Which part is mostly degenerated in spinal cord in patients with HAM/TSP? a. Anterior column b. Lateral column c. Posterior column

HAM/TSP (HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis) is a neurodegenerative condition that is caused by the human T-cell lymphotropic virus type 1 (HTLV-1). This condition is characterized by progressive weakness, spasticity, and sensory disturbances in the lower limbs. In HAM/TSP, inflammation and degeneration of the spinal cord occur, leading to neurological dysfunction.

We have three options for the partes of the spinal cord that might be degenerated in HAM/TSP patients: a) Anterior column, b) Lateral column, and c) Posterior column.

HAM/TSP manifests as progressive weakness, spasticity, and sensory disturbances in the lower limbs. These symptoms suggest that the degeneration must involve the long tracts of the spinal cord responsible for motor and sensory functions. The various columns in the spinal cord consist of the following tracts: a) Anterior column: Consists of the anterior corticospinal tract, which is responsible for the control of voluntary movements. b) Lateral column: Contains the lateral corticospinal tract, which also contributes to voluntary movement, and the spinothalamic tract, which transmits pain and temperature sensations. c) Posterior column: Consists of the fasciculus gracilis and fasciculus cuneatus, which transmit proprioceptive, vibratory, and discriminative touch sensations.

Considering the symptoms of HAM/TSP, as well as the functions of each column of the spinal cord, it becomes clear that the affected area in HAM/TSP patients must include both motor and sensory tracts. Among the given options, only the lateral column contains tracts related to motor functions (lateral corticospinal tract) and pain/temperature sensations (spinothalamic tract). Degeneration of these tracts would lead to progressive weakness, spasticity, and sensory disturbances, which are the characteristic symptoms of HAM/TSP.

Based on the analysis in Step 4, the correct answer is b) Lateral column, as it is the part of the spinal cord that would most likely be degenerated in patients with HAM/TSP.