{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:22:05Z","timestamp":1782318125328,"version":"3.54.5"},"reference-count":25,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T00:00:00Z","timestamp":1681171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Malaya Department of Medicine","award":["DOMRSF-2021-01"],"award-info":[{"award-number":["DOMRSF-2021-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Studies have suggested that, by applying certain nerve ultrasound scores, demyelinating and axonal polyneuropathies can be differentiated. In the current study, we investigated the utility of ultrasound pattern sub-score A (UPSA) and intra- and internerve cross-sectional area (CSA) variability in the diagnostic evaluation of demyelinating neuropathies. Materials and Methods: Nerve ultrasound was performed in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and acute inflammatory demyelinating polyneuropathy (AIDP) and compared to patients with axonal neuropathies. The UPSA, i.e., the sum of ultrasound scores at eight predefined measurement points in the median (forearm, elbow and mid-arm), ulnar (forearm and mid-arm), tibial (popliteal fossa and ankle) and fibular (lateral popliteal fossa) nerves, was applied. Intra- and internerve CSA variability were defined as maximal CSA\/minimal CSA for each nerve and each subject, respectively. Results: A total of 34 CIDP, 15 AIDP and 16 axonal neuropathies (including eight axonal Guillain-Barr\u00e9 syndrome (GBS), four hereditary transthyretin amyloidosis, three diabetic polyneuropathy and one vasculitic neuropathy) were included. A total of 30 age- and sex-matched healthy controls were recruited for comparison. Significantly enlarged nerve CSA was observed in CIDP and AIDP with significantly higher UPSA in CIDP compared to the other groups (9.9 \u00b1 2.9 vs. 5.9 \u00b1 2.0 vs. 4.6 \u00b1 1.9 in AIDP vs. axonal neuropathies, p &lt; 0.001). A total of 89.3% of the patients with CIDP had an UPSA score \u22657 compared to the patients with AIDP (33.3%) and axonal neuropathies (25.0%) (p &lt; 0.001). Using this cut-off, the performance of UPSA in differentiating CIDP from other neuropathies including AIDP was excellent (area under the curve of 0.943) with high sensitivity (89.3%), specificity (85.2%) and positive predictive value (73.5%). There were no significant differences in intra- and internerve CSA variability between the three groups. Conclusion: The UPSA ultrasound score was useful in distinguishing CIDP from other neuropathies compared to nerve CSA alone.<\/jats:p>","DOI":"10.3390\/medicina59040747","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T02:57:08Z","timestamp":1681268228000},"page":"747","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Nerve Ultrasound Score in Chronic Inflammatory Demyelinating Polyneuropathy"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3578-3493","authenticated-orcid":false,"given":"Cheng-Yin","family":"Tan","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Azly","family":"Yahya","sequence":"additional","affiliation":[{"name":"Neurophysiology Laboratory, University of Malaya Medical Centre, Kuala Lumpur 59100, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khean-Jin","family":"Goh","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nortina","family":"Shahrizaila","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1002\/mus.24238","article-title":"Ultrasound differentiation of axonal and demyelinating neuropathies","volume":"50","author":"Grimm","year":"2014","journal-title":"Muscle Nerve"},{"key":"ref_2","first-page":"459","article-title":"Different patterns of nerve enlargement in polyneuropathy subtypes as detected by ultrasonography","volume":"35","author":"Scheidl","year":"2014","journal-title":"Ultrasound Med. 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