{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T05:50:51Z","timestamp":1781934651956,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Current consensus guidelines for the electrodiagnosis of polyneuropathy derive from highly standardized investigations performed in specialist centers, raising the question of whether they are equally applicable in everyday general neurology outpatient settings. This multicenter study evaluated the consistency of electrodiagnostic findings in chronic axonal polyneuropathy across different clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively collected sural sensory nerve action potential (SNAP) and peroneal compound muscle action potential (CMAP) amplitude data from 62 patients with cryptogenic axonal polyneuropathy. Recordings were obtained both in general neurology outpatient clinics and in a specialized neuromuscular center in the Netherlands. After excluding technically inadequate waveforms, we assessed agreement and inter\u2010center variability using Bland\u2013Altman plots, standard error of measurement (SEM), intraclass correlation coefficients (ICC), relative inter\u2010trial variation (RIV), concordance rates, and Krippendorff's \u03b1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In quality review, 22% of sural and 2% of peroneal recordings from general neurology clinics were either reclassified or excluded because of a technically inadequate waveform. Inter\u2010center variability was substantial for sural SNAP (ICC 0.49; RIV \u2212200% to 200%; SEM 81%) and peroneal CMAP amplitudes (ICC 0.82; RIV \u221278% to 110%; SEM 37%). Agreement was poor for the classification of sural SNAP (concordance rate 69%; Krippendorff's \u03b1 0.36) and peroneal CMAP (concordance rate 73%; Krippendorff's \u03b1 0.45) as normal\/abnormal, and for the electrodiagnosis of polyneuropathy (concordance rate 71%; Krippendorff's \u03b1 \u22120.15).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In everyday clinical practice, substantial variability in sural SNAP and peroneal CMAP amplitudes limits consistent electrodiagnosis of polyneuropathy. Our findings underscore the necessity of rigorous quality control during nerve conduction studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70236","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:00:46Z","timestamp":1776319246000},"page":"83-91","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Variability of Sural\n                    <scp>SNAP<\/scp>\n                    and Peroneal\n                    <scp>CMAP<\/scp>\n                    Amplitudes Limits Consistent Electrodiagnosis of Chronic Axonal Polyneuropathy: A Cross\u2010Sectional Multicenter Study"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0043-0109","authenticated-orcid":false,"given":"Gerjan M.","family":"van der Star","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery UMC Utrecht Brain Center, University Medical Center  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7132-5967","authenticated-orcid":false,"given":"Ruben P. A.","family":"van Eijk","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery UMC Utrecht Brain Center, University Medical Center  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9591-1672","authenticated-orcid":false,"given":"H. Stephan","family":"Goedee","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery UMC Utrecht Brain Center, University Medical Center  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurien L.","family":"Teunissen","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurophysiology St. Antonius Hospital  Nieuwegein the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter A.","family":"van Doorn","sequence":"additional","affiliation":[{"name":"Department of Neurology Erasmus University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolette C.","family":"Notermans","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery UMC Utrecht Brain Center, University Medical Center  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander F. J. E.","family":"Vrancken","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery UMC Utrecht Brain Center, University Medical Center  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000013200"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2025.2110792"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23765"},{"key":"e_1_2_11_5_1","volume-title":"Richtlijn Polyneuropathie","author":"Federatie Medisch Specialisten","year":"2019"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20233"},{"key":"e_1_2_11_7_1","unstructured":"American Academy of Neurology American Association of Neuromuscular and Electrodiagnostic Medicine American College of Physicians AAN Quality and Safety Subcommittee Facilitators \u201cDistal Symmetric Polyneuropathy Performance Measurement Set. American Academy of Neurology \u201d2024.https:\/\/www.aan.com\/siteassets\/home\u2010page\/policy\u2010and\u2010guidelines\/quality\/quality\u2010measures\/other\u2010neurologic\u2010conditions\/2019\u2010aan\u2010dsp\u2010quality\u2010measurement\u2010set\u2010final.pdf."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007148"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/1028415X.2021.1985751"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-023-06859-w"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0469"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns5.12042"},{"key":"e_1_2_11_13_1","volume-title":"Clinical Electromyography: Nerve Conduction Studies","author":"Oh S. 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