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Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage
INTRODUCTION: Chronic inflammatory demyelinating polyneuropathy (CIDP) may have a similar clinical and electrophysiological presentation to non-inflammatory axonal polyneuropathies (NIAPs) when secondary axonal damage occurs. We aimed to investigate if nerve ultrasound can help to differentiate CIDP...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831897/ https://www.ncbi.nlm.nih.gov/pubmed/35153986 http://dx.doi.org/10.3389/fneur.2021.809359 |
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author | Brünger, Jil Motte, Jeremias Grüter, Thomas Mork, Hannah Bulut, Yesim Carolus, Anne Athanasopoulos, Diamantis Yoon, Min-Suk Gold, Ralf Pitarokoili, Kalliopi Fisse, Anna Lena |
author_facet | Brünger, Jil Motte, Jeremias Grüter, Thomas Mork, Hannah Bulut, Yesim Carolus, Anne Athanasopoulos, Diamantis Yoon, Min-Suk Gold, Ralf Pitarokoili, Kalliopi Fisse, Anna Lena |
author_sort | Brünger, Jil |
collection | PubMed |
description | INTRODUCTION: Chronic inflammatory demyelinating polyneuropathy (CIDP) may have a similar clinical and electrophysiological presentation to non-inflammatory axonal polyneuropathies (NIAPs) when secondary axonal damage occurs. We aimed to investigate if nerve ultrasound can help to differentiate CIDP with additional secondary axonal damage from NIAP. METHODS: In a retrospective analysis, the cross-sectional area (CSA) of the peripheral nerves measured by ultrasound at six suitable nerve sites was compared in 95 patients with CIDP and 82 patients with NIAP. We developed the adjusted Bochum ultrasound score (aBUS) ranging from 0 to 6 resulting from the number of sites with enlarged CSA (median, ulnar, radial, and sural nerve). RESULTS: The mean CSA of patients with CIDP was enlarged at all six nerve sites compared with the mean CSA of patients with NIAP. A total of 21 patients with CIDP did not meet 2010 electrophysiological diagnostic criteria (European Academy of Neurology/Peripheral Nerve Society Guideline, EFNS/PNS criteria) for CIDP at examination timepoint but only in further follow-up, while 25 patients with NIAP fulfilled electrophysiological EFNS/PNS criteria for CIDP as “possible” or “probable” CIDP. To increase diagnostic power, we included aBUS measured by ultrasound in patients classified as “possible” or “probable” resulting in an improved specificity of 94% and a sensitivity of 59%, compared to a specificity of the EFNS/PNS criteria alone of 60% and sensitivity of 78%. CONCLUSION: Using nerve ultrasound and the aBUS as a complementary method to distinguish CIDP from NIAP in case of secondary axonal damage can facilitate the diagnosis of CIDP. |
format | Online Article Text |
id | pubmed-8831897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-88318972022-02-12 Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage Brünger, Jil Motte, Jeremias Grüter, Thomas Mork, Hannah Bulut, Yesim Carolus, Anne Athanasopoulos, Diamantis Yoon, Min-Suk Gold, Ralf Pitarokoili, Kalliopi Fisse, Anna Lena Front Neurol Neurology INTRODUCTION: Chronic inflammatory demyelinating polyneuropathy (CIDP) may have a similar clinical and electrophysiological presentation to non-inflammatory axonal polyneuropathies (NIAPs) when secondary axonal damage occurs. We aimed to investigate if nerve ultrasound can help to differentiate CIDP with additional secondary axonal damage from NIAP. METHODS: In a retrospective analysis, the cross-sectional area (CSA) of the peripheral nerves measured by ultrasound at six suitable nerve sites was compared in 95 patients with CIDP and 82 patients with NIAP. We developed the adjusted Bochum ultrasound score (aBUS) ranging from 0 to 6 resulting from the number of sites with enlarged CSA (median, ulnar, radial, and sural nerve). RESULTS: The mean CSA of patients with CIDP was enlarged at all six nerve sites compared with the mean CSA of patients with NIAP. A total of 21 patients with CIDP did not meet 2010 electrophysiological diagnostic criteria (European Academy of Neurology/Peripheral Nerve Society Guideline, EFNS/PNS criteria) for CIDP at examination timepoint but only in further follow-up, while 25 patients with NIAP fulfilled electrophysiological EFNS/PNS criteria for CIDP as “possible” or “probable” CIDP. To increase diagnostic power, we included aBUS measured by ultrasound in patients classified as “possible” or “probable” resulting in an improved specificity of 94% and a sensitivity of 59%, compared to a specificity of the EFNS/PNS criteria alone of 60% and sensitivity of 78%. CONCLUSION: Using nerve ultrasound and the aBUS as a complementary method to distinguish CIDP from NIAP in case of secondary axonal damage can facilitate the diagnosis of CIDP. Frontiers Media S.A. 2022-01-28 /pmc/articles/PMC8831897/ /pubmed/35153986 http://dx.doi.org/10.3389/fneur.2021.809359 Text en Copyright © 2022 Brünger, Motte, Grüter, Mork, Bulut, Carolus, Athanasopoulos, Yoon, Gold, Pitarokoili and Fisse. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Brünger, Jil Motte, Jeremias Grüter, Thomas Mork, Hannah Bulut, Yesim Carolus, Anne Athanasopoulos, Diamantis Yoon, Min-Suk Gold, Ralf Pitarokoili, Kalliopi Fisse, Anna Lena Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage |
title | Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage |
title_full | Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage |
title_fullStr | Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage |
title_full_unstemmed | Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage |
title_short | Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage |
title_sort | nerve ultrasound distinguishes non-inflammatory axonal polyneuropathy from inflammatory polyneuropathy with secondary axonal damage |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831897/ https://www.ncbi.nlm.nih.gov/pubmed/35153986 http://dx.doi.org/10.3389/fneur.2021.809359 |
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