Neuropathology of two Brazilian autopsied cases of tropical spastic paraparesis / HTLV-I associated myelopathy (TSP/HAM) of long evolution

Castro-Costa, Carlos Maurício de; Dom, René; Carton, Herwig; Goubau, Patrick; Santos, Terezinha de Jesus Teixeira; Ferreira, Márcia Valéria Pitombeira; Neto, Francisco Ursino da Silva

doi:10.1590/s0004-282x2002000400003

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…In HAM/TSP, a slow and progressive degeneration of the lateral funiculus of the spinal cord has been consistently described. [17][18][19] It mainly involves the lateral cortico-spinal tract as well as the descending autonomic fibers from the hypothalamus, spinocerebellar, and spinothalamic tracts, especially at the thoracic level. 17 As it happens with MS, in HAM/TSP, there is also a correlation between sexual and bladder dysfunction and it can also be explained by the neurological level involved.…”

Section: Discussionmentioning

confidence: 99%

Erectile dysfunction and HTLV-I infection: a silent problem

et al. 2005

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The human T-lymphotropic virus type I (HTLV-I) is a retrovirus associated with a chronic myelopathy known as HTLV-I-Associated Myelopathy or Tropical Spastic Paraparesis (HAM/TSP). The main objective was to assess the frequency of erectile dysfunction (ED) in HTLV-I-infected individuals from Salvador and other cities from Bahia, Brazil, as well as to verify if sexual dysfunction correlates with urinary symptoms and overall neurological impairment. From January 2001 to April 2004, 218 HTLV-I carriers (111 male and 107 female subjects) had complete clinical, neurological, and urological evaluation. They were assessed using standardized questionnaires to determine urinary complaints (Urinary Distress Inventory) and ED (Brief Male Sexual Function Inventory). Neurological impairment was established by Expanded Disability Status Scale (EDSS) from 0 to 10. HAM/TSP was considered as EDSSZ2. A total of 17 males had clinically defined HAM/ TSP (group 1). From the 94 HTLV-I-infected males, 62 were selected (group 2) and paired by age with patients in group 1. A total of 79 individuals were selected for this study. The age ranged from 35 to 81 y (mean ¼ 47.979.65). The percentage of ED in the studied population was 40.5%. In the HAM/TSP group, ED frequency was 88.2%. The associations among sexual dissatisfaction, erectile dysfunction, urinary symptoms (frequency, nocturia, and urgency) and EDSSZ2 were statistically significant. In HAM/TSP, there is a slow and progressive degeneration of the lateral funiculus of the spinal cord. HTLV-I-infected individuals present a high frequency of ED and it is closely associated to urinary symptoms and the overall neurological picture. The HTLV-I carriers already had prominent compromise of the sexual activity.

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Section: Discussionmentioning

confidence: 99%

Erectile dysfunction and HTLV-I infection: a silent problem

et al. 2005

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“…Known cases of hearing loss, such as ear trauma, congenital ear problems, ototoxic drugs, meningitis, posterior fossa tumors, multiple sclerosis, hypothyroidism, mumps, chronic otitis media, cholesteatoma, diabetes, noise-induced hearing loss, and systemic autoimmune diseases, were excluded. Next, a physical examination and microscopic ear exam were performed, followed by audiometric evaluation including measurements of speech reception threshold (SRT), speech discrimination score, pure-tone audiometry (PTA), including high frequencies (10,12,14, and 16 kHz) evaluation (MA53; MAICO, Berlin, Germany), and impedance tests including tympanogram, and acoustic reflex (MI44, MAICO). An evoked auditory brainstem responses (ABR) test was performed (Eclips, EP 25; Interacoustics, Assens, Denmark).…”

Section: Methodsmentioning

confidence: 99%

“…Some cytokines, such as tumor necrosis factor, platelet activating factor, and interleukins have been found in the serum of HAM/TSP patients, and these appear to be responsible for demyelination in the nervous system. The ratio of CD4‐positive to CD8‐positive T cells is increased in these patients, and the function of natural killer cells is altered in ATLL and HAM/TSP patients …”

Section: Introductionmentioning

confidence: 99%

“…The ratio of CD4positive to CD8-positive T cells is increased in these patients, and the function of natural killer cells is altered in ATLL and HAM/TSP patients. 1,[10][11][12][13] To the best of our knowledge through searches of the literature using MEDLINE and other online databases, no studies have been published on a possible audiovestibular involvement of this infection; however, there is one case report of hearing loss in an HTLV-1infected patient with ATLL 14 and another report on multimodality-evoked potentials including brainstem auditory evoked potentials in HTLV-1-associated myelopathy. 15 The aim of this study was to evaluate audiovestibular abnormalities that might be associated with HTLV-1 infection.…”

Section: Introductionmentioning

confidence: 99%

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Is human T‐lymphotropic virus type 1 infection associated with hearing loss?

Bakhshaee¹,

Sorouri

Shoeibi

et al. 2014

The Laryngoscope

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Atrophy, focal spinal cord lesions and alterations of diffusion tensor imaging (DTI) parameters in asymptomatic virus carriers and patients suffering from human T-lymphotrophic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP)

et al. 2014

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In tropical spastic paraparesis, spinal cord atrophy is a well-known finding in magnetic resonance imaging. But in contrast to histological reports, focal lesions of the spinal cord have only been described in imaging reports in exceptional acute cases. Here, we looked for such focal lesions and for alterations of diffusion tensor imaging parameters of the long fibre tracts in the usual case of a long-standing and slowly progressive disease. We examined 10 symptomatic patients, 11 seropositive, but asymptomatic human T-lymphotrophic virus type 1 carriers and 18 seronegative volunteers as controls. Sagittal and transversal T2-weighted images were visually assessed for atrophy and focal cord lesions. The spinal cord cross-sectional areas and the segmental cord volumes were measured at all levels. High-resolution diffusion tensor imaging was performed in sagittal planes from the bregma down to the cervical spine. For tractography and calculation of fractional anisotropy and mean diffusivity, we used manufacturer-provided software. Two-thirds of patients showed focal lesions affecting the antero-lateral columns and in two cases also the dorsal columns. Compared to carriers and volunteers, patients presented a significant spinal cord atrophy and a reduction of fractional anisotropy (p < 0.05), correlating more to duration of symptoms than to clinical impairment. Because our carriers did not show a significant atrophy, focal lesions or a change of diffusion tensor imaging parameters, we need further long-term studies to see if these parameters at some stage may be used as early indicators of spinal cord affection in virus carriers.

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Neuropathology of two Brazilian autopsied cases of tropical spastic paraparesis / HTLV-I associated myelopathy (TSP/HAM) of long evolution

Cited by 4 publications

References 14 publications

Erectile dysfunction and HTLV-I infection: a silent problem

Erectile dysfunction and HTLV-I infection: a silent problem

Is human T‐lymphotropic virus type 1 infection associated with hearing loss?

Atrophy, focal spinal cord lesions and alterations of diffusion tensor imaging (DTI) parameters in asymptomatic virus carriers and patients suffering from human T-lymphotrophic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP)

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