Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DEMYELINATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,099 records · Page 61Linked to original sources

CNS involvement in chronic inflammatory demyelinating polyneuropathy: an electrophysiological and MRI study.

Eight consecutive patients with chronic inflammatory demyelinating polyneuropathy (CIDP) were investigated by visual evoked potential (VEP), brainstem auditory evoked response (BAER) and magnetic resonance imaging (MRI) to assess central nervous system (CNS) involvement. VEPs were abnormal in 6 patients and BAERs in 2. MRI showed changes suggestive of CNS demyelination in 2 cases. Our findings suggest the existence of a combined central and peripheral demyelinating syndrome and emphasize the possibility of a common pathogenetic mechanism for both.

Adult↗

Subperineurial demyelination associated with reduced nerve blood flow and oxygen tension after epineurial vascular stripping.

Using laser Doppler measurements of nerve blood flow and electron microscopy, we determined that removal of the vasa nervorum from the surface of rat peripheral nerve results in an immediate 58.4% +/- (SD) 12.6% reduction in nerve blood flow (p less than 0.017) and subsequent subperineurial demyelination. To further assess the role of ischemia in demyelination, a second group of Sprague-Dawley rats (250 to 300 gm) was anesthetized and oxygen tensions were recorded with platinum microelectrodes in the tibial epineurial and endoneurial spaces before and 30 minutes after epineurial devascularization. Normal epineurial oxygen tension was 40.4 +/- (SD) 6.5 mm Hg before devascularization and 26.3 +/- 12.3 mm Hg after (p less than 0.012). Normal endoneurial oxygen tension was 22.9 +/- 6.0 mm Hg before devascularization and 14.3 +/- 5.4 mm Hg after (p less than 0.003). The topography of nerve fiber injury in this experimental model is identical with the changes induced in the sciatic nerve by circumferential compression at 30 mm Hg which is also thought to impede epineurial circulation. This subperineurial pattern of demyelination and axonal degeneration is associated with experimental interference with the epineurial circulation and may be contrasted with the central fascicular degeneration caused by microsphere embolization of the vasa nervorum via the common iliac artery. The data suggest that ischemia is the mechanism for subperineurial fiber injury after epineurial devascularization and highlight the importance of the transperineurial vessels which connect the epineurial anastomotic circulation and endoneurial capillary network.

Animals↗

[Multifocal demyelinating polyneuropathy with persistent conduction block (Lewis-Sumner syndrome)].

Multifocal demyelinating neuropathy with persistent conduction block (Lewis-Sumner syndrome) is a variant of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which often clinically simulates a motor neuron disease (MND). We report here three patients initially suspected to have MND, who later were diagnosed as a Lewis-Sumner syndrome. One of them showed a remarkable clinical improvement after immunoglobulin therapy. The definitive diagnosis of this syndrome rests upon nerve conduction studies, uncovering multiple sites of persistent conduction block. Technically, it is important to exclude insufficient stimulus which may lead to an erroneous impression of conduction block. Magnetic stimulation, as compared to electric current, elicited larger responses possibly because of deeper current penetration. We found this mode of stimulation useful especially in testing focal demyelination requiring full activation of a diseased nerve at a most proximal segment.

Adult↗

Chronic inflammatory demyelinating polyneuropathy as first manifestation of human immunodeficiency virus infection.

We studied three patients who were admitted to the hospital because of progressive weakness without other systemic signs or symptoms. All three cases were young males who had been intravenous drug user for many years. Electrophysiologic study showed prolonged distal latencies and marked slowing of motor and sensory conduction velocities, consistent with primary demyelination. Nerve biopsy also showed signs of demyelination. Antibodies against HIV in CSF and blood were detected during the diagnostic evaluation. Clinical and electrophysiological studies improved in two cases after prednisone administration. Patients with predominant motor demyelinating neuropathies and risk factors should be screen for HIV infection.

