Pathophysiology inferred from electrodiagnostic nerve tests and classification of polyneuropathies. Suggested guidelines

Tankisi, Hatice; Pugdahl, Kirsten; Fuglsang-Frederiksen, Anders; Johnsen, Birger; Carvalho, Mamede de; Fawcett, Peter; Labarre-Vila, Annick; Liguori, Rocco; Nix, Wilfred A.; Schofield, Ian

doi:10.1016/j.clinph.2005.04.003

Cited by 129 publications

(104 citation statements)

References 46 publications

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“…For this purpose, the amplitude and latency of the sensory (sural) and motor (proneal and tibial) nerves were recorded. The motor or sensory nerve conduction velocity of 39 m/s was adopted as the lower limit (cutoff value: below average = 2 standard deviation [SD] of the normal range) [16,33].…”

Section: Assessments and Measurementsmentioning

confidence: 99%

Dynamic stability training improves standing balance control in neuropathic patients with type 2 diabetes

Salsabili

Bahrpeyma²,

Forogh³

et al. 2011

JRRD

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Abstract-Patients with type 2 diabetic neuropathy (DN) are at an increased risk of falls due to the decreased accurate proprioceptive feedbacks. Effective balance training should treat context-specific instabilities of postural control of patients with DN. For this purpose, evaluations and balance training were designed with a 3-week baseline with evaluation after 3 weeks, followed by training over 3 weeks with reevaluation. We acquired control scores for standing balance from the Biodex stability system and fluctuations of the center of pressure. We performed repeated measure analysis of variance to test mean differences in three sessions of assessments. In addition, we compared mean differences of each pair of sessions with the least significant difference test. We used the paired t-test to compare the pure effects of trainings. Our investigation showed that the results of Biodex stability scores and force platform medial-lateral sway measurements improved statistically. Significant higher open-eyes median and mean frequency values of postural sway in the medial-lateral direction indicated that balance training allowed patients to develop control over the degree of freedom at the hip joint. In conclusion, training that compensates for disordered balance indicated by subclinical constraints with respect to the guidance effect of external visual feedback improves standing postural control in patients with type 2 DN.Clinical Trial Registration: Clinical Trial Registration: UMIN-CTR Search Clinical Trials, UMIN000004485, "Dynamic stability training can promote quiet standing control in neuropathic patients with type 2 diabetes"; http:// www.umin.ac.jp/ctr/index.htm.

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Section: Assessments and Measurementsmentioning

confidence: 99%

Dynamic stability training improves standing balance control in neuropathic patients with type 2 diabetes

Salsabili

Bahrpeyma²,

Forogh³

et al. 2011

JRRD

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“…This reflects the challenge in distinguishing secondary axonal degeneration from segmental demyelination in patients with CIDP by measuring dCMAP amplitudes in conventional NCSs as both pathologies could result in decreased dCMAP amplitudes (Harbo et al., 2008; Kuwabara et al., 2006, 2002; Tankisi et al., 2005, 2007). Based on this perspective, MUS should be considered as a complementary tool for NCSs in patients with CIDP as it can detect axonal degeneration by assessing muscle structural changes due to denervation.…”

Section: Discussionmentioning

confidence: 99%

“…, 2008; Tankisi, Pugdahl, Johnsen, & Fuglsang‐Frederiksen, 2007 ; Tankisi et al. , 2005). In nerve conduction studies (NCSs), not only axonal degeneration but also conduction block or increased temporal dispersion due to segmental demyelination result in decreased compound muscle action potential (CMAP) amplitude (Harbo et al.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative muscle ultrasound is useful for evaluating secondary axonal degeneration in chronic inflammatory demyelinating polyneuropathy

