Differences in membrane properties of axonal and demyelinating Guillain-Barré syndromes

Satoshi Kuwabara, Kazue Ogawara, Jia Ying Sung, Masahiro Mori, Kazuaki Kanai, Takamichi Hattori, Nobuhiro Yuki, Cindy S Y Lin, David Burke, Hugh Bostock

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Guillain-Barré syndrome is classified into acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyneuropathy (AIDP) by electrodiagnostic and pathological criteria. In AMAN, the immune attack appears directed against the axolemma and nodes of Ranvier. Threshold tracking was used to measure indices of axonal excitability (refractoriness, supernormality, and threshold electrotonus) for median nerve axons at the wrist of patients with AMAN (n = 10) and AIDP (n = 8). Refractoriness (the increase in threshold current during the relative refractory period) was greatly increased in AMAN patients, but the abruptness of the threshold increases at short interstimulus intervals indicated conduction failure distal to the stimulation (ie, an increased refractory period of transmission). During the 4 week period from onset, the high refractoriness returned toward normal, and the amplitude of the compound muscle action potential increased, consistent with improvement in the safety margin for impulse transmission in the distal nerve. In contrast, refractoriness was normal in AIDP, even though there was marked prolongation of distal latencies. Supernormality and threshold electrotonus were normal in both groups of patients, suggesting that, at the wrist, membrane potential was normal and pathology was relatively minor. These results support the view that the predominantly distal targets of immune attack are different for AMAN and AIDP. Possible mechanisms for the reduced safety factor in AMAN are discussed.

Original languageEnglish
Pages (from-to)180-187
Number of pages8
JournalAnnals of Neurology
Volume52
Issue number2
DOIs
Publication statusPublished - 2002
Externally publishedYes

Fingerprint

Guillain-Barre Syndrome
Membranes
Wrist
Ranvier's Nodes
Safety
Median Nerve
Membrane Potentials
Action Potentials
Axons
Pathology
Muscles

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Kuwabara, S., Ogawara, K., Sung, J. Y., Mori, M., Kanai, K., Hattori, T., ... Bostock, H. (2002). Differences in membrane properties of axonal and demyelinating Guillain-Barré syndromes. Annals of Neurology, 52(2), 180-187. https://doi.org/10.1002/ana.10275

Differences in membrane properties of axonal and demyelinating Guillain-Barré syndromes. / Kuwabara, Satoshi; Ogawara, Kazue; Sung, Jia Ying; Mori, Masahiro; Kanai, Kazuaki; Hattori, Takamichi; Yuki, Nobuhiro; Lin, Cindy S Y; Burke, David; Bostock, Hugh.

In: Annals of Neurology, Vol. 52, No. 2, 2002, p. 180-187.

Research output: Contribution to journalArticle

Kuwabara, S, Ogawara, K, Sung, JY, Mori, M, Kanai, K, Hattori, T, Yuki, N, Lin, CSY, Burke, D & Bostock, H 2002, 'Differences in membrane properties of axonal and demyelinating Guillain-Barré syndromes', Annals of Neurology, vol. 52, no. 2, pp. 180-187. https://doi.org/10.1002/ana.10275
Kuwabara, Satoshi ; Ogawara, Kazue ; Sung, Jia Ying ; Mori, Masahiro ; Kanai, Kazuaki ; Hattori, Takamichi ; Yuki, Nobuhiro ; Lin, Cindy S Y ; Burke, David ; Bostock, Hugh. / Differences in membrane properties of axonal and demyelinating Guillain-Barré syndromes. In: Annals of Neurology. 2002 ; Vol. 52, No. 2. pp. 180-187.
@article{0f1256e5b70b48608a6665a1a83fc4c9,
title = "Differences in membrane properties of axonal and demyelinating Guillain-Barr{\'e} syndromes",
abstract = "Guillain-Barr{\'e} syndrome is classified into acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyneuropathy (AIDP) by electrodiagnostic and pathological criteria. In AMAN, the immune attack appears directed against the axolemma and nodes of Ranvier. Threshold tracking was used to measure indices of axonal excitability (refractoriness, supernormality, and threshold electrotonus) for median nerve axons at the wrist of patients with AMAN (n = 10) and AIDP (n = 8). Refractoriness (the increase in threshold current during the relative refractory period) was greatly increased in AMAN patients, but the abruptness of the threshold increases at short interstimulus intervals indicated conduction failure distal to the stimulation (ie, an increased refractory period of transmission). During the 4 week period from onset, the high refractoriness returned toward normal, and the amplitude of the compound muscle action potential increased, consistent with improvement in the safety margin for impulse transmission in the distal nerve. In contrast, refractoriness was normal in AIDP, even though there was marked prolongation of distal latencies. Supernormality and threshold electrotonus were normal in both groups of patients, suggesting that, at the wrist, membrane potential was normal and pathology was relatively minor. These results support the view that the predominantly distal targets of immune attack are different for AMAN and AIDP. Possible mechanisms for the reduced safety factor in AMAN are discussed.",
author = "Satoshi Kuwabara and Kazue Ogawara and Sung, {Jia Ying} and Masahiro Mori and Kazuaki Kanai and Takamichi Hattori and Nobuhiro Yuki and Lin, {Cindy S Y} and David Burke and Hugh Bostock",
year = "2002",
doi = "10.1002/ana.10275",
language = "English",
volume = "52",
pages = "180--187",
journal = "Annals of Neurology",
issn = "0364-5134",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - Differences in membrane properties of axonal and demyelinating Guillain-Barré syndromes

