Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis
In this work, we aim to identify sensitive neurophysiological biomarkers of axonal degeneration in CIDP patients. A total of 16 CIDP patients, fulfilling the clinical and neurophysiological criteria for typical CIDP, treated with subcutaneous immunoglobulin (ScIg) (0.4 g/kg/week) were evaluated at b...
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ftdoajarticles:oai:doaj.org/article:84f146db56e84630932dada707e0f377 2023-05-15T16:02:04+02:00 Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis Dario Ricciardi Federica Amitrano Armando Coccia Vincenzo Todisco Francesca Trojsi Gioacchino Tedeschi Giovanni Cirillo 2022-11-01T00:00:00Z https://doi.org/10.3390/brainsci12111510 https://doaj.org/article/84f146db56e84630932dada707e0f377 EN eng MDPI AG https://www.mdpi.com/2076-3425/12/11/1510 https://doaj.org/toc/2076-3425 doi:10.3390/brainsci12111510 2076-3425 https://doaj.org/article/84f146db56e84630932dada707e0f377 Brain Sciences, Vol 12, Iss 1510, p 1510 (2022) chronic inflammatory demyelinating polyneuropathy EMG axonal degeneration motor unit analysis subcutaneous immunoglobulin Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 article 2022 ftdoajarticles https://doi.org/10.3390/brainsci12111510 2022-12-30T19:37:27Z In this work, we aim to identify sensitive neurophysiological biomarkers of axonal degeneration in CIDP patients. A total of 16 CIDP patients, fulfilling the clinical and neurophysiological criteria for typical CIDP, treated with subcutaneous immunoglobulin (ScIg) (0.4 g/kg/week) were evaluated at baseline (before ScIg treatment) and after long-term treatment with ScIg (24 months) by clinical assessment scales, nerve conduction studies (NCS) and electromyography (EMG). Conventional and non-conventional neurophysiological parameters: motor unit potential (MUP) analysis, MUP thickness and size index (SI)] and interference pattern (IP) features were evaluated after long-term treatment (24 months) and compared with a population of 16 healthy controls (HC). An increase of distal motor latency (DML) and reduced compound motor action potential (CMAP) amplitude and area in CIDP patients suggest axonal damage of motor fibers, together with a significant increase of MUP amplitude, duration and area. Analysis of non-conventional MUP parameters shows no difference for MUP thickness; however, in CIDP patients, SI is increased and IP area and amplitude values are lower than HC. Despite clinical and neurophysiological improvement after ScIg treatment, neurophysiological analysis revealed axonal degeneration of motor fibers and motor unit remodeling. Correlation analysis shows that the axonal degeneration process is related to the diagnostic and therapeutic delay. MUP area and SI parameters can detect early signs of axonal degeneration, and their introduction in clinical practice may help to identify patients with the worst outcome. Article in Journal/Newspaper DML Directory of Open Access Journals: DOAJ Articles Brain Sciences 12 11 1510 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
chronic inflammatory demyelinating polyneuropathy EMG axonal degeneration motor unit analysis subcutaneous immunoglobulin Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 |
spellingShingle |
chronic inflammatory demyelinating polyneuropathy EMG axonal degeneration motor unit analysis subcutaneous immunoglobulin Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Dario Ricciardi Federica Amitrano Armando Coccia Vincenzo Todisco Francesca Trojsi Gioacchino Tedeschi Giovanni Cirillo Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis |
topic_facet |
chronic inflammatory demyelinating polyneuropathy EMG axonal degeneration motor unit analysis subcutaneous immunoglobulin Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 |
description |
In this work, we aim to identify sensitive neurophysiological biomarkers of axonal degeneration in CIDP patients. A total of 16 CIDP patients, fulfilling the clinical and neurophysiological criteria for typical CIDP, treated with subcutaneous immunoglobulin (ScIg) (0.4 g/kg/week) were evaluated at baseline (before ScIg treatment) and after long-term treatment with ScIg (24 months) by clinical assessment scales, nerve conduction studies (NCS) and electromyography (EMG). Conventional and non-conventional neurophysiological parameters: motor unit potential (MUP) analysis, MUP thickness and size index (SI)] and interference pattern (IP) features were evaluated after long-term treatment (24 months) and compared with a population of 16 healthy controls (HC). An increase of distal motor latency (DML) and reduced compound motor action potential (CMAP) amplitude and area in CIDP patients suggest axonal damage of motor fibers, together with a significant increase of MUP amplitude, duration and area. Analysis of non-conventional MUP parameters shows no difference for MUP thickness; however, in CIDP patients, SI is increased and IP area and amplitude values are lower than HC. Despite clinical and neurophysiological improvement after ScIg treatment, neurophysiological analysis revealed axonal degeneration of motor fibers and motor unit remodeling. Correlation analysis shows that the axonal degeneration process is related to the diagnostic and therapeutic delay. MUP area and SI parameters can detect early signs of axonal degeneration, and their introduction in clinical practice may help to identify patients with the worst outcome. |
format |
Article in Journal/Newspaper |
author |
Dario Ricciardi Federica Amitrano Armando Coccia Vincenzo Todisco Francesca Trojsi Gioacchino Tedeschi Giovanni Cirillo |
author_facet |
Dario Ricciardi Federica Amitrano Armando Coccia Vincenzo Todisco Francesca Trojsi Gioacchino Tedeschi Giovanni Cirillo |
author_sort |
Dario Ricciardi |
title |
Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis |
title_short |
Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis |
title_full |
Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis |
title_fullStr |
Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis |
title_full_unstemmed |
Neurophysiological Hallmarks of Axonal Degeneration in CIDP Patients: A Pilot Analysis |
title_sort |
neurophysiological hallmarks of axonal degeneration in cidp patients: a pilot analysis |
publisher |
MDPI AG |
publishDate |
2022 |
url |
https://doi.org/10.3390/brainsci12111510 https://doaj.org/article/84f146db56e84630932dada707e0f377 |
genre |
DML |
genre_facet |
DML |
op_source |
Brain Sciences, Vol 12, Iss 1510, p 1510 (2022) |
op_relation |
https://www.mdpi.com/2076-3425/12/11/1510 https://doaj.org/toc/2076-3425 doi:10.3390/brainsci12111510 2076-3425 https://doaj.org/article/84f146db56e84630932dada707e0f377 |
op_doi |
https://doi.org/10.3390/brainsci12111510 |
container_title |
Brain Sciences |
container_volume |
12 |
container_issue |
11 |
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1510 |
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1766397696338296832 |