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Wu Y, Barrere V, Han A, Andre MP, Orozco E, Cheng X, Chang EY, Shah SB. Quantitative evaluation of rat sciatic nerve degeneration using high-frequency ultrasound. Sci Rep 2023; 13:20228. [PMID: 37980432 PMCID: PMC10657462 DOI: 10.1038/s41598-023-47264-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 11/11/2023] [Indexed: 11/20/2023] Open
Abstract
In this study, we evaluated the utility of using high-frequency ultrasound to non-invasively track the degenerative process in a rat model of peripheral nerve injury. Primary analyses explored spatial and temporal changes in quantitative backscatter coefficient (BSC) spectrum-based outcomes and B-mode textural outcomes, using gray level co-occurrence matrices (GLCMs), during the progressive transition from acute to chronic injury. As secondary analyses, correlations among GLCM and BSC spectrum-based parameters were evaluated, and immunohistochemistry were used to suggest a structural basis for ultrasound outcomes. Both mean BSC spectrum-based and mean GLCM-based measures exhibited significant spatial differences across presurgical and 1-month/2-month time points, distal stumps enclosed proximity to the injury site being particularly affected. The two sets of parameters sensitively detected peripheral nerve degeneration at 1-month and 2-month post-injury, with area under the receiver operating charactersitic curve > 0.8 for most parameters. The results also indicated that the many BSC spectrum-based and GLCM-based parameters significantly correlate with each other, and suggested a common structural basis for a diverse set of quantitative ultrasound parameters. The findings of this study suggest that BSC spectrum-based and GLCM-based analysis are promising non-invasive techniques for diagnosing peripheral nerve degeneration.
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Affiliation(s)
- Yuanshan Wu
- Department of Bioengineering, University of California, San Diego, 9500 Gilman Drive, MC 0863, La Jolla, CA, 92093-0683, USA
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Victor Barrere
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Aiguo Han
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Michael P Andre
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Elisabeth Orozco
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Xin Cheng
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Eric Y Chang
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Sameer B Shah
- Department of Bioengineering, University of California, San Diego, 9500 Gilman Drive, MC 0863, La Jolla, CA, 92093-0683, USA.
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA.
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
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Pitarokoili K, Gold R, Fisse AL. Nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies. Curr Opin Neurol 2023; 36:373-381. [PMID: 37382111 DOI: 10.1097/wco.0000000000001183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
PURPOSE OF REVIEW The purpose if this review is to provide an overview of the available data on the use of nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies. RECENT FINDINGS During the last decade, nerve ultrasound has been established as a complementary tool for the evaluation of morphological changes mostly for immune-mediated polyneuropathies. Through the development of ultrasound protocols for evaluation of disease-specific sites, nerve ultrasound has proven to be a practical, widely available, reproducible diagnostic tool with no relevant contraindications. SUMMARY Cross-sectional area, echogenicity, morphology of the individual nerve fascicles, thickness of the epineurium, vascularization and mobility of the nerve are the main parameters evaluated with nerve ultrasound in polyneuropathies. Patients with typical chronic inflammatory demyelinating polyneuropathy show multifocal nerve enlargements easily visible on the upper extremities and the brachial plexus, whereas its variants show focal nerve enlargements. On the other hand, axonal neuropathies including diabetic neuropathy present with isolated nerve enlargement mostly in compression sites.
