Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Eur J Neurol. 2024 Dec;31(12):e16444. doi: 10.1111/ene.16444. Epub 2024 Sep 5.
This study was undertaken to compare the sensitivity and specificity of the 2010 European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) diagnostic criteria for multifocal motor neuropathy (MMN) with those of the American Association of Electrodiagnostic Medicine (AAEM).
Sensitivity and specificity of the two sets of criteria were retrospectively evaluated in 53 patients with MMN and 280 controls with axonal peripheral neuropathy, inflammatory demyelinating polyneuropathy, or amyotrophic lateral sclerosis. Comparison of the utility of nerve conduction studies with different numbers of nerves examined was also assessed.
The 2010 EFNS/PNS criteria had a sensitivity of 47% for definite MMN and 57% for probable/definite MMN, whereas the AAEM criteria had a sensitivity of 28% for definite MMN and 53% for probable/definite MMN. The sensitivity of the AAEM criteria was higher when utilizing area compared to amplitude reduction to define conduction block. Using supportive criteria, the sensitivity of the 2010 EFNS/PNS criteria for probable/definite MMN increased to 64%, and an additional 36% patients fulfilled the criteria (possible MMN). Specificity values for definite and probable/definite MMN were slightly higher with the AAEM criteria (100%) compared to the EFNS/PNS criteria (98.5% and 97%). Extended nerve conduction studies yielded slightly increased diagnostic sensitivity for both sets of criteria without significantly affecting specificity.
In our patient populations, the 2010 EFNS/PNS criteria demonstrated higher sensitivity but slightly lower specificity compared to the AAEM criteria. Extended nerve conduction studies are advised to achieve slightly higher sensitivity while maintaining very high specificity.
本研究旨在比较 2010 年欧洲神经病学会/周围神经学会（EFNS/PNS）多发性运动神经病（MMN）诊断标准与美国电诊断医学协会（AAEM）的敏感性和特异性。
回顾性评估了 53 例 MMN 患者和 280 例轴索性周围神经病、炎性脱髓鞘性多发性神经病或肌萎缩侧索硬化症对照患者的两套标准的敏感性和特异性。还评估了不同数量神经检查的神经传导研究的实用性比较。
2010 年 EFNS/PNS 标准对明确 MMN 的敏感性为 47%，对可能/明确 MMN 的敏感性为 57%，而 AAEM 标准对明确 MMN 的敏感性为 28%，对可能/明确 MMN 的敏感性为 53%。当使用面积而不是幅度降低来定义传导阻滞时，AAEM 标准的敏感性更高。使用支持性标准，2010 年 EFNS/PNS 标准对可能/明确 MMN 的敏感性增加到 64%，另外 36%的患者符合标准（可能 MMN）。与 EFNS/PNS 标准（分别为 100%和 97%）相比，AAEM 标准对明确和可能/明确 MMN 的特异性值略高（100%）。扩展神经传导研究略微提高了两套标准的诊断敏感性，而特异性没有显著影响。
在我们的患者群体中，2010 年 EFNS/PNS 标准的敏感性较高，但特异性略低。建议进行扩展神经传导研究以获得稍高的敏感性，同时保持非常高的特异性。
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