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Clin Neurophysiol. 2014 Jan;125(1):160-5. doi: 10.1016/j.clinph.2013.07.023. Epub 2013 Oct 5.

Heterogeneity of root and nerve ultrasound pattern in CIDP patients.

Author information

1
Institute of Neurology, Catholic University, Rome, Italy; Don Carlo Gnocchi Onlus Foundation, Rome, Italy. Electronic address: lpadua@rm.unicatt.it.
2
Institute of Neurology, Catholic University, Rome, Italy.
3
Institute of Neurology, "Sapienza" University of Rome, Rome, Italy.
4
Department of Neurosciences, University of Padua, Padua, Italy.
5
Don Carlo Gnocchi Onlus Foundation, Rome, Italy.
6
Radiology Institute, "R" - DICMI, University of Genoa, Genoa, Italy.

Abstract

OBJECTIVE:

The few published ultrasound (US) studies on chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) report diffusely increased cross-sectional area (CSA) of nerves. The data are, however, heterogeneous and correlations with clinical history or disease severity are lacking.

METHODS:

Thirty-four patients with CIDP underwent US nerve evaluation by two neurologists blinded to clinical data. US nerve pattern for each patient was defined by a third neurologist blinded to clinical data. Three US classes were identified based on CSA and echogenicity: large nerves with hypoechoic nerves/fascicles (class 1); large nerves with heterogeneous hypo- and hyperechoic fascicles (class 2); normal size nerve but abnormal hyperechoic array (class 3).

RESULTS:

In all patients, US nerve changes were observed: in most of the cases, enlarged nerves or nerve segments were observed. The three 'classes' of US nerve changes significantly correlated (R: 0.68, p<0.001) with disease duration, but not with age or Inflammatory Neuropathy Cause and Treatment (INCAT) disability score.

CONCLUSIONS:

US may be of adjunctive diagnostic value in CIDP assessment. Nerve morphological changes may mirror the underlying pathophysiological mechanisms and seem to correlate with disease duration.

SIGNIFICANCE:

These results offer the possibility of exploring the use of US to assess CIDP disease activity and treatment.

KEYWORDS:

Autoimmune diseases; Chronic inflammatory demyelinating polyneuropathy; Peripheral neuropathy; Ultrasound

PMID:
24099922
DOI:
10.1016/j.clinph.2013.07.023
[Indexed for MEDLINE]

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