Muscle & Nerve最新文献

筛选
英文 中文
Diagnostic accuracy of ultrasound and MR imaging in peroneal neuropathy: A prospective, single-center study. 超声波和磁共振成像对腓肠肌神经病的诊断准确性:前瞻性单中心研究
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-27 DOI: 10.1002/mus.28187
Christophe Oosterbos, Olaf De Weerdt, Matthias Lembrechts, Ahmed Radwan, Peter Brys, Marius Brusselmans, Kris Bogaerts, Ronald Peeters, Anaïs Van Hoylandt, Sophie Hoornaert, Robin Lemmens, Tom Theys
{"title":"Diagnostic accuracy of ultrasound and MR imaging in peroneal neuropathy: A prospective, single-center study.","authors":"Christophe Oosterbos, Olaf De Weerdt, Matthias Lembrechts, Ahmed Radwan, Peter Brys, Marius Brusselmans, Kris Bogaerts, Ronald Peeters, Anaïs Van Hoylandt, Sophie Hoornaert, Robin Lemmens, Tom Theys","doi":"10.1002/mus.28187","DOIUrl":"10.1002/mus.28187","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Magnetic resonance imaging (MRI) findings in peroneal neuropathy are not well documented and the prognostic value of imaging remains uncertain. Upper limits of cross-sectional area (CSA) on ultrasound (US) have been established, but uncertainty regarding generalizability remains. We aimed to describe MRI findings of the peroneal nerve in patients and healthy controls and to compare these results to US findings and clinical characteristics.</p><p><strong>Methods: </strong>We prospectively included patients with foot drop and electrodiagnostically confirmed peroneal neuropathy, and performed clinical follow-up, US and MRI of both peroneal nerves. We compared MRI findings to healthy controls. Two radiologists evaluated MRI features in an exploratory analysis after images were anonymized and randomized.</p><p><strong>Results: </strong>Twenty-two patients and 38 healthy controls were included. Whereas significant increased MRI CSA values were documented in patients (mean CSA 20 mm<sup>2</sup> vs. 13 mm<sup>2</sup> in healthy controls), intra- and interobserver variability was substantial (variability of, respectively, 7 and 9 mm<sup>2</sup> around the mean in 95% of repeated measurements). A pathological T2 hyperintense signal of the nerve was found in 52.6% of patients (50% interobserver agreement). Increased CSA measurements (MRI/US), pathological T2 hyperintensity of the nerve and muscle edema were not predictive for recovery.</p><p><strong>Discussion: </strong>Imaging is recommended in all patients with peroneal neuropathy to exclude compressive intrinsic and extrinsic masses but we do not advise routine MRI for diagnosis or prediction of outcome in patients with peroneal neuropathy due to high observer variability. Further studies should aim at reducing MRI observer variability potentially by semi-automation.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An atypical case of pure motor neuropathy with proximal limb weakness and polyphasic course. 一个非典型的纯运动神经病变病例,伴有近端肢体无力和多相病程。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-28 DOI: 10.1002/mus.28195
Conor W Kelly, David Lacomis, Tawfiq Al-Lahham
{"title":"An atypical case of pure motor neuropathy with proximal limb weakness and polyphasic course.","authors":"Conor W Kelly, David Lacomis, Tawfiq Al-Lahham","doi":"10.1002/mus.28195","DOIUrl":"10.1002/mus.28195","url":null,"abstract":"","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of patients' pre-treatment expectations on immunosuppressive treatment outcomes in myasthenia gravis: A pilot correlational study. 重症肌无力患者治疗前的期望对免疫抑制治疗结果的影响:一项试验性相关研究。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-28 DOI: 10.1002/mus.28189
Elisa Frisaldi, Bruno Ferrero, Alessandra Di Liberto, Diletta Barbiani, Eleonora Maria Camerone, Alessandro Piedimonte, Jan Vollert, Roberto Cavallo, Maurizio Zibetti, Leonardo Lopiano, Aziz Shaibani, Fabrizio Benedetti
