Utility of the distal compound muscle action potential duration for diagnosis of demyelinating neuropathies
Sagiri Isose
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorCorresponding Author
Satoshi Kuwabara
Department of Neurology, Chiba University Hospital, Chiba, Japan
Satoshi Kuwabara, MD, Department of Neurology, Chiba University School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Tel: +81-43-2227171 Ext. 5414; Fax: +81-43-2262160; E-mail: [email protected]Search for more papers by this authorYasunori Sato
Clinical Research Center, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorMasahiro Mori
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorKazumoto Shibuya
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorYukari Sekiguchi
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorSaiko Nasu
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorYumi Fujimaki
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorYuichi Noto
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorSetsu Sawai
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorKazuaki Kanai
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorSonoko Misawa
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorThe Tokyo Metropolitan Neuromuscular Electrodiagnosis Study Group
The Tokyo Metropolitan Neuromuscular Electrodiagnosis Study Group: M. Sonoo, Teikyo University; T. Shimizu, Tokyo Metropolitan Neurological Hospital; T. Komori, Saitama Medical School; F. Hirashima, Saitama Prefectural Rehabilitation Center; and A. Inaba, Kanto Central Hospital.
Search for more papers by this authorSagiri Isose
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorCorresponding Author
Satoshi Kuwabara
Department of Neurology, Chiba University Hospital, Chiba, Japan
Satoshi Kuwabara, MD, Department of Neurology, Chiba University School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Tel: +81-43-2227171 Ext. 5414; Fax: +81-43-2262160; E-mail: [email protected]Search for more papers by this authorYasunori Sato
Clinical Research Center, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorMasahiro Mori
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorKazumoto Shibuya
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorYukari Sekiguchi
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorSaiko Nasu
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorYumi Fujimaki
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorYuichi Noto
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorSetsu Sawai
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorKazuaki Kanai
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorSonoko Misawa
Department of Neurology, Chiba University Hospital, Chiba, Japan
Search for more papers by this authorThe Tokyo Metropolitan Neuromuscular Electrodiagnosis Study Group
The Tokyo Metropolitan Neuromuscular Electrodiagnosis Study Group: M. Sonoo, Teikyo University; T. Shimizu, Tokyo Metropolitan Neurological Hospital; T. Komori, Saitama Medical School; F. Hirashima, Saitama Prefectural Rehabilitation Center; and A. Inaba, Kanto Central Hospital.
Search for more papers by this authorAbstract
To assess the significance of distal compound muscle action potential (CMAP) duration for diagnosis of demyelinating neuropathies, electrophysiologic data were reviewed from 471 subjects, including 145 normal controls, 60 patients with chronic inflammatory demyelinating polyneuropathy (CIDP), 205 with other neuropathy, and 61 with amyotrophic lateral sclerosis (ALS). The duration of distally evoked CMAP was measured in the median, ulnar, tibial, and peroneal nerves. Optimal cut-off values were calculated with receiver-operating characteristic (ROC) curves. In comparison of normal controls and CIDP patients, ROC analyses showed the sufficient area under the curves (82-93%). When the cut-off values in the detection of demyelination were determined as the point with 98% specificity vs. normal on the ROC curves (median, 6.6 ms; ulnar, 6.7 ms; peroneal, 7.6 ms; tibial, 8.8 ms), the sensitivity was 77% for CIDP, with a specificity of 90% vs. ALS and 95% vs. diabetic neuropathy. The distal CMAP duration is a useful index for the detection of distal demyelination. We suggest the above cut-off values for each nerve as one of the electrodiagnostic criteria for demyelinating neuropathies, preferentially affecting the distal nerve terminals, such as CIDP.
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