Heterogeneity and continuum of multiple sclerosis phenotypes in Japanese according to the results of the fourth nationwide survey

Takaaki Ishizu, Jun-Ichi Kira, Manabu Osoegawa, Toshiyuki Fukazawa, Seiji Kikuchi, Kazuo Fujihara, Makoto Matsui, Tatsuo Kohriyama, Gen Sobue, Takashi Yamamura, Yasuto Itoyama, Takahiko Saida, Kiyomi Sakata

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

There are two distinct phenotypes of multiple sclerosis (MS) in Asians, optic-spinal MS (OSMS) and conventional MS (CMS). In 2004, we performed the fourth nationwide epidemiological survey of MS. The epidemiological features were reported elsewhere; here we report the characteristic features of patients with each MS phenotype, classified according to the clinically estimated sites of involvement and MRI findings. Among 1493 MS patients collated, 57.7% were classified as having CMS and 16.5% were classified as having OSMS. Based on MRI findings, MS patients were further subdivided into those with OSMS with or without longitudinally extensive spinal cord lesions (LESCLs) and those with CMS with or without LESCLs. Although disease duration did not differ significantly among the four groups, EDSS scores were significantly higher in patients with LESCLs than in those without LESCLs, irrespective of OSMS or CMS phenotype. Similar trends were found for the frequencies of bilateral visual loss, transverse myelitis, and marked CSF pleocytosis and neutrophilia. Increased IgG index, brain lesions fulfilling the Barkhof criteria and secondary progression were more commonly found in CMS patients than in OSMS patients, while negative brain MRIs were more commonly encountered in OSMS patients than CMS patients, irrespective of the presence of LESCLs. These findings suggest that demographic features not only vary based on CMS or OSMS phenotype, but also with the presence or absence of LESCLs, and that nonetheless, these four phenotypes constitute a continuum.

Original languageEnglish
Pages (from-to)22-28
Number of pages7
JournalJournal of the Neurological Sciences
Volume280
Issue number1-2
DOIs
Publication statusPublished - May 15 2009

Fingerprint

Multiple Sclerosis
Phenotype
Spinal Cord
Transverse Myelitis
Surveys and Questionnaires
Leukocytosis
Brain
Opticospinal Multiple Sclerosis
Immunoglobulin G
Demography

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Heterogeneity and continuum of multiple sclerosis phenotypes in Japanese according to the results of the fourth nationwide survey. / Ishizu, Takaaki; Kira, Jun-Ichi; Osoegawa, Manabu; Fukazawa, Toshiyuki; Kikuchi, Seiji; Fujihara, Kazuo; Matsui, Makoto; Kohriyama, Tatsuo; Sobue, Gen; Yamamura, Takashi; Itoyama, Yasuto; Saida, Takahiko; Sakata, Kiyomi.

In: Journal of the Neurological Sciences, Vol. 280, No. 1-2, 15.05.2009, p. 22-28.

Research output: Contribution to journalArticle

Ishizu, T, Kira, J-I, Osoegawa, M, Fukazawa, T, Kikuchi, S, Fujihara, K, Matsui, M, Kohriyama, T, Sobue, G, Yamamura, T, Itoyama, Y, Saida, T & Sakata, K 2009, 'Heterogeneity and continuum of multiple sclerosis phenotypes in Japanese according to the results of the fourth nationwide survey', Journal of the Neurological Sciences, vol. 280, no. 1-2, pp. 22-28. https://doi.org/10.1016/j.jns.2009.01.008
Ishizu, Takaaki ; Kira, Jun-Ichi ; Osoegawa, Manabu ; Fukazawa, Toshiyuki ; Kikuchi, Seiji ; Fujihara, Kazuo ; Matsui, Makoto ; Kohriyama, Tatsuo ; Sobue, Gen ; Yamamura, Takashi ; Itoyama, Yasuto ; Saida, Takahiko ; Sakata, Kiyomi. / Heterogeneity and continuum of multiple sclerosis phenotypes in Japanese according to the results of the fourth nationwide survey. In: Journal of the Neurological Sciences. 2009 ; Vol. 280, No. 1-2. pp. 22-28.
@article{1ef4e3c476484943beab5c429e509c93,
title = "Heterogeneity and continuum of multiple sclerosis phenotypes in Japanese according to the results of the fourth nationwide survey",
abstract = "There are two distinct phenotypes of multiple sclerosis (MS) in Asians, optic-spinal MS (OSMS) and conventional MS (CMS). In 2004, we performed the fourth nationwide epidemiological survey of MS. The epidemiological features were reported elsewhere; here we report the characteristic features of patients with each MS phenotype, classified according to the clinically estimated sites of involvement and MRI findings. Among 1493 MS patients collated, 57.7{\%} were classified as having CMS and 16.5{\%} were classified as having OSMS. Based on MRI findings, MS patients were further subdivided into those with OSMS with or without longitudinally extensive spinal cord lesions (LESCLs) and those with CMS with or without LESCLs. Although disease duration did not differ significantly among the four groups, EDSS scores were significantly higher in patients with LESCLs than in those without LESCLs, irrespective of OSMS or CMS phenotype. Similar trends were found for the frequencies of bilateral visual loss, transverse myelitis, and marked CSF pleocytosis and neutrophilia. Increased IgG index, brain lesions fulfilling the Barkhof criteria and secondary progression were more commonly found in CMS patients than in OSMS patients, while negative brain MRIs were more commonly encountered in OSMS patients than CMS patients, irrespective of the presence of LESCLs. These findings suggest that demographic features not only vary based on CMS or OSMS phenotype, but also with the presence or absence of LESCLs, and that nonetheless, these four phenotypes constitute a continuum.",
author = "Takaaki Ishizu and Jun-Ichi Kira and Manabu Osoegawa and Toshiyuki Fukazawa and Seiji Kikuchi and Kazuo Fujihara and Makoto Matsui and Tatsuo Kohriyama and Gen Sobue and Takashi Yamamura and Yasuto Itoyama and Takahiko Saida and Kiyomi Sakata",
year = "2009",
month = "5",
day = "15",
doi = "10.1016/j.jns.2009.01.008",
language = "English",
volume = "280",
pages = "22--28",
journal = "Journal of the Neurological Sciences",
issn = "0022-510X",
publisher = "Elsevier",
number = "1-2",