{"title":"The impact of patients' pre-treatment expectations on immunosuppressive treatment outcomes in myasthenia gravis: A pilot correlational study.","authors":"Elisa Frisaldi, Bruno Ferrero, Alessandra Di Liberto, Diletta Barbiani, Eleonora Maria Camerone, Alessandro Piedimonte, Jan Vollert, Roberto Cavallo, Maurizio Zibetti, Leonardo Lopiano, Aziz Shaibani, Fabrizio Benedetti","doi":"10.1002/mus.28189","DOIUrl":"10.1002/mus.28189","url":null,"abstract":"<p><strong>Introduction/aims: </strong>The impact of treatment expectations on active treatment outcomes has not been specifically investigated in neuromuscular disorders. We thus explored in myasthenia gravis (MG) the contribution of patients' pre-treatment expectations combined with an immunosuppressant drug on treatment outcomes.</p><p><strong>Methods: </strong>This pilot correlational study involved 17 patients with generalized MG, scheduled to start immunosuppressant azathioprine. At baseline, a healthcare professional administered: (i) the Stanford Expectations of Treatment Scale; (ii) a structured checklist paper form asking patients which side-effects they expected to develop after starting azathioprine, coupled with a standardized framing of statements. Quantitative Myasthenia Gravis (QMG) score and daily dose of concomitant drugs were assessed by neurologists as clinical outcomes. Clinical outcomes and side-effects were re-assessed at 3 and 6 months, and clinical outcomes were monitored at 18 months.</p><p><strong>Results: </strong>Clinically significant improvement in the QMG scores was achieved at 3 or 6 months. The level of state anxiety appeared to act as moderator of pre-treatment negative expectations (strong, positive, indicative correlation, rs = .733, p = .001). The latter were, in turn, associated with the fulfillment of side-effects that patients expected to develop with the new treatment (moderate, positive, indicative correlation, rs = .699, p = .002). No significant correlation emerged between positive and negative expectations.</p><p><strong>Discussion: </strong>Our findings show a very quick clinical response and also suggest that patients' expectations and anxiety contributed to treatment outcomes, highlighting the importance of promoting safety messages and education strategies around newly introduced treatments. Future goals include evaluating a larger cohort that includes a matched control group.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Burden and preparedness of care partners of people living with amyotrophic lateral sclerosis at home in Korea: A care partner survey. 韩国肌萎缩侧索硬化症患者居家护理伙伴的负担和准备情况:护理伙伴调查。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-05-18 DOI: 10.1002/mus.28115
Sun Young Lee, Shin Hye Yoo, Belong Cho, Kye Hyung Kim, Min Seoul Jang, Jeongmi Shin, Inyoung Hwang, Seok-Jin Choi, Jung-Joon Sung, Min Sun Kim
{"title":"Burden and preparedness of care partners of people living with amyotrophic lateral sclerosis at home in Korea: A care partner survey.","authors":"Sun Young Lee, Shin Hye Yoo, Belong Cho, Kye Hyung Kim, Min Seoul Jang, Jeongmi Shin, Inyoung Hwang, Seok-Jin Choi, Jung-Joon Sung, Min Sun Kim","doi":"10.1002/mus.28115","DOIUrl":"10.1002/mus.28115","url":null,"abstract":"<p><strong>Introduction/aims: </strong>The care burden of people living with amyotrophic lateral sclerosis (pALS) increases with disease progression. This study aimed to investigate the home care status and preparedness of care partners of pALS (cALS) in Korea.</p><p><strong>Methods: </strong>An online survey was conducted with family care partners of patients diagnosed with ALS for over 1 year in 2022. The data collected included care time, depression evaluated using the patient health questionnaire-9 (PHQ-9), preparedness for caregiving scale (PCS), and caregiver competence scale (CCS). Results were compared based on whether the pALS underwent a tracheostomy or not.</p><p><strong>Results: </strong>Ninety-eight cALS of 98 pALS participated in the study, of whom 59 pALS had undergone tracheostomy. Among the cALS, 60.2% were spouses, and 34.7% were children. The cALS took care of the patients for 13 (8-20) hours/day (median, interquartile range [IQR]) on weekdays and 15 (10-24) h/day on weekends. Among the cALS, 91.8% were depressed, and 28.6% had severe depression. The median (IQR) PCS and CCS scores were low (11/32 (8-15) and 8/20 (8-11), respectively), and both were lower in those caring for patients without than with tracheostomy (p < .001 and p < .02, respectively). Most cALS (77.6%) wished to continue caring for their pALS at home.