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An overview of the role of monoamine oxidase-B in Parkinson’s disease: implications for neurodegeneration and therapy 概述单胺氧化酶-B 在帕金森病中的作用:对神经变性和治疗的影响
Pub Date : 2024-07-14 DOI: 10.37349/ent.2024.00085
Praveen Kumar Chandra Sekar, Sheena Mariam Thomas, Ramakrishnan Veerabathiran
Parkinson’s disease (PD) is a neurodegenerative disorder characterized by both non-motor and motor symptoms, due to the loss of dopamine-producing neurons in the brain. Monoamine oxidase-B (MAO-B) inhibitors are essential in the treatment of PD, as they increase dopamine levels and could potentially slow down the progression of the disease. MAO-B inhibitors block the ability of the enzyme to degrade dopamine in the brain. MAO-B inhibitors work by inhibiting this enzyme, which raises dopamine levels and helps reduce motor symptoms, such as akinesia and stiffness in the muscles. In addition to their impact on dopamine levels, MAO-B inhibitors may possess neuroprotective properties. Research indicates that these inhibitors can shield neurons from the harmful byproducts of dopamine breakdown, such as dihydroxy acetaldehyde and hydrogen peroxide. This neuroprotective effect could potentially slow the progression of PD and protect against neuronal damage. MAO-B inhibitors are effective in treating both advanced and early stages of PD. They are recommended as initial treatments for individuals with early PD and can also be used as supplementary therapy in advanced PD to assist in managing motor complications. Additionally, MAO-B inhibitors have shown promise for the treatment of non-motor symptoms of PD, such as fatigue and sleep disturbances. MAO-B inhibitors are an important class of drugs for the treatment of PD, offering both symptomatic relief and potential disease-modifying effects. The goal of ongoing research and development of MAO-B inhibitors is to enhance their safety and selectivity profiles, which could lead to improved treatment approaches for PD and other neurodegenerative disorders.
帕金森病(Parkinson's disease,PD)是一种神经退行性疾病,由于大脑中产生多巴胺的神经元缺失,导致患者出现非运动症状和运动症状。单胺氧化酶-B(MAO-B)抑制剂对治疗帕金森病至关重要,因为它们能提高多巴胺水平,并有可能减缓疾病的进展。MAO-B抑制剂能阻止大脑中的多巴胺酶降解多巴胺。MAO-B抑制剂通过抑制这种酶发挥作用,从而提高多巴胺水平,帮助减轻运动症状,如肌肉运动障碍和肌肉僵硬。除了对多巴胺水平有影响外,MAO-B 抑制剂还可能具有神经保护特性。研究表明,这些抑制剂可以保护神经元免受多巴胺分解产生的有害副产品(如二羟基乙醛和过氧化氢)的伤害。这种神经保护作用有可能减缓帕金森氏症的进展并防止神经元受损。MAO-B 抑制剂对治疗晚期和早期帕金森病都很有效。建议将它们作为早期帕金森病患者的初始治疗药物,也可作为晚期帕金森病患者的辅助治疗药物,以协助控制运动并发症。此外,MAO-B 抑制剂还有望治疗帕金森病的非运动症状,如疲劳和睡眠障碍。MAO-B抑制剂是治疗帕金森病的一类重要药物,既能缓解症状,又有潜在的疾病改变作用。目前对MAO-B抑制剂的研发目标是提高其安全性和选择性,从而改进帕金森病和其他神经退行性疾病的治疗方法。
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引用次数: 0
Vitactions: vitamins for the brain 维生素:脑部维生素
Pub Date : 2024-07-01 DOI: 10.37349/ent.2024.00084
Rafael Franco
A novel concept has been recently put forward in the mind/body interface (https://doi.org/10.37349/ent.2024.00074). The new concept has led to a new word: vitaction. Vitactions offer benefits to the brain and mind comparable to the advantages vitamins provide for the body’s overall health. The field of vitactions is as it was the vitamin field one century ago, i.e., without tools to make a complete classification. I propose to classify vitactions into five categories according to the behaviours necessary to maintain balanced brain functionality. A deficit of vitactions would contribute to the enormous prevalence in developed countries of diseases ranging from type 2 diabetes to neuropsychiatric diseases. The concept should help to identify which vitactions are deficient and to outline how they can be progressively implemented to improve the quality of life. The parallelism vitactions/vitamins also extends to overdosing; both hypervitaminosis and hypervitactinosis may be detrimental. This perspective article argues that vitactions should be considered at the practical and the scientific research levels, and that a balanced vitamin and vitaction supply is essential for a better life. In addition, reasons for proposing a synonym, “vitactin”, are given.
