Comparison of the diagnostic accuracy of the 2010 European Federation of Neurological Societies/Peripheral Nerve Society and American Association of Electrodiagnostic Medicine diagnostic criteria for multifocal motor neuropathy

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

European Journal of Neurology Pub Date : 2024-09-05 DOI:10.1111/ene.16444

Pietro Emiliano Doneddu, Chiara Gallo, Luca Gentile, Dario Cocito, Yuri Falzone, Vincenzo Di Stefano, Maurizio Inghilleri, Giuseppe Cosentino, Sabrina Matà, Anna Mazzeo, Massimiliano Filosto, Erdita Peci, Benedetta Sorrenti, Filippo Brighina, Federica Moret, Elisa Vegezzi, Martina Sperti, Barbara Risi, Eduardo Nobile-Orazio, on the behalf of the Italian MMN Database Study Group

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Abstract

Background and Purpose

This study was undertaken to compare the sensitivity and specificity of the 2010 European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) diagnostic criteria for multifocal motor neuropathy (MMN) with those of the American Association of Electrodiagnostic Medicine (AAEM).

Methods

Sensitivity and specificity of the two sets of criteria were retrospectively evaluated in 53 patients with MMN and 280 controls with axonal peripheral neuropathy, inflammatory demyelinating polyneuropathy, or amyotrophic lateral sclerosis. Comparison of the utility of nerve conduction studies with different numbers of nerves examined was also assessed.

Results

The 2010 EFNS/PNS criteria had a sensitivity of 47% for definite MMN and 57% for probable/definite MMN, whereas the AAEM criteria had a sensitivity of 28% for definite MMN and 53% for probable/definite MMN. The sensitivity of the AAEM criteria was higher when utilizing area compared to amplitude reduction to define conduction block. Using supportive criteria, the sensitivity of the 2010 EFNS/PNS criteria for probable/definite MMN increased to 64%, and an additional 36% patients fulfilled the criteria (possible MMN). Specificity values for definite and probable/definite MMN were slightly higher with the AAEM criteria (100%) compared to the EFNS/PNS criteria (98.5% and 97%). Extended nerve conduction studies yielded slightly increased diagnostic sensitivity for both sets of criteria without significantly affecting specificity.

Conclusions

In our patient populations, the 2010 EFNS/PNS criteria demonstrated higher sensitivity but slightly lower specificity compared to the AAEM criteria. Extended nerve conduction studies are advised to achieve slightly higher sensitivity while maintaining very high specificity.

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比较 2010 年欧洲神经学会联合会/周围神经学会和美国电诊断医学协会多灶性运动神经病诊断标准的诊断准确性。

背景和目的：本研究旨在比较 2010 年欧洲神经学会联合会/周围神经学会（EFNS/PNS）多灶性运动神经病（MMN）诊断标准与美国电诊断医学协会（AAEM）诊断标准的敏感性和特异性：对 53 名多灶性运动神经病患者和 280 名轴索周围神经病、炎症性脱髓鞘多发性神经病或肌萎缩性脊髓侧索硬化症的对照者进行了回顾性评估。此外，还对不同神经数量的神经传导研究的实用性进行了评估比较：2010年EFNS/PNS标准对确诊MMN的灵敏度为47%，对可能/不确定MMN的灵敏度为57%，而AAEM标准对确诊MMN的灵敏度为28%，对可能/不确定MMN的灵敏度为53%。与振幅缩小相比，AAEM 标准在使用面积来定义传导阻滞时灵敏度更高。使用支持性标准，2010 年 EFNS/PNS 标准对可能/不确定 MMN 的灵敏度提高到 64%，另有 36% 的患者符合标准（可能 MMN）。与 EFNS/PNS 标准（98.5% 和 97%）相比，AAEM 标准（100%）对明确和可能/不明确 MMN 的特异性略高。扩展神经传导研究使两套标准的诊断灵敏度略有提高，但对特异性无明显影响：在我们的患者群体中，2010 年 EFNS/PNS 标准与 AAEM 标准相比，灵敏度更高，但特异性略低。建议进行扩展神经传导研究，以获得稍高的灵敏度，同时保持极高的特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).