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孤発性小脳性運動失調症の代表的疾患は小脳性運動失調優位型多系統萎縮症(MSA-C)と皮質性小脳萎縮症である。両疾患は,αシヌクレイン病理により明瞭に異なる。しかし,MSA-Cは発症から小脳性運動失調と自律神経不全が揃うのに約2年かかり,小脳失調のみを呈する時期(mono system atrophy)は10年以上に及び得る。Mono system atrophyの理解は,早期診断と創薬開発に重要である。
Abstract
Cerebellar ataxia-predominant multiple system atrophy (MSA-C) and cortical cerebellar atrophy are representative diseases of adult-onset sporadic degenerative ataxia. Both diseases are distinctly different because of α-synuclein pathology. However, it takes approximately 2 years for cerebellar ataxia to progress to concomitant severe autonomic dysfunction in patients with MSA-C. The period of only cerebellar ataxia (mono system atrophy) may extend to more than 10 years. Understanding mono system atrophy is vital for the early diagnosis and drug development for MSA. In this review, we discuss mono system atrophy focusing on the concept and natural history and the possibility of the of early diagnosis and disease-modifying therapy for MSA.
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