Jerie Martin, Vackova Zuzana, Vojtech Zdenek, Mares Jan, Meluzinova Eva, Krajciova Jana, Vymazal Josef, Cerna Hana, Martinek Jan
First Faculty of Medicine, Charles University, 12108 Prague, Czech Republic.
Department of Neurology, Na Homolce Hospital, 15000 Prague, Czech Republic.
Transl Neurosci. 2022 Oct 10;13(1):361-368. doi: 10.1515/tnsci-2022-0249. eCollection 2022 Jan 1.
Esophageal achalasia is a primary motility disorder. Although the exact pathogenesis is unknown, autoimmune, and neurodegenerative processes seem to be involved similarly to neurodegenerative and/or demyelinating disorders (NDDs). We hypothesized that the prevalence of NDD may be higher among patients with achalasia and vice versa as the background pathogenetic mechanisms are similar.
This was a prospective, comparative questionnaire-based study. Patients with achalasia and patients with NDD were enrolled. Selected patients with achalasia were thoroughly examined by a neurologist and selected patients with NDD were examined by a gastroenterologist to confirm or rule out NDD or achalasia. We assessed the prevalence of both achalasia and NDD and compared them with their prevalence in general population.
A total of 150 patients with achalasia and 112 patients with NDD were enrolled. We observed an increased prevalence of NDD among patients with achalasia (6.0% (9/150); 95% CI (confidence interval): 3.1-11.2%) as compared to the estimated 2.0% prevalence in general population ( = 0.003). Although 32 out of 112 patients (28.6%) with NDD reported dysphagia, we did not observe significantly increased prevalence of achalasia in these patients (1.8% (2/112) vs 0.8% in general population, = 0.226).
The prevalence of NDD was significantly higher among patients with achalasia (6.0%) compared to general population (2.0%), suggesting an association of these disorders. Large-volume studies are necessary to confirm this finding.
食管贲门失弛缓症是一种原发性动力障碍性疾病。尽管确切的发病机制尚不清楚，但自身免疫和神经退行性过程似乎与神经退行性和/或脱髓鞘疾病（NDDs）类似。我们推测，由于背景发病机制相似，贲门失弛缓症患者中NDD的患病率可能更高，反之亦然。
这是一项基于问卷的前瞻性比较研究。纳入了贲门失弛缓症患者和NDD患者。选定的贲门失弛缓症患者由神经科医生进行全面检查，选定的NDD患者由胃肠病学家进行检查，以确认或排除NDD或贲门失弛缓症。我们评估了贲门失弛缓症和NDD的患病率，并将它们与一般人群中的患病率进行比较。
共纳入150例贲门失弛缓症患者和112例NDD患者。我们观察到，与一般人群估计的2.0%患病率相比，贲门失弛缓症患者中NDD的患病率有所增加（6.0%（9/150）；95%置信区间：3.1 - 11.2%）（P = 0.003）。尽管112例NDD患者中有32例（28.6%）报告有吞咽困难，但我们并未观察到这些患者中贲门失弛缓症的患病率显著增加（1.8%（2/112），而一般人群为0.8%，P = 0.226）。
与一般人群（2.0%）相比，贲门失弛缓症患者中NDD的患病率显著更高（6.0%），提示这些疾病之间存在关联。需要进行大规模研究来证实这一发现。