Acquired Immunodeficiency Syndrome↗

[Chronic inflammatory demyelinating polyradiculoneuropathy associated with central nervous system involvement--as compared to multiple sclerosis].

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with central nervous system (CNS) demyelinating lesions has recently been reported to mimic multiple sclerosis (MS). In this paper, a series of patients with CIDP were examined to see if they had CNS involvement. CIDP patients with CNS lesions were then compared to patients with MS with peripheral nervous system (PNS) involvement for similarities. CNS and PNS involvement were detected by clinical symptoms, neurological findings, neuro-otological and neuro-ophthalmological tests, electrophysiological examinations such as electroencephalography, evoked potentials, blink reflex, conventional peripheral nerve conduction studies and electromyography, as well as computed tomography and magnetic resonance imaging (MRI). There were 7 of 17 CIDP patients with CNS involvement, but only 2 of 59 MS patients with PNS lesions were found. The rate of CIDP with CNS involvement (41.2%) was higher than that of MS with PNS lesions (3.4%). The CNS signs and symptoms of 7 CIDP patients were not so constant as their PNS symptoms, and consisted of 1 case with optic neuritis, 4 cases with cerebellar atxia and/or nystagmus, and 3 cases with spinal symptoms. These signs and symptoms are all well known in MS. Prolonged latencies on evoked potentials and high signal white matter lesions on T2 weighted MRI, indicating demyelinating CNS lesions were also similar to those found in MS. The CNS involvement in those patients with CIDP was therefore similar in character to those found in MS, but was far less severe than the PNS finding.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[A case of demyelinating disease showing a peculiar honeycomb-like and lamellar structure on magnetic resonance imaging].

A case of subacute demyelinating disease showing large honeycomb-like and lamellar lesions in bilateral cerebral white matter on MRI was reported. A 22 year-old woman felt general fatigue on sept. 30, 1988, and developed complete quadriplegia and mutism in about 10 days. She recovered shortly after high-dose corticosteroid therapy. She had neither fever nor meningeal irritation. There were no inflammatory changes in examinations of blood and CSF. On MRI, high and low signal areas of irregular shape in the cerebral white matter and brainstem, were observed on T2 and T1 weighted images, respectively, suggesting that the lesions are of demyelinating nature. These lesions appeared lamellar or honeycomb-like structures on T1 and T2 weighted image. This patient was diagnosed as having a subacute type of demyelinating disease similar to Balo's disease (concentric sclerosis).

Adult↗

[Toxic demyelination of the central nervous system. I. Effect of an intercalating gliotoxic drug on the spinal cord in Wistar rats].

Small volumes of ethidium bromide were injected into the dorsal columns of the spinal cord of Wistar rats. It was induced a demyelinating process, variable in nature and speed of repair according to the dose used. The induced lesions were classified into three groups (type I or fast lesions; type II or slow lesions; type III or intermediate lesions) according to the histological appearance and extension of remyelination. In some lesions or in areas within the same lesion, myelin and glial cell debris were rapidly processed by macrophages and the naked axons soon remyelinated by Schwann cells. In other lesions of similar duration, or areas within the lesions, myelin underwent transformation into mazes of membranes which persisted around the axons for long periods of time. In the lesions which contained such myelin-derived membranes, macrophages were scant and remyelination by Schwann cells was slow and arduous. It may be concluded that the slow resolution of some lesions resulted from the time elapsed between intoxication and disappearance of myelin-related cells. That time difference determined that the cellular responses to demyelination took place in an area devoid of glial cells and therefore without a support for the cellular migration needed for the removal of myelin debris and eventual remyelination. This investigation indicates that the development and outcome of demyelination may be altered by the cellular events that occur during oligodendrocyte degeneration.

Animals↗

[Toxic demyelination of the central nervous system. II. Biological aspects of Schwann cells observed during the tissue repair process].