最近,心身界面(https://doi.org/10.37349/ent.2024.00074)提出了一个新概念。这个新概念产生了一个新词:"维他命作用"(vitaction)。维生素作用对大脑和心智的益处堪比维生素对人体整体健康的益处。维生素作用领域就像一个世纪前的维生素领域一样,没有完整的分类工具。我建议根据维持大脑功能平衡所需的行为,将维生素分为五类。维生素缺乏将导致发达国家从 2 型糖尿病到神经精神疾病的巨大患病率。这一概念应有助于确定哪些维生素缺乏,并概述如何逐步补充维生素以提高生活质量。维生素作用/维生素的平行关系也延伸到过量摄入维生素的问题;维生素过量和维生素不足都可能造成危害。这篇视角独特的文章认为,应在实际操作和科学研究层面上考虑维生素作用,均衡的维生素和维生素作用供应对改善生活至关重要。此外,文章还提出了一个同义词 "vitactin "的理由。
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引用次数: 0
Cognitive-motor interference in multiple sclerosis and healthy controls: results from single, dual, and triple task posturography 多发性硬化症和健康对照组的认知运动干扰:单任务、双任务和三任务体位测量法的结果
Pub Date : 2024-06-12 DOI: 10.37349/ent.2024.00082
Patrik Althoff, Friederike Rosenthal, Eva-Maria Dorsch, Daniel Drebinger, Radina Arsenova, Anna Chorschew, S. Rosenkranz, J. Bellmann-Strobl, Christoph Heesen, Friedemann Paul, M. Weygandt, Tanja Schmitz-Hübsch
Aim: This article is based on our previous research, which was presented as a poster at the ECTRIMS Congress 2018 and published as a conference abstract (https://www.professionalabstracts.com/ectrims2018/iplanner/#/presentation/1698). Cognitive-motor interference (CMI) has been observed in both healthy controls (HC) and persons with multiple sclerosis (pwMS), but limited and contradictory data is making it difficult to assess the impact of motor and cognitive functioning levels on CMI. The aim of this study was to investigate CMI in pwMS and HC by means of a dual task postural paradigm, to compare them between groups and to analyse the influence of motor and cognitive functioning levels assessed with complementary instruments on observed CMI. Methods: The dual task posturography paradigm serves to quantify the impact of a cognitive (i.e., performing serial subtractions), a motor challenge (closing eyes), or both challenges combined (triple task) on body sway during standing in an upright position feet closed. The data analysed were acquired in one interventional and four observational studies and selected based on predefined criteria and by systematic quality control. A total of 113 pwMS and 42 HC were selected for analysis. Results: Comparable changes in motor and cognitive performance due to cognitive or combined cognitive-motor challenges were observed in both HC and pwMS. Combining both tasks did not result in further changes in motor performance but resulted in a decrease in cognitive performance. This reduction in cognitive performance with an additional motor challenge correlated with lower levels of cognitive and motor functioning in pwMS. Unexpectedly, an increase in body sway due to a cognitive or combined cognitive-motor challenges was primarily observed in pwMS and HC with better cognitive and motor functioning. Conclusions: The results suggest that dual-task effects are not disease-specific but rather reflect individually different adaptation strategies depending on the specific motor and cognitive functioning levels.
