Griffith Kathleen A, Dorsey Susan G, Renn Cynthia L, Zhu Shijun, Johantgen Mary E, Cornblath David R, Argyriou Andreas A, Cavaletti Guido, Merkies Ingemar S J, Alberti Paola, Postma Tjeerd J, Rossi Emanuela, Frigeni Barbara, Bruna Jordi, Velasco Roser, Kalofonos Haralabos P, Psimaras Dimitri, Ricard Damien, Pace Andrea, Galie Edvina, Briani Chiara, Dalla Torre Chiara, Faber Catharina G, Lalisang Roy I, Boogerd Willem, Brandsma Dieta, Koeppen Susanne, Hense Joerg, Storey Dawn J, Kerrigan Simon, Schenone Angelo, Fabbri Sabrina, Valsecchi Maria Grazia
Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, MD, USA.
J Peripher Nerv Syst. 2014 Jun;19(2):127-35. doi: 10.1111/jns5.12064.
Chemotherapy-induced peripheral neuropathy (CIPN) lacks standardized clinical measurement. The objective of the current secondary analysis was to examine data from the CIPN Outcomes Standardization (CI-PeriNomS) study for associations between clinical examinations and neurophysiological abnormalities. Logistic regression estimated the strength of associations of vibration, pin, and monofilament examinations with lower limb sensory and motor amplitudes. Examinations were classified as normal (0), moderately abnormal (1), or severely abnormal (2). Among 218 participants, those with class 1 upper extremity (UE) and classes 1 or 2 lower extremity (LE) monofilament abnormality were 2.79 (95% confidence interval [CI]: 1.28-6.07), 3.49 (95%CI: 1.61-7.55), and 4.42 (95%CI: 1.35-14.46) times more likely to have abnormal sural nerve amplitudes, respectively, compared to individuals with normal examinations. Likewise, those with class 2 UE and classes 1 or 2 LE vibration abnormality were 8.65 (95%CI: 1.81-41.42), 2.54 (95%CI: 1.19-5.41), and 7.47 (95%CI: 2.49-22.40) times more likely to have abnormal sural nerve amplitudes, respectively, compared to participants with normal examinations. Abnormalities in vibration and monofilament examinations are associated with abnormal sural nerve amplitudes and are useful in identifying CIPN.
化疗引起的周围神经病变(CIPN)缺乏标准化的临床测量方法。当前这项二次分析的目的是检查来自CIPN结果标准化(CI-PeriNomS)研究的数据,以探究临床检查与神经生理异常之间的关联。逻辑回归估计了振动、针刺和单丝检查与下肢感觉和运动幅度之间关联的强度。检查结果分为正常(0)、中度异常(1)或重度异常(2)。在218名参与者中,与检查结果正常的个体相比,上肢(UE)为1级且下肢(LE)为1级或2级单丝异常的参与者,腓肠神经幅度异常的可能性分别高出2.79倍(95%置信区间[CI]:1.28 - 6.07)、3.49倍(95%CI:1.61 - 7.55)和4.42倍(95%CI:1.35 - 14.46)。同样,与检查结果正常的参与者相比,上肢为2级且下肢为1级或2级振动异常的参与者,腓肠神经幅度异常的可能性分别高出8.65倍(95%CI:1.81 - 41.42)、2.54倍(95%CI:1.19 - 5.41)和7.47倍(95%CI:2.49 - 22.40)。振动和单丝检查异常与腓肠神经幅度异常相关,有助于识别CIPN。