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Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy.
Clin Neurophysiol. 2014 Mar; 125(3):635-41.CN

Abstract

OBJECTIVE

Aim of this study was to develop and evaluate the applicability of an ultrasound score (Bochum ultrasound score - BUS) in distinguishing chronic (CIDP) from acute inflammatory demyelinating polyneuropathy (AIDP).

METHODS

Step 1: For the development of BUS 75 healthy-controls, 20 CIDP, 20 AIDP patients underwent US 4.55 ± 3.5 and 3.4 ± 2.91 years, respectively after onset. After comparing the distribution pattern and frequency of pathological US changes between the two study groups, we developed BUS, summarizing the cross sectional area (CSA) of: (1) the ulnar nerve in Guyons' canal, (2) the ulnar nerve in upper-arm, (3) the radial nerve in spiral groove, (4) the sural nerve between the gastrocnemius muscle. Step 2: The BUS underwent blinded evaluation in further 10 CIDP, 21 AIDP patients 3.8 ± 2.7 and 2.3 ± 1.5 years, respectively after onset. Step 3: The BUS underwent blinded, prospective evaluation in 8 patients with acute/subacute polyradiculoneuropathy (5 CIDP, 3 AIDP) 2.6 ± 1.8 weeks after onset.

RESULTS

The BUS showed a sensitivity of 90% and specificity of 90.4% (positive predictive value, PPV=81.8%; negative predictive value, NPV=95%) in distinguishing CIDP from AIDP, when they showed no differences in disease duration (p=0.0551).In addition, the BUS distinguished subacute-CIDP from AIDP with a sensitivity of 80%, specificity of 100% (PPV=100%, NPV=75%).

CONCLUSION

The BUS seems to allow a reliable distinction of CIDP from AIDP.

SIGNIFICANCE

The BUS may be helpful in distinguishing subacute-CIDP from AIDP.

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Authors+Show Affiliations

Kerasnoudis A
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: antonis.kerasnoudis@gmail.com.
Pitarokoili K
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: kalliapit@yahoo.gr.
Behrendt V
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: volker.behrendt@gmx.net.
Gold R
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: Ralf.Gold@ruhr-uni-bochum.de.
Yoon MS
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: min-suk.yoon@uni-due.de.

MeSH

AdultAgedCross-Sectional StudiesDiagnosis, DifferentialFemaleGuillain-Barre SyndromeHumansMaleMiddle AgedProspective StudiesRadial NerveSensitivity and SpecificitySural NerveUlnar NerveUltrasonography

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

24070674

Clinical Trial Links

Ultrasonography and Electrophysiology in GBS

Citation

Kerasnoudis, A, et al. "Nerve Ultrasound Score in Distinguishing Chronic From Acute Inflammatory Demyelinating Polyneuropathy." Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, vol. 125, no. 3, 2014, pp. 635-41.
Kerasnoudis A, Pitarokoili K, Behrendt V, et al. Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy. Clin Neurophysiol. 2014;125(3):635-41.
Kerasnoudis, A., Pitarokoili, K., Behrendt, V., Gold, R., & Yoon, M. S. (2014). Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 125(3), 635-41. https://doi.org/10.1016/j.clinph.2013.08.014
Kerasnoudis A, et al. Nerve Ultrasound Score in Distinguishing Chronic From Acute Inflammatory Demyelinating Polyneuropathy. Clin Neurophysiol. 2014;125(3):635-41. PubMed PMID: 24070674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy. AU - Kerasnoudis,A, AU - Pitarokoili,K, AU - Behrendt,V, AU - Gold,R, AU - Yoon,M-S, Y1 - 2013/09/23/ PY - 2013/06/26/received PY - 2013/08/04/revised PY - 2013/08/08/accepted PY - 2013/9/28/entrez PY - 2013/9/28/pubmed PY - 2014/11/5/medline KW - Acute inflammatory demyelinating polyneuropathy KW - Bochum ultrasound score KW - Chronic inflammatory demyelinating polyneuropathy KW - Cross sectional area KW - Guillain–Barre syndrome SP - 635 EP - 41 JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology JO - Clin Neurophysiol VL - 125 IS - 3 N2 - OBJECTIVE: Aim of this study was to develop and evaluate the applicability of an ultrasound score (Bochum ultrasound score - BUS) in distinguishing chronic (CIDP) from acute inflammatory demyelinating polyneuropathy (AIDP). METHODS: Step 1: For the development of BUS 75 healthy-controls, 20 CIDP, 20 AIDP patients underwent US 4.55 ± 3.5 and 3.4 ± 2.91 years, respectively after onset. After comparing the distribution pattern and frequency of pathological US changes between the two study groups, we developed BUS, summarizing the cross sectional area (CSA) of: (1) the ulnar nerve in Guyons' canal, (2) the ulnar nerve in upper-arm, (3) the radial nerve in spiral groove, (4) the sural nerve between the gastrocnemius muscle. Step 2: The BUS underwent blinded evaluation in further 10 CIDP, 21 AIDP patients 3.8 ± 2.7 and 2.3 ± 1.5 years, respectively after onset. Step 3: The BUS underwent blinded, prospective evaluation in 8 patients with acute/subacute polyradiculoneuropathy (5 CIDP, 3 AIDP) 2.6 ± 1.8 weeks after onset. RESULTS: The BUS showed a sensitivity of 90% and specificity of 90.4% (positive predictive value, PPV=81.8%; negative predictive value, NPV=95%) in distinguishing CIDP from AIDP, when they showed no differences in disease duration (p=0.0551).In addition, the BUS distinguished subacute-CIDP from AIDP with a sensitivity of 80%, specificity of 100% (PPV=100%, NPV=75%). CONCLUSION: The BUS seems to allow a reliable distinction of CIDP from AIDP. SIGNIFICANCE: The BUS may be helpful in distinguishing subacute-CIDP from AIDP. SN - 1872-8952 UR - https://www.unboundmedicine.com/medline/citation/24070674/Nerve_ultrasound_score_in_distinguishing_chronic_from_acute_inflammatory_demyelinating_polyneuropathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1388-2457(13)01001-8 DB - PRIME DP - Unbound Medicine ER -