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Published in: Journal of Neurology 8/2021

01-08-2021 | Ultrasound | Original Communication

Changes of clinical, neurophysiological and nerve ultrasound characteristics in CIDP over time: a 3-year follow-up

Authors: Laura Fionda, Antonella Di Pasquale, Stefania Morino, Luca Leonardi, Fiammetta Vanoli, Simona Loreti, Matteo Garibaldi, Antonio Lauletta, Girolamo Alfieri, Elisabetta Bucci, Marco Salvetti, Giovanni Antonini

Published in: Journal of Neurology | Issue 8/2021

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Abstract

Objectives

To evaluate, in a prospective study, high-resolution ultrasound (HRUS) changes of nerve segments in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and their relationships with clinical and electrodiagnostic (EDX) characteristics.

Methods

Twenty-three consecutive patients with CIDP were included in a 3-year follow-up (FU) study. Each patient underwent neurologic examination, EDX and HRUS study. HRUS was performed on median, ulnar and peroneal nerves, yielding a total of 319 scanned nerve segments. INCAT and MRC-sum scores, motor nerve conduction velocity (NCV), compound muscle action potential (cMAP) amplitude, and nerve cross-sectional area (NCSA) were collected at baseline and at FU end, and were used for statistical analysis. Twenty-two healthy individuals, matched to patients for age and BMI, served as controls.

Results

NCSA was higher in patients than in controls (p < 0.0001) and showed significant direct correlation with disease severity, and inverse correlation with NCV and cMAP amplitude, both at baseline and at FU end. Disease duration, clinical scores and EDX were predictors of NCSA enlargement at both time points. During FU, NCSA increased in 51% of nerve segments (p = 0.006), in correlation with INCAT increase and with NCV and cMAP reduction. Considering EDX changes in subgroups that reflect the different types of nerve damage, NCSA significantly increased in those nerve segments that from normal EDX switched to prevalent myelinopathic EDX characteristics.

Conclusions

Peripheral nerve size tends to increase over time in patients with CIDP, in correlation with clinical and EDX changes, in particular in those nerve segments that undergo a predominantly demyelinating damage.
Literature
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go back to reference Joint Task Force of the EFNS and the PNS (2010) European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of paraproteinemic demyelinating neuropathies. Report of a Joint Task Force of the European Federation of Neurological Societies and the Peripheral Nerve Society first revision. J Peripher Nerv Syst. 15(3):185–195. https://doi.org/10.1111/j.1529-8027.2010.00278.xCrossRef Joint Task Force of the EFNS and the PNS (2010) European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of paraproteinemic demyelinating neuropathies. Report of a Joint Task Force of the European Federation of Neurological Societies and the Peripheral Nerve Society first revision. J Peripher Nerv Syst. 15(3):185–195. https://​doi.​org/​10.​1111/​j.​1529-8027.​2010.​00278.​xCrossRef
Metadata
Title
Changes of clinical, neurophysiological and nerve ultrasound characteristics in CIDP over time: a 3-year follow-up
Authors
Laura Fionda
Antonella Di Pasquale
Stefania Morino
Luca Leonardi
Fiammetta Vanoli
Simona Loreti
Matteo Garibaldi
Antonio Lauletta
Girolamo Alfieri
Elisabetta Bucci
Marco Salvetti
Giovanni Antonini
Publication date
01-08-2021
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 8/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-021-10485-x

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