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Nerve excitability changes after intravenous immunoglobulin infusions in multifocal motor neuropathy and chronic inflammatory demyelinating neuropathy.
J Neurol Sci. 2010 May 15; 292(1-2):63-71.JN

Abstract

Intravenous immunoglobulin (IVIg) infusions may provide clinical benefits in multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP). The short delay in the clinical response to IVIg therapy is not consistent with a process of remyelination or axonal regeneration. We assessed whether or not the efficacy of IVIg infusions in MMN and CIDP could reflect changes in axonal membrane properties and nerve excitability. Ulnar motor nerve excitability was studied before and after three to five consecutive days of IVIg infusions (0.4 g/kg/day) in 10 patients with MMN, 10 patients with CIDP, and 10 neurological controls (CTRLs). Excitability recovery cycle, stimulus-response and strength-duration properties were investigated. The recovery cycle parameters (absolute and relative refractory period durations, refractoriness and supernormality) were similar in all groups and did not change after IVIg infusions. At baseline, patients with CIDP, but not with MMN, showed a reduced strength-duration time constant (chronaxie) and increased rheobase when compared to CTRLs. After IVIg infusions, strength-duration time constant remained stable in CTRLs, but decreased in patients with MMN or CIDP. Rheobase increased in the three groups after treatment. The decreased strength-duration time constant after IVIg infusions in patients with MMN or CIDP could reflect a reduction of persistent Na(+) current, able to limit intraaxonal Na(+) accumulation and then to produce neuroprotective effects. However, this could also reflect compensatory mechanisms that did not directly underlie the therapeutic effect. Whatever the underlying process, this result revealed that IVIgs were able to produce early nerve excitability changes.

Authors+Show Affiliations

Service de Physiologie, Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique, Hôpitaux de Paris, Créteil, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20219211

Citation

Boërio, Delphine, et al. "Nerve Excitability Changes After Intravenous Immunoglobulin Infusions in Multifocal Motor Neuropathy and Chronic Inflammatory Demyelinating Neuropathy." Journal of the Neurological Sciences, vol. 292, no. 1-2, 2010, pp. 63-71.
Boërio D, Créange A, Hogrel JY, et al. Nerve excitability changes after intravenous immunoglobulin infusions in multifocal motor neuropathy and chronic inflammatory demyelinating neuropathy. J Neurol Sci. 2010;292(1-2):63-71.
Boërio, D., Créange, A., Hogrel, J. Y., Guéguen, A., Bertrand, D., & Lefaucheur, J. P. (2010). Nerve excitability changes after intravenous immunoglobulin infusions in multifocal motor neuropathy and chronic inflammatory demyelinating neuropathy. Journal of the Neurological Sciences, 292(1-2), 63-71. https://doi.org/10.1016/j.jns.2010.02.002
Boërio D, et al. Nerve Excitability Changes After Intravenous Immunoglobulin Infusions in Multifocal Motor Neuropathy and Chronic Inflammatory Demyelinating Neuropathy. J Neurol Sci. 2010 May 15;292(1-2):63-71. PubMed PMID: 20219211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nerve excitability changes after intravenous immunoglobulin infusions in multifocal motor neuropathy and chronic inflammatory demyelinating neuropathy. AU - Boërio,Delphine, AU - Créange,Alain, AU - Hogrel,Jean-Yves, AU - Guéguen,Antoine, AU - Bertrand,Dominique, AU - Lefaucheur,Jean-Pascal, Y1 - 2010/03/10/ PY - 2009/07/18/received PY - 2009/12/22/revised PY - 2010/02/02/accepted PY - 2010/3/12/entrez PY - 2010/3/12/pubmed PY - 2010/6/15/medline SP - 63 EP - 71 JF - Journal of the neurological sciences JO - J Neurol Sci VL - 292 IS - 1-2 N2 - Intravenous immunoglobulin (IVIg) infusions may provide clinical benefits in multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP). The short delay in the clinical response to IVIg therapy is not consistent with a process of remyelination or axonal regeneration. We assessed whether or not the efficacy of IVIg infusions in MMN and CIDP could reflect changes in axonal membrane properties and nerve excitability. Ulnar motor nerve excitability was studied before and after three to five consecutive days of IVIg infusions (0.4 g/kg/day) in 10 patients with MMN, 10 patients with CIDP, and 10 neurological controls (CTRLs). Excitability recovery cycle, stimulus-response and strength-duration properties were investigated. The recovery cycle parameters (absolute and relative refractory period durations, refractoriness and supernormality) were similar in all groups and did not change after IVIg infusions. At baseline, patients with CIDP, but not with MMN, showed a reduced strength-duration time constant (chronaxie) and increased rheobase when compared to CTRLs. After IVIg infusions, strength-duration time constant remained stable in CTRLs, but decreased in patients with MMN or CIDP. Rheobase increased in the three groups after treatment. The decreased strength-duration time constant after IVIg infusions in patients with MMN or CIDP could reflect a reduction of persistent Na(+) current, able to limit intraaxonal Na(+) accumulation and then to produce neuroprotective effects. However, this could also reflect compensatory mechanisms that did not directly underlie the therapeutic effect. Whatever the underlying process, this result revealed that IVIgs were able to produce early nerve excitability changes. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/20219211/Nerve_excitability_changes_after_intravenous_immunoglobulin_infusions_in_multifocal_motor_neuropathy_and_chronic_inflammatory_demyelinating_neuropathy_ DB - PRIME DP - Unbound Medicine ER -