| Modulatory effects on axonal function after intravenous immunoglobulin therapy in chronic inflammatory demyelinating polyneuropathy. | |
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MedLine Citation:
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PMID: 21747028 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the immediate and longitudinal mechanisms of action of intravenous immunoglobulin (IVIg) on axonal function in chronic inflammatory demyelinating polyneuropathy (CIDP). DESIGN: Prospective single-center study. SETTING: Hospitals and outpatient clinics. PARTICIPANTS: Clinical and functional assessment, nerve conduction studies, and 526 motor excitability studies were undertaken in 27 patients, matched before and immediately after infusion and followed up longitudinally. MAIN OUTCOME MEASURES: Axonal excitability variables were measured before and immediately after infusion and compared with matched studies and findings in healthy controls. RESULTS: Immediately after infusion, patients demonstrated decreased threshold, with significant reduction in strength-duration time constant (P = .003), reduction in accommodation to depolarization (P = .04), and reduced threshold change during hyperpolarization (P = .003), accompanied by significant decreases in superexcitability (P = .03) and subexcitability (P = .02). In contrast, changes were absent in disease controls, confirming a specific IVIg action in CIDP patients. Longitudinally, changes correlated with clinical improvement (mean [SE] increase in the Medical Research Council sum score, 2.7 [0.7]; P = .005). Increased compound muscle action potential amplitude was associated with reduction in terminal latency (correlation coefficient, -0.65; P = .02). In addition, these changes translated into improvement in functional assessment with the adjusted Inflammatory Neuropathy Cause and Treatment score, which demonstrated a significant correlation with nerve excitability variables longitudinally (P = .01). CONCLUSIONS: Findings from the present series establish a modulatory effect of IVIg on axonal function in CIDP patients, suggesting that IVIg stabilizes axonal membrane potential and promotes axonal recovery. |
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Authors:
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Cindy Shin-Yi Lin; Arun V Krishnan; Susanna B Park; Matthew C Kiernan |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of neurology Volume: 68 ISSN: 1538-3687 ISO Abbreviation: Arch. Neurol. Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-07-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372436 Medline TA: Arch Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 862-9 Citation Subset: AIM; IM |
Affiliation:
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Faculty of Medicine, School of Medical Science, Wallace Wurth Building, University of New South Wales, Sydney, New South Wales, Australia 2051. c.lin@unsw.edu.au. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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