Is distal motor and/or sensory demyelination a distinctive feature of anti-MAG neuropathy?

Details

Serval ID
serval:BIB_1C97A5A9DE27
Type
Article: article from journal or magazin.
Collection
Publications
Title
Is distal motor and/or sensory demyelination a distinctive feature of anti-MAG neuropathy?
Journal
Journal of neurology
Author(s)
Lozeron P., Ribrag V., Adams D., Brisset M., Vignon M., Baron M., Malphettes M., Theaudin M., Arnulf B., Kubis N.
ISSN
1432-1459 (Electronic)
ISSN-L
0340-5354
Publication state
Published
Issued date
09/2016
Peer-reviewed
Oui
Volume
263
Number
9
Pages
1761-1770
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
To report the frequency of the different patterns of sensory and motor electrophysiological demyelination distribution in patients with anti-MAG neuropathy in comparison with patients with IgM neuropathy without MAG reactivity (IgM-NP). Thirty-five anti-MAG patients at early disease stage (20.1 months) were compared to 23 patients with IgM-NP; 21 CIDP patients and 13 patients with CMT1a neuropathy were used as gold standard neuropathies with multifocal and homogeneous demyelination, respectively. In all groups, standard motor and sensory electrophysiological parameters, terminal latency index and modified F ratio were investigated. Motor electrophysiological demyelination was divided in four profiles: distal, homogeneous, proximal, and proximo-distal. Distal sensory and sensorimotor demyelination were evaluated. Anti-MAG neuropathy is a demyelinating neuropathy in 91 % of cases. In the upper limbs, reduced TLI is more frequent in anti-MAG neuropathy, compared to IgM-NP. But, predominant distal demyelination of the median nerve is encountered in only 43 % of anti-MAG neuropathy and is also common in IgM-NP (35 %). Homogeneous demyelination was the second most frequent pattern (31 %). Concordance of electrophysiological profiles across motor nerves trunks is low and median nerve is the main site of distal motor conduction slowing. Reduced sensory conduction velocities occurs in 14 % of patients without evidence of predominant distal slowing. Simultaneous sensory and motor distal slowing was more common in the median nerve of anti-MAG neuropathy than IgM-NP. Electrophysiological distal motor demyelination and sensory demyelination are not a distinctive feature of anti-MAG reactivity. In anti-MAG neuropathy it is mainly found in the median nerve suggesting a frequent nerve compression at wrist.

Keywords
Aged, Autoantibodies/blood, Demyelinating Autoimmune Diseases, CNS/complications, Demyelinating Autoimmune Diseases, CNS/diagnosis, Demyelinating Autoimmune Diseases, CNS/physiopathology, Disease Progression, Female, Humans, Immunoglobulin M/blood, Male, Neural Conduction, Peripheral Nerves/physiopathology, Peripheral Nervous System Diseases/complications, Peripheral Nervous System Diseases/diagnosis, Peripheral Nervous System Diseases/physiopathology, Phenotype, Retrospective Studies, Anti-MAG, Distal, EMG, Nerve conduction, Neuropathy, TLI
Pubmed
Web of science
Create date
12/12/2017 17:19
Last modification date
20/08/2019 12:53
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