The distribution pattern of nerve enlargement in clinical subtypes of chronic inflammatory demyelinating polyneuropathy

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY Journal of Neuroimaging Pub Date : 2023-10-12 DOI:10.1111/jon.13162

Jingwen Niu, Lei Zhang, Nan Hu, Liying Cui, Mingsheng Liu

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Abstract

Background and Purpose

We aim to investigate nerve enlargement patterns and their correlation with clinical subtypes and treatment response using nerve ultrasound in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Methods

Between March 2015 and December 2021, 135 CIDP patients were recruited. Nerve ultrasound and electrophysiological studies were performed on the median and ulnar nerves. The responses to intravenous immunoglobulin (IVIg) or prednisone were evaluated with the disability score.

Results

There were 99 typical CIDP cases, 10 Lewis-Sumner syndrome (LSS) cases, 15 distal acquired demyelinating symmetric neuropathy (DADS) cases, nine pure motor CIDP cases, and two pure sensory CIDP cases. Sixty (61%) typical CIDP and seven (78%) pure motor CIDP patients had moderately increased or normal cross-sectional area (CSA), and 10 (67%) DADS and seven (70%) LSS patients had significantly increased CSA. The peripheral nerve showed a diffuse enlargement pattern in 46 (51%) typical CIDP, five (50%) LSS, three (25%) DADS, and three (33%) pure motor CIDP patients and a proximal regional enlargement pattern in 11 (12%) typical CIDP, one (10%) LSS, six (50%) DADS, and four (44%) pure motor CIDP patients. Patients with diffusely moderate enlargement patterns and those with proximal regional enlargement showed a higher response rate to glucocorticoids than to IVIg.

Conclusions

Various distribution patterns of nerve enlargement existed in CIDP. Although almost all patterns could be detected in each CIDP subtype, diffusely moderate enlargement was more common in typical CIDP and LSS, while proximal regional enlargement was more common in DADS and pure motor CIDP. Different enlargement patterns might indicate different treatment responses.

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慢性炎症性脱髓鞘性多发性神经病临床亚型中神经增大的分布模式。

背景和目的：我们旨在研究慢性炎症性脱髓鞘多发性神经根神经病（CIDP）的神经扩大模式及其与临床亚型和神经超声治疗反应的相关性。方法：2015年3月至2021年12月，共招募135名CIDP患者。对正中神经和尺神经进行了神经超声和电生理研究。对静脉注射免疫球蛋白（IVIg）或泼尼松的反应用残疾评分进行评估。结果：有99例典型CIDP病例，10例Lewis Sumner综合征（LSS）病例，15例远端获得性脱髓鞘对称性神经病（DADS）病例，9例纯运动CIDP病例和2例纯感觉CIDP病例。60（61%）名典型CIDP和7（78%）名纯运动CIDP患者的截面积（CSA）中度增加或正常，10（67%）名DADS和7（70%）名LSS患者的CSA显著增加。46例（51%）典型CIDP、5例（50%）LSS、3例（25%）DADS和3例（33%）纯运动CIDP患者的外周神经呈现弥漫性增大模式，11例（12%）典型CIDD、1例（10%）LSS和6例（50%。弥漫性中度扩张型和近端区域扩张型患者对糖皮质激素的反应率高于IVIg。结论：CIDP存在多种神经扩张分布模式。尽管在每个CIDP亚型中几乎可以检测到所有模式，但在典型的CIDP和LSS中，弥漫性中度扩大更常见，而在DADS和纯运动CIDP中，近端区域扩大更常见。不同的扩大模式可能表明不同的治疗反应。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!