The gliotoxic chemical ethidium bromide when injected locally in the rat spinal cord induced areas of demyelination which developed at various times according to the dose used. High doses induced lesions of fast development (type I) and intermediate lesions (type III) whereas low doses induced slow lesions (type II). Following the demyelinating process, naked axons were remyelinated either by oligodendrocytes or Schwann cells (SC) depending on their location in areas respectively with or without astrocytes. In most lesions the area remyelinated by SC was prominent. In lesions of slow development it was possible to observe the factors that influenced SC behavior within the central nervous system. Following the initial invasion from subpial areas and perivascular spaces, SC expansion depended on the presence of a stable extracellular matrix. In type I lesions this matrix was present due to the inflammatory nature of the process. In type II lesions that matrix did not occur thus SC only could migrate among demyelinated axons using them as stepping stones. Between adjacent SC thin diameter collagen fibres could be detected. It was not found any evidence of SC migration along the naked axons.

Animals↗

[Immunochemical findings in the cerebrospinal fluid in patients with inflammatory demyelinating polyradiculoneuropathy].

The aim of the study was to check the hypothesis of involvement of the structure of the central nervous system on the basis of the analysis of the integrity of blood-brain barrier and the degree of IgG synthesis in the intrathecal space of patients with inflammatory demyelinization polyradiculoneuropathy. The study involved 27 patients with acute and 14 patients with chronic inflammatory demyelinization polyradiculoneuropathy. The analysis of liquor was performed in different stages of the disease. The results have shown that in the acute phase, in the phase of the maximal functional deficit there are signs of damaged integrity of the blood-brain barrier but without signs of increased intrathecal IgG synthesis. It has been concluded that there are no reliable signs of increased immunologic activity in the intrathecal space of patients with inflammatory demyelinization polyradiculoneuropathy.

Adult↗

Cellular and molecular mechanisms of autoimmune demyelination in the central nervous system.

Experimental autoimmune encephalomyelitis (EAE), particularly in its chronic form, shares features with the major human demyelinating disease multiple sclerosis (MS). The roles of lymphocytes and antigen-presenting cells in EAE are increasingly clear. However, little information has been collated on the molecular events involving myelin components in the initiation and perpetuation of the autoimmune condition and in demyelination itself. To draw together relevant data, this review first outlines the molecular structure of the myelin sheath. Evidence implicating individual myelin molecules, as autoimmunogens, as targets for autoimmune attack, or as participants in the demyelinating processes in EAE, is then discussed. Finally, the extent to which the experimental findings are mirrored in MS, and the natural genesis of myelin-directed autoimmunity are considered.

Animals↗

Axonal dystrophy as a consequence of long-term demyelination.

Central nervous system lesions in guinea pigs sensitized for chronic relapsing experimental allergic encephalomyelitis for between 18 and 36 months have been found to possess a small but probably significant degree of axonal involvement. Axonal identity was established by light and electron microscopy and immunocytochemistry. The axonal changes were restricted to white matter and consisted of massive (up to 95 microns) scattered axonal spheroids which displayed lateral branches and vacuoles; small groups of spheroids filled with a wide assortment of axoplasmic organelles; and deeper, more extensive collections of affected demyelinated axons and spheroids which frequently displayed abortive axonal regeneration into the Virchow-Robin space. Although accumulations of most axoplasmic organelles occurred in the spheroids and reactive axons, microtubules were relatively rare. These formations were never seen in adjacent unaffected white matter and spinal cord tissue from normal aged animals contained only the occasional spheroid. It is hypothesized that the disease process in experimental allergic encephalomyelitis may be more dynamic than previously described and that prolonged interruption in normal axon-glial relationships in chronically demyelinated (sometimes remyelinated) gliotic lesions might lead to a block in axoplasmic transport and a disruption of the axonal cytoskeleton. Although most affected axons appeared intact, some of the spheroids probably represented proximal stumps from which sprouting occurred, leading to neuroma-like formations. The implications of the findings are discussed in reference to long-term demyelination and multiple sclerosis where almost identical profiles have been documented.

