Dupont L, Defebvre L, Davion J-B, Delval A, Tard C
Inserm, UMR-S1172 - LilNCog (Lille Neuroscience & Cognition), université de Lille, CHU de Lille, 59000 Lille, France.
Inserm, UMR-S1172 - LilNCog (Lille Neuroscience & Cognition), université de Lille, CHU de Lille, 59000 Lille, France.
Rev Neurol (Paris). 2025 Jan-Feb;181(1-2):98-105. doi: 10.1016/j.neurol.2024.10.002. Epub 2024 Oct 28.
Demyelinating polyneuropathies affect posture and can be either hereditary, as in Charcot-Marie-Tooth type 1A (CMT1A), or autoimmune, as in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Clinical differentiation between these two neuropathies can be challenging and biomarkers are lacking. No comparative analysis of their balance profiles has been conducted.
The postural balance of 23 patients with CIDP and 23 patients with CMT1A, matched for age, sex, and functional scores, were recorded using a force platform under various conditions. The effects of visual dependence were examined based on center of pressure velocity, 90% confidence ellipse area, and the Romberg quotient which represents the ratio between posturography with eyes closed and eyes open.
With eyes open, the two groups exhibited similar area and velocity. They increased their postural sway when visual input was eliminated. Nevertheless, the increase in postural sway was less pronounced in CMT1A patients than in patients with CIDP, who then had a higher Romberg quotient.
Patients with CMT1A appear to have developed compensatory mechanisms over time resulting in reduced visual dependence. Further studies are necessary to explore other compensatory mechanisms of equilibrium that could be targeted by rehabilitation for patients with CIDP.
脱髓鞘性多发性神经病会影响姿势,可分为遗传性,如1A型遗传性运动感觉神经病(CMT1A),或自身免疫性,如慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)。这两种神经病的临床鉴别可能具有挑战性,且缺乏生物标志物。尚未对它们的平衡特征进行比较分析。
使用测力平台记录23例CIDP患者和23例CMT1A患者在各种条件下的姿势平衡,这些患者在年龄、性别和功能评分方面相匹配。基于压力中心速度、90%置信椭圆面积以及代表闭眼和睁眼姿势描记法之间比率的罗姆伯格商来检查视觉依赖的影响。
睁眼时,两组的面积和速度相似。当视觉输入消除时,他们的姿势摆动增加。然而,CMT1A患者姿势摆动的增加不如CIDP患者明显,后者的罗姆伯格商更高。
随着时间的推移,CMT1A患者似乎已经形成了代偿机制,导致视觉依赖降低。有必要进一步研究探索其他平衡代偿机制,以便针对CIDP患者进行康复治疗。