Departments of Neurology and Neurophysiology, Bay of Plenty District Health Board, Tauranga Hospital, Tauranga, New Zealand.
Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua, Italy.
Muscle Nerve. 2024 Dec;70(6):1263-1267. doi: 10.1002/mus.28260. Epub 2024 Sep 19.
INTRODUCTION/AIMS: In a recent study, we showed that nerve ultrasound of the upper limbs could distinguish inherited sensory neuronopathy from inherited axonopathy; surprisingly, no differences were found in the lower limb nerves. In this study, we compared lower limb nerve ultrasound measurements in inherited neuronopathy, inherited axonopathy, and acquired axonopathy.
Tibial and sural nerve ultrasound cross-sectional areas (CSAs) of 34 healthy controls were retrospectively compared with those of three patient groups: 17 with cerebellar ataxia with neuronopathy and vestibular areflexia syndrome (CANVAS), 18 with Charcot-Marie-Tooth type 2 (CMT2), and 18 with acquired length-dependent sensorimotor axonal neuropathy, using ANOVA with post-hoc Tukey honestly significance difference (HSD) (significance level set at p < .05).
The nerve CSAs of CANVAS and CMT2 patients were not significantly different. Both the tibial and the sural nerve CSAs were significantly smaller in CANVAS and CMT2 compared with the acquired axonal neuropathy group. Tibial nerve CSAs of CANVAS and CMT2 were significantly smaller than controls. Tibial and sural nerve CSAs of the acquired axonal neuropathy group were also significantly larger than the controls'.
Ultrasound of the lower limb nerves distinguished inherited from acquired axonopathy with the nerve size respectively reduced and increased in these two groups. This has potential implication for the differential diagnosis of these diseases in clinical practice.
简介/目的：在最近的一项研究中，我们发现上肢神经超声检查可以区分遗传性感觉神经元病和遗传性轴索性神经病；令人惊讶的是，下肢神经没有发现差异。在这项研究中，我们比较了遗传性神经元病、遗传性轴索性神经病和获得性轴索性神经病的下肢神经超声测量值。
回顾性比较 34 名健康对照者的胫骨和腓肠神经超声横截面积（CSA）与三个患者组：17 例小脑共济失调伴神经元病和前庭反射消失综合征（CANVAS）、18 例遗传性运动感觉轴索性神经病（CMT2）和 18 例获得性长度依赖性感觉运动轴索性神经病。采用方差分析（ANOVA），并进行事后 Tukey Honestly 显著性差异（HSD）检验（显著性水平设为 p <.05）。
CANVAS 和 CMT2 患者的神经 CSA 无显著差异。CANVAS 和 CMT2 患者的胫骨和腓肠神经 CSA 均明显小于获得性轴索性神经病组。CANVAS 和 CMT2 患者的胫骨神经 CSA 明显小于对照组。获得性轴索性神经病组的胫骨和腓肠神经 CSA 也明显大于对照组。
下肢神经超声检查可区分遗传性和获得性轴索性神经病，这两组的神经大小分别减小和增大。这对临床实践中这些疾病的鉴别诊断具有潜在意义。
