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Borire AA, Arnold R, Pussell BA, Kwai NC, Visser LH, Simon NG, Kiernan MC, Krishnan AV. Effects of hemodialysis on intraneural blood flow in end-stage kidney disease. Muscle Nerve 2017; 57:287-293. [PMID: 28556350 DOI: 10.1002/mus.25704] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/17/2017] [Accepted: 05/23/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION We quantified intraneural blood flow (INBF) in 18 patients with end-stage kidney disease (ESKD) and examined its relationship with nerve size, neuropathy severity, and nerve excitability parameters. METHODS Sonographic measurements of the median nerve were performed at the same site before and after hemodialysis. INBF was quantified by analyzing power Doppler sonograms to obtain the vessel score (VSc) and maximum perfusion intensity (MPI). Corresponding median motor nerve excitability studies were performed. Neuropathy severity was assessed using Total Neuropathy Score. RESULTS A total of 39% of ESKD patients had detectable INBF compared with none in the control group (P < 0.0001). Patients with detectable INBF had larger nerves and more severe neuropathy (P < 0.01). INBF parameters were significantly reduced after a session of dialysis (VSc: P < 0.01; MPI: P < 0.01). A significant relationship was found between interdialytic change in INBF and changes in nerve excitability. CONCLUSIONS Increased INBF is a potential marker for neuropathy severity in ESKD patients. Muscle Nerve 57: 287-293, 2018.
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Affiliation(s)
- Adeniyi A Borire
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Ria Arnold
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Bruce A Pussell
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Natalie C Kwai
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Leo H Visser
- Elisabeth-Tweesteden Hospital, Department of Neurology, Tilburg, the Netherlands
| | - Neil G Simon
- St Vincent's Clinical School, University of New South Wales, Sydney, Australia.,Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - Arun V Krishnan
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
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Borire AA, Visser LH, Padua L, Colebatch JG, Huynh W, Simon NG, Kiernan MC, Krishnan AV. Utility of maximum perfusion intensity as an ultrasonographic marker of intraneural blood flow. Muscle Nerve 2016; 55:77-83. [PMID: 27226421 DOI: 10.1002/mus.25200] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2016] [Indexed: 12/21/2022]
Abstract
We quantified intraneural blood flow (INBF) using perfusion measurement software (PixelFlux), and compared it with the qualitative method of counting blood vessels (vessel score) in a cohort of carpal tunnel syndrome (CTS) patients. METHODS Forty-seven patients (67 wrists) with a clinical and electrophysiological diagnosis of CTS, and 20 healthy controls (40 wrists) were enrolled. Median nerve ultrasound (US) was performed at the carpal tunnel inlet to measure the cross-sectional area (CSA) and vessel score. Power Doppler sonograms from nerves with detectable INBF were processed with PixelFlux to obtain the maximum perfusion intensity (MPI). RESULTS Forty-nine percent of CTS patients had detectable INBF compared with none in the control group (P < 0.0001). MPI correlated significantly with vessel score (r = 0.945, P < 0.0001), CSA (r = 0.613, P < 0.0001), and electrophysiological severity (r = 0.440, P < 0.0001). MPI had higher intra- or interobserver reliability compared with vessel score (0.95 vs. 0.47). CONCLUSION MPI is a better method for quantification of INBF. Muscle Nerve, 2016 Muscle Nerve 55: 77-83, 2017.
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Affiliation(s)
- Adeniyi A Borire
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Leo H Visser
- St. Elisabeth Ziekenhuis, Tilburg, The Netherlands
| | - Luca Padua
- Department of Geriatrics, Neurosciences, and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy.,Don Gnocchi Foundation, Milan, Italy
| | - James G Colebatch
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - William Huynh
- Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, New South Wales, Australia.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Neil G Simon
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew C Kiernan
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Arun V Krishnan
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, New South Wales, Australia
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