Nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies

Pitarokoili, Kalliopi; Gold, Ralf; Fisse, Anna Lena

doi:10.1097/wco.0000000000001183

Cited by 4 publications

(4 citation statements)

References 68 publications

(100 reference statements)

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“…In the present study, the clinical examination revealing progressive distal symmetrical sensory symptoms with predominant hypoesthesia and NCS yielding a decrease mainly in SNAPs and less pronounced in CMAPs with preserved NCVs and F-wave latencies are compatible with a predominantly sensory, length-dependent axonal character of TIPN [27]. Slight CSA enlargements in distal nerves and at compression sites combined with a constant INV in HRUS can be interpreted as typical signs of an axonal, non-inflammatory neuropathy [23]. Paclitaxel hyperstabilizes the microtubules by inhibiting their depolymerization, thus leading to inhibition of mitosis and to alterations in the microtubule structure especially in distal nerve segments.…”

Section: Discussionsupporting

confidence: 61%

“…In our study, a mean sural nerve CSA of 3.3 mm 2 6 months after taxane treatment represents an increase compared to the results of a recent meta-analysis (Fisse et al [22,23], mean 2.4 mm 2 , 95% confidence interval 1.7-3.1 mm 2 ), to baseline and to the healthy control group. The healthy control group was introduced to make Lycan et al [4], taking into consideration that the sural nerve has a low interrater reliability in nerve ultrasound [26] and that multivariable analyses in small numbers can provide misleading signals despite significant results.…”

Section: Discussioncontrasting

confidence: 42%

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High‐resolution nerve ultrasound and corneal confocal microscopy in taxane‐induced polyneuropathy

Katz,

Mork,

Baghdasaryan

et al. 2023

Euro J of Neurology

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Background and purposeThe role of high‐resolution nerve ultrasound (HRUS) and corneal confocal microscopy (CCM) in the early detection of taxane‐induced polyneuropathy (TIPN) is unclear. The present prospective longitudinal controlled observational pilot study estimates the role of HRUS and CCM in the early diagnosis of TIPN in breast cancer patients.MethodsFifteen breast cancer patients receiving paclitaxel and 15 healthy age matched controls were included. Visits before and 3 weeks, 8 weeks and 6 months after treatment included clinical examination, the total neuropathy score, nerve conduction studies (NCS), monocular CCM including corneal nerve fibre length, density and branching and HRUS of bilateral median, ulnar, radial, tibial, peroneal and sural nerves. Patients were compared between different visits and to healthy controls.ResultsTotal neuropathy score increased from 2.2 at baseline to 5.8 (p < 0.001) at week 8. NCS showed a decreased sensory amplitude in the sural, radial, ulnar and median nerve after 6 months (p < 0.001). HRUS revealed a significant increase of cross‐sectional area in the sural nerve (p = 0.004), the median nerve (p = 0.003) at the carpal tunnel and the ulnar nerve in the forearm (p = 0.006) after 6 months. CCM showed no changes at different visits.ConclusionsCorneal confocal microscopy and HRUS do not detect early signs of TIPN during the paclitaxel treatment period. HRUS and NCS might detect congruent signs of an axonal, predominantly sensory polyneuropathy after 6 months. The clinical examination remains the most sensitive tool in the early detection of TIPN in breast cancer patients.

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Section: Discussionsupporting

confidence: 61%

Section: Discussioncontrasting

confidence: 42%

High‐resolution nerve ultrasound and corneal confocal microscopy in taxane‐induced polyneuropathy

Katz,

Mork,

Baghdasaryan

et al. 2023

Euro J of Neurology

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“…540 The primary advantage of nerve ultrasound lies in its non-invasive and convenient nature, enabling the assessment of peripheral neuropathy through the use of a high-resolution ultrasound probe, as opposed to skin biopsy. 541 However, the positive findings of both skin biopsy and neuroultrasound cannot be directly linked to the diagnosis of pain. 542 The primary challenge in pain diagnosis is the absence of objective standards and effective assessment approaches.…”

