Neurology Department, Westmead Hospital Sydney, Westmead, New South Wales, Australia.
Neurology Department, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Muscle Nerve. 2022 Jan;65(1):43-50. doi: 10.1002/mus.27398. Epub 2021 Aug 24.
INTRODUCTION/AIMS: Imbalance is a common feature of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Intravenous immunoglobulin (IVIg) exerts clinical benefit in CIDP, including improving balance, although objective markers of efficacy are lacking. Posturography is an established objective marker of balance; therefore, this study aimed to determine the utility of posturography as an objective marker of treatment efficacy in CIDP.
Posturography was performed on 18 CIDP patients, established on IVIg infusions, and results were compared to age-matched healthy controls. CIDP patients were assessed just prior to IVIg infusion and at the mid-point of the cycle. Center of pressure (CoP) was measured and the total path traveled by CoP (Sway Path, SP) was calculated for five different conditions: feet placed in parallel 16 cm apart at the medial border with eyes open (16cmEO) and eyes closed (16cmEC); medial borders of the feet touching with eyes open (0cmEO) and eyes closed (0cmEC); and tandem stance.
The sway path (SP) was significantly increased in CIDP patients (mean SP 1191 ± 104 mm) when compared to healthy controls (mean SP 724 ± 26 mm, P < .001). The increase was most prominent during eyes closed and tandem stance conditions. Treatment with IVIg significantly reduced SP when assessing 0cmEC (1759 ± 324 mm vs. 1081 ± 134 mm, P = .019) and tandem stance (1775 ± 290 mm vs. 1152 ± 113 mm, P = .027).
Posturography detected significant improvements in balance following IVIg in CIDP patients established on maintenance therapy. As such, posturography may be considered an objective marker of treatment response in clinical management and therapeutic trials.
简介/目的:不平衡是慢性炎症性脱髓鞘性多发性神经病(CIDP)的常见特征。静脉注射免疫球蛋白(IVIg)在 CIDP 中具有临床益处,包括改善平衡,尽管缺乏疗效的客观标志物。平衡测试是平衡的既定客观标志物;因此,本研究旨在确定平衡测试作为 CIDP 治疗效果的客观标志物的效用。
对 18 名接受 IVIg 输注的 CIDP 患者进行平衡测试,并将结果与年龄匹配的健康对照组进行比较。在 IVIg 输注前和周期中期对 CIDP 患者进行评估。测量中心压力(CoP)并计算 CoP 总行程(Sway Path,SP)在五种不同条件下:双脚平行放置在 16cm 处,内侧边界睁眼(16cmEO)和闭眼(16cmEC);双脚内侧边缘接触睁眼(0cmEO)和闭眼(0cmEC);和串联姿势。
与健康对照组(平均 SP 724 ± 26mm,P <.001)相比,CIDP 患者的摇摆路径(SP)显着增加(平均 SP 1191 ± 104mm)。闭眼和串联姿势条件下的增加最为明显。在评估 0cmEC 时,IVIg 治疗显着降低了 SP(1759 ± 324mm 与 1081 ± 134mm,P =.019)和串联姿势(1775 ± 290mm 与 1152 ± 113mm,P =.027)。
在接受维持治疗的 CIDP 患者中,平衡测试检测到 IVIg 后平衡显着改善。因此,平衡测试可能被认为是临床管理和治疗试验中治疗反应的客观标志物。