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
. 2025 Jun;30(2):e70017.
doi: 10.1111/jns.70017.

CIDP Treatment Outcomes Correlation With First Nerve Conduction Changes: Ascertainment of Initial and Long-Term Responders

Thapat Wannarong  1 , Michael P Skolka  1 , Natthapon Rattanathamsakul  2 , Grace Swart  1 , James B Dyck  1 , Sarah E Berini  1 , Divyanshu Dubey  1   3 , Kamal Shouman  1 , Marcus V Pinto  1 , Michelle L Mauermann  1 , Anthony J Windebank  1 , Nathan P Staff  1 , Christopher J Klein  1   3
Affiliations

CIDP Treatment Outcomes Correlation With First Nerve Conduction Changes: Ascertainment of Initial and Long-Term Responders

Thapat Wannarong et al. J Peripher Nerv Syst. 2025 Jun.

Abstract

Background and aims: Nerve conduction studies (NCS) are integral to diagnosing chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), but their role in predicting treatment outcomes remains underexplored. This study evaluates NCS changes at first follow-up (first NCS changes) as predictors of treatment success in CIDP, focusing on their correlation with clinical outcomes over time.

Methods: Newly diagnosed CIDP patients meeting the 2021 EAN/PNS criteria were retrospectively evaluated. Baseline and first follow-up NCS parameters were compared with clinical outcomes, assessed by the Neuropathy Impairment Score (NIS) and Inflammatory Neuropathy Cause and Treatment (INCAT) disability score. All patients received first-line immunotherapy (intravenous immunoglobulin, corticosteroids, or plasma exchange).

Results: Of 39 treated patients, 26 (66.7%) were responders based on improving NIS trends, while 13 (33.3%) were nonresponders. Responders showed significant improvements at the first follow-up in fibular compound muscle action potential (CMAP) amplitude, ulnar CMAP amplitude, summated CMAP amplitudes, and fibular motor conduction velocity. Changes in fibular CMAP amplitude consistently correlated with NIS (R = -0.8 to -0.6, p ≤ 0.004) and INCAT disability score improvements (R = -0.6 to -0.3, p ≤ 0.032) across all follow-up intervals up to 60 months. Ulnar and summated CMAP amplitude changes also correlated with clinical outcomes, though their associations were less sustained than those of fibular CMAP amplitude.

Interpretation: The first change in fibular CMAP amplitude is a reliable biomarker for predicting CIDP treatment response, with ulnar and summated CMAP amplitudes as alternatives when the fibular response is absent. Our findings highlight the utility of first NCS changes in monitoring and predicting treatment outcomes in CIDP.

Keywords: CIDP; INCAT; NIS; chronic inflammatory demyelinating polyradiculoneuropathy; nerve conduction study.

PubMed Disclaimer

References

    1. P. Y. K. Van den Bergh, P. A. van Doorn, R. D. M. Hadden, 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,” European Journal of Neurology 28, no. 11 (2021): 3556–3583, https://doi.org/10.1111/ene.14959.
    1. N. L. Ashworth, D. W. Zochodne, A. F. Hahn, et al., “Impact of Plasma Exchange on Indices of Demyelination in Chronic Inflammatory Demyelinating Polyradiculoneuropathy,” Muscle & Nerve 23, no. 2 (2000): 206–210, https://doi.org/10.1002/(sici)1097‐4598(200002)23:2<206::aid‐mus10&gt....
    1. P. J. Dyck, J. Daube, P. O'Brien, et al., “Plasma Exchange in Chronic Inflammatory Demyelinating Polyradiculoneuropathy,” New England Journal of Medicine 314, no. 8 (1986): 461–465, https://doi.org/10.1056/NEJM198602203140801.
    1. A. F. Hahn, C. F. Bolton, N. Pillay, et al., “Plasma‐Exchange Therapy in Chronic Inflammatory Demyelinating Polyneuropathy. A Double‐Blind, Sham‐Controlled, Cross‐Over Study,” Brain 119, no. 4 (1996): 1055–1066, https://doi.org/10.1093/brain/119.4.1055.
    1. P. J. Dyck, W. J. Litchy, K. M. Kratz, et al., “A Plasma Exchange Versus Immune Globulin Infusion Trial in Chronic Inflammatory Demyelinating Polyradiculoneuropathy,” Annals of Neurology 36, no. 6 (1994): 838–845, https://doi.org/10.1002/ana.410360607.

MeSH terms

Substances

LinkOut - more resources