Individual attributes versus composite scores of nerve conduction abnormality: Sensitivity, reproducibility, and concordance with impairment
Individual attributes versus composite scores of nerve conduction abnormality: Sensitivity, reproducibility, and concordance with impairment
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DOI：
10.1002/mus.10320
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发表时间：
2003-02-01
期刊：
影响因子：
3.4
通讯作者：
O'Brien, PC
中科院分区：
文献类型：
--
作者：
Dyck, PJ;Litchy, WJ;O'Brien, PC
对于检测周围神经病变，综合评分可能比神经传导的单一属性更敏感且可重复，但这需要在大型患者群体中进行验证。此外，尚未测试个体属性与综合评分与临床严重程度测量的一致性。在这里，我们在前瞻性研究队列中研究这些问题：来自明尼苏达州罗切斯特的糖尿病患者（RDNS；n = 396）；慢性炎症性脱髓鞘性多发性神经病 (CIDP) 患者 (n = 55)；和多灶性运动神经病 (MMN) 患者 (n = 18)。特异性固定在 97.5 百分位，我们发现，在全身性多发性神经病（糖尿病和 CIDP）中，单个或多个神经的综合评分（尤其是包括传导速度、远端潜伏期和 F 波的评分）往往比单个属性更敏感。相比之下，对于多发性单神经病，个别神经的某些个体属性或综合评分比综合评分更敏感。在糖尿病性多发性神经病中，综合评分往往比神经传导的个体属性更具可重复性。在糖尿病性多发性神经病和 CIDP 中，个体属性或综合评分与神经系统损伤之间存在高度显着的相关性；一般来说，综合分数的相关系数较高。振幅的相关性高于传导速度或远端延迟的相关性。我们的结论是，随着微处理器和规范数据库的出现，肌电图学家可能会越来越多地寻求将神经传导异常表达为单个或多个神经的综合评分。
Composite scores may be more sensitive and reproducible than single attributes of nerve conduction for detection of peripheral neuropathy, but this requires validation in large patient cohorts. Also, the concordance of individual attributes versus composite scores with clinical measures of severity has not been tested. Here, we study these issues in prospectively studied cohorts: diabetic patients from Rochester, Minnesota (RDNS; n = 396); chronic inflammatory demyelinating polyneuropathy (CIDP) patients (n = 55); and multifocal motor neuropathy (MMN) patients (n = 18). With specificity fixed at the 97.5 percentile, we found that, in generalized polyneuropathies (diabetic and CIDP), composite scores (especially ones including conduction velocity, distal latencies, and F-waves) of individual or multiple nerves tended to be more sensitive than individual attributes. By contrast, for multiple mononeuropathies, some individual attributes or composite scores of individual nerves were more sensitive than composite scores. In diabetic polyneuropathy, composite scores tended to be more reproducible than individual attributes of nerve conduction. Highly significant correlations were found between individual attributes or composite scores and neurologic impairment in diabetic polyneuropathy and in CIDP; in general, correlation coefficients were higher for composite scores. These correlations were higher for amplitudes than for conduction velocities or distal latencies. We conclude that, with the availability of microprocessors and normative databases, electromyographers may increasingly seek to express nerve conduction abnormality also as composite scores of individual or several nerves.