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

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

doi:10.1007/s00415-021-10485-x

Cited by 11 publications

(17 citation statements)

References 28 publications

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“…In some previous studies, nerve ultrasound can accurately discriminate segmental demyelinating and disintegration, and fracture and atrophy of correlative muscle fasciculus, and provide some clues for the judgment of disease severity, the selection of the treatment regimen, and the evaluation of prognosis to some extent. Nerve ultrasound can observe an increase in peripheral nerve size over time especially in demyelinated nerve segments and correlates with clinical and electrodiagnostic changes ( 25 , 26 ). The latest EAN/PNS CIDP criteria have acknowledged the application of MRI and ultrasound in possible adult CIDP patients, while systematic studies in pediatric patients are lacking.…”

Section: Overview Of Cidpmentioning

confidence: 99%

Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Association With Concomitant Diseases: Identification and Management

Chen

Tang

2022

Front. Immunol.

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Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare, heterogeneous, but treatable autoimmune-mediated peripheral neuropathy characterized by demyelination. CIDP can occur independently or simultaneously with a variety of diseases such as diabetes, monoclonal gammopathy of undetermined significance (MGUS), connective tissue disease, and HIV. It is important to identify CIDP and specific peripheral neuropathies caused by these diseases; this review aims to summarize the CIDP literatures related to diabetes, MGUS, SLE, and HIV, and to be helpful for the management of such patients.

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Section: Overview Of Cidpmentioning

confidence: 99%

Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Association With Concomitant Diseases: Identification and Management

Chen

Tang

2022

Front. Immunol.

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“…119 Ultrasound provides surrogate markers for disease severity in CIDP, such as hypervascularity, number of nerves involved and cervical nerve root CSA. 121,122 Larger nerve CSA has been correlated with slower conduction velocities on EDX testing in many 123,124 but not all studies. 125 Nerve enlargement has also been associated with clinical weakness and disability.…”

Section: Immune Mediated Polyneuropathy Chronic Inflammatory Demyelinating Polyneuropathy (Cidp)mentioning

confidence: 99%

“…125 Nerve enlargement has also been associated with clinical weakness and disability. 124,125 Additionally, ultrasound provides prognostic information in CIDP, with both decreasing intra-nerve CSA variability and normal or decreasing nerve calibre predicting treatment responsiveness. 126 Furthermore, ultrasound has potential as an outcome measure in CIDP.…”

Section: Immune Mediated Polyneuropathy Chronic Inflammatory Demyelinating Polyneuropathy (Cidp)mentioning

confidence: 99%

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Review Article “Spotlight on Ultrasonography in the Diagnosis of Peripheral Nerve Disease: The Evidence to Date”

Hannaford¹,

Vucic²,

Kiernan³

et al. 2021

IJGM

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Neuromuscular ultrasound is rapidly becoming incorporated into clinical practice as a standard tool in the assessment of peripheral nerve diseases. Ultrasound complements clinical phenotyping and electrodiagnostic evaluation, providing critical structural anatomical information to enhance diagnosis and identify structural pathology. This review article examines the evidence supporting neuromuscular ultrasound in the diagnosis of compressive mononeuropathies, traumatic nerve injury, generalised peripheral neuropathy and motor neuron disease. Extending the sonographic evaluation of nerves beyond simple morphological measurements has the potential to improve diagnostics in peripheral neuropathy, as well as advancing the understanding of pathological mechanisms, which in turn will promote precise therapies and improve therapeutic outcomes.

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“…1 Proposed biomarkers for monitoring disease activity in CIDP include serum neurofilament light chain (sNFL; marker for axon damage), 2,3 sphingomyelin (a myelin-enriched lipid), 4 electrophysiological measures such as compound muscle action potential (CMAP) 5 and motor unit number index (MUNIX), 6,7 imaging measures such as magnetic resonance imaging of peripheral nerves 8 and lower leg muscles, 9 and nerve ultrasound. [10][11][12] Most of those studies have compared patients with active CIDP to those with stable disease, and have assessed the relationship to clinical scores. Values of potential biomarkers, such as sNFL and sphingomyelin, were found to be significantly increased in CIDP patients with active disease compared to those with stable disease.…”

Section: Introductionmentioning

confidence: 99%

Disease activity in chronic inflammatory demyelinating polyneuropathy: A comparative study of clinical and skin biopsy markers

et al. 2022

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Introduction/Aims: Epidermal nerve fiber involvement in chronic inflammatory demyelinating neuropathy (CIDP) has been reported in a limited number of patients.We quantified small-fiber involvement in a mixed cohort of patients with typical CIDP and CIDP variants to evaluate relationships with clinical outcome measures at different disease stages.Methods: Intraepidermal nerve fiber densities (IENFDs) were evaluated by skin punch biopsies of 23 patients with CIDP and 13 healthy controls at the forearm, thigh, and distal leg. Skin sections were optimally interpreted in all three regions in 16 CIDP patients and 10 age-and sex-matched healthy controls. Statistical analysis was performed in these subjects. Results:The IENFDs in forearm, thigh, and distal leg were similar among seven typical CIDP and nine CIDP variants. IENFDs in those regions were significantly reduced in CIDP compared with healthy controls, with a moderate negative correlation with scores on the International Neuropathy Cause and Treatment (INCAT) Upper Limb Functional Disability Scale. The reduction in IENFD compared with controls was more remarkable in the distal leg. In clinically unstable CIDP patients, the IENFDs of distal leg and forearm were significantly reduced compared with stable CIDP patients and controls. Stable CIDP patients had significantly reduced IENFDs in distal leg and forearm compared with controls.Discussion: In this exploratory study, we confirm that small fibers are also affected in CIDP. Larger studies are needed to explore longitudinal changes of IENFD in CIDP and its relation to disease stage.

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

Cited by 11 publications

References 28 publications

Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Association With Concomitant Diseases: Identification and Management

Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Association With Concomitant Diseases: Identification and Management

Review Article “Spotlight on Ultrasonography in the Diagnosis of Peripheral Nerve Disease: The Evidence to Date”

Disease activity in chronic inflammatory demyelinating polyneuropathy: A comparative study of clinical and skin biopsy markers

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