Nerve cross-sectional area in vincristine-induced polyneuropathy: A nerve ultrasound pilot study

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2024-12-09 DOI:10.1111/jon.13255

Jörg Philipps, Mark Knaup, Maria Katz, Konrad Axton, Hannah Mork, Jasmin Treichel, Benjamin Lüling, Rafael Klimas, Kai Wille, Peter Dieter Schellinger, Kalliopi Pitarokoili

{"title":"Nerve cross-sectional area in vincristine-induced polyneuropathy: A nerve ultrasound pilot study","authors":"Jörg Philipps, Mark Knaup, Maria Katz, Konrad Axton, Hannah Mork, Jasmin Treichel, Benjamin Lüling, Rafael Klimas, Kai Wille, Peter Dieter Schellinger, Kalliopi Pitarokoili","doi":"10.1111/jon.13255","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Purpose</h3>\n \n <p>The role of high-resolution nerve ultrasound (HRUS) in the diagnosis of chemotherapy-induced polyneuropathy is unclear. The present prospective longitudinal controlled study evaluates the utility of HRUS in vincristine-induced polyneuropathy (VIPN).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Twelve patients receiving vincristine and 12 healthy age-matched controls were included. Visits before and 3 weeks, 8 weeks, and 6 months after the start of vincristine treatment included clinical examination, the total neuropathy score (TNS), nerve conduction studies (NCSs), and HRUS of the bilateral median, ulnar, radial, tibial, peroneal, and sural nerve cross-sectional areas (CSAs).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Median TNS increased from 0 points (interquartile range [IQR] 0) to 0.5 points (IQR 1, <i>p</i> = .26) at Week 3 and to 4 points (IQR 2.5, <i>p</i> < .001) at Week 8. At 6 months, there was a nonsignificant decrease to 2 points (IQR 2, <i>p</i> = .66). HRUS of individual nerve sites showed no significant changes in CSA and intranerve variability. The total CSA of all entrapment sites increased significantly (<i>p</i> = .007) at Week 8. Sensory nerve action potentials decreased significantly after 6 months (sural nerve, <i>p</i> = .001; radial nerve, <i>p</i> = .004; ulnar and median nerve, <i>p</i> < .001). The tibial nerve compound muscle action potential (<i>p</i> = .006) and nerve conduction velocity (<i>p</i> < .001) were reduced.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>At mid-treatment, there is an increase in the total CSA at entrapment sites parallel to an increase in clinical symptoms. In individual nerve sites, HRUS does not detect significant signs of VIPN. NCSs exhibit signs of a predominantly sensory axonal polyneuropathy. The clinical examination remains the most sensitive tool in the early detection of VIPN.</p>\n </section>\n </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628663/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuroimaging","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jon.13255","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and Purpose

The role of high-resolution nerve ultrasound (HRUS) in the diagnosis of chemotherapy-induced polyneuropathy is unclear. The present prospective longitudinal controlled study evaluates the utility of HRUS in vincristine-induced polyneuropathy (VIPN).

Methods

Twelve patients receiving vincristine and 12 healthy age-matched controls were included. Visits before and 3 weeks, 8 weeks, and 6 months after the start of vincristine treatment included clinical examination, the total neuropathy score (TNS), nerve conduction studies (NCSs), and HRUS of the bilateral median, ulnar, radial, tibial, peroneal, and sural nerve cross-sectional areas (CSAs).

Results

Median TNS increased from 0 points (interquartile range [IQR] 0) to 0.5 points (IQR 1, p = .26) at Week 3 and to 4 points (IQR 2.5, p < .001) at Week 8. At 6 months, there was a nonsignificant decrease to 2 points (IQR 2, p = .66). HRUS of individual nerve sites showed no significant changes in CSA and intranerve variability. The total CSA of all entrapment sites increased significantly (p = .007) at Week 8. Sensory nerve action potentials decreased significantly after 6 months (sural nerve, p = .001; radial nerve, p = .004; ulnar and median nerve, p < .001). The tibial nerve compound muscle action potential (p = .006) and nerve conduction velocity (p < .001) were reduced.

Conclusions

At mid-treatment, there is an increase in the total CSA at entrapment sites parallel to an increase in clinical symptoms. In individual nerve sites, HRUS does not detect significant signs of VIPN. NCSs exhibit signs of a predominantly sensory axonal polyneuropathy. The clinical examination remains the most sensitive tool in the early detection of VIPN.

Abstract Image

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!