Section: Approaches For Pain Assessment and Diagnosismentioning

confidence: 99%

Pathology of pain and its implications for therapeutic interventions

Cao,

Xu,

Shi

et al. 2024

Sig Transduct Target Ther

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Pain is estimated to affect more than 20% of the global population, imposing incalculable health and economic burdens. Effective pain management is crucial for individuals suffering from pain. However, the current methods for pain assessment and treatment fall short of clinical needs. Benefiting from advances in neuroscience and biotechnology, the neuronal circuits and molecular mechanisms critically involved in pain modulation have been elucidated. These research achievements have incited progress in identifying new diagnostic and therapeutic targets. In this review, we first introduce fundamental knowledge about pain, setting the stage for the subsequent contents. The review next delves into the molecular mechanisms underlying pain disorders, including gene mutation, epigenetic modification, posttranslational modification, inflammasome, signaling pathways and microbiota. To better present a comprehensive view of pain research, two prominent issues, sexual dimorphism and pain comorbidities, are discussed in detail based on current findings. The status quo of pain evaluation and manipulation is summarized. A series of improved and innovative pain management strategies, such as gene therapy, monoclonal antibody, brain-computer interface and microbial intervention, are making strides towards clinical application. We highlight existing limitations and future directions for enhancing the quality of preclinical and clinical research. Efforts to decipher the complexities of pain pathology will be instrumental in translating scientific discoveries into clinical practice, thereby improving pain management from bench to bedside.

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“…High‐resolution ultrasound (HRUS) of peripheral nerves is a non‐invasive and reliable method [1] to visualize parts of the peripheral nervous system. It can be applied as a diagnostic tool in a broad spectrum of diseases of the peripheral nerves, such as entrapment syndromes, inflammatory and non‐inflammatory polyneuropathies [2, 3], and axonal degeneration, for example, in motor neuron disease [4], spinocerebellar ataxia [5] and Parkinson's disease [6]. In addition to these diagnostic applications, nerve HRUS cross‐sectional area (CSA) measurements offer a unique opportunity to analyze human peripheral nerve size in vivo over a wide age range.…”

Section: Introductionmentioning

confidence: 99%

Nerve cross‐sectional area from childhood to old age: A high‐resolution nerve ultrasound study

Philipps,

Denz,

Tahmaz

et al. 2024

Euro J of Neurology

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Background and purposeNerve cross‐sectional area (CSA) is not constant over the human lifespan. The relationship between an increasing CSA and age has been described as a linear positive correlation, but few studies have found a linear decrease in nerve size with older age. The aim of the present study was to analyze the development of nerve CSA in a healthy population from early childhood to old age using high‐resolution ultrasound.MethodsThe median, ulnar, radial and sural nerves were examined bilaterally at 18 nerve sites in 110 healthy children, adolescents and adults aged between 2 and 98 years. The CSA of every nerve site was evaluated separately and in different age groups. The correlation of CSA with age, height and weight was analyzed in a linear, logarithmic and quadratic model and correlation coefficients were compared in a goodness‐of‐fit analysis. Models were then adjusted for weight and height.ResultsLinear CSA–age correlations showed the lowest correlation coefficients for all nerve sites. An inverted parabolic curve suggesting a quadratic correlation of CSA and age was the best‐fitting model. Weight and height had a higher predictive value than age in adjusted models.ConclusionsThere is an increase in nerve size during childhood and adolescence and a trend towards a decrease in old age, suggesting an inverted parabolic curve partly explained by age‐related changes in weight and height. Enlarged nerves in elderly individuals should not be attributed to age alone.

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Nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies

Cited by 4 publications

References 68 publications

High‐resolution nerve ultrasound and corneal confocal microscopy in taxane‐induced polyneuropathy

High‐resolution nerve ultrasound and corneal confocal microscopy in taxane‐induced polyneuropathy

Pathology of pain and its implications for therapeutic interventions

Nerve cross‐sectional area from childhood to old age: A high‐resolution nerve ultrasound study

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