目的:本文基于我们之前的研究,该研究曾在2018年ECTRIMS大会上以海报形式展示,并以会议摘要形式发表(https://www.professionalabstracts.com/ectrims2018/iplanner/#/presentation/1698)。在健康对照组(HC)和多发性硬化症患者(pwMS)中都观察到了认知运动干扰(CMI),但由于数据有限且相互矛盾,因此很难评估运动和认知功能水平对 CMI 的影响。本研究的目的是通过双任务姿势范式调查多发性硬化症患者和健康对照组的 CMI,在组间进行比较,并分析用互补工具评估的运动和认知功能水平对观察到的 CMI 的影响。研究方法双任务姿势测量范式用于量化认知挑战(即进行连续减法)、运动挑战(闭眼)或两种挑战相结合(三重任务)对双脚闭合直立时身体摇摆的影响。所分析的数据来自一项干预性研究和四项观察性研究,并根据预定标准和系统质量控制进行筛选。共选取了 113 名重症肌无力患者和 42 名高血压患者的数据进行分析。研究结果在认知挑战或认知-运动挑战相结合的情况下,运动和认知能力都发生了类似的变化。将两项任务结合在一起不会导致运动表现的进一步变化,但会导致认知表现的下降。认知能力的下降与额外的运动挑战有关,而认知能力的下降又与 pwMS 较低的认知和运动功能水平有关。出乎意料的是,认知挑战或认知-运动联合挑战导致的身体摇摆增加主要出现在认知和运动功能较好的 pwMS 和 HC 中。结论研究结果表明,双任务效应并不是疾病的特异性,而是根据具体的运动和认知功能水平反映出各自不同的适应策略。
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引用次数: 0
Effect of gardening physical activity on neuroplasticity and cognitive function 园艺体育活动对神经可塑性和认知功能的影响
Pub Date : 2024-06-05 DOI: 10.37349/ent.2024.00081
A. Lentoor
Background: The beneficial effects of gardening as a form of physical activity have garnered growing interest in recent years. This research aimed to evaluate the effect of gardening as a physical activity on promoting neuroplasticity and cognitive functioning in people. Methods: A systematic review was conducted on published articles between January 2010 to December 2022. The systematic search identified 3,470 records based on the PRISMA recommendations, 23 studies were eligible for inclusion in the review. Results: The study revealed the potential benefit of gardening physical activity on brain health. The evidence suggests that engaging in gardening physical activity not only boosts immunity and lowers inflammation but can also increase levels of growth neurotrophic factors like brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF), which are essential for promoting neuroplasticity and improving cognitive function. These results should be interpreted cautiously given the small number of included studies and few randomized controlled trials. Discussion: The study results of gardening physical activity are promising. However, to adequately comprehend the underlying mechanism of the physical activity of gardening on brain health, more well-designed research is still necessary.
