School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Department of Clinical Neurophysiology, The Birmingham Women's and Children's Hospital NHS Foundation Trust, UK.
Inflammatory Neuropathy Clinic, University Hospitals Birmingham, Birmingham, UK.
Clin Neurophysiol. 2020 Dec;131(12):2926-2931. doi: 10.1016/j.clinph.2020.08.011. Epub 2020 Sep 3.
To explore the relationship between fatigue, standard electrophysiological parameters and number and size of functioning motor units in patients with chronic inflammatory demyelinating polyneuropathy (CIDP).
Experienced fatigue was assessed using the linearly-weighted, modified Rasch-built fatigue severity scale (R-FSS) and the multidimensional Checklist of Individual Strength (CIS). Averaged electrophysiology values were calculated from multiple nerves. Motor Unit Number Index (MUNIX) technique was utilised to assess motor unit function. Assessments were repeated in 15 patients receiving regular intravenous immunoglobulin therapy, with changes in parameters calculated.
R-FSS and CIS scores did not correlate MUNIX or MUSIX sum scores from 3 different muscles. Inverse correlation was observed only between distal CMAP area and R-FSS but not CIS scores. However, changes in distal CMAP area and R-FSS scores on repeat assessment were not correlated.
Experienced fatigue does not appear to correlate with loss of functioning motor units in patients with CIDP. Changes in experienced fatigue on repeat assessment did not correlate with changes in any of the electrophysiological parameters, suggesting fatigue experienced in CIDP is not strongly correlated with peripheral nerve dysfunction.
Nerve conduction studies and MUNIX values do not appear to be useful surrogate markers for fatigue in CIDP.
探讨慢性炎症性脱髓鞘性多发性神经病（CIDP）患者的疲劳与标准电生理参数以及功能运动单位数量和大小的关系。
使用经线性加权、改良的 Rasch 构建疲劳严重程度量表（R-FSS）和多维个体力量检查表（CIS）评估体验性疲劳。从多条神经中计算平均电生理值。使用运动单位数量指数（MUNIX）技术评估运动单位功能。对 15 名接受常规静脉免疫球蛋白治疗的患者进行重复评估，并计算参数变化。
R-FSS 和 CIS 评分与来自 3 块不同肌肉的 MUNIX 和 MUSIX 总和评分均无相关性。仅观察到远端 CMAP 面积与 R-FSS 呈负相关，而与 CIS 评分无相关性。然而，重复评估时远端 CMAP 面积和 R-FSS 评分的变化无相关性。
CIDP 患者的体验性疲劳似乎与功能丧失的运动单位无关。重复评估时体验性疲劳的变化与任何电生理参数的变化均无相关性，这表明 CIDP 中的疲劳与周围神经功能障碍相关性不强。
神经传导研究和 MUNIX 值似乎不能作为 CIDP 中疲劳的有用替代标志物。
