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[与中枢神经系统脱髓鞘疾病相关的遗传性视神经病变]

[Hereditary optic neuropathy associated with demyelinating diseases of the central nervous system].

作者信息

Eliseeva D D, Kalashnikova A K, Bryukhov V V, Andreeva N A, Zhorzholadze N V, Murakhovskaya Yu K, Krilova T D, Tsygankova P G, Zakharova M N, Sheremet N L

机构信息

Research Center of Neurology, Moscow, Russia.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(7. Vyp. 2):122-132. doi: 10.17116/jnevro2023123072122.

Abstract

Demyelinating optic neuritis and hereditary optic neuropathy (HON) take a leading place among the diseases, the leading clinical syndrome of which is bilateral optic neuropathy with a simultaneous or sequential significant decrease in visual acuity. Optic neuritis can occur at the onset or be one of the syndromes within multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOGAD). HON are a group of neurodegenerative diseases, among which the most common variants are Leber's hereditary optic neuropathy (LHON), associated with mitochondrial DNA (mtDNA) mutations, and autosomal recessive optic neuropathy (ARON), caused by nuclear DNA (nDNA) mutations in . There are phenotypes of LHON «plus», one of which is the association of HON and CNS demyelination in the same patient. In such cases, the diagnosis of each of these diseases causes significant difficulties, due to the fact that in some cases there are clinical and radiological coincidences between demyelinating and hereditary mitochondrial diseases.

摘要

脱髓鞘性视神经炎和遗传性视神经病变(HON)在以双侧视神经病变为主要临床综合征且视力同时或相继显著下降的疾病中占主导地位。视神经炎可在发病时出现,或是多发性硬化(MS)、视神经脊髓炎谱系障碍(NMOSD)和髓鞘少突胶质细胞糖蛋白(MOG)抗体病(MOGAD)中的综合征之一。HON是一组神经退行性疾病,其中最常见的类型是与线粒体DNA(mtDNA)突变相关的Leber遗传性视神经病变(LHON),以及由核DNA(nDNA)突变引起的常染色体隐性视神经病变(ARON)。存在LHON“plus”的表型,其中之一是同一患者中HON与中枢神经系统脱髓鞘相关。在这种情况下,由于在某些情况下脱髓鞘性疾病和遗传性线粒体疾病之间存在临床和放射学上的巧合,对这些疾病中的每一种进行诊断都会带来很大困难。

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