Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug;66(2):131-135.
doi: 10.1002/mus.27530. Epub 2022 Apr 2.

Different patterns of sensory nerve involvement in chronic inflammatory demyelinating polyneuropathy subtypes

Kazumoto Shibuya  1 , Atsuko Tsuneyama  1 , Sonoko Misawa  1 , Yo-Ichi Suzuki  1 , Tomoki Suichi  1 , Yuta Kojima  1 , Keigo Nakamura  1 , Hiroki Kano  1 , Ryo Ohtani  1 , Yuya Aotsuka  1 , Marie Morooka  1 , Mario Prado  1 , Satoshi Kuwabara  1
Affiliations

Different patterns of sensory nerve involvement in chronic inflammatory demyelinating polyneuropathy subtypes

Kazumoto Shibuya et al. Muscle Nerve. 2022 Aug.

Abstract

Introduction/aims: Among subtypes of chronic inflammatory demyelinating polyneuropathy (CIDP), different immune pathophysiologies have been proposed. In this study, sensory nerve conduction studies were compared among clinical subtypes to attempt to better understand the underlying pathophysiology.

Methods: A total of 138 patients with CIDP was classified into clinical subtypes: typical CIDP (N = 68), multifocal CIDP (N = 27), or other (N = 2). Patients with immunoglobulin M (IgM) neuropathy anti-myelin-associated glycoprotein neuropathy (MAG; N = 19) were also included as disease controls. Sensory nerve action potentials (SNAPs) were recorded in the median, ulnar, and superficial radial and sural nerves.

Results: SNAP amplitudes (P < .05) and conduction velocities (P < .01) in the median nerve and conduction velocities (P < .05) in the ulnar nerve were lower in typical CIDP than in multifocal CIDP, whereas those in the radial and sural nerves were comparable in each group. Low median and normal sural SNAP amplitudes were more common in typical CIDP (P < .005) than in multifocal CIDP, suggesting predominant involvement at terminal portions of the nerves.

Discussion: Terminal portions of sensory nerves are preferentially affected in typical CIDP compared with multifocal CIDP. These findings might be partially explained by the hypothesis of antibody-mediated demyelination in typical CIDP at the regions where the blood-nerve barrier is anatomically deficient, whereas multifocal CIDP predominantly affects the nerve trunks, largely due to cell-mediated demyelination, with disruption of the blood-nerve barrier.

Keywords: blood-nerve barrier; chronic inflammatory demyelinating polyneuropathy; clinical subtypes; nerve conduction study; sensory nerve action potential.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Van den Bergh PYK, van Doorn PA, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint Task Force - second revision. J Peripher Nerv Syst. 2021;26:242-268.
    1. Kuwabara S, Isose S, Mori M, et al. Different electrophysiological profiles and treatment response in ‘typical’ and ‘atypical’ chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry. 2015;86(10):1054-1059.
    1. Kuwabara S, Misawa S, Mori M, Tamura N, Kubota M, Hattori T. Long term prognosis of chronic inflammatory demyelinating polyneuropathy: a five year follow up of 38 cases. J Neurol Neurosurg Psychiatry. 2006;77(1):66-70.
    1. Shibuya K, Sugiyama A, Ito S, et al. Reconstruction magnetic resonance neurography in chronic inflammatory demyelinating polyneuropathy. Ann Neurol. 2015;77(2):333-337.
    1. Shibuya K, Tsuneyama A, Misawa S, et al. Different distribution of demyelination in chronic inflammatory demyelinating polyneuropathy subtypes. J Neuroimmunol. 2020;341:577170.

Publication types

LinkOut - more resources