|Budget Amount *help
¥3,100,000 (Direct Cost : ¥3,100,000)
Fiscal Year 1998 : ¥700,000 (Direct Cost : ¥700,000)
Fiscal Year 1997 : ¥2,400,000 (Direct Cost : ¥2,400,000)
Although osteoporosis is crucial in patients with neurological disease, elaborate studies regarding bone change and neurological disturbances have not been fully conducted. In this study, we determined the relationship between age-related bone change and neurological disturbance in the patients with cerebrovascular disease (CVD), Parkinson's disease (PD), peripheral neuropathy (PN), and amyotrophic lateral sclerosis (ALS).
(Methods) Bone studies were performed by DXA (Hologic, QDR 4500) and CXD (Teijin, Bonalyzer). We examined lumber supine (L1-4), the forearm (distal sites of ulna and radius), the second metacarpal of the hand, and the neck of the femur. We examined the correlation between lateralization of bone changes and clinical background of the disease. Osteopenia was evaluated by comparing with standard values of young adults (T-score, peak%). We studied clinical features of the patients such as age, onset of disease, duration of illness, characteristic signs and symptoms, and Hoehn & Yahr stage. We also examined autonomic nervous test, electrophysio-logical test in the peripheral nerves, and bone metabolic marker in blood and urine.
(RESULTS) CVD and PD patients with asymmetrical osteopenia, side of severe symptoms and predominant osteopenia were associated. In CVD Patients whose hand grip was less than 10kg, the side on which symptoms were more severe coincided with that of predominant osteopenia. Although the hand grip of PD patients was more than 10 kg, the more severely affected side as to PD symptoms and autonomic symptoms coincided with that of predominant osteopenia in the hand. Diffuse osteopenia was shown in PN.Abnormal bone metabolic maker was detected in ALS patients.
(Conclusion) Decreased bone density in neurological disorders was related to the pathophysiology of the disease. We speculated that neurological disturbances affected the remodeling of local sites of the bone.