背景:近年来,园艺作为一种体育活动的有益效果越来越受到人们的关注。本研究旨在评估园艺作为一种体育活动对促进人的神经可塑性和认知功能的影响。研究方法对 2010 年 1 月至 2022 年 12 月期间发表的文章进行了系统性回顾。根据 PRISMA 建议,系统检索共发现 3470 条记录,其中 23 项研究符合纳入综述的条件。研究结果研究揭示了园艺体育活动对大脑健康的潜在益处。有证据表明,从事园艺体育活动不仅能提高免疫力、降低炎症反应,还能提高生长神经营养因子的水平,如脑源性神经营养因子(BDNF)、血管内皮生长因子(VEGF)和血小板衍生生长因子(PDGF),这些因子对促进神经可塑性和改善认知功能至关重要。由于纳入的研究较少,随机对照试验也不多,因此应谨慎解释这些结果。讨论:园艺体育活动的研究结果很有希望。然而,要充分理解园艺体育活动对大脑健康的潜在机制,仍需进行更多精心设计的研究。
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引用次数: 0
Diverse avenues of research support the transmethylation theory of psychosis: implications for neuroprotection 支持精神病跨甲基化理论的多种研究途径:对神经保护的影响
Pub Date : 2024-05-15 DOI: 10.37349/ent.2024.00079
Christine L. Miller
Transmethylation in the context of psychiatry has historically referred to the enzymatic transfer of a methyl group from one biochemical to another, whose resulting function can change so dramatically that a biochemical like tryptamine, for example, is converted into the hallucinogen dimethyltryptamine. Central to endogenous methylation activity is the folate cycle, which generates the primary transferable methyl groups in mammalian biochemistry. The relevance of this cycle to mental health becomes clear when the cycle is dysregulated, often leading to a buildup of both homocysteine and S-adenosylhomocysteine (SAH), while accompanied by a transient reduction in the intended physiologic target, S-adenosylmethionine (SAM). This paper includes an in-depth review of the causes of folate cycle perturbations associated with psychotic symptoms, expounding on alternative downstream pathways which are activated and pointing toward potential etiologic agents of the associated psychosis, the methylated tertiary amines N-methyl-salsolinol, N-methyl-norsalsolinol, and adrenochrome, which appear in scientific reports concerning their association with hallucinogenic and/or neurotoxic outcomes. Electrotopological state (E-state) data has been generated for these compounds, illustrating a strong similarity with hallucinogens, particularly in terms of the E-state of the nitrogen in their tertiary amine moieties. In light of the role the folate cycle plays in transmethylation, neuroprotective strategies to prevent the transition to psychosis are suggested, including the advisory that folate supplementation can be harmful depending on the status of other relevant biochemicals.
在精神病学中,跨甲基化历来指的是一种生化物质的甲基在酶的作用下转移到另一种生化物质上,由此产生的功能会发生巨大变化,例如色胺等生化物质会转化为致幻剂二甲基色胺。内源性甲基化活动的核心是叶酸循环,它在哺乳动物的生物化学中产生主要的可转移甲基。当叶酸循环失调时,往往会导致同型半胱氨酸和 S-腺苷同型半胱氨酸(SAH)的积累,同时伴随着预期生理目标 S-腺苷蛋氨酸(SAM)的短暂减少,这时叶酸循环与心理健康的相关性就显而易见了。本文深入探讨了与精神病症状相关的叶酸循环紊乱的原因,阐述了被激活的替代下游途径,并指出了相关精神病的潜在致病因子--甲基化叔胺 N-甲基缬草酚、N-甲基缬草酚和肾上腺色素,这些物质出现在与致幻和/或神经毒性结果相关的科学报告中。这些化合物的电拓扑状态(E-state)数据已经生成,表明它们与致幻剂非常相似,特别是在其三级胺分子中的氮的 E-state方面。鉴于叶酸循环在转甲基化过程中所起的作用,我们提出了防止向精神病过渡的神经保护策略,包括根据其他相关生化物质的状况补充叶酸可能有害的建议。
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引用次数: 0
Targeting short-chain fatty acids receptors signalling for neurological disorders treatment 针对短链脂肪酸受体信号治疗神经系统疾病
Pub Date : 2024-03-19 DOI: 10.37349/ent.2024.00073
C. Prado, Rodrigo Pacheco
Short-chain fatty acids (SCFAs) play a key role regulating immune and metabolic homeostasis. Consequently, dysregulation in SCFA levels is involved in the pathogenesis of autoimmune, inflammatory, metabolic, and neurodegenerative disorders. These metabolites are generated by gut microbiota, and their production is influenced mainly by diet. Here, an overview is provided of how SCFA production is associated with diet and with neurological disorders. The mechanisms by which SCFAs exert beneficial effects are analysed, along with how their production may be boosted by diet and how the use of specific dietary interventions might improve the outcome of neurological diseases.
