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僵人谱系障碍病理生理学的神经生理学见解

Neurophysiological Insights into the Pathophysiology of Stiff-Person Spectrum Disorders.

作者信息

Moura João, Rocchi Lorenzo, Zandi Michael, Balint Bettina, Bhatia Kailash P, Latorre Anna

机构信息

Department of Neurology, Unidade Local de Saúde de Santo António, Porto, Portugal.

ICBAS School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal.

出版信息

Mov Disord Clin Pract. 2025 Apr;12(4):409-417. doi: 10.1002/mdc3.14328. Epub 2025 Jan 8.

Abstract

BACKGROUND

Stiff Person Spectrum Disorders (SPSD) are classically defined by the presence of muscle stiffness, spasms and hyperactivity of the central nervous system. There is a notable correlation between neurophysiological features and the clinical hallmark of SPSD, which has greatly encouraged the use of these techniques for diagnostic purposes. Besides, electrophysiological techniques allow for a functional evaluation of the 'hyperactivity of the CNS', thus offering the opportunity to clarify the mechanisms underlying this disorder. This review delves into the current knowledge on the electrophysiological aspects of SPSD, highlighting the pivotal role of various studies in unravelling its pathophysiology.

METHODS

Literature review for studies on SPSD that included a neurophysiological evaluation.

RESULTS

We first examined the abnormal neurophysiological findings of SPSD across the central nervous system, from the spinal circuit to the motor cortex. Subsequently, we discussed their pathological implications and explored how these findings can be interpreted within the framework of an immune-mediated disorder.

CONCLUSIONS

Two primary questions remain unanswered: the localization of the primary abnormality within the central nervous system and the connection between the autoimmune basis of SPSD and its neurophysiological aspects. Addressing these questions could provide invaluable insights into SPSD etiology and targeted therapeutic strategies.

摘要

背景

僵人谱系障碍(SPSD)的经典定义是存在肌肉僵硬、痉挛以及中枢神经系统功能亢进。神经生理学特征与SPSD的临床特征之间存在显著相关性,这极大地推动了这些技术在诊断中的应用。此外,电生理技术能够对“中枢神经系统功能亢进”进行功能评估,从而为阐明该疾病的潜在机制提供了机会。本综述深入探讨了目前关于SPSD电生理方面的知识,强调了各项研究在揭示其病理生理学方面的关键作用。

方法

对包含神经生理学评估的SPSD研究进行文献综述。

结果

我们首先研究了SPSD在整个中枢神经系统(从脊髓回路到运动皮层)的异常神经生理学发现。随后,我们讨论了它们的病理意义,并探讨了如何在免疫介导性疾病的框架内解释这些发现。

结论

仍有两个主要问题未得到解答:中枢神经系统内原发性异常的定位以及SPSD的自身免疫基础与其神经生理学方面之间的联系。解决这些问题可为SPSD的病因和靶向治疗策略提供宝贵的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef96/11998688/ce77e9502ac0/MDC3-12-409-g001.jpg

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