Open AccessRapid neurophysiological screening for sensory ganglionopathy: A novel approach
Author(s) -
Zis Panagiotis,
Hadjivassiliou Marios,
Sarrigiannis Ptolemaios Georgios,
Barker Alexander St John Edward,
Rao Dasappaiah Ganesh
Publication year - 2017
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.880
Subject(s) - snap , medicine , receiver operating characteristic , sural nerve , neurophysiology , sensory system , sensory nerve , radial nerve , anatomy , neuroscience , psychology , computer graphics (images) , psychiatry , computer science
Abstract Background and Aim Pure sensory neuropathies involving the dorsal root ganglia are commonly referred to as sensory ganglionopathies ( SG ). Causes of SG can be inherited (as seen in Friedreich's ataxia) or acquired (e.g. immune‐mediated or paraneoplastic). Diagnostic criteria for confirming SG have been published and consist of a combination of clinical and neurophysiological parameters. The aim of our study was to develop a neurophysiological method for rapid screening for diagnosis of SG . Methods For each subject we obtained the sensory nerve action potentials ( SNAP s) of five nerves (median, ulnar, radial, sural and superficial peroneal) bilaterally. In the presence of an entrapment neuropathy we obtained the SNAP of the medial antebrachial cutaneous nerves bilaterally. We estimated the number of pairs of nerves showing a SNAP asymmetry of >50% (difference of SNAP s/ lower SNAP ). Results Sixty‐eight subjects, 34 patients with SG and 34 age and sex‐matched controls, participated in the study. Among all subjects using a receiver operating characteristic ( ROC ) curve analysis, the area under the curve was 0.984 (95% CI , 0.960–1.000; SE , 0.012; p < .001). In order to detect SG , presence of SNAP asymmetry of >50% in 2 pairs of nerves, not explained by an entrapment neuropathy, shows a sensitivity of 97.1%, a specificity of 94.1%, a positive predictive value of 94.3% and a negative predictive value of 97.0 Conclusion The number of pairs of nerves showing a SNAP asymmetry of >50% may be used as a novel rapid screening tool of patients with SG .