Nerve size correlates with clinical severity in Charcot-Marie-Tooth disease 1A

Muscle Nerve. 2019 Dec;60(6):744-748. doi: 10.1002/mus.26688. Epub 2019 Sep 10.

Abstract

Introduction: Nerve cross-sectional area (CSA) is larger than normal in Charcot-Marie-Tooth disease 1A (CMT1A), although to a variable extent. We explored whether CSA is correlated with CMT clinical severity measured with neuropathy score version 2 (CMTNS2) and its examination subscore (CMTES2) in CMT1A.

Methods: We assessed 56 patients with CMT1A (42 families). They underwent nerve conduction study (NCS) and nerve high-resolution ultrasound (HRUS) of the left median, ulnar, and fibular nerves.

Results: Univariate analysis showed NCS and HRUS variables to be significantly correlated with CMTNS2 and CMTES2 and with each other. Multivariate analysis showed that ulnar motor nerve conduction velocity (β: -0.19) and fibular compound muscle action potential amplitude (-1.50) significantly influenced CMTNS2 and that median forearm CSA significantly influenced CMTNS2 (β: 5.29) and CMTES2 (4.28).

Discussion: Nerve size is significantly associated with clinical scores in CMT1A, which suggests that it might represent a potential biomarker of CMT damage and progression.

Keywords: CSA; HRUS; NCS; clinical scores; cross sectional area; high resolution ultrasound; inherited neuropathy; multivariate analysis; nerve conduction study.

MeSH terms

  • Adult
  • Charcot-Marie-Tooth Disease / diagnostic imaging
  • Charcot-Marie-Tooth Disease / pathology
  • Charcot-Marie-Tooth Disease / physiopathology*
  • Female
  • Humans
  • Male
  • Median Nerve / diagnostic imaging
  • Median Nerve / pathology
  • Median Nerve / physiopathology*
  • Middle Aged
  • Neural Conduction / physiology*
  • Organ Size
  • Peroneal Nerve / diagnostic imaging
  • Peroneal Nerve / pathology
  • Peroneal Nerve / physiopathology*
  • Severity of Illness Index
  • Ulnar Nerve / diagnostic imaging
  • Ulnar Nerve / pathology
  • Ulnar Nerve / physiopathology*
  • Ultrasonography