Animals↗

[Chronic inflammatory demyelinating polyradiculoneuropathy of acute onset: relapse after temporary improvement by plasma exchange and longstanding remission by corticosteroid therapy].

A 59-year-old woman became tetraparetic and unable to stand or walk acutely in several days after she had first developed weakness of her legs and dysesthesia of both hands. Neurological examination revealed facial weakness, proximal dominant tetraparesis, areflexia and acrodysesthesia. The cerebrospinal fluid protein was elevated without pleocytosis, and the nerve conduction velocity was markedly slowed. The sural nerve biopsy indicated demyelination. The tentative diagnosis was Guillain-Barré syndrome (GBS). The initial and second courses of plasma exchanges temporarily improved the weakness, but relapses occurred within a few weeks. The third course of plasma exchange was, therefore, immediately followed by corticosteroid therapy, which successfully improved the tetraparesis. However, weakness again worsened during the rapid reduction of corticosteroid. A high dose of corticosteroid was again started and maintained for two months. The patient recovered gradually and relapses had not occurred so far after gradual reduction of the dose of corticosteroid. Her disease was finally diagnosed as corticosteroid-dependent chronic inflammatory demyelinating polyradiculoneuropathy, although the onset had been as acute as that of GBS. The present case suggests that corticosteroid-dependent chronic inflammatory demyelinating polyradiculoneuropathy may present as a case of acute onset polyradiculoneuropathy resembling GBS, and that corticosteroid therapy must be tried in such a case when plasma exchanges are not effective or relapses occur.

Acute Disease↗

Focal experimental demyelination in monkey optic nerve by lysophosphatidylcholine.

The optic nerve of 2 adult male Macaca fuscata was exposed and lysophosphatidylcholine dissolved in saline at 2% was slowly injected into the nerve at about 5 mm posteriorly from the eyeball. This procedure produced a focal lesion of demyelinating plaque. Klüver-Barreras and Bodian stain for myelin and axon revealed demyelination with myelin ovoids and relatively well preserved axons in the focal plaque. It was thought that this lesion would be an experimental model of the demyelinating lesion of retrobulbar optic neuritis.

Animals↗

Demyelination of the brain in tuberous sclerosis: computed tomography evidence.

Two patients with tuberous sclerosis are described in whom computed tomography of the head revealed areas of diffuse diminution of density suggestive of demyelination. Computed tomography is a sensitive test for the detection of intracerebral lesions in tuberous sclerosis, and the finding of areas of diminished density in the absence of evidence for tumor or ventricular obstruction correlates with the common histologic finding of diffuse demyelination. Serial studies with computed tomography are likely to determine whether such demyelination precedes the growth of hamartomas and calcification that characterize tuberous sclerosis.

Brain↗

The nervous system in genital herpes simplex virus type 2 infections in mice. Lethal panmyelitis or nonlethal demyelinative myelitis or meningitis.

Female mice were inoculated vaginally with the MS strain of herpes simplex virus type 2, and serially positive vaginal cultures were used to confirm infection. The proportion of mice infected and the mortality rate in infected mice decreased with increasing age. In mice 12 weeks old, clinical, neuropathologic, and virologic criteria defined four patterns of disease. Moribund mice had severe genital lesions, hindleg paralysis, and urinary and fecal retention, and most died during the second week of infection. These mice had a panmyelitis with a decreasing gradient of both viral antigen and lesions extending rostrally from the lumbosacral cord into the brain stem. Lesions were about equally distributed in gray and white matter and were characterized by neuronal loss and axonal demyelination, respectively. By contrast, mice with nonfatal infections had mild or no evident genital lesions and a small proportion had mild hindleg weakness. Of these, some mice had demyelinative lesions, particularly in the lower spinal cord but also at higher cord and brain stem levels, whereas others had leptomeningitis. Both of these groups had sacral sensory root abnormalities. A third group of survivors lacked both sensory root and central nervous system abnormalities. This report defines a broader spectrum of disease patterns following infection by a natural route than has been previously appreciated. It provides the first evidence that nonfatal herpes simplex virus type 2 infection by a peripheral route can produce central nervous system demyelination. It indicates that in aseptic meningitis with this agent, the route of virus spread to the central nervous system is neural and not hematogenous. Finally, the antigenic and pathologic observations presented here complement and confirm the virus isolation data and pathologic findings of others that genital herpes simplex virus type 2 infection causes ascending infection in the peripheral and central nervous system.