et al. 2017

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IntroductionIn chronic inflammatory demyelinating polyneuropathy (CIDP), exclusion of secondary axonal degeneration is challenging with conventional methods such as nerve conduction study (NCS), needle electromyography, and nerve biopsy. Increased echo intensity (EI) and decreased muscle thickness (MT) identified on muscle ultrasound (MUS) examination represent muscle denervation due to axonal degeneration in neurogenic disorders, suggesting MUS as a new tool to detect secondary axonal degeneration in patients with CIDP.Methods EI and MT of abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles were measured in 16 CIDP patients. Raw values were converted into z‐scores using data from 60 normal controls (NCs).ResultsSix of 45 muscles showed abnormally high EI and low MT, suggesting denervation following secondary axonal degeneration. These six muscles belonged to two patients with long disease history, unresponsiveness to treatment, and long interval from onset to initial therapy. There were no significant differences in EI and MT (p = .23 and .67, respectively) between the CIDP and NC groups, although NCS results revealed obvious demyelinating abnormalities in all CIDP patients, suggesting the fact that muscle structures will be preserved, and EI and MT will not change unless secondary axonal degeneration occurs in CIDP.Conclusion MUS is a promising tool for evaluating secondary axonal degeneration in patients with CIDP.

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“…In addition to direct, physicochemical effects, such as trapping and cross-linking of macromolecules, AGEs exert indirect, biological effects, mediated by cell surface receptors. RAGE, whose expression is positively regulated by AGEs (26), is the prototypic AGE receptor mediating AGE-induced tissue injury via induction of reactive oxygen species formation and activation of redoxsensitive signaling pathways, and CML is a major RAGE ligand (27). The finding that, despite a comparable, dramatic degree of skin denervation, patients in the KI-s groups showed a significant reduction in RAGE expression (associated with a nonsignificant decrease in CML content) in nerves and vasa nervorum compared with KD patients, supports a role for the downregulation of the AGE-RAGE pathway as a molecular mechanism underlying the improvement of neuropathy observed after successful islet transplantation.…”

Section: Limitations Of the Studymentioning

confidence: 99%

Evaluation of Polyneuropathy Markers in Type 1 Diabetic Kidney Transplant Patients and Effects of Islet Transplantation

et al. 2007

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OBJECTIVE -The purpose of this study was to evaluate whether islet transplantation may stabilize polyneuropathy in uremic type 1 diabetic patients (end-stage renal disease [ESRD] and type 1 diabetes), who received a successful islet-after-kidney transplantation (KI-s).RESEARCH DESIGN AND METHODS -Eighteen KI-s patients underwent electroneurographic tests of sural, peroneal, ulnar, and median nerves: the nerve conduction velocity (NCV) index and amplitudes of both sensory action potentials (SAPs) and compound motor action potentials (CMAPs) were analyzed longitudinally at 2, 4, and 6 years after islet transplantation. Skin content of advanced glycation end products (AGEs) and expression of their specific receptors (RAGE) were also studied at the 4-year follow-up. Nine patients with ESRD and type 1 diabetes who received kidney transplantation alone (KD) served as control subjects.RESULTS -The NCV score improved in the KI-s group up to the 4-year time point (P ϭ 0.01 versus baseline) and stabilized 2 years later, whereas the same parameter did not change significantly in the KD group throughout the follow-up period or when a cross-sectional analysis between groups was performed. Either SAP or CMAP amplitudes recovered in the KI-s group, whereas they continued worsening in KD control subjects. AGE and RAGE levels in perineurium and vasa nervorum of skin biopsies were lower in the KI-s than in the KD group (P Ͻ 0.01 for RAGE).CONCLUSIONS -Islet transplantation seems to prevent long-term worsening of polyneuropathy in patients with ESRD and type 1 diabetes who receive islets after kidney transplantation. No statistical differences between the two groups were evident on cross-sectional analysis. A reduction in AGE/RAGE expression in the peripheral nervous system was shown in patients receiving islet transplantation.

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Pathophysiology inferred from electrodiagnostic nerve tests and classification of polyneuropathies. Suggested guidelines

Cited by 129 publications

References 46 publications

Dynamic stability training improves standing balance control in neuropathic patients with type 2 diabetes

Dynamic stability training improves standing balance control in neuropathic patients with type 2 diabetes

Quantitative muscle ultrasound is useful for evaluating secondary axonal degeneration in chronic inflammatory demyelinating polyneuropathy

Evaluation of Polyneuropathy Markers in Type 1 Diabetic Kidney Transplant Patients and Effects of Islet Transplantation

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