短链脂肪酸(SCFAs)在调节免疫和代谢平衡方面发挥着关键作用。因此,SCFA 水平失调与自身免疫、炎症、代谢和神经退行性疾病的发病机制有关。这些代谢物由肠道微生物群产生,其产生主要受饮食影响。本文概述了 SCFA 的产生如何与饮食和神经系统疾病相关。本文分析了 SCFAs 发挥有益作用的机制,以及如何通过饮食促进 SCFAs 的产生,以及如何使用特定的饮食干预措施来改善神经系统疾病的治疗效果。
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引用次数: 0
Advances in neuroprotective therapy for acute ischemic stroke 急性缺血性脑卒中神经保护疗法的进展
Pub Date : 2024-02-27 DOI: 10.37349/ent.2024.00070
Yang Yang, Dandan Guo, Yiming Liu, Yi Li
Acute ischemic stroke (AIS) is the leading cause of disability worldwide, and recanalization therapy is significant in the hyperacute phase of AIS. However, reperfusion injury and hemorrhagic transformation after recanalization predict poor prognosis of AIS. How to minimize reperfusion injury and hemorrhagic transformation, which greatly improves the prognosis of vascular recanalization, is becoming a hot topic in AIS research and an urgent problem to be solved. A wealth of neuroprotective drug studies is now available, while some of the neuroprotectants have met with failure in human studies. It is discussed in this review about the progress in neuroprotective therapy for AIS based on understanding the pathophysiologic mechanisms of reperfusion injury and hemorrhagic transformation, as well as challenges in exploring new neuroprotectants.
急性缺血性卒中(AIS)是全球致残的主要原因,而再通血管疗法在 AIS 的超急性期意义重大。然而,再通后的再灌注损伤和出血转化预示着 AIS 的不良预后。如何最大限度地减少再灌注损伤和出血转化,从而大大改善血管再通的预后,正成为AIS研究的热点和亟待解决的问题。目前已有大量的神经保护药物研究,而一些神经保护剂在人体研究中却遭遇失败。本综述将讨论在了解再灌注损伤和出血转化的病理生理机制的基础上,AIS 神经保护疗法所取得的进展,以及探索新的神经保护剂所面临的挑战。
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引用次数: 0
Analysis of congenital Zika syndrome clinicopathologic findings reported in the 8 years since the Brazilian outbreak 巴西疫情爆发 8 年来所报告的先天性寨卡综合征临床病理结果分析
Pub Date : 2024-02-27 DOI: 10.37349/ent.2024.00072
Dhaara Shah, Dhairavi Shah, Olivia Mua, Rana Zeine
Aim: A Zika virus outbreak that began in Brazil, developed into an international public health emergency that extended from February 2015 until November 2016. Zika-infected pregnant women gave birth to a cohort of infants with congenital Zika syndrome (CZS) originally defined by severe microcephaly, retinal scarring, joint deformities, and hypertonia. This study examines the nature, extent, and severity of all CZS clinicopathologic findings described to date, compiled and analyzed by system. It reviews studies monitoring disease progression and proposing classification schemes for CZS stages. The teratogenic cellular and molecular mechanisms implicated in CZS pathogenesis are also discussed. Methods: A systematic review was conducted by literature search through WorldCat.org and ProQuest Central databases to identify studies on case series from the 2015–2016 CZS outbreak. Results: Twenty-six reports were included describing radiologic, ophthalmologic, audiologic, orthopedic, and laboratory test results in CZS cases including stillborns between 2016 and 2023. CZS neuropathology included prenatal and postnatal microcephaly, cerebral calcifications, quadriparesis, epilepsy, ventriculomegaly, reduced cerebral parenchyma, malformation of cortical development, and sleep electroencephalogram disturbances. Visual deficits were due to retinal and optic nerve lesions. Conductive and sensorineural hearing deficits were stable. Hypertonia, hypotonia, and spasticity with foot, hip, knee, and shoulder deformities resulted in arthrogryposis and restricted joint mobility. There was enlargement of immune organs, increased leukocyte counts, and cytokine dysregulation. Oro-craniofacial deformities affected the midface and caused dental eruption delay. Additional studies proposed that these systemic teratogenic effects could be attributable to transplacental Zika virus infection of multiple fetal progenitor cell lineages. Conclusions: The CZS-associated impairments in brain, eye, musculoskeletal, and immunologic functions caused disabilities that varied from moderate to severe, and significantly increased age-specific mortality rates. Further research is warranted to assess progression, classify stages, elucidate the precise molecular mechanisms mediating Zika teratogenicity, develop suitable therapeutic strategies, and design supportive social policies.