Aging↗

Augmentation of immune-mediated demyelination by lipid haptens.

The encephalitogenic effects of bovine galactocerbroside and total myelin lipids given in the presence or absence of a known encephalitogenic dose of bovine myelin basic protein (MBP) in complete Freund's adjuvant have been examined in Hartley strain guinea pigs. The lipid haptens and MBP were given in the ratio in which they occur in intact myelin and were compared with experimental allergic encephalomyelitis (EAE) induced by whole bovine white matter in complete Freund's adjuvant. Clinically, bovine white matter- and MBP-induced EAE were similar, but in lesions in the central nervous system. Lipid/complete Freund's adjuvant emulsions were ineffective both clinically and histologically. In combination with MBP, galactocerebroside and total myelin lipids induced an EAE as severe as MBP-induced disease except that central nervous system lesions also showed demyelination. When given separately into opposite hindfeet, the lipid haptens and MBP produced EAE, but the lesions were not demyelinative. It appears, therefore, that lipid haptens have an augmenting effect on MBP when given in the same emulsion and produce central nervous system lesions which are both inflammatory and demyelinative.

Animals↗

Experimental study on segmental demyelination in tellurium neuropathy.

Weanling rats fed a diet containing elemental tellurium became paralyzed of their hind legs based on segmental demyelination of the sciatic nerves. Recovery from the paralysis and remyelination took place despite continued receiving of the diet. The author could divide the process of demyelination and remyelination into four stages (Stage I-IV). The earliest changes were observed in the Schwann cell cytoplasm in which the Golgi complex revealed shrinkage, fragmentation and vacuolation. These changes soon involved the endoplasmic reticulum (Stage I). Degenerative changes of the Golgi complex and the endoplasmic reticulum were considered to disturb the active Schwann cell metabolism inhibiting the synthesis and maintenance of the myelin, resulted in disintegration and destruction of the myelin sheath (Stage II). Schwann cells proliferated around the demyelinated axons extending numerous elongated processes (Stage III). When remyelination began, only one simple shaped Schwann cell was associated with the axon. Remyelinated fibers were generally small in size, which was considered to be related to the formation of the short segments as well as to the Schwann cell proliferation (Stage IV).

Animals↗

Experimental demyelinating optic neuropathy: a model for combined morphological and electrophysiological studies.

A model is described for the morphological and electrophysiological study of demyelinative optic neuropathy in the rat. Cortical visual evoked potentials (VEPs) to flash stimuli were recorded before and after the intraneural microinjection of lysophosphatidyl choline (LPC) and galacto-cerebroside (Gal-C) antiserum. Progress was monitored by calculating the interocular latency differences (ILD) for the N40 and P60 components of the rat VEP, thus allowing a longitudinal evaluation of optic nerve function. Histological examination of the visual pathway using light and electron microscopy was performed at intervals through the course of the study. LPC produced a less selective lesion than did Gal-C antiserum. In lesions induced by the latter there was relatively little accompanying anoxal degeneration and subsequent remyelination was prominent. Control serum did not result in demyelination. This model should permit accurate electrophysiological and morphological correlations to be made during the developing and the reparative phases of demyelinative optic neuropathy and the assessment of potential therapeutic manoeuvres.

Animals↗