Satsuki Mitsuma1, Peter Van den Bergh2, Yusuf A Rajabally3, Vinciane Van Parijs2, Darren Martin-Lamb3, Masahiro Sonoo4, Akira Inaba5, Toshio Shimizu6, Sagiri Isose1, Yasunori Sato7, Tetsuo Komori8, Sonoko Misawa1, Satoshi Kuwabara9. 1. Department of Neurology, Chiba University Hospital, Chiba, Japan. 2. Institute of Neuroscience, Neuromuscular Reference Centre, University Hospitals St-Luc, University of Louvain, Brussels, Belgium. 3. Department of Neurophysiology, University Hospitals of Leicester, Leicester, UK. 4. Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan. 5. Department of Neurology, Kanto Central Hospital, Tokyo, Japan. 6. Department of Neurology, Tokyo Metropolitan neurological Hospital, Tokyo, Japan. 7. Clinical Research Center, Chiba University Hospital, Chiba, Japan. 8. Department of Neurology, National Hakone Hospital, Hakone, Japan. 9. Department of Neurology, Chiba University Hospital, Chiba, Japan. Electronic address: kuwabara-s@faculty.chiba-u.jp.
Abstract
OBJECTIVE: The duration of the distal compound muscle action potential (DCMAP) is a useful index to detect demyelination in the distal nerve segments. However in published electrodiagnostic criteria for chronic inflammatory demyelinating polyneuropathy (CIDP), the cut-off values of DCMAP duration are defined using an EMG low frequency filter of only 20 Hz. We aimed to provide widely-available reference data using several low cut filters. METHODS: In 13 Japanese and European tertiary centers, DCMAP duration data using 2, 5, 10, and 20 Hz low frequency filters were prospectively collected from 147 normal controls, 59 patients with typical CIDP, and 100 with diabetic polyneuropathy. Optimal cut-off values were calculated with receiver-operating characteristic curves, offering 100% specificity versus normal controls. RESULTS: The higher low frequency filter was associated with significantly shorter DCMAP duration in all groups. For CIDP diagnosis, the calculated cut-off values had a sensitivity ranging from 51% to 66%, and a specificity versus diabetic neuropathy from 96% to 98%. CONCLUSIONS: Our results show that DCMAP duration is largely dependent on low frequency filter settings, but is a useful index for CIDP diagnosis when the cut-off values are properly determined at each filter setting. SIGNIFICANCE: Our data provide the systematic reference values of DCMAP duration for CIDP diagnosis available for most EMG laboratories.
OBJECTIVE: The duration of the distal compound muscle action potential (DCMAP) is a useful index to detect demyelination in the distal nerve segments. However in published electrodiagnostic criteria for chronic inflammatory demyelinating polyneuropathy (CIDP), the cut-off values of DCMAP duration are defined using an EMG low frequency filter of only 20 Hz. We aimed to provide widely-available reference data using several low cut filters. METHODS: In 13 Japanese and European tertiary centers, DCMAP duration data using 2, 5, 10, and 20 Hz low frequency filters were prospectively collected from 147 normal controls, 59 patients with typical CIDP, and 100 with diabetic polyneuropathy. Optimal cut-off values were calculated with receiver-operating characteristic curves, offering 100% specificity versus normal controls. RESULTS: The higher low frequency filter was associated with significantly shorter DCMAP duration in all groups. For CIDP diagnosis, the calculated cut-off values had a sensitivity ranging from 51% to 66%, and a specificity versus diabetic neuropathy from 96% to 98%. CONCLUSIONS: Our results show that DCMAP duration is largely dependent on low frequency filter settings, but is a useful index for CIDP diagnosis when the cut-off values are properly determined at each filter setting. SIGNIFICANCE: Our data provide the systematic reference values of DCMAP duration for CIDP diagnosis available for most EMG laboratories.
Authors: Michael Fleischer; Inn Lee; Friedrich Erdlenbruch; Lena Hinrichs; Ioannis N Petropoulos; Rayaz A Malik; Hans-Peter Hartung; Bernd C Kieseier; Christoph Kleinschnitz; Mark Stettner Journal: J Neuroinflammation Date: 2021-04-08 Impact factor: 8.322
Authors: Samuel Arends; Judith Drenthen; Peter Y K Van den Bergh; Robert D M Hadden; Nortina Shahrizaila; Mazen M Dimachkie; Gerardo Gutiérrez Gutiérrez; Hans Katzberg; Lynette Kiers; Helmar C Lehmann; Yann Péréon; Ricardo C Reisin; Antonino Uncini; Camiel Verhamme; Wagar Waheed; David R Cornblath; Bart C Jacobs Journal: J Peripher Nerv Syst Date: 2022-06-24 Impact factor: 5.188