目的:始于巴西的寨卡病毒疫情从2015年2月持续到2016年11月,并发展成为国际公共卫生紧急事件。受寨卡病毒感染的孕妇所生的一组婴儿患有先天性寨卡综合征(CZS),最初定义为严重小头畸形、视网膜瘢痕、关节畸形和肌张力过高。本研究探讨了迄今为止描述的所有 CZS 临床病理结果的性质、范围和严重程度,并按系统进行了汇编和分析。它回顾了监测疾病进展的研究,并提出了 CZS 分期的分类方案。此外,还讨论了与 CZS 发病机制有关的致畸细胞和分子机制。方法:通过WorldCat.org和ProQuest Central数据库进行文献检索,对2015-2016年CZS爆发的系列病例研究进行系统回顾。结果收录了 26 篇报告,描述了 2016 年至 2023 年间 CZS 病例(包括死胎)的放射学、眼科学、听力学、整形外科和实验室检测结果。CZS神经病理学包括产前和产后小头畸形、脑钙化、四肢瘫痪、癫痫、脑室肥大、脑实质减少、皮质发育畸形和睡眠脑电图紊乱。视力障碍是由于视网膜和视神经病变造成的。传导性和感音神经性听力障碍稳定。肌张力过高、肌张力过低和痉挛伴有足部、髋部、膝部和肩部畸形,导致关节畸形和关节活动受限。免疫器官增大,白细胞计数增加,细胞因子失调。颅面畸形影响了中面部,并导致牙齿萌出延迟。其他研究提出,这些全身性致畸效应可能是由于胎儿多个祖细胞系受到经胎盘寨卡病毒感染所致。结论与 CZS 相关的大脑、眼睛、肌肉骨骼和免疫功能损害造成了从中度到重度不等的残疾,并显著增加了特定年龄的死亡率。有必要开展进一步的研究,以评估进展情况、划分阶段、阐明介导寨卡致畸的确切分子机制、制定合适的治疗策略以及设计支持性社会政策。
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引用次数: 0
Carbon nanotubes as neuroprotective agents 作为神经保护剂的碳纳米管
Pub Date : 2024-02-27 DOI: 10.37349/ent.2024.00071
Daisy L. Wilson, J. Ahlawat, Mahesh Narayan
Carbon nanotubes, an emerging class of carbon nanomaterials, possess tremendous potential for application in biotechnology and biomedicine particularly in neurological disorders. Carbon nanotubes owing to their fascinating properties have the potential to revolutionize medicine and technology, particularly in the realm of drug delivery, biosensing, bioimaging, and as therapeutic agents to tackle complex neurological disorders such as Alzheimer’s and Parkinson’s disease. In this review, a summary of the use of carbon nanotubes for neuropathological outcomes such as alleviating oxidative stress and amyloid formation, which are well-studied molecular outcomes associated with Alzheimer’s and Parkinson’s disease. In the end, challenges associated with the clinical testing of carbon nanotubes and possible ways to overcome them are highlighted.
