Early axonal loss predicts long-term disability in chronic inflammatory demyelinating polyneuropathy
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Early axonal loss predicts long-term disability in chronic inflammatory demyelinating polyneuropathy. / Al-Zuhairy, Ali; Jakobsen, Johannes; Krarup, Christian.
In: Clinical Neurophysiology, Vol. 132, No. 4, 2021, p. 1000-1007.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Early axonal loss predicts long-term disability in chronic inflammatory demyelinating polyneuropathy
AU - Al-Zuhairy, Ali
AU - Jakobsen, Johannes
AU - Krarup, Christian
PY - 2021
Y1 - 2021
N2 - Objective: To investigate early pre-treatment nerve fiber loss as a predictor of long-term clinical outcome in chronic inflammatory demyelinating polyneuropathy (CIDP). Methods: In 14 patients, motor and sensory conduction studies of the median, fibular, and sural nerves were performed at pre-treatment and follow-up 11–28 years later. Z-scores of amplitudes were combined as biomarkers of axonal loss and Z-scores of conduction properties as demyelination scores. The axonal loss was further examined by electromyography (EMG) and motor unit number estimation. Axonal and demyelination scores were compared to clinical outcomes in the Inflammatory Rasch-built Overall Disability Scale, the Neuropathy Impairment Score, and dynamometry. Results: At follow-up 12 patients walked independently, one needed support and one could not walk. The initial and follow-up axonal and demyelination scores were markedly abnormal. The initial axonal loss but not demyelination was strongly associated with both the follow-up axonal loss and the clinical measures. Moreover, delay of treatment initiation negatively influenced the axonal scores and clinical outcomes. Conclusion: In this hypothesis generating limited study, we found that axonal loss at early CIDP was highly predictive for long-term nerve fiber loss and disability. Significance: The study indicates that prompt initiation of treatment to prevent nerve fiber loss is necessary for outcome in CIDP.
AB - Objective: To investigate early pre-treatment nerve fiber loss as a predictor of long-term clinical outcome in chronic inflammatory demyelinating polyneuropathy (CIDP). Methods: In 14 patients, motor and sensory conduction studies of the median, fibular, and sural nerves were performed at pre-treatment and follow-up 11–28 years later. Z-scores of amplitudes were combined as biomarkers of axonal loss and Z-scores of conduction properties as demyelination scores. The axonal loss was further examined by electromyography (EMG) and motor unit number estimation. Axonal and demyelination scores were compared to clinical outcomes in the Inflammatory Rasch-built Overall Disability Scale, the Neuropathy Impairment Score, and dynamometry. Results: At follow-up 12 patients walked independently, one needed support and one could not walk. The initial and follow-up axonal and demyelination scores were markedly abnormal. The initial axonal loss but not demyelination was strongly associated with both the follow-up axonal loss and the clinical measures. Moreover, delay of treatment initiation negatively influenced the axonal scores and clinical outcomes. Conclusion: In this hypothesis generating limited study, we found that axonal loss at early CIDP was highly predictive for long-term nerve fiber loss and disability. Significance: The study indicates that prompt initiation of treatment to prevent nerve fiber loss is necessary for outcome in CIDP.
KW - Axonal loss
KW - Electrophysiological examination
KW - Long-term follow-up
KW - Prediction of CIDP
KW - Prognosis
U2 - 10.1016/j.clinph.2020.12.017
DO - 10.1016/j.clinph.2020.12.017
M3 - Journal article
C2 - 33581994
AN - SCOPUS:85101219165
VL - 132
SP - 1000
EP - 1007
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
SN - 1388-2457
IS - 4
ER -
ID: 259900678