Ultrasound imaging (US) is largely used for visualizing peripheral nerve pathology in traumatic and entrapment neuropathies. Few data are available on the applications of US in inflammatory neuropathies. In a blinded case–control study, we evaluated the US characteristics of morphological changes and their correlations with the neurophysiological data in the nerves of a series of patientswith CIDP. An expert evaluator (ADP), blinded to clinical data, performed the US study using a 15 MHz US linear transducer, in 14 continuous CIDP patients (10 M, 5 F; median age 62, range 28–78 yrs.; median disease duration 6.5, range 1–18 yrs.; INCAT range 0–4) and in 20 age- and body mass index-matched healthy controls.Median, ulnar and peroneal nerves were scanned on both sides. Nerve cross sectional area (NCSA) was evaluated at forearm, arm and axilla for median and ulnar nerves and at popliteal fossa for peroneal nerves. Nerves were not scanned at sites of possible entrapment or compression (wrist, elbow and fibular head). Nerve conduction velocity (NCV) and CMAP Prox/Dist RATIO were measured along forearms, arms and legs. Mann–Whitney U Test was used to compare NCSA of patients and controls; linear regression analysis was used to evaluate the correlation of NCSA with neurophysiological data and with disease duration. CIDP patients showed a significant increase of NCSA of median nerve at forearm (p<0.03), arm (p<0.001) and axilla (p<0.001), and of ulnar nerve at arm (p=0.04) and axilla (p<0.005). NCSA was inversely correlated to NCV along the evaluated segments (p<0.03). Most of the nerve segments with highest NCSA had a more marked reduction of NCV and a higher frequency of conduction blocks. Finally, NCSA was inversely correlated to disease duration (p<0.03). This study shows that US is able to detect morphological changes in nerves of patients with CIDP. These changes are characterized by an increase of NCSA along the nerves of upper limbs, either in their proximal or distal segments, and are correlated to nerve functional changes, as shown by reduction of NCV and the occurrence of conduction blocks.

CORRELATIONS BETWEEN ULTRASOUND CHARACTERISTICS AND NEUROPHYSIOLOGICAL DATA IN PATIENTS WITH CHRONIC INFLAMMATORY DEMYELINATING NEUROPATHY (CIDP): A BLINDED CASE-CONTROL STUDY / Di Pasquale, A; Morino, S; Loreti, S; Garibaldi, Matteo; Antonini, Giovanni. - In: JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM. - ISSN 1085-9489. - STAMPA. - 18:(2013), pp. 31-32.

CORRELATIONS BETWEEN ULTRASOUND CHARACTERISTICS AND NEUROPHYSIOLOGICAL DATA IN PATIENTS WITH CHRONIC INFLAMMATORY DEMYELINATING NEUROPATHY (CIDP): A BLINDED CASE-CONTROL STUDY

Di Pasquale, A;GARIBALDI, MATTEO;ANTONINI, Giovanni
2013

Abstract

Ultrasound imaging (US) is largely used for visualizing peripheral nerve pathology in traumatic and entrapment neuropathies. Few data are available on the applications of US in inflammatory neuropathies. In a blinded case–control study, we evaluated the US characteristics of morphological changes and their correlations with the neurophysiological data in the nerves of a series of patientswith CIDP. An expert evaluator (ADP), blinded to clinical data, performed the US study using a 15 MHz US linear transducer, in 14 continuous CIDP patients (10 M, 5 F; median age 62, range 28–78 yrs.; median disease duration 6.5, range 1–18 yrs.; INCAT range 0–4) and in 20 age- and body mass index-matched healthy controls.Median, ulnar and peroneal nerves were scanned on both sides. Nerve cross sectional area (NCSA) was evaluated at forearm, arm and axilla for median and ulnar nerves and at popliteal fossa for peroneal nerves. Nerves were not scanned at sites of possible entrapment or compression (wrist, elbow and fibular head). Nerve conduction velocity (NCV) and CMAP Prox/Dist RATIO were measured along forearms, arms and legs. Mann–Whitney U Test was used to compare NCSA of patients and controls; linear regression analysis was used to evaluate the correlation of NCSA with neurophysiological data and with disease duration. CIDP patients showed a significant increase of NCSA of median nerve at forearm (p<0.03), arm (p<0.001) and axilla (p<0.001), and of ulnar nerve at arm (p=0.04) and axilla (p<0.005). NCSA was inversely correlated to NCV along the evaluated segments (p<0.03). Most of the nerve segments with highest NCSA had a more marked reduction of NCV and a higher frequency of conduction blocks. Finally, NCSA was inversely correlated to disease duration (p<0.03). This study shows that US is able to detect morphological changes in nerves of patients with CIDP. These changes are characterized by an increase of NCSA along the nerves of upper limbs, either in their proximal or distal segments, and are correlated to nerve functional changes, as shown by reduction of NCV and the occurrence of conduction blocks.
2013
01 Pubblicazione su rivista::01a Articolo in rivista
CORRELATIONS BETWEEN ULTRASOUND CHARACTERISTICS AND NEUROPHYSIOLOGICAL DATA IN PATIENTS WITH CHRONIC INFLAMMATORY DEMYELINATING NEUROPATHY (CIDP): A BLINDED CASE-CONTROL STUDY / Di Pasquale, A; Morino, S; Loreti, S; Garibaldi, Matteo; Antonini, Giovanni. - In: JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM. - ISSN 1085-9489. - STAMPA. - 18:(2013), pp. 31-32.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/914067
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