多発性硬化症・視神経脊髄炎患者での頸静脈還流障害の検討  [in Japanese] Evaluation of blood flow and the cross-sectional area of internal jugular vein in Japanese multiple sclerosis and neuromyelitis optica patients  [in Japanese]

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Author(s)

Abstract

頭蓋内から体循環へもどる静脈の還流障害により中枢神経組織に鉄が沈着し,リンパ球が鉄に反応することで脱髄病変が生じるというZamboniらの多発性硬化症(MS)血管障害説を検証した.日本人MS 17例および視神経脊髄炎(NMO)患者11例を対象に頸部エコーをもちいて内頸静脈の断面積および流速を測定した.断面積では両疾患に差異はみられなかったが,MS 1例,NMO 2例で血流障害をみとめた.今回の結果から,頸部エコー検査でみるかぎり,内頸静脈での静脈還流障害は,抗アクアポリン4抗体が病態に関与するNMOと比較してMSで顕著であるとはいえず,Zamboniらの仮説を支持する根拠はえられなかった.<br>

Zamboni et al proposed a new hypothesis for the pathomechanisms of multiple sclerosis (MS): chronic cerebrospinal venous insufficiency (CCSVI). Using Doppler ultrasound and venograms, they found severe extracranial venous stenosis in MS patients. They suggested that a venous obstruction in the neck caused a reflux back into the brain, which led to edema and demyelination.<br> We examined the blood flow and the cross-sectional area of the internal jugular veins using Doppler ultrasound (Vivid 7 PRO, GE Health Japan, Tokyo) in 17 MS (8 males and 9 females; 20-58 years of age, median 38 years) and 11 neuromyelitis optica (NMO) Japanese patients (1 male and 10 females; 23-60 years of age, median 44 years). Nine of the 11 NMO patients were seropositive for anti-aquaporin4 antibodies.<br> We did not find any obstruction or stenosis of the internal jugular veins in any patient. Other disorders such as bilateral internal and external jugular venous ligation or radical neck dissection, which result in venous stasis, are not known causes of demyelination in the central nervous system. Our data also does not support the hypothesis of CCSVI theory, despite the fact that our study was limited to a small group of patients and the examination was performed only using Doppler ultrasound.<br>

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 51(6), 430-432, 2011-06-01

    Societas Neurologica Japonica

References:  10

Codes

  • NII Article ID (NAID)
    10031164026
  • NII NACSIS-CAT ID (NCID)
    AN00253207
  • Text Lang
    JPN
  • Article Type
    SHO
  • ISSN
    0009918X
  • NDL Article ID
    11152710
  • NDL Source Classification
    ZS31(科学技術--医学--精神神経科学)
  • NDL Call No.
    Z19-298
  • Data Source
    CJP  NDL  J-STAGE 
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