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体感诱发电位在监测慢性炎症性脱髓鞘性多发神经根神经病患者临床病程中的作用。

Usefulness of somatosensory evoked potentials for monitoring the clinical course of patients with chronic inflammatory demyelinating polyradiculoneuropathy.

机构信息

Department of Neurology, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Barcelona, Spain.

Department of Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain.

出版信息

Muscle Nerve. 2024 Nov;70(5):1089-1094. doi: 10.1002/mus.28234. Epub 2024 Aug 12.

Abstract

INTRODUCTION/AIMS: Somatosensory evoked potentials (SSEPs) are described as a supportive tool to diagnose chronic inflammatory demyelinating polyradiculoneuropathy (CIDP); however, there is a lack of studies determining the effectiveness of SSEPs in monitoring the clinical course of individuals with this condition. The aims of this study are to evaluate the utility of SSEPs in monitoring patients with CIDP and to assess their association with clinical outcomes following immunomodulatory therapy.

METHODS

This was a single-center retrospective observational study that included patients who met European Federation of Neurological Societies and Peripheral Nerve Society criteria for CIDP between 2018 and 2023. SSEPs were performed at diagnosis and during follow-up after the start of immunomodulatory treatment. Fisher's exact test was employed to assess the association between clinical improvement and SSEP improvement.

RESULTS

Eighteen patients were included in the study. Ten patients had a typical CIDP pattern and 11 were male. In 17, SSEPs were abnormal prior to the start of immunomodulatory treatment. In patients who showed clinical improvement with immunomodulatory therapy, we observed that 15/17 had partial or complete improvement in SSEPs. Patients who showed no clinical improvement with first-line treatment exhibited worsening SSEPs. There was a significant association between clinical and SSEPs improvement (p = 0.009).

DISCUSSION

We observed a positive association between improvement in SSEPs and clinical improvement in patients with CIDP. Our data suggest that SSEPs may be useful for monitoring the clinical course of patients with CIDP, but additional, larger studies are needed.

摘要

简介/目的:体感诱发电位(SSEP)被描述为诊断慢性炎症性脱髓鞘性多发性神经病(CIDP)的辅助工具;然而,缺乏研究确定 SSEP 在监测该疾病患者临床病程中的有效性。本研究旨在评估 SSEP 在监测 CIDP 患者中的作用,并评估其与免疫调节治疗后临床结局的相关性。

方法

这是一项单中心回顾性观察研究,纳入了 2018 年至 2023 年间符合欧洲神经病学联合会和周围神经学会 CIDP 标准的患者。在诊断时和免疫调节治疗开始后的随访期间进行 SSEP。采用 Fisher 确切检验评估临床改善与 SSEP 改善之间的相关性。

结果

研究纳入了 18 例患者。10 例患者具有典型 CIDP 模式,11 例为男性。在 17 例患者中,免疫调节治疗前 SSEP 异常。在接受免疫调节治疗后临床改善的患者中,我们观察到 15/17 例患者的 SSEP 部分或完全改善。在一线治疗无临床改善的患者中,SSEP 恶化。SSEP 改善与临床改善之间存在显著相关性(p=0.009)。

讨论

我们观察到 CIDP 患者 SSEP 改善与临床改善之间存在正相关。我们的数据表明,SSEP 可能有助于监测 CIDP 患者的临床病程,但需要进一步进行更大规模的研究。

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