Hansen Peter N, Mohammed Abdullahi A, Markvardsen Lars K, Andersen Henning, Tankisi Hatice, Sindrup Søren H, Krøigård Thomas
Neurology Research Unit, Odense University Hospital, Odense, Denmark, University of Southern Denmark, Odense, Denmark.
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
J Peripher Nerv Syst. 2025 Mar;30(1):e70001. doi: 10.1111/jns.70001.
Loss of motor units in chronic inflammatory demyelinating polyneuropathy is difficult to assess by conventional nerve conduction due to collateral innervation. We aimed to assess the association between a motor unit number estimate (MUNE) derived from the compound muscle action potential (CMAP) scan using MScanFit and hand function and the clinical response to intravenous immunoglobulin (IVIG).
Forty-nine CIDP patients and 52 control subjects were included. CMAP scan recordings were obtained from the right abductor pollicis brevis muscle. The primary outcome was the correlation between MUNE and the duration of the nine-hole-peg test (9-HPT) at baseline and the change in the duration of the 9-HPT following treatment with IVIG. Secondary outcomes were grip strength, 10-m-walk test, six-spot-step test, medical research council sum score, inflammatory neuropathy cause and treatment sensory sum score, overall neuropathy limitations scale, and the Rasch-built overall disability scale (R-ODS).
MScanFit analysis suggested both loss of motor units (reduced MUNE (p = 0.022) and N50 (p < 0.0001)) and collateral reinnervation (increased median amplitude (p < 0.0001) and size of the largest unit (p < 0.0001)) in CIDP patients compared to controls. In CIDP patients, there was a statistically significant correlation between MUNE and the duration of the 9-HPT (Spearman's r = -0.342; p = 0.016). Further, patients with a low MUNE had the largest reduction in the duration of the 9-HPT following IVIG treatment (r = -0.577; p = 0.043). MUNE also correlated significantly with R-ODS (r = -0.722; p = 0.007).
MScanFit MUNE could be a useful method for assessing motor axonal loss in CIDP, which correlates with the clinical function and treatment response.
由于侧支神经支配，慢性炎症性脱髓鞘性多发性神经病中运动单位的丧失难以通过传统神经传导来评估。我们旨在评估使用MScanFit从复合肌肉动作电位（CMAP）扫描得出的运动单位数量估计值（MUNE）与手功能以及静脉注射免疫球蛋白（IVIG）临床反应之间的关联。
纳入49例CIDP患者和52例对照受试者。从右侧拇短展肌获取CMAP扫描记录。主要结局是基线时MUNE与九孔插针试验（9-HPT）持续时间之间的相关性，以及IVIG治疗后9-HPT持续时间的变化。次要结局包括握力、10米步行试验、六点步态试验、医学研究委员会总分、炎性神经病病因和治疗感觉总分、总体神经病限制量表以及Rasch构建的总体残疾量表（R-ODS）。
与对照组相比，MScanFit分析表明CIDP患者存在运动单位丧失（MUNE降低（p = 0.022）和N50降低（p < 0.0001））以及侧支神经再支配（中位幅度增加（p < 0.0001）和最大单位大小增加（p < 0.0001））。在CIDP患者中，MUNE与9-HPT持续时间之间存在统计学显著相关性（Spearman相关系数r = -0.342；p = 0.016）。此外，MUNE较低的患者在IVIG治疗后9-HPT持续时间的降低幅度最大（r = -0.577；p = 0.043）。MUNE与R-ODS也显著相关（r = -0.722；p = 0.007）。
MScanFit MUNE可能是评估CIDP中运动轴突丧失的一种有用方法，其与临床功能和治疗反应相关。
