Heterogeneity of root and nerve ultrasound pattern in CIDP patients

Luca Padua, Mario Sabatelli, Giuseppe Granata, Marco Luigetti, M. Inghilleri, M. Lucchetta, D. Coraci, C. Martinoli, C. Briani

Research output: Contribution to journalArticle

104 Citations (Scopus)

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.
Original languageEnglish
Pages (from-to)160-165
Number of pages6
JournalClinical Neurophysiology
Volume125
DOIs
Publication statusPublished - 2013

Keywords

  • Autoimmune diseases
  • Chronic inflammatory demyelinating polineuropathy
  • Peripheral neuropathy
  • Ultrasound

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