}

TY - JOUR

T1 - Heterogeneity and continuum of multiple sclerosis phenotypes in Japanese according to the results of the fourth nationwide survey

AU - Ishizu, Takaaki

AU - Kira, Jun-Ichi

AU - Osoegawa, Manabu

AU - Fukazawa, Toshiyuki

AU - Kikuchi, Seiji

AU - Fujihara, Kazuo

AU - Matsui, Makoto

AU - Kohriyama, Tatsuo

AU - Sobue, Gen

AU - Yamamura, Takashi

AU - Itoyama, Yasuto

AU - Saida, Takahiko

AU - Sakata, Kiyomi

PY - 2009/5/15

Y1 - 2009/5/15

N2 - There are two distinct phenotypes of multiple sclerosis (MS) in Asians, optic-spinal MS (OSMS) and conventional MS (CMS). In 2004, we performed the fourth nationwide epidemiological survey of MS. The epidemiological features were reported elsewhere; here we report the characteristic features of patients with each MS phenotype, classified according to the clinically estimated sites of involvement and MRI findings. Among 1493 MS patients collated, 57.7% were classified as having CMS and 16.5% were classified as having OSMS. Based on MRI findings, MS patients were further subdivided into those with OSMS with or without longitudinally extensive spinal cord lesions (LESCLs) and those with CMS with or without LESCLs. Although disease duration did not differ significantly among the four groups, EDSS scores were significantly higher in patients with LESCLs than in those without LESCLs, irrespective of OSMS or CMS phenotype. Similar trends were found for the frequencies of bilateral visual loss, transverse myelitis, and marked CSF pleocytosis and neutrophilia. Increased IgG index, brain lesions fulfilling the Barkhof criteria and secondary progression were more commonly found in CMS patients than in OSMS patients, while negative brain MRIs were more commonly encountered in OSMS patients than CMS patients, irrespective of the presence of LESCLs. These findings suggest that demographic features not only vary based on CMS or OSMS phenotype, but also with the presence or absence of LESCLs, and that nonetheless, these four phenotypes constitute a continuum.

AB - There are two distinct phenotypes of multiple sclerosis (MS) in Asians, optic-spinal MS (OSMS) and conventional MS (CMS). In 2004, we performed the fourth nationwide epidemiological survey of MS. The epidemiological features were reported elsewhere; here we report the characteristic features of patients with each MS phenotype, classified according to the clinically estimated sites of involvement and MRI findings. Among 1493 MS patients collated, 57.7% were classified as having CMS and 16.5% were classified as having OSMS. Based on MRI findings, MS patients were further subdivided into those with OSMS with or without longitudinally extensive spinal cord lesions (LESCLs) and those with CMS with or without LESCLs. Although disease duration did not differ significantly among the four groups, EDSS scores were significantly higher in patients with LESCLs than in those without LESCLs, irrespective of OSMS or CMS phenotype. Similar trends were found for the frequencies of bilateral visual loss, transverse myelitis, and marked CSF pleocytosis and neutrophilia. Increased IgG index, brain lesions fulfilling the Barkhof criteria and secondary progression were more commonly found in CMS patients than in OSMS patients, while negative brain MRIs were more commonly encountered in OSMS patients than CMS patients, irrespective of the presence of LESCLs. These findings suggest that demographic features not only vary based on CMS or OSMS phenotype, but also with the presence or absence of LESCLs, and that nonetheless, these four phenotypes constitute a continuum.

UR - http://www.scopus.com/inward/record.url?scp=63349090713&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=63349090713&partnerID=8YFLogxK

U2 - 10.1016/j.jns.2009.01.008

DO - 10.1016/j.jns.2009.01.008

M3 - Article

VL - 280

SP - 22

EP - 28

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

SN - 0022-510X

IS - 1-2

ER -