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Hildebrand A, Schreiber F, Weber L, Arndt P, Garz C, Petri S, Prudlo J, Meuth SG, Waerzeggers Y, Henneicke S, Vielhaber S, Schreiber S. Peripheral Nerve Ultrasound for the Differentiation between ALS, Inflammatory, and Hereditary Polyneuropathies. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1192. [PMID: 37512004 PMCID: PMC10383275 DOI: 10.3390/medicina59071192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/10/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Ultrasound (US) is a non-invasive tool for the in vivo detection of peripheral nerve alterations. Materials and Methods: In this study, we applied nerve US to assist the discrimination between the spectrum of amyotrophic lateral sclerosis (ALS, n = 11), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP, n = 5), and genetically confirmed Charcot-Marie-Tooth disease (CMT, n = 5). All participants and n = 15 controls without neurological diseases underwent high-resolution US of the bilateral tibial nerve. The nerve cross-sectional area (CSA) and nerve microvascular blood flow were compared between the groups and related to cerebrospinal fluid (CSF) measures, clinical symptoms, and nerve conduction studies. The analyses are part of a larger multimodal study on the comparison between US and 7 Tesla (7T) magnetic resonance neurography (MRN). Results: The patients and controls were matched with respect to their demographical data. CMT had the longest disease duration, followed by CIDP and ALS. CSA was related to age, weight, and disease duration. CSA was larger in CMT and CIDP compared to ALS and controls. The blood flow was greatest in CIDP, and higher than in CMT, ALS, and controls. In ALS, greater CSA was correlated with greater CSF total protein and higher albumin quotient. The US measures did not correlate with clinical scores or nerve conduction studies in any of the subgroups. Conclusion: Our results point towards the feasibility of CSA and blood flow to discriminate between ALS, CIDP, and CMT, even in groups of small sample size. In ALS, larger CSA could indicate an inflammatory disease subtype characterized by reduced blood-nerve barrier integrity. Our upcoming analysis will focus on the additive value of 7T MRN in combination with US to disentangle the spectrum between more inflammatory or more degenerative disease variants among the disease groups.
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Affiliation(s)
- Annkatrin Hildebrand
- Department of Neurology, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
| | - Frank Schreiber
- Department of Neurology, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Luisa Weber
- Department of Neurology, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
- Department of Neurology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Philipp Arndt
- Department of Neurology, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
| | - Cornelia Garz
- Leibniz Institute for Neurobiology (LIN), 39120 Magdeburg, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany
| | - Johannes Prudlo
- Department of Neurology, Rostock University Medical Center, 18147 Rostock, Germany
- German Center for Neurodegenerative Diseases (DZNE), 18147 Rostock, Germany
| | - Sven G Meuth
- Department of Neurology, Medical Faculty, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - Yannic Waerzeggers
- Department of Neurology, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
| | - Solveig Henneicke
- Department of Neurology, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Stefan Vielhaber
- Department of Neurology, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), 39120 Magdeburg, Germany
| | - Stefanie Schreiber
- Department of Neurology, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), 39120 Magdeburg, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany
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Fisse AL, Pitarokoili K, Schreiber S. Moderner Ultraschall in der Diagnostik Neuromuskulärer
Erkrankungen. KLIN NEUROPHYSIOL 2022. [DOI: 10.1055/a-1740-0649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungDer neuromuskuläre Ultraschall hat sich in den letzten Jahren zu einem
festen Bestandteil in der neurologischen Diagnostik entwickelt. Dazu tragen auch
die fortwährende technische Weiterentwicklung der Methode und ihr
unkomplizierter und nebenwirkungsfreier Einsatz direkt am Patienten bei. Im
klinischen Alltag wird der Ultraschall in der Diagnostik und
Differentialdiagnostik sowie in der Verlaufskontrolle traumatischer
Nervenläsionen, sekundärer und dynamischer nervaler
Kompressionssyndrome, hereditärer und akuter sowie chronisch autoimmuner
Polyneuropathien, Motoneuron- und Muskelerkrankungen verwendet. Dabei spielt die
Ultraschalldiagnostik auch zunehmend eine Rolle für
Therapieentscheidungen, v.a. im Hinblick auf die operative Versorgung und den
Einsatz oder die Fortführung immunmodulatorischer Medikamente. In den
nächsten Jahren ist eine weitere interdisziplinäre Verbreitung
und fortwährend zunehmende Standardisierung der Methode zu erwarten.
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Affiliation(s)
- Anna Lena Fisse
- Klinik für Neurologie, Ruhr-Universität Bochum, St.
Josef Hospital, Bochum
| | | | - Stefanie Schreiber
- Universitätsklinik für Neurologie, Otto-von-Guericke
Universität, Magdeburg
- Deutsches Zentrum für Neurodegenerative Erkrankungen,
Magdeburg
- Center for Behavioral Brain Sciences (CBBS), Otto-von-Guericke
Universität, Magdeburg
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Schreiber S, Haghikia A. From many, one: A call for meta-cohorts in neuromuscular ultrasound. Eur J Neurol 2021; 28:1435-1436. [PMID: 33560538 DOI: 10.1111/ene.14767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Stefanie Schreiber
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany.,German Center for Neurodegenerative Diseases, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Aiden Haghikia
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany.,German Center for Neurodegenerative Diseases, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
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