碳纳米管是一类新兴的碳纳米材料,在生物技术和生物医学领域具有巨大的应用潜力,尤其是在神经系统疾病方面。碳纳米管由于其迷人的特性,有可能给医学和技术带来革命性的变化,尤其是在药物输送、生物传感、生物成像领域,以及作为治疗剂来应对阿尔茨海默氏症和帕金森氏症等复杂的神经系统疾病方面。本综述总结了碳纳米管在神经病理学方面的应用,如减轻氧化应激和淀粉样蛋白的形成,这些都是与阿尔茨海默氏症和帕金森氏症相关的分子结果,已被充分研究。最后,重点介绍了与碳纳米管临床试验相关的挑战以及克服这些挑战的可能方法。
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引用次数: 0
The diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) in children 儿童髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)的诊断
Pub Date : 2024-02-27 DOI: 10.37349/ent.2024.00069
Ünsal Yılmaz
Over the last two decades, immunoglobulin G (IgG) antibodies against myelin oligodendrocyte glycoprotein (MOG), previously thought to be a biomarker of multiple sclerosis (MS), have been shown to cause a distinct disease called MOG antibody-associated disease (MOGAD). MOGAD accounts for approximately one-third of all demyelinating syndromes in children and is the second most common central nervous system (CNS) demyelinating disease after MS. The diagnosis is made by detecting anti-MOG IgG antibodies against the natural MOG antigen, in the presence of compatible clinical and neuroradiological features. However, due to controversies in the methodologies for detecting anti-MOG antibodies and their diagnostic cutoff values, as well as the expanding clinical spectrum, accurate diagnosis may be challenging, at least in a subset of patients. Clinical presentations of MOGAD vary by age; the highest rates are seen in acute disseminated encephalomyelitis in younger children and optic neuritis, myelitis, or brainstem symptoms in older children. Although it was previously thought to be a milder demyelinating disorder and to have a monophasic course in the majority of patients, recent studies have shown that relapses occur in about half of the patients and sequelae develop in a significant proportion of them, especially in those with persistently high antibody titers, leukodystrophy-like magnetic resonance imaging (MRI) lesions, and spinal cord involvement. However, due to the monophasic course in about half of the patients, long-term treatment is not recommended after the first clinical episode but is recommended for patients who experience relapse. Accurate and early diagnosis of MOGAD is essential for proper management and better outcome. This review covers the challenges in the diagnosis of MOGAD in children.
在过去的二十年中,针对髓鞘少突胶质细胞糖蛋白(MOG)的免疫球蛋白 G(IgG)抗体(以前被认为是多发性硬化症(MS)的生物标志物)已被证明可导致一种称为 MOG 抗体相关疾病(MOGAD)的独特疾病。MOGAD约占儿童脱髓鞘综合征的三分之一,是仅次于多发性硬化症的第二大常见中枢神经系统(CNS)脱髓鞘疾病。该病的诊断是通过检测针对天然 MOG 抗原的抗 MOG IgG 抗体,并结合临床和神经放射学特征。然而,由于检测抗 MOG 抗体的方法及其诊断临界值存在争议,而且临床范围不断扩大,准确诊断可能具有挑战性,至少在一部分患者中是如此。MOGAD 的临床表现因年龄而异;年龄较小的儿童中急性播散性脑脊髓炎的发病率最高,年龄较大的儿童中视神经炎、脊髓炎或脑干症状的发病率最高。虽然以前认为该病是一种较轻的脱髓鞘疾病,而且大多数患者的病程为单相,但最近的研究表明,约有一半的患者会复发,而且其中相当一部分患者会出现后遗症,尤其是那些抗体滴度持续较高、出现类似白肌萎缩症的磁共振成像(MRI)病变和脊髓受累的患者。然而,由于约半数患者的病程为单相,因此不建议在首次临床发作后进行长期治疗,但建议对复发患者进行治疗。准确和早期诊断 MOGAD 对正确治疗和改善预后至关重要。本综述涵盖了儿童 MOGAD 诊断中面临的挑战。
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引用次数: 0
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Exploration of Neuroprotective Therapy
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