Refining Electrophysiological Criteria in CIDP and MMN: Toward a Unified Definition of Motor Conduction Block and Proximal Temporal Dispersion.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gallo Chiara, Fasano Carla, Fonseca Angelo, Falzone Yuri, Cocito Dario, Manganelli Fiore, Matà Sabrina, Cosentino Giuseppe, Di Stefano Vincenzo, Filosto Massimiliano, Leonardi Luca, Ricciardi Dario, Mazzeo Anna, Benedetti Luana, Luigetti Marco, Solla Paolo, Inghilleri Maurizio, Habetswallner Francesco, Barilaro Alessandro, Canale Fabrizio, De Lorenzo Alberto, Ratti Adele, Cassano Emanuele, Spalletti Maddalena, Vegezzi Elisa, Brighina Filippo, Risi Barbara, Forcina Francesca, Fasolino Alessandra, Gentile Luca, Iabichella Giacomo, Beronio Alessandro, Vitali Francesca, Moret Federica, Gazzina Stefano, Cabona Corrado, Todisco Vincenzo, Nobile-Orazio Eduardo, Doneddu Pietro Emiliano, Italian CIDP and MMN Database Study Groups
Аннотация
METHODS: Nerve conduction waveforms from 106 CIDP, 87 MMN, and 234 controls were analyzed. Motor CB was defined by ≥ 30%, ≥ 40%, or ≥ 50% amplitude or area reduction. Proximal TD was defined as a ≥ 30% increase in negative peak duration, total CMAP duration, or either criterion. Sensitivity, specificity, and inter-rater reliability were analyzed.
RESULTS: Across both CIDP and MMN, a ≥ 30% reduction in CMAP amplitude showed diagnostic performance comparable to area-based CB definitions and outperformed higher cutoff values. Requiring CB in multiple nerves increased specificity but reduced sensitivity. For proximal TD, negative peak duration was the most robust single parameter. Total CMAP duration identified additional abnormalities and, when combined with negative peak duration, improved diagnostic sensitivity in both disorders while maintaining high specificity. Total CMAP duration demonstrated good inter-rater agreement at the patient level. CMAP morphology showed substantial overlap between CIDP and MMN and limited discriminatory value.
CONCLUSIONS: A ≥ 30% reduction in CMAP amplitude can be used as a universal definition of motor CB in both CIDP and MMN, providing diagnostic performance comparable to area-based criteria with greater simplicity. In addition, proximal TD assessed using total CMAP duration may represent a complementary electrophysiological criterion in both disorders.