</p><p><strong>Discussion: </strong>Family care partners of pALS spend more than half of each day caring for patients and are often depressed. Most cALS preferred providing care at home, but felt ill-prepared. Designing home-based medical care is necessary for pALS to thrive at home.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Refining quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome to account for acceptable variations in practice: Expert review process. 完善疑似腕管综合征电诊断测试的质量标准,以考虑可接受的实践差异:专家评审过程。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-12 DOI: 10.1002/mus.28176
Kanaka D Shetty, Aashna R Basu, Teryl K Nuckols
{"title":"Refining quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome to account for acceptable variations in practice: Expert review process.","authors":"Kanaka D Shetty, Aashna R Basu, Teryl K Nuckols","doi":"10.1002/mus.28176","DOIUrl":"10.1002/mus.28176","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Using a set of process-of-care quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome (CTS), the research team previously documented large variations in electrodiagnostic testing practices and adherence to quality measures. This study sought to enhance the applicability and validity of the quality measures by integrating acceptable variations in testing practices.</p><p><strong>Methods: </strong>We recruited 13 expert electrodiagnostic medicine specialists from five specialty societies. The experts iteratively refined five quality measures, and then rated the validity of the refined quality measures (1-9 scale). During this process, the experts reviewed data on adherence to existing quality measures and variations in electrodiagnostic testing practices, and considered recently published quality measures from the American Association of Neuromuscular and Electrodiagnostic Medicine.</p><p><strong>Results: </strong>Three quality measures (electrodiagnostic testing before surgery for CTS, temperature assessment during electrodiagnostic testing, and electrodiagnostic criteria for severe median neuropathy) underwent few refinements and were rated valid (medians 8-9). Two measures (essential components of electrodiagnosis, criteria for interpreting electrodiagnostic tests as median neuropathy) were judged valid (medians 8) after revisions. For these measures, experts' ratings on the recommended components of sensory or mixed nerve conduction studies varied: agreement among the experts about the use of sensory peak latency was greater than for onset latency or sensory velocity.</p><p><strong>Discussion: </strong>This study produced quality measures that provide minimum standards for electrodiagnostic testing for suspected CTS that are more comprehensive and nuanced than prior versions. Future work can assess the feasibility, reliability, and validity of these refined measures in diverse physician practices.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a major histocompatibility complex class II conditional knockout mouse to study cell-specific and time-dependent adaptive immune responses in peripheral nerves. 开发主要组织相容性复合体 II 类条件性基因敲除小鼠,以研究周围神经中细胞特异性和时间依赖性的适应性免疫反应。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-26 DOI: 10.1002/mus.28193
Eroboghene E Ubogu, Jeremy A Conner, Yimin Wang, Dinesh Yadav, Thomas L Saunders
