Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage
IntroductionChronic 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 w...
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.809359/full |
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| author | Jil Brünger Jil Brünger Jeremias Motte Jeremias Motte Thomas Grüter Thomas Grüter Hannah Mork Hannah Mork Yesim Bulut Yesim Bulut Anne Carolus Diamantis Athanasopoulos Diamantis Athanasopoulos Min-Suk Yoon Min-Suk Yoon Ralf Gold Ralf Gold Kalliopi Pitarokoili Kalliopi Pitarokoili Anna Lena Fisse Anna Lena Fisse |
| author_facet | Jil Brünger Jil Brünger Jeremias Motte Jeremias Motte Thomas Grüter Thomas Grüter Hannah Mork Hannah Mork Yesim Bulut Yesim Bulut Anne Carolus Diamantis Athanasopoulos Diamantis Athanasopoulos Min-Suk Yoon Min-Suk Yoon Ralf Gold Ralf Gold Kalliopi Pitarokoili Kalliopi Pitarokoili Anna Lena Fisse Anna Lena Fisse |
| author_sort | Jil Brünger |
| collection | DOAJ |
| description | IntroductionChronic 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.MethodsIn 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).ResultsThe 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%.ConclusionUsing 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. |
| first_indexed | 2024-12-17T18:37:39Z |
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| id | doaj.art-d63a23938f0a4030b77e2ccf4ca319a1 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-17T18:37:39Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-d63a23938f0a4030b77e2ccf4ca319a12022-12-21T21:37:03ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-01-011210.3389/fneur.2021.809359809359Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal DamageJil Brünger0Jil Brünger1Jeremias Motte2Jeremias Motte3Thomas Grüter4Thomas Grüter5Hannah Mork6Hannah Mork7Yesim Bulut8Yesim Bulut9Anne Carolus10Diamantis Athanasopoulos11Diamantis Athanasopoulos12Min-Suk Yoon13Min-Suk Yoon14Ralf Gold15Ralf Gold16Kalliopi Pitarokoili17Kalliopi Pitarokoili18Anna Lena Fisse19Anna Lena Fisse20Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyClinic for Neurosurgery, University Medical Center Knappschaftskrankenhaus Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, Evangelisches Krankenhaus Hattingen, Hattingen, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, GermanyImmunmediated Neuropathies Biobank (INHIBIT), Ruhr University Bochum, Bochum, GermanyIntroductionChronic 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.MethodsIn 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).ResultsThe 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%.ConclusionUsing 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.https://www.frontiersin.org/articles/10.3389/fneur.2021.809359/fullchronic inflammatory demyelinating polyneuropathyaxonal damageBochum ultrasound scorehigh-resolution ultrasonographyinflammatory neuropathy |
| spellingShingle | Jil Brünger Jil Brünger Jeremias Motte Jeremias Motte Thomas Grüter Thomas Grüter Hannah Mork Hannah Mork Yesim Bulut Yesim Bulut Anne Carolus Diamantis Athanasopoulos Diamantis Athanasopoulos Min-Suk Yoon Min-Suk Yoon Ralf Gold Ralf Gold Kalliopi Pitarokoili Kalliopi Pitarokoili Anna Lena Fisse Anna Lena Fisse Nerve Ultrasound Distinguishes Non-Inflammatory Axonal Polyneuropathy From Inflammatory Polyneuropathy With Secondary Axonal Damage Frontiers in Neurology chronic inflammatory demyelinating polyneuropathy axonal damage Bochum ultrasound score high-resolution ultrasonography inflammatory neuropathy |
| 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 | chronic inflammatory demyelinating polyneuropathy axonal damage Bochum ultrasound score high-resolution ultrasonography inflammatory neuropathy |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.809359/full |
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