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多发性硬化症中的周围神经病变:伊朗患者的电生理研究

Peripheral Neuropathy in Multiple Sclerosis: An Electrophysiologic Study in Iranian Patients.

作者信息

Emad Mohammad Reza, Zeinali Leila, Nikseresht Alireza, Naseri Mahshid, Karimian Hajar

机构信息

Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Acta Med Iran. 2017 Aug;55(8):496-501.

Abstract

Multiple sclerosis (MS) is the most common cause of disability after trauma in young adults in Northern Hemisphere; it imposes a major burden on the affected young people. A significant association between MS and demyelinating peripheral neuropathy which might be due to common pathogenesis for the central and peripheral nerves demyelination has been reported in several studies. We aimed to assess if there is any peripheral nervous system involvement in a sample of Iranian MS population. Extensive nerve conduction studies (NCS) were conducted in 20 MS patients according to McDonald criteria, and 20 age and gender matched healthy appearing controls. The F-wave ratio was calculated through placing the minimum amount of F-wave proximal latency after 10 stimuli and median or tibial nerves compound motor action potential (CMAP) proximal latency in the corresponding formula. Data were compared between groups. Finally, we found the significantly lower median and tibial nerves conduction velocities (NCV) in MS patients than healthy controls (P=0.008 and 0.003 respectively, Independent Samples t-test). Also, tibial NCV had a significant statistical correlation with Kurtzke's expanded disability scale score (EDSS) as patients with higher EDSS had lower tibial NCV (Pearson's correlation coefficient, r2=0.8). No statistical relationship was found between MS subtypes and NCS parameters. Although we found some electrodiagnostic abnormalities in Iranian MS patients in comparison to the healthy participants, these differences were small and inconclusive. More extensive well-designed electrodiagnostic studies for evaluation of peripheral nervous system involvement and its probable pattern in these patients seems to be needed.

摘要

多发性硬化症(MS)是北半球年轻人创伤后致残的最常见原因;它给受影响的年轻人带来了重大负担。多项研究报告称,MS与脱髓鞘性周围神经病之间存在显著关联,这可能是由于中枢和周围神经脱髓鞘的共同发病机制所致。我们旨在评估伊朗MS患者样本中是否存在任何周围神经系统受累情况。根据麦克唐纳标准,对20例MS患者以及20名年龄和性别匹配的健康对照者进行了广泛的神经传导研究(NCS)。通过在10次刺激后放置最小量的F波近端潜伏期,并将其代入相应公式计算正中神经或胫神经复合运动动作电位(CMAP)近端潜伏期,得出F波比率。对两组数据进行比较。最后,我们发现MS患者的正中神经和胫神经传导速度(NCV)显著低于健康对照组(分别为P = 0.008和0.003,独立样本t检验)。此外,胫神经NCV与库尔茨克扩展残疾量表评分(EDSS)具有显著的统计学相关性,即EDSS较高的患者胫神经NCV较低(皮尔逊相关系数,r2 = 0.8)。未发现MS亚型与NCS参数之间存在统计学关系。尽管与健康参与者相比,我们在伊朗MS患者中发现了一些电诊断异常,但这些差异较小且无定论。似乎需要进行更广泛、设计更完善的电诊断研究,以评估这些患者的周围神经系统受累情况及其可能的模式。

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