{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T04:58:27Z","timestamp":1791003507786,"version":"4.1.0"},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Diagnosis and monitoring of nerve function impairment (NFI) presents an ongoing challenge in global leprosy control. This was a prospective, observational study in leprosy patients receiving treatment with cutaneous and neurological examinations done every 3 months for 1 year. High-resolution ultrasonography and color Doppler (HRUS-CD) was performed in all patients at baseline, completion of treatment, and anytime during the study period if a patient had deterioration of nerve function noted clinically. All peripheral nerves were assessed, and parameters studied were cross-sectional area (CSA), length of thickening, endoneural flow signals (ENFS), and distortion in fascicular symmetry. Of 54 treatment-naive leprosy patients, loss of sensation was noted in 37 (68.5%), paresthesia in 20 (37.0%), and neuropathic pain in 7 (12.9%) at baseline presentation. At end of treatment of leprosy, maximum improvement in NFI across all clinical criteria was seen in ulnar and radial nerves (<jats:italic>P<\/jats:italic> &lt;0.05). The number of impairments on HRUS-CD decreased consistently, significantly for ulnar (<jats:italic>P<\/jats:italic> = 0.009 right ulnar, <jats:italic>P<\/jats:italic> = 0.012 left ulnar) and right radial (<jats:italic>P<\/jats:italic> = 0.025) nerves, and significant improvements in CSA and ENFS were seen across multiple nerves, which correlated with improvement in NFI as well. Abnormal HRUS-CD findings in the target nerves were significantly associated with multibacillary cases (odds ratio [OR]: 4.33; 95% CI: 0.62\u201330.31), those in reaction (OR: 9.42; 95% CI: 1.51\u201358.66), and those older than 40 years (OR: 3.14; 95% CI: 0.49\u201319.93). This study provides objective evidence of improvement in NFI with anti-leprosy treatment, supporting integration of HRUS-CD imaging in monitoring nerve involvement in leprosy.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0256","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T13:32:03Z","timestamp":1726666323000},"page":"1046-1050","source":"Crossref","is-referenced-by-count":4,"title":["Exploring the Utility of High-Resolution Ultrasonography and Color Doppler of Peripheral Nerves in Monitoring Response to Treatment in Leprosy Patients: A Prospective, Observational Study"],"prefix":"10.4269","volume":"111","author":[{"given":"Apoorva","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Narang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijaya Kumar","family":"Padhi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Dogra","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"J Clin Ultrasound","first-page":"1529","article-title":"Neuromuscular ultrasound in leprosy: A scanning protocol","volume":"51","author":"Pirola","year":"2023"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e498","article-title":"High-resolution sonography: A new technique to detect nerve damage in leprosy","volume":"3","author":"Jain","year":"2009"},{"key":"b3","series-title":"Indian J Dermatol Venereol Leprol","first-page":"199","article-title":"High-resolution ultrasound in the assessment of peripheral nerves in leprosy: A comparative cross-sectional study","volume":"87","author":"Sreejith","year":"2021"},{"key":"b4","series-title":"Front Med (Lausanne)","first-page":"865485","article-title":"Leprosy reactions and neuropathic pain in pure neural leprosy in a reference center in Rio de Janeiro \u2013 Brazil","volume":"9","author":"Pitta","year":"2022"},{"key":"b5","series-title":"Guidelines for the Diagnosis, Treatment and Prevention of Leprosy","year":"2018"},{"key":"b6","series-title":"Lepr Rev","first-page":"18","article-title":"Incidence rates of acute nerve function impairment in leprosy: A prospective cohort analysis after 24 months (The Bangladesh Acute Nerve Damage Study)","volume":"71","author":"Croft","year":"2000"},{"key":"b7","series-title":"Lepr Rev","first-page":"S146","article-title":"Peripheral neuropathy in leprosy and its consequences","volume":"71","author":"Van Brakel","year":"2000"},{"key":"b8","series-title":"Lepr Rev","first-page":"14","article-title":"The INFIR Cohort Study: Investigating prediction, detection and pathogenesis of neuropathy and reactions in leprosy. Methods and baseline results of a cohort of multibacillary leprosy patients in north India","volume":"76","author":"van Brakel","year":"2005"},{"key":"b9","series-title":"Lepr Rev","first-page":"367","article-title":"A field trial of detection and treatment of nerve function impairment in leprosy \u2013 Report from national POD pilot project","volume":"69","author":"Jiang","year":"1998"},{"key":"b10","series-title":"PLoS Negl Trop Dis","first-page":"e500","article-title":"Predicting neuropathy and reactions in leprosy at diagnosis and before incident events \u2013 Results from the INFIR cohort study","volume":"3","author":"Smith","year":"2009"},{"key":"b11","series-title":"Leprosy","first-page":"411","article-title":"Disability, deformity and rehabilitation","author":"Srinivasan","year":"1994"},{"key":"b12","series-title":"Int J Lepr Other Mycobact Dis","first-page":"S19","article-title":"Pathology and pathogenesis of leprous neuritis; A preventable and treatable complication","volume":"69","author":"Job","year":"2001"},{"key":"b13","series-title":"PLoS Negl Trop Dis","first-page":"e0005111","article-title":"Ultrasonography of leprosy neuropathy: A longitudinal prospective study","volume":"10","author":"Lug\u00e3o","year":"2016"},{"key":"b14","series-title":"Indian J Dermatol Venereol Leprol","first-page":"114","article-title":"Methylprednisolone pulse therapy for leprosy neuritis: A retrospective study with sensory testing and peripheral nerve ultrasonography correlation","volume":"88","author":"Lug\u00e3o","year":"2021"},{"key":"b15","series-title":"Lepr Rev","first-page":"364","article-title":"Ultrasonography versus clinical examination in detecting leprosy neuropathy","volume":"90","author":"Kumaran","year":"2019"},{"key":"b16","series-title":"Skeletal Radiol","first-page":"142","article-title":"US and MR imaging of peripheral nerves in leprosy","volume":"29","author":"Martinoli","year":"2000"},{"key":"b17","series-title":"J Neuroimaging","first-page":"76","article-title":"A hand-held ultrasound device for the assessment of peripheral nerves in leprosy","volume":"31","author":"Wheat","year":"2021"},{"key":"b18","series-title":"Ultraschall Med","first-page":"80","article-title":"High-resolution sonography as an additional diagnostic and prognostic tool to monitor disease activity in leprosy: A two-year prospective study","volume":"39","author":"Chaduvula","year":"2018"},{"key":"b19","series-title":"J Peripher Nerv Syst","first-page":"191","article-title":"Pathological, ultrasonographic, and electrophysiological characterization of clinically diagnosed cases of pure neuritic leprosy","volume":"25","author":"Shukla","year":"2020"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/5\/article-p1046.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/5\/article-p1046.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/5\/article-p1046.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T13:46:06Z","timestamp":1730900766000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/5\/article-p1046.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,6]]},"references-count":19,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0256","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,6]]}}}