{"title":"Development of a major histocompatibility complex class II conditional knockout mouse to study cell-specific and time-dependent adaptive immune responses in peripheral nerves.","authors":"Eroboghene E Ubogu, Jeremy A Conner, Yimin Wang, Dinesh Yadav, Thomas L Saunders","doi":"10.1002/mus.28193","DOIUrl":"10.1002/mus.28193","url":null,"abstract":"<p><strong>Introduction/aims: </strong>The precise relationship between molecular mimicry and tissue-specific autoimmunity is unknown. Major histocompatibility complex (MHC) class II antigen presenting cell-CD4+ T-cell receptor complex interactions are necessary for adaptive immunity. This study aimed to determine the role of endoneurial endothelial cell MHC class II in autoimmune polyneuropathy.</p><p><strong>Methods: </strong>Cryopreserved Guillain-Barré syndrome (GBS) patient sural nerve biopsies and sciatic nerves from the severe murine experimental autoimmune neuritis (sm-EAN) GBS model were studied. Cultured conditional ready MHC Class II antigen A-alpha chain (H2-Aa) embryonic stem cells were used to generate H2-Aa<sup>flox/+</sup> C57BL/6 mice. Mice were backcrossed and intercrossed to the SJL background to generate H2-Aa<sup>flox/flox</sup> SJL mice, bred with hemizygous Tamoxifen-inducible von Willebrand factor Cre recombinase (vWF-iCre/+) SJL mice to generate H2-Aa<sup>flox/flox</sup>; vWF-iCre/+ mice to study microvascular endothelial cell adaptive immune responses. Sm-EAN was induced in Tamoxifen-treated H2-Aa<sup>flox/flox</sup>; vWF-iCre/+, H2-Aa<sup>flox/flox</sup>; +/+, H2-Aa<sup>+/+</sup>; vWF-iCre/+ and untreated H2-Aa<sup>flox/flox</sup>; vWF-iCre/+ adult female SJL mice. Neurobehavioral, electrophysiological and histopathological assessments were performed at predefined time points.</p><p><strong>Results: </strong>Endoneurial endothelial cell MHC class II expression was observed in normal and inflamed human and mouse peripheral nerves. Tamoxifen-treated H2-Aa<sup>flox/flox</sup>; vWF-iCre/+ mice were resistant to sm-EAN despite extensive MHC class II expression in lymphoid and non-lymphoid tissues.</p><p><strong>Discussion: </strong>A conditional MHC class II knockout mouse to study cell- and time-dependent adaptive immune responses in vivo was developed. Initial studies show microvascular endothelial cell MHC class II expression is necessary for peripheral nerve specific autoimmunity, as advocated by human in vitro adaptive immunity and ex vivo transplant rejection studies.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
F wave analysis based on the compound muscle action potential scan. 基于复合肌肉动作电位扫描的 F 波分析。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-07-04 DOI: 10.1002/mus.28197
Xiaoyan Li, Maoqi Chen, Paul E Barkhaus, Sanjeev D Nandedkar, Brian Schmit, Ping Zhou
{"title":"F wave analysis based on the compound muscle action potential scan.","authors":"Xiaoyan Li, Maoqi Chen, Paul E Barkhaus, Sanjeev D Nandedkar, Brian Schmit, Ping Zhou","doi":"10.1002/mus.28197","DOIUrl":"10.1002/mus.28197","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Conventional F wave analysis involves a relatively uniform physiological environment induced by supramaximal stimulations. The F wave characteristics in a dynamic physiological condition, however, are rarely investigated. This study aimed to improve understanding of F wave properties in the more dynamic process by introducing a novel method to analyze F waves based on the compound muscle action potential (CMAP) scan technique.</p><p><strong>Methods: </strong>Twenty four healthy subjects participated in the study. The CMAP scan was applied to record muscle responses in the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles, respectively. F wave characteristics including mean F wave amplitude and latency (F-M latency), persistence and activating threshold were quantified.</p><p><strong>Results: </strong>An average of 200 F waves per muscle were obtained from the CMAP scan recording. Weak to moderate correlations between F wave amplitude and stimulating intensity were observed in most of the APB (19 muscles; r = 0.33 ± 0.14, all p < .05) and ADM (23 muscles, r = 0.46 ± 0.16, all p < .05) muscles. Significantly longer mean F latency and lower activating F-threshold were found in the ADM muscles (F-M latency: APB: 25.43 ± 2.39 ms, ADM: 26.15 ± 2.32 ms, p < .05; F-threshold: APB: 7.68 ± 8.96% CMAP, ADM: 2.35 ± 2.42% CMAP, p < .05).