MD Program, University of British Columbia, Vancouver, BC, Canada.
Department of Radiology, University of British Columbia, Vancouver, BC, Canada; Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada; Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada.
Mult Scler Relat Disord. 2019 Jan;27:232-238. doi: 10.1016/j.msard.2018.10.109. Epub 2018 Oct 27.
People with multiple sclerosis (MS) are living longer than ever and will likely face the same age-related diseases as other seniors; however, there is strikingly little information on the coexistence of MS with many common diseases of aging. In particular, little appears to be known about the coexistence of MS with Alzheimer's disease (AD), the most common form of dementia.
In this review, we explore what is known about the coexistence of MS and AD, including a focused literature search to identify any reports of individuals with both MS and AD (PubMed, to May 2017). We also discuss the wider epidemiology, diagnosis, and pathophysiology of MS and AD.
In total, we found 24 individuals with pathological features of both MS and AD described as case series or reports (published between 1976-2014), but no epidemiological or population-based studies, aside from one conference proceeding (2011). Comorbid MS and AD was reported in a broad range of MS disease courses including relapsing-remitting, primary progressive, secondary progressive and so-called 'benign.' Despite the clear diagnostic challenges involved, these individual case reports provide evidence that AD and MS can coexist in the same person.
In summary, we highlight a major knowledge gap in our understanding of two potentially common neurological conditions. With the ageing population, and an estimated 2.3 million people living with MS and 46 million with AD or other dementias worldwide, it will become increasingly important to recognize and understand how to manage individuals with these complex comorbid conditions.
多发性硬化症(MS)患者的寿命比以往任何时候都长,他们可能会像其他老年人一样面临与年龄相关的疾病;然而,关于 MS 与许多常见老年病同时存在的信息却少得惊人。特别是,关于 MS 与阿尔茨海默病(AD)同时存在的情况似乎知之甚少,AD 是最常见的痴呆症。
在这篇综述中,我们探讨了 MS 与 AD 同时存在的情况,包括针对有 MS 和 AD 的个体的文献进行了重点搜索(PubMed,截至 2017 年 5 月)。我们还讨论了 MS 和 AD 的更广泛的流行病学、诊断和病理生理学。
我们总共发现了 24 名个体的病理特征同时具有 MS 和 AD,描述为病例系列或报告(发表于 1976 年至 2014 年之间),但除了一篇会议记录(2011 年)之外,没有流行病学或基于人群的研究。在广泛的 MS 病程中,包括复发缓解型、原发性进行性、继发性进行性和所谓的“良性”,都报告了合并 MS 和 AD。尽管存在明确的诊断挑战,但这些个案报告提供了证据表明 AD 和 MS 可以同时存在于同一个人身上。
总之,我们强调了我们对两种潜在常见神经状况的理解存在一个主要的知识空白。随着人口老龄化,全球估计有 230 万人患有 MS,4600 万人患有 AD 或其他痴呆症,认识和理解如何管理这些具有复杂合并症的个体将变得越来越重要。