Objective: To evaluate the utility of nerve diffusion tensor imaging (DTI), nerve cross-sectional area, and muscle magnetic resonance imaging (MRI) multiecho Dixon for assessing proximal nerve injury in chronic inflammatory demyelinating polyneuropathy (CIDP).
Methods: In this prospective observational cohort study, 11 patients with CIDP and 11 healthy controls underwent a multiparametric MRI protocol with DTI of the sciatic nerve and assessment of muscle proton-density fat fraction of the biceps femoris and the quadriceps femoris muscles by multiecho Dixon MRI. Patients were longitudinally evaluated by MRI, clinical examination, and nerve conduction studies at baseline and after 6 months.
Results: In sciatic nerves of CIDP patients, mean cross-sectional area was significantly higher and fractional anisotropy value was significantly lower, compared to controls. In contrast, muscle proton-density fat fraction was significantly higher in thigh muscles of patients with CIDP, compared to controls. MRI parameters showed high reproducibility at baseline and 6 months.
Interpretation: Advanced MRI parameters demonstrate subclinical proximal nerve damage and intramuscular fat accumulation in CIDP. Data suggest DTI and multiecho Dixon MRI might be useful in estimating axonal damage and neurogenic muscle changes in CIDP.
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http://dx.doi.org/10.1002/acn3.502 | DOI Listing |
Cureus
November 2024
Trauma and Orthopaedics, Hull Royal Infirmary, Hull, GBR.
Introduction Paediatric forearm fractures are common, but isolated radial diaphyseal fractures are rare, representing a small subset. Unlike fractures involving both the radius and ulna, these fractures lack well-established management guidelines. The potential for alignment loss during treatment underscores the need for specific protocols.
View Article and Find Full Text PDFBrain Nerve
January 2025
Department of Neurology, Graduate School of Medicine, Chiba University.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) includes a number of clinical subtypes. The major phenotype is "typical CIDP," which is characterized by symmetric and "proximal and distal" muscle weakness. Due to historical changes in the concept of CIDP, multifocal motor neuropathy, anti-myelin-associated glycoprotein (anti-MAG) neuropathy, and autoimmune nodopathy were excluded.
View Article and Find Full Text PDFJBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFeNeurologicalSci
March 2025
Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA.
Obesity and the metabolic syndrome (MetS) are major global health challenges that contribute significantly to the rising prevalence of type 2 diabetes (T2D) and neuropathy. Neuropathy, a common and disabling complication of T2D, is characterized by progressive distal-to-proximal axonal degeneration, driven in part by mitochondrial dysfunction in both neurons and axons. Recent evidence points to the toxic effects of saturated fatty acids on peripheral nerve health, with studies demonstrating that these fats impair mitochondrial function and bioenergetics, leading to distal axonal loss.
View Article and Find Full Text PDFBrain
December 2024
Department of Neurology, Mayo Clinic, Rochester, MN, 55905 USA.
Vasculitic neuropathy is caused by inflammatory destruction of nerve blood vessels resulting in nerve ischemia. Nerve vasculitis can be divided into two categories based on vessel size - large arteriole vasculitis (≥75 µm) and microvasculitis (<75 µm). Herein, we characterize the clinical features of nerve large-arteriole vasculitis compared to nerve microvasculitis.
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