</p><p><strong>Discussion: </strong>This study introduces new features of F waves using the CMAP scan technique and identifies differences of F wave characteristics between the hand muscles. The CMAP scan based F waves analysis can be combined with the motor unit number estimation to assess functional alterations in motor neurons in neurological disorders.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rasch analysis of the modified Fatigue Severity Scale in neuromuscular disorders and comparison between sex, age and diagnoses. 对神经肌肉疾病患者的改良疲劳严重程度量表进行拉施分析,并对性别、年龄和诊断进行比较。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-07-02 DOI: 10.1002/mus.28186
Joshua P J Fulton, James K L Holt, Roger J Mills, Carolyn A Young
{"title":"Rasch analysis of the modified Fatigue Severity Scale in neuromuscular disorders and comparison between sex, age and diagnoses.","authors":"Joshua P J Fulton, James K L Holt, Roger J Mills, Carolyn A Young","doi":"10.1002/mus.28186","DOIUrl":"10.1002/mus.28186","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Fatigue is a common and debilitating symptom encountered in the neuromuscular clinic. The 7-item Fatigue Severity Scale (FSS-7) is a Rasch-modified assessment validated in inflammatory neuropathies but not across a typical neuromuscular patient population. The aim of this study was to validate this measure in neuromuscular disorders and to compare between patient sex, age and diagnoses.</p><p><strong>Methods: </strong>The modified FSS-7 was mailed to patients recruited from a specialist neuromuscular clinic at the Walton Centre. Responses were subjected to Rasch analysis and descriptive statistics were performed on the Rasch converted data.</p><p><strong>Results: </strong>The mFSS-7 met the Rasch model expectations with an overall Chi-square probability of 0.4918, a strict unidimensional scale free from differential item functioning (DIF) that satisfied the model with substantial test-retest reliability using Lin's concordance correlation coefficient 0.71 (95% CI 0.63-0.77). A 15.7% ceiling effect was observed in this patient cohort. Post hoc analysis did not show any significant difference in fatigue between sex, age or neuromuscular diagnoses.</p><p><strong>Discussion: </strong>The self-completed Rasch mFSS-7 showed acceptable test-retest reliability across patients with varied disorders under follow-up in a specialist neuromuscular clinic. The ceiling effect constrains its use for those with the most severe fatigue. Future considerations could include assessment of the benefits of clinical interventions, particularly multidisciplinary team input or dedicated fatigue clinics.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efgartigimod in refractory autoimmune myasthenia gravis. 依夫加替莫德治疗难治性自身免疫性肌无力。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-20 DOI: 10.1002/mus.28184
Linda Remijn-Nelissen, Martijn R Tannemaat, Annabel M Ruiter, Yvonne J M Campman, Jan J G M Verschuuren
{"title":"Efgartigimod in refractory autoimmune myasthenia gravis.","authors":"Linda Remijn-Nelissen, Martijn R Tannemaat, Annabel M Ruiter, Yvonne J M Campman, Jan J G M Verschuuren","doi":"10.1002/mus.28184","DOIUrl":"10.1002/mus.28184","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Efgartigimod, a neonatal Fc-receptor inhibitor, has recently been approved as treatment for myasthenia gravis (MG). In this retrospective cohort study, we aimed to systematically assess short- and long-term effectiveness of efgartigimod in patients with refractory MG.</p><p><strong>Methods: </strong>Sixteen patients with refractory autoimmune acetylcholine receptor MG were treated with efgartigimod. Data were collected from January 2021 to March 2023 on Myasthenia Gravis Activities of Daily Living (MG-ADL), Quantitative Myasthenia Gravis score (QMG), Myasthenia Gravis Composite score (MGC) and the 15-item revised version of the Myasthenia Gravis Quality of Life questionnaire (MG-QoL15r).