title: Axonal pathology in Japanese Guillain-Barré syndrome: a study of 15 autopsied cases.
abstract: We assessed the frequency and extent of axonal involvement in the ventral spinal roots in 15 Japanese autopsied patients with Guillain-Barré syndrome (GBS). Teased-fiber preparation revealed that five had predominantly axonal pathology with minimal segmental demyelination, seven had predominantly segmental demyelination with minimal axonal changes, two patients showed a mixture of both conditions, and one patient did not show any particular pathologic changes. We confirmed axon loss by immunohistochemical analysis of high-molecular-weight neurofilament protein. Macrophage invasion was a prominent feature in nerves with predominantly axonal changes. Two patients with severe axonal involvement and prolonged clinical courses exhibited motor neuron loss with astrogliosis in the ventral horns. These results suggest that autopsy-verified axonal involvement is more frequent among Japanese GBS patients than in Caucasian populations but less frequent than that reported from northern China.
authors.affiliation: Department of Neurology, Nagoya University School of Medicine, Japan.
authors.forename: G
authors.initials: G
authors.lastname: Sobue
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: S
authors.initials: S
authors.lastname: Terao
authors.forename: S
authors.initials: S
authors.lastname: Aoki
authors.forename: M
authors.initials: M
authors.lastname: Ichimura
authors.forename: T
authors.initials: T
authors.lastname: Ieda
authors.forename: M
authors.initials: M
authors.lastname: Doyu
authors.forename: T
authors.initials: T
authors.lastname: Yasuda
authors.forename: Y
authors.initials: Y
authors.lastname: Hashizume
authors.forename: T
authors.initials: T
authors.lastname: Mitsuma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001369:Axons / Q000737:chemistry / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000737:chemistry / Q000473:pathology / Q000648:ultrastructure; D016900:Neurofilament Proteins / Q000032:analysis; D011129:Polyradiculoneuropathy / Q000401:mortality / Q000473:pathology*; D013126:Spinal Nerve Roots / Q000473:pathology
chemical_list: D016900:Neurofilament Proteins; C051774:neurofilament protein H