ObjectiveTo evaluate the utility of nerve diffusion tensor imaging (DTI), nerve cross‐sectional area, and muscle magnetic resonance imaging (MRI) multiecho Dixon for assessing proximal nerve injury in chronic inflammatory demyelinating polyneuropathy (CIDP).MethodsIn this prospective observational cohort study, 11 patients with CIDP and 11 healthy controls underwent a multiparametric MRI protocol with DTI of the sciatic nerve and assessment of muscle proton‐density fat fraction of the biceps femoris and the quadriceps femoris muscles by multiecho Dixon MRI. Patients were longitudinally evaluated by MRI, clinical examination, and nerve conduction studies at baseline and after 6 months.ResultsIn sciatic nerves of CIDP patients, mean cross‐sectional area was significantly higher and fractional anisotropy value was significantly lower, compared to controls. In contrast, muscle proton‐density fat fraction was significantly higher in thigh muscles of patients with CIDP, compared to controls. MRI parameters showed high reproducibility at baseline and 6 months.InterpretationAdvanced MRI parameters demonstrate subclinical proximal nerve damage and intramuscular fat accumulation in CIDP. Data suggest DTI and multiecho Dixon MRI might be useful in estimating axonal damage and neurogenic muscle changes in CIDP.

No abstract

Dear Sirs, Whether COVID-19 can trigger Guillain-Barré syndrome (GBS) is currently controversially discussed. Recent studies in this and other journals [2-4] indicate an association. However others did not find any epidemiological evidence so far [1]. In this latter study, no significant association between COVID-19 and GBS was found. In 47 patients with GBS (of those 13 patients with definite, 12 with probable, and 22 patients without COVID-19) there was no atypical pattern in incidence, clinical presentation or response to established therapies in COVID-19 associated GBS [1]. Uniquely, a higher rate of assisted ventilation requirement was observed in GBS subsequent to COVID-19 [1]. Notably, several case series already conveyed a rapid sequence and even significant overlap of COVID-19 pneumonia and GBS [4-6]. We also observed such a rapid temporal sequence in three patients consecutively treated in our department between October 2020 and January 2021: The first patient, a 76-year-old male, presented with a reduction of his general condition and dyspnoea. Thoracic CT revealed pneumonic infiltrates typical for COVID-19. PCR analysis for SARS-CoV-2 were equivocal. Four days after hospitalization, the patient showed a rapidly evolving flaccid tetraparesis with general areflexia and phrenicobulbar involvement with consecutive requirement of intensive care. Cerebrospinal fluid (CSF) showed albuminocytologic dissociation and IgM autoantibodies against sulfatide were detected in serum (Table 1). Nerve conduction studies (NCS) revealed an axonal-demyelinating sensorimotor polyradiculoneuropathy. Intravenous immunoglobulin (IVIg) led to

No abstract

ObjectiveTo evaluate the utility of nerve magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), and muscle MRI multi-echo Dixon for assessing lower motor neuron (LMN) degeneration in amyotrophic lateral sclerosis (ALS).MethodsIn this prospective observational cohort study, 14 patients with ALS and 13 healthy controls underwent a multiparametric MRI protocol, including DTI of the sciatic nerve and assessment of muscle proton density fat fraction of the biceps femoris and the quadriceps femoris muscles by a multi-echo Dixon sequence.ResultsIn ALS patients, mean fractional anisotropy values of the sciatic nerve were significantly lower than those of healthy controls. The quadriceps femoris, but not the biceps femoris muscle, showed significantly higher intramuscular fat fractions in ALS.InterpretationOur study provides evidence that multiparametric MRI protocols might help estimate structural nerve damage and neurogenic muscle changes in ALS.

No abstract

No abstract

No abstract