10.5152/npa.2016.19301. Epub 2017 Jan 2.
We aimed to assess central and peripheral nervous system involvement in systemic lupus erythematosus (SLE) patients without any neurological signs and symptoms by performing electrophysiological investigations.
Thirty-eight SLE patients and 35 healthy volunteers participated in this study. Peripheral nerve conduction and brainstem reflexes were evaluated by performing nerve conduction studies (NCSs) and blink reflex (BR) and masseter inhibitory reflex (MIR) recordings.
Eleven patients (29%) had an abnormality in at least 1 NCS parameter, and 1 (2.6%) patient was diagnosed with polyneuropathy. The number of patients with abnormal BR and MIR was 23 (60.5%) and 14 (37%), respectively. The contralateral R2 latency of BR and the silent period 1 (SP1) latency of MIR were significantly prolonged in the patients compared with the controls (p=0.015 and p<0.001, respectively).
This study showed that irrespective of peripheral nervous system involvement, brainstem reflexes could be affected in SLE patients even without clinical neurological findings. Brainstem reflex abnormalities suggested that the functional integrity of the inhibitory or excitatory interneurons in the lateral caudal pons and lateral medulla is disturbed in SLE patients.
我们旨在通过进行电生理检查,评估无任何神经体征和症状的系统性红斑狼疮(SLE)患者的中枢和周围神经系统受累情况。
38例SLE患者和35名健康志愿者参与了本研究。通过进行神经传导研究(NCS)以及眨眼反射(BR)和咬肌抑制反射(MIR)记录来评估周围神经传导和脑干反射。
11例患者(29%)至少有1项NCS参数异常,1例(2.6%)患者被诊断为多发性神经病。BR和MIR异常的患者数量分别为23例(60.5%)和14例(37%)。与对照组相比,患者的BR对侧R2潜伏期和MIR的沉默期1(SP1)潜伏期显著延长(分别为p = 0.015和p < 0.001)。
本研究表明,无论周围神经系统是否受累,即使没有临床神经学表现,SLE患者的脑干反射也可能受到影响。脑干反射异常表明,SLE患者尾侧脑桥外侧和延髓外侧抑制性或兴奋性中间神经元的功能完整性受到干扰。