Vucic S, Black K, Baldassari L E, Tick Chong P Siao, Dawson K T, Cros D
Prince of Wales Medical Research Institute and Prince of Wales Clinical School, University of New South Wales, Australia.
Clin Neurophysiol. 2007 Sep;118(9):1980-4. doi: 10.1016/j.clinph.2007.05.001. Epub 2007 Jun 28.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired demyelinating disease of the peripheral nervous system characterized by muscle weakness, areflexia or hyporeflexia, and sensory disturbances. Although short-term efficacy of intravenous immunoglobulin (IVIg) has been demonstrated in randomized-controlled trials, the data pertaining to long-term outcome in CIDP are limited. Consequently, the aim of the present study was to assess the long-term effects of IVIg on neurophysiological parameters in CIDP.
Neurophysiological records from 11 CIDP patients, treated with IVIg for 12 months, were reviewed. Nerve conduction studies were assessed at baseline, 1-year, and last follow-up.
There was a significant reduction in the frequency of conduction blocks (pre-treatment nerve segments affected 61%; last follow-up 39%, P<0.01) and a reduction in ongoing axonal loss (pre-treatment regions with spontaneous activity, 47%; post-treatment 29%, P<0.01) with IVIg treatment. Further, there was significant improvement in sensory nerve conduction studies with IVIg treatment (sensory amplitudes reduced pre-treatment, 90% nerves tested; post-treatment, 62%, P<0.01).
The present study suggests that long-term IVIg maintenance therapy improves neurophysiological parameters in CIDP. However, CIDP patients remain IVIg dependent and new conduction blocks may develop.
The present study suggests that long-term IVIg maintenance therapy improves neurophysiological parameters in CIDP, possibly by reducing the immune response and thereby fostering nerve healing.
慢性炎症性脱髓鞘性多发性神经根神经病（CIDP）是一种获得性周围神经系统脱髓鞘疾病，其特征为肌肉无力、反射消失或反射减弱以及感觉障碍。尽管静脉注射免疫球蛋白（IVIg）的短期疗效已在随机对照试验中得到证实，但关于CIDP长期预后的数据有限。因此，本研究的目的是评估IVIg对CIDP患者神经生理学参数的长期影响。
回顾了11例接受IVIg治疗12个月的CIDP患者的神经生理学记录。在基线、1年和末次随访时评估神经传导研究。
IVIg治疗后，传导阻滞频率显著降低（治疗前受影响的神经节段为61%；末次随访时为39%，P<0.01），持续性轴突丢失减少（治疗前有自发活动的区域为47%；治疗后为29%，P<0.01）。此外，IVIg治疗后感觉神经传导研究有显著改善（治疗前感觉波幅降低，90%的受试神经；治疗后为62%，P<0.01）。
本研究表明，长期IVIg维持治疗可改善CIDP患者的神经生理学参数。然而，CIDP患者仍依赖IVIg，且可能会出现新的传导阻滞。
本研究表明，长期IVIg维持治疗可改善CIDP患者的神经生理学参数，可能是通过降低免疫反应从而促进神经愈合。
