Department of Pediatrics, MetroHealth Medical Center, Cleveland, Ohio, USA.
Department of Neurology, Medical College of Georgia, Augusta, Georgia, USA.
Muscle Nerve. 2024 May;69(5):580-587. doi: 10.1002/mus.28071. Epub 2024 Mar 4.
INTRODUCTION/AIMS: Objective outcome measures in children undergoing treatment for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are lacking. The aim of the study was to record serial grip strength and motor nerve conduction studies to assess interval change.
This was a retrospective review of 16 children (8 females and 8 males; median age, 9.7 years; interquartile range, 6-13 years) with CIDP followed at a tertiary children's hospital from 2013 to 2021. Subjects were treated with intravenous immunoglobulin (IVIG). Right and left grip strength measurements were obtained at each clinic visit using a handheld dynamometer. Annual right median motor nerve conduction study data were recorded during the study period.
Mean duration of follow-up was 2.9 years. Grip strength (right: 0.19 kg/month, p < 0.001; left 0.23 kg/month, p < 0.001) and median F-wave latencies (-0.23/month, p = 0.015) showed significant improvement over time. Akaike information criterion showed time + IVIG frequency <21 days as best fit for grip strength and distal compound muscle action potential amplitude.
Our study results indicate serial grip strength measurements are a feasible and objective way to assess motor strength improvement in children with CIDP receiving immunotherapy.
简介/目的:在接受慢性炎症性脱髓鞘性多发性神经病 (CIDP) 治疗的儿童中,缺乏客观的结局测量指标。本研究的目的是记录连续的握力和运动神经传导研究,以评估间隔变化。
这是对 2013 年至 2021 年在一家三级儿童医院接受治疗的 16 名 CIDP 儿童(8 名女性和 8 名男性;中位年龄为 9.7 岁;四分位距为 6-13 岁)进行的回顾性研究。受试者接受静脉注射免疫球蛋白(IVIG)治疗。在每次就诊时,使用手持测力计测量右手和左手的握力。在研究期间,记录了每年右正中运动神经传导研究的数据。
平均随访时间为 2.9 年。握力(右侧:0.19kg/月,p<0.001;左侧 0.23kg/月,p<0.001)和正中 F 波潜伏期(-0.23/月,p=0.015)随时间显著改善。赤池信息量准则表明,时间+IVIG 频率<21 天是评估接受免疫治疗的 CIDP 儿童握力和远端复合肌肉动作电位幅度的最佳拟合。
我们的研究结果表明,连续的握力测量是评估接受免疫治疗的 CIDP 儿童运动力量改善的一种可行且客观的方法。