Charcot-Marie-Tooth; Chronic inflammatory demyelinating polyneuropathy; Excitability; Guillain-Barré syndrome; Motor axon; Peripheral nerve; Adult; Aged; Axons/physiology; Charcot-Marie-Tooth Disease/physiopathology; Female; Guillain-Barre Syndrome/physiopathology; Humans; Male; Median Nerve/physiology; Middle Aged; Motor Neurons/physiology; Neural Conduction/physiology; Peripheral Nervous System Diseases/physiopathology; Peroneal Nerve/physiology; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/physiopathology; Prospective Studies; Ulnar Nerve/physiology; Young Adult; Axons; Charcot-Marie-Tooth Disease; Median Nerve; Motor Neurons; Neural Conduction; Peripheral Nervous System Diseases; Peroneal Nerve; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating; Ulnar Nerve; Sensory Systems; Neurology; Neurology (clinical); Physiology (medical)
Abstract :
[en] OBJECTIVE: This study was undertaken to establish by a multicentric approach the reliability of a new technique evaluating motor axon excitability.
METHODS: The minimal threshold, the lowest stimulus intensity allowing a maximal response by 1 mA increments (iUP) and then by 0.1 mA adjustments (iMAX) were prospectively derived from three nerves (median, ulnar, fibular) in four university centers (Liège, Marseille, Fraiture, Nice). iMAX procedure was applied in 28 healthy volunteers (twice) and 32 patients with Charcot-Marie-Tooth (CMT1a), chronic inflammatory demyelinating polyneuropathy (CIDP), Guillain-Barré syndrome (SGB) or axonal neuropathy.
RESULTS: Healthy volunteers results were not significantly different between centers. Correlation coefficients between test and retest were moderate (> 0.5). Upper limits of normal were established using the 95th percentile. Comparison of volunteers and patient groups indicated significant increases in iMAX parameters especially for the CMT1a and CIDP groups. In CMT1a, iMAX abnormalities were homogeneous at the three stimulation sites, which was not the case for CIDP.
CONCLUSIONS: The iMAX procedure is reliable and allows the monitoring of motor axon excitability disorders.
SIGNIFICANCE: The iMAX technique should prove useful to monitor motor axonal excitability in routine clinical practice as it is a fast, non-invasive procedure, easily applicable without specific software or devices.
Disciplines :
Neurology
Author, co-author :
TYBERGHEIN, Maëlle ; Centre Hospitalier Universitaire de Liège - CHU > > Service de médecine de l'appareil locomoteur
Grapperon, Aude-Marie; APHM, Timone University Hospital, Referral Center for Neuromuscular Diseases and ALS, Filnemus, Euro-NMD, Marseille, France
BOUQUIAUX, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > > Service de médecine de l'appareil locomoteur ; CNRF, Neurologic Center, Fraiture, Belgium
Puma, Angela; Université Côte d'Azur, Peripheral Nervous System & Muscle Department, Pasteur 2 Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
Attarian, Shahram; APHM, Timone University Hospital, Referral Center for Neuromuscular Diseases and ALS, Filnemus, Euro-NMD, Marseille, France
WANG, François-Charles ; Centre Hospitalier Universitaire de Liège - CHU > > Service de médecine de l'appareil locomoteur
Language :
English
Title :
iMAX: A new tool for assessment of motor axon excitability. A multicenter prospective study.
Funding information: Fonds De La Recherche Scientifique ? FNRS. No role of study sponsor in data collection, analysis and interpretation and in drafting of the manuscript. If the study sponsors did not have such an implication.
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