感觉神经传导中轴突退变和脱髓鞘的诊断标志物。

Diagnostic markers of axonal degeneration and demyelination in sensory nerve conduction.

作者信息

Oh Shin J, Hemmi Shoji, Hatanaka Yuki

机构信息

Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Department of Neurology, Kawasaki Medical School, Kurashiki, Okayama, Japan.

出版信息

Muscle Nerve. 2016 Jun;53(6):866-71. doi: 10.1002/mus.24950. Epub 2016 Feb 9.

DOI:10.1002/mus.24950

PMID:26501987

Abstract

INTRODUCTION

The aim of this study was to formulate diagnostic hallmarks of axonal degeneration and demyelination in sensory nerve conduction studies (NCS).

METHODS

We compared nerve conduction data obtained with surface electrode (SE) NCS and on-nerve needle (ONN) NCS in 50 cases of demyelination and 22 cases of axonal degeneration as assessed by sural nerve biopsy.

RESULTS

The overall diagnostic sensitivities of sensory nerve conduction were 26% by SE-NCS and 69% by ONN-NCS. The most helpful marker for demyelination was negative-peak nerve conduction velocity (NP-NCV), using a 36% decrease from the means in both techniques. Dispersion was also helpful in identifying demyelination. Low amplitude and absence of compound nerve action potential were indicative of general pathology in SE-NCS but of axonal degeneration in ONN-NCS.

CONCLUSION

Although diagnostic sensitivity is low, NP-NCV and dispersion can be used for diagnosis of demyelination in sensory NCS. Muscle Nerve 53: 866-871, 2016.

摘要

引言

本研究的目的是制定感觉神经传导研究（NCS）中轴索性变性和脱髓鞘的诊断标志。

方法

我们比较了通过腓肠神经活检评估的50例脱髓鞘病例和22例轴索性变性病例中，表面电极（SE）NCS和神经内针电极（ONN）NCS所获得的神经传导数据。

结果

感觉神经传导的总体诊断敏感性，SE-NCS为26%，ONN-NCS为69%。脱髓鞘最有用的标志物是负峰神经传导速度（NP-NCV），两种技术均采用较平均值降低36%作为标准。离散度对识别脱髓鞘也有帮助。低波幅和复合神经动作电位缺失在SE-NCS中提示一般病理情况，而在ONN-NCS中提示轴索性变性。