Motor unit number index (MUNIX) in chronic inflammatory demyelinating polyneuropathy: A potential role in monitoring response to intravenous immunoglobulins.

Clin Neurophysiol

School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Regional Neuromuscular Service, University Hospitals Birmingham, Birmingham, UK. Electronic address:

Published: October 2019

AI Article Synopsis

  • The study compares motor unit number index (MUNIX) values between patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and healthy individuals, finding significantly lower scores in CIDP patients.
  • MUNIX scores showed a strong correlation with motor and sensory function assessments, as well as disability scales in CIDP patients.
  • Short-term improvements in MUNIX values were observed after treatment with intravenous immunoglobulins (IVIg), indicating that MUNIX may serve as an effective objective marker for treatment response.

Article Abstract

Objective: To compare motor unit number index (MUNIX) values in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and healthy controls, to assess correlations between MUNIX and clinical assessments used in CIDP and to assess short-term changes in MUNIX in CIDP following intravenous immunoglobulins (IVIg).

Methods: MUNIX sum scores were calculated from three muscles in patients and healthy controls. CIDP patients also underwent a series of clinical assessments and completed the Overall Neuropathy Limitations Scale (ONLS) and the Rasch-built Overall-Disability Scale (R-ODS). Repeat assessments were performed in CIDP patients receiving IVIg and CIDP patients not on active treatment.

Results: MUNIX sum scores were significantly lower in CIDP patients than healthy controls (mean values 214.0 vs 516.9, respectively; p < 0.001). MUNIX sum scores correlated with clinical assessment of motor and sensory function and ONLS and R-ODS scores in CIDP patients. Significant short-term improvements were seen in MUNIX values on repeat testing following IVIg (188.3-226.4, p = 0.001), but not in CIDP patients not receiving IVIg.

Conclusions: MUNIX values show stronger correlation with commonly-used clinical assessments and disability scores than other routinely used electrophysiological parameters. Rapid improvements in MUNIX sum scores are seen following IVIg.

Significance: MUNIX sum score may provide an objective marker of response to IVIg.

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Source
http://dx.doi.org/10.1016/j.clinph.2019.06.231DOI Listing

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