</p><p><strong>Results: </strong>A favorable outcome was seen in 56% of patients at the last measurement. Out of 16 patients, 50% were an MG-ADL responder after the first treatment cycle. After 4 weeks, a clinically meaningful improvement compared to baseline was seen on the MG-ADL, QMG, and MGC. There was a statistically significant improvement on the MGQoL15r from baseline to week 4. The improvement was maintained until the last measurement for the MGC and the MGQoL15r. At the last visit, all patients had discontinued 4-weekly dosages, shifting to administration frequencies of 1, 2, or 3 weeks. Drug doses could be decreased for prednisolone (n = 7), azathioprine (n = 2), and intravenous immunoglobulin (n = 9). Frequency of plasma exchange was decreased in nine patients.</p><p><strong>Discussion: </strong>In patients with refractory MG, efgartigimod was effective for at least half of all patients. Patients required more frequent dosing compared to the ADAPT phase 3 trial. In 80% of the patients concurrent medication could be reduced or discontinued.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paradoxical thinning of the diaphragm on ultrasound is a risk factor for requiring non-invasive ventilation in patients with neuromuscular diaphragmatic dysfunction. 超声波显示膈肌异常变薄是神经肌肉膈肌功能障碍患者需要无创通气的一个风险因素。
IF 2.8 3区 医学
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-27 DOI: 10.1002/mus.28194
Andrea J Boon, James B Meiling, Marianne T Luetmer, Christopher J Klein, Eric J Sorenson, C Michel Harper, Grayson Beecher
{"title":"Paradoxical thinning of the diaphragm on ultrasound is a risk factor for requiring non-invasive ventilation in patients with neuromuscular diaphragmatic dysfunction.","authors":"Andrea J Boon, James B Meiling, Marianne T Luetmer, Christopher J Klein, Eric J Sorenson, C Michel Harper, Grayson Beecher","doi":"10.1002/mus.28194","DOIUrl":"10.1002/mus.28194","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Point-of-care ultrasound of the diaphragm is highly sensitive and specific in the detection of neuromuscular diaphragmatic dysfunction. In some patients with neuromuscular diaphragmatic dysfunction, paradoxical thinning of the diaphragm during inspiration is observed on ultrasound; however, its frequency, electrodiagnostic associations, and prognostic significance remain uncertain.</p><p><strong>Methods: </strong>Medical records of patients presenting to two electrodiagnostic laboratories (Mayo Clinic, Rochester, Minnesota and University of Alberta, Edmonton, Alberta) from January 1, 2022 to December 31, 2022, for evaluation of suspected neuromuscular respiratory failure, were reviewed.</p><p><strong>Results: </strong>214 patients were referred and 19 patients excluded due to incomplete information. Of 195 patients (384 hemidiaphragms), 104 had phrenic neuropathy, 12 had myopathy, and 79 had no evidence of neuromuscular disease affecting the diaphragm. Paradoxical thinning occurred in 31 (27%) patients with neuromuscular diaphragmatic dysfunction and was unilateral in 30, the majority (83%) having normal contralateral ultrasound. Phrenic nerve conduction studies and diaphragm electromyography results did not distinguish patients with paradoxical thinning versus without. Most patients (71%) with paradoxical thinning required non-invasive ventilation (NIV), including 16 with unilateral paradoxical thinning. Paradoxical thinning and BMI ≥30 kg/m<sup>2</sup> were risk factors for requiring NIV in multivariable logistic regression analysis, with odds ratios of 2.887 (95% CI:1.166, 7.151) and 2.561 (95% CI: 1.186, 5.532), respectively.</p><p><strong>Discussion: </strong>Paradoxical thinning of the diaphragm occurs in patients with prominent neuromuscular diaphragmatic dysfunction, most commonly from phrenic neuropathy, and is a significant risk factor for requiring NIV. Unilateral paradoxical thinning is sufficient for needing NIV. BMI ≥30 kg/m<sup>2</sup> additionally increases risk of requiring NIV in patients with neuromuscular diaphragmatic dysfunction.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信