慢性炎性脱髓鞘性多根神经病变的失衡和下肢震颤

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Journal of the Peripheral Nervous System Pub Date : 2023-06-14 DOI:10.1111/jns.12574
Matthew Silsby, Con Yiannikas, Alessandro F. Fois, Karl Ng, Matthew C. Kiernan, Victor S. C. Fung, Steve Vucic
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引用次数: 2

摘要

背景与目的失衡是慢性炎症性脱髓鞘性多根神经病变(CIDP)的一个突出症状。虽然对CIDP的上肢震颤进行了描述,但下肢震颤尚未得到评估。本研究的目的是确定下肢震颤是否存在于CIDP中,并评估其与失衡的潜在关系。方法前瞻性连续招募典型CIDP患者(N = 25)进行横断面观察性研究。临床表型,下肢神经传导和震颤研究,以及姿势分析。伯格平衡量表(BBS)将CIDP患者分为“良好”和“差”两组。结果32%的CIDP患者下肢震颤明显,并伴有平衡不良(bbs震颤35 [23-46],BBSNo震颤52 [44-55],p = 0.035)。除了4名站立时震颤频率较低(3.8-4.6 Hz)的患者外,双腿伸展和站立时震颤频率为10.2-12.5 Hz。体位照相分析显示44%的CIDP患者在纵轴处出现高频频谱峰(16.0±0.4 Hz)。这在那些“良好”平衡的人身上更有可能发生(40%对4%,p = 0.013)。解释:三分之一的CIDP患者存在下肢震颤,并伴有平衡能力差。姿势照相的高频峰值与CIDP中更好的平衡有关。下肢震颤和体位学评估可以作为临床平衡的重要生物标志物。
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Imbalance and lower limb tremor in chronic inflammatory demyelinating polyradiculoneuropathy

Background and Aims

Imbalance is a prominent symptom of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Although upper limb tremor in CIDP is described, lower limb tremor has not been assessed. The aim of this study was to determine whether lower limb tremor was present in CIDP and assess potential relationships with imbalance.

Methods

This was a cross-sectional observational study of prospectively recruited consecutive patients with typical CIDP (N = 25). Clinical phenotyping, lower limb nerve conduction and tremor studies, and posturography analyses were performed. The Berg Balance Scale (BBS) divided CIDP patients into those with “good” and “poor” balance.

Results

Lower limb tremor was evident in 32% of CIDP patients and associated with poor balance (BBSTremor 35 [23–46], BBSNo Tremor 52 [44–55], p = .035). Tremor frequency was 10.2–12.5 Hz with legs outstretched and on standing, apart from four patients with a lower frequency tremor (3.8–4.6 Hz) while standing. Posturography analysis revealed a high-frequency spectral peak in the vertical axis in 44% of CIDP patients (16.0 ± 0.4 Hz). This was more likely in those with “good” balance (40% vs. 4%, p = .013).

Interpretation

Lower limb tremor is present in one third of CIDP patients and is associated with poor balance. A high-frequency peak on posturography is associated with better balance in CIDP. Lower limb tremor and posturography assessments could serve as important biomarkers of balance in a clinical setting.

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来源期刊
CiteScore
6.10
自引率
7.90%
发文量
45
审稿时长
>12 weeks
期刊介绍: The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.
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