{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:25:46Z","timestamp":1791318346533,"version":"4.3.1"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T00:00:00Z","timestamp":1679788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Intramuscular blood flow increases during physical activity and may be quantified immediately following exercise using power Doppler sonography. Post\u2010exercise intramuscular blood flow is reduced in patients with muscular dystrophy, associated with disease severity and degenerative changes. It is not known if intramuscular blood flow is reduced in patients with neuropathy, nor if it correlates with muscle strength and structural changes. The aim was to determine whether blood flow is reduced in patients with polyneuropathy due to Charcot\u2013Marie\u2013Tooth disease type 1 (CMT1) and to compare more affected distal to less affected proximal muscles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross\u2010sectional study including 21 healthy volunteers and 17 CMT patients. Power Doppler ultrasound was used to quantify post\u2010exercise intramuscular blood flow in distal (gastrocnemius) and proximal (elbow flexor) muscles. Intramuscular blood flow was compared to muscle echo intensity, muscle strength, disease severity score, patient age and electromyography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Polyneuropathy patients showed reduced post\u2010exercise blood flow in both gastrocnemius and elbow flexors compared to controls. A more prominent reduction was seen in the gastrocnemius (2.51% vs. 10.34%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.0001) than in elbow flexors (4.48% vs. 7.03%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.0001). Gastrocnemius intramuscular blood flow correlated with muscle strength, disease severity and age. Receiver operating characteristic analysis showed that quantification of intramuscular blood flow was superior to echo intensity for detecting impairment in the gastrocnemius (area under the curve 0.962 vs. 0.738, <jats:italic>p<\/jats:italic>\u00a0=\u20090.0126).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Post\u2010exercise intramuscular blood flow is reduced in CMT1 polyneuropathy. This reduction is present in both impaired distal and minimally affected proximal muscles, indicating it as an early marker of muscle impairment due to neuropathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15789","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T11:49:10Z","timestamp":1678794550000},"page":"1991-2000","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Exercise induced muscle blood flow is decreased in Charcot\u2013Marie\u2013Tooth disease type 1 polyneuropathy: a power Doppler analysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0235-2291","authenticated-orcid":false,"given":"Orna","family":"Gera","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrat","family":"Shavit\u2010Stein","sequence":"additional","affiliation":[{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"},{"name":"Department of Neurology and Neurosurgery, Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taly","family":"Amichai","sequence":"additional","affiliation":[{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Nikitin","sequence":"additional","affiliation":[{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merav Ben","family":"David","sequence":"additional","affiliation":[{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lior","family":"Greenbaum","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"The Danek Gertner Institute of Human Genetics Sheba Medical Center  Tel Hashomer Israel"},{"name":"The Joseph Sagol Neuroscience Center Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joab","family":"Chapman","sequence":"additional","affiliation":[{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"},{"name":"Department of Neurology and Neurosurgery, Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Robert and Martha Harden Chair in Mental and Neurological Diseases, Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Dori","sequence":"additional","affiliation":[{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"},{"name":"Department of Neurology and Neurosurgery, Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Sheba Talpiot Medical Leadership Program  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2741\/Tyml"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0185(20000301)258:3"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25108"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2019.09.023"},{"key":"e_1_2_11_6_1","unstructured":"BirdTD.Charcot\u2013Marie\u2013Tooth hereditary neuropathy overview.GeneReviews\u00ae. 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