Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
J Clin Neurol. 2012 Jun;8(2):139-45. doi: 10.3988/jcn.2012.8.2.139. Epub 2012 Jun 29.
Charcot-Marie-Tooth disease (CMT) type 1A (CMT1A) is the demyelinating form of CMT that is significantly associated with PMP22 duplication. Some studies have found that the disease-related disabilities of these patients are correlated with their compound muscle action potentials (CMAPs), while others have suggested that they are related to the nerve conduction velocities. In the present study, we investigated the correlations between the disease-related disabilities and the electrophysiological values in a large cohort of Korean CMT1A patients.
We analyzed 167 CMT1A patients of Korean origin with PMP22 duplication using clinical and electrophysiological assessments, including the CMT neuropathy score and the functional disability scale.
Clinical motor disabilities were significantly correlated with the CMAPs but not the motor nerve conduction velocities (MNCVs). Moreover, the observed sensory impairments matched the corresponding reductions in the sensory nerve action potentials (SNAPs) but not with slowing of the sensory nerve conduction velocities (SNCVs). In addition, CMAPs were strongly correlated with the disease duration but not with the age at onset. The terminal latency index did not differ between CMT1A patients and healthy controls.
In CMT1A patients, disease-related disabilities such as muscle wasting and sensory impairment were strongly correlated with CMAPs and SNAPs but not with the MNCVs or SNCVs. Therefore, we suggest that the clinical disabilities of CMT patients are determined by the extent of axonal dysfunction.
Charcot-Marie-Tooth 病(CMT)1A 型(CMT1A)是脱髓鞘型 CMT,与 PMP22 重复显著相关。一些研究发现,这些患者的疾病相关残疾与他们的复合肌肉动作电位(CMAP)相关,而另一些研究则表明与神经传导速度相关。在本研究中,我们对大量韩国 CMT1A 患者进行了研究,以探讨疾病相关残疾与电生理学值之间的相关性。
我们分析了 167 名韩国起源的 PMP22 重复 CMT1A 患者,采用临床和电生理评估,包括 CMT 神经病评分和功能残疾量表。
临床运动障碍与 CMAPs 显著相关,与运动神经传导速度(MNCV)无关。此外,观察到的感觉损伤与相应的感觉神经动作电位(SNAPs)降低相匹配,但与感觉神经传导速度(SNCV)减慢无关。此外,CMAPs 与疾病持续时间密切相关,但与发病年龄无关。末端潜伏期指数在 CMT1A 患者和健康对照组之间无差异。
在 CMT1A 患者中,肌肉萎缩和感觉损伤等疾病相关残疾与 CMAPs 和 SNAPs 密切相关,但与 MNCV 或 SNCV 无关。因此,我们认为 CMT 患者的临床残疾取决于轴突功能障碍的程度。