AU - Kuwabara, Satoshi

AU - Ogawara, Kazue

AU - Sung, Jia Ying

AU - Mori, Masahiro

AU - Kanai, Kazuaki

AU - Hattori, Takamichi

AU - Yuki, Nobuhiro

AU - Lin, Cindy S Y

AU - Burke, David

AU - Bostock, Hugh

PY - 2002

Y1 - 2002

N2 - Guillain-Barré syndrome is classified into acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyneuropathy (AIDP) by electrodiagnostic and pathological criteria. In AMAN, the immune attack appears directed against the axolemma and nodes of Ranvier. Threshold tracking was used to measure indices of axonal excitability (refractoriness, supernormality, and threshold electrotonus) for median nerve axons at the wrist of patients with AMAN (n = 10) and AIDP (n = 8). Refractoriness (the increase in threshold current during the relative refractory period) was greatly increased in AMAN patients, but the abruptness of the threshold increases at short interstimulus intervals indicated conduction failure distal to the stimulation (ie, an increased refractory period of transmission). During the 4 week period from onset, the high refractoriness returned toward normal, and the amplitude of the compound muscle action potential increased, consistent with improvement in the safety margin for impulse transmission in the distal nerve. In contrast, refractoriness was normal in AIDP, even though there was marked prolongation of distal latencies. Supernormality and threshold electrotonus were normal in both groups of patients, suggesting that, at the wrist, membrane potential was normal and pathology was relatively minor. These results support the view that the predominantly distal targets of immune attack are different for AMAN and AIDP. Possible mechanisms for the reduced safety factor in AMAN are discussed.

AB - Guillain-Barré syndrome is classified into acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyneuropathy (AIDP) by electrodiagnostic and pathological criteria. In AMAN, the immune attack appears directed against the axolemma and nodes of Ranvier. Threshold tracking was used to measure indices of axonal excitability (refractoriness, supernormality, and threshold electrotonus) for median nerve axons at the wrist of patients with AMAN (n = 10) and AIDP (n = 8). Refractoriness (the increase in threshold current during the relative refractory period) was greatly increased in AMAN patients, but the abruptness of the threshold increases at short interstimulus intervals indicated conduction failure distal to the stimulation (ie, an increased refractory period of transmission). During the 4 week period from onset, the high refractoriness returned toward normal, and the amplitude of the compound muscle action potential increased, consistent with improvement in the safety margin for impulse transmission in the distal nerve. In contrast, refractoriness was normal in AIDP, even though there was marked prolongation of distal latencies. Supernormality and threshold electrotonus were normal in both groups of patients, suggesting that, at the wrist, membrane potential was normal and pathology was relatively minor. These results support the view that the predominantly distal targets of immune attack are different for AMAN and AIDP. Possible mechanisms for the reduced safety factor in AMAN are discussed.

UR - http://www.scopus.com/inward/record.url?scp=0036321899&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036321899&partnerID=8YFLogxK

U2 - 10.1002/ana.10275

DO - 10.1002/ana.10275

M3 - Article

VL - 52

SP - 180

EP - 187

JO - Annals of Neurology

JF - Annals of Neurology

SN - 0364-5134

IS - 2

ER -