Multiple Sclerosis in Hokkaido, the Northernmost Island of Japan. Prospective Analyses of Clinical Features.

Fukazawa, Toshiyuki; Tashiro, Kunio; Hamada, Takeshi; Moriwaka, Fumio; Matsumoto, Akihisa; Shima, K; Maruo, Yuji

doi:10.2169/internalmedicine.31.349

Cited by 32 publications

(29 citation statements)

References 18 publications

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“…Nearly 90% of the patients were women. The average onset age was 35 years, which was higher than that of CMS reported in Japan [1,8]. Transverse myelitis and sustained severe optic neuritis had been described as characteristic features of OSMS [2,3,7,8] and were rarely seen in CMS patients.…”

Section: Discussionmentioning

confidence: 80%

Two subtypes of optic-spinal form of multiple sclerosis in Japan: clinical and laboratory features

et al. 2007

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Seventy-seven cases of the optic-spinal form of multiple sclerosis (OSMS) were collected from 6 institutes in 3 cities of Japan, and the clinical and MRI features were analyzed. Two-thirds of the OSMS patients had longitudinally extensive spinal cord MRI lesions (LESL), and had clinical features similar to those of relapsing neuromyelitis optica which often causes severe disability. In contrast, OSMS patients without LESL tended to have milder disease and had some feature commonly seen in the conventional form of MS. The percentage of OSMS without LESL in total OSMS has recently been increasing. The present study suggests that LESL is crucially important for distinguishing the two subtypes of OSMS.

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Section: Discussionmentioning

confidence: 80%

Two subtypes of optic-spinal form of multiple sclerosis in Japan: clinical and laboratory features

et al. 2007

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“…Previous studies have also emphasized some distinct clinical features of Japanese MS patients including a relatively higher rate of the opticospinal form of MS and a greater incidence of visual loss at the onset of illness (2)(3)(4). Recently, clinical and laboratory features have been reported for MS patients living in the northernmost part, Hokkaido (42-46 degrees north latitude) (5,6), and the southernmost part, Kyushu (31-34 degrees north latitude) (7,8), of mainland Japan. As is the case in the temperate zones of the USA and Australia, a small but statistically significant north-south gradient of MS prevalence rates exists in Japan with proportionally more opticospinal MS in the southern region of Japan (2).…”

Section: Introductionmentioning

confidence: 99%

Clinical and Laboratory Features of in-Patients with Multiple Sclerosis in a University Hospital in Tokyo from 1988-2002

et al. 2005

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Objective The aim of this study was to analyze the clinical and laboratory features of each subtype of multiple sclerosis (MS) (relapsing-remitting, primary progressive, and secondary progressive) in the Tokyo metropolitan area.Methods and Patients We retrospectively analyzed the medical records of 104 consecutive patients with a diagnosis of MS, who had been admitted to our university hospital from 1988 to 2002. They all met criteria for definite MS, by clinical or laboratory standards.Results Eighty-four (80.8%) patients were classified as having relapsing-remitting MS, while 8 patients (7.7%) and 12 patients (11.5%) were classified as having primary progressive MS and secondary progressive MS, respectively. A significant female predominance existed in the relapse-remitting MS (female : male=2.4 : 1) cohort, but this ratio was 1 : 1 in both primary progressive and secondary progressive MS. The age at onset was older in the primary progressive MS (36.6±17.1 years of old) population than in either the relapsing-remitting MS (27.9±11.1) or the secondary progressive MS (27.8±11.5) subjects. Although the duration of illness was similar among the three types of MS, the number of exacerbations in the secondary progressive (5.9±4.6) cohort was significantly higher than that in the relapsing-remitting MS subjects (3.2±2.6). Patients with primary progressive MS showed a significantly higher rate of gait disturbance (87.5%) as the initial symptom than those with relapsingremitting MS (23.8%), and this was thought to be due to the higher incidence of brainstem and spinal cord lesions. Visual disturbance as the initial symptom was frequently noted in those with secondary progressive MS (50.0%), while it was noted only in 29.8% and 12.5% in the relapsing-remitting and primary progressive patients, respectively. Primary progressive MS subjects had a higher propensity to be wheelchair-bound (75.0%) than those suffering from relapsing-remitting MS (1.2%). Increased total protein in the cerebrospinal fluid (CSF) of the secondary progressive cohort was statistically significant compared to the relapsing-remitting cohort. The frequency of oligoclonal IgG bands was rather low in each type of MS (17.1-33.3%). Gadolinium enhancement of plaques on MRI was more frequently present in secondary progressive MS (66.7%) than in either relapsingremitting MS (32.1%) or primary progressive MS (50.0%). Of note, the opticospinal form was found in only 16.3% of the total MS patients, a proportion less than that in previous reports from southern Japan.Conclusion

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“…The primary progressive (PP) type was diagnosed using the criteria of Polman et al [2]. On the basis of the distribution of lesions, cases were categorized into 2 types, namely, OS-MS and C-MS. OS-MS was defined as MS in which the clinically identified lesions were restricted to the optic nerve and spinal cord, and C-MS was defined as MS with clinical signs involving the cerebrum, brainstem, or cerebellum [11,12]. Clinical disability was estimated using Kurtzke's expanded disability status scale (EDSS) [36].…”

Section: Case Ascertainmentmentioning

confidence: 99%

Relationship between Barkhof criteria and the clinical features of multiple sclerosis in northern Japan

et al. 2009

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Multiple Sclerosis in Hokkaido, the Northernmost Island of Japan. Prospective Analyses of Clinical Features.

Cited by 32 publications

References 18 publications

Two subtypes of optic-spinal form of multiple sclerosis in Japan: clinical and laboratory features

Two subtypes of optic-spinal form of multiple sclerosis in Japan: clinical and laboratory features

Clinical and Laboratory Features of in-Patients with Multiple Sclerosis in a University Hospital in Tokyo from 1988-2002

Relationship between Barkhof criteria and the clinical features of multiple sclerosis in northern Japan

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