TY - JOUR
T1 - Electrodiagnostic subtyping in Guillain-Barré syndrome
T2 - Use of criteria in practice based on a survey study in IGOS
AU - Arends, Samuel
AU - Drenthen, Judith
AU - van den Bergh, Peter Y. K.
AU - Hadden, Robert D. M.
AU - Shahrizaila, Nortina
AU - Dimachkie, Mazen M.
AU - Gutiérrez Gutiérrez, Gerardo
AU - Katzberg, Hans
AU - Kiers, Lynette
AU - Lehmann, Helmar C.
AU - Péréon, Yann
AU - Reisin, Ricardo C.
AU - Uncini, Antonino
AU - Verhamme, Camiel
AU - Waheed, Wagar
AU - Cornblath, David R.
AU - the IGOS Electrophysiology Expertise Group
AU - Jacobs, Bart C.
N1 - Funding Information: T.H. Brannagan received consulting fees from Argenix and Grifols and honoraria from CSL Behring for giving lectures. D.R. Cornblath is member of the IGOS steering committee. M. Dimachkie received research and/or educational grants from Alexion, Alnylam Pharmaceuticals, Amicus, Biomarin, Bristol‐Myers Squibb, Catalyst, Corbus, CSL Behring, FDA/OOPD, GlaxoSmithKline, Genentech, Grifols, Kezar, Mitsubishi Tanabe Pharma, MDA, NIH, Novartis, Octapharma, Orphazyme, RaPharma/UCB, Sanofi Genzyme, Sarepta Therapeutics, Shire Takeda, Spark Therapeutics, The Myositis Association, UCB Biopharma/RaPharma, Viromed/Healixmith and TMA. He serves or recently served as consultant for Amazentis, Argenx, Catalyst, Cello, Covance/Labcorp, CSL Behring, EcoR1, Janssen, Kezar, Medlink, Momenta, NuFactor, Octapharma, RaPharma/UCB, Roivant Sciences Inc., Sanofi Genzyme, Shire Takeda, Scholar Rock, Spark Therapeutics, Abata/Third Rock, UCB Biopharma, UpToDate. He received honoraria for lectures and/or presentations at AAN, AANEM and Academic Institutions and participates in a data safety monitoring or advisory board for Covance/Labcorp. B.C. Jacobs received unrestricted research grants for work outside the current study from Baxalta, Grifols, CSL Behring, Annexon, Hansa Biopharma, Roche, Prinses Beatrix Spierfonds, GBS‐CIDP Foundation International and Horizon 2020. He received consulting fees from Roche for activities outside current study. Payments made to the Erasmus Medical Center. He is the chair of steering committee of the International GBS Outcome Study (IGOS). H. Katzberg received grants from Takaeda and CIHR for research support and consulting fees from Akcea, Alnylam, CSL Behring, Merz Pharma and Takaeda, he participates in a monitoring or advisory board for Alexion, Octapharma and UCB Pharma and has stock(options) for Romtech, H.C. Lehmann received honoraria for lectures and presentations from Akcea, Alnylam, Biogen, Celgene, CSL Behring, Grifols, Gruenenthal, LFB Pharma, Takeda, UCB. Y. Péréon received honoraria from Natus for lectures or presentations. R. Reisin received honoraria for lectures or presentations from Takeda, PTC, CSL Behring. He has patents planned, issued or pending by CSL Behring. He participates in data safety monitoring or advisory board of Takeda. He received a donation from PTC. The following authors declared no conflict of interest: S. Arends, P. van den Bergh, D. Binda, C. Casasnovas, D.R. Cornblath, J. Drenthen, E. Fulgenzi, G. Gutiérrez Gutiérrez, S.T. Hsieh, L. Kiers, G.A. Marfia, G. Mataluni, J. Pardo, Y. Sekiguchi, N. Shahrizaila, A. Uncini, C. Verhamme, W. Waheed, M. Wang. Publisher Copyright: © 2022 The Authors. Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society.
PY - 2022/9
Y1 - 2022/9
N2 - Electrodiagnostic (EDx) studies are helpful in diagnosing and subtyping of Guillain-Barré syndrome (GBS). Published criteria for differentiation into GBS subtypes focus on cutoff values, but other items receive less attention, although they may influence EDx subtyping: (a) extensiveness of EDx testing, (b) nerve-specific considerations, (c) distal compound muscle action potential (CMAP)-amplitude requirements, (d) criteria for conduction block and temporal dispersion. The aims of this study were to investigate how these aspects were approached by neuromuscular EDx experts in practice and how this was done in previously published EDx criteria for GBS. A completed questionnaire was returned by 24 (of 49) members of the electrophysiology expertise group from the International GBS Outcome Study. Six published EDx criteria for GBS subtyping were compared regarding these aspects. The indicated minimal number of motor nerves to study varied among respondents and tended to be more extensive in equivocal than normal studies. Respondents varied considerably regarding usage of compression sites for subtyping (median/wrist, ulnar/elbow, peroneal/fibular head): 29% used all variables from all sites, 13% excluded all sites, and 58% used only some sites and/or variables. Thirty-eight percent of respondents required a minimal distal CMAP amplitude to classify distal motor latency as demyelinating, and 58% did for motor conduction velocity. For proximal/distal CMAP-amplitude ratio and F-wave latency, a requisite minimal CMAP amplitude was more often required (79%). Also, the various published criteria sets showed differences on all items. Practical use of EDx criteria for subtyping GBS vary extensively across respondents, potentially lowering the reproducibility of GBS subtyping.
AB - Electrodiagnostic (EDx) studies are helpful in diagnosing and subtyping of Guillain-Barré syndrome (GBS). Published criteria for differentiation into GBS subtypes focus on cutoff values, but other items receive less attention, although they may influence EDx subtyping: (a) extensiveness of EDx testing, (b) nerve-specific considerations, (c) distal compound muscle action potential (CMAP)-amplitude requirements, (d) criteria for conduction block and temporal dispersion. The aims of this study were to investigate how these aspects were approached by neuromuscular EDx experts in practice and how this was done in previously published EDx criteria for GBS. A completed questionnaire was returned by 24 (of 49) members of the electrophysiology expertise group from the International GBS Outcome Study. Six published EDx criteria for GBS subtyping were compared regarding these aspects. The indicated minimal number of motor nerves to study varied among respondents and tended to be more extensive in equivocal than normal studies. Respondents varied considerably regarding usage of compression sites for subtyping (median/wrist, ulnar/elbow, peroneal/fibular head): 29% used all variables from all sites, 13% excluded all sites, and 58% used only some sites and/or variables. Thirty-eight percent of respondents required a minimal distal CMAP amplitude to classify distal motor latency as demyelinating, and 58% did for motor conduction velocity. For proximal/distal CMAP-amplitude ratio and F-wave latency, a requisite minimal CMAP amplitude was more often required (79%). Also, the various published criteria sets showed differences on all items. Practical use of EDx criteria for subtyping GBS vary extensively across respondents, potentially lowering the reproducibility of GBS subtyping.
KW - Guillain-Barré syndrome
KW - electrodiagnostic criteria
KW - electromyography
KW - nerve conduction studies
KW - variation
UR - http://www.scopus.com/inward/record.url?scp=85133745522&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/jns.12504
DO - https://doi.org/10.1111/jns.12504
M3 - Article
C2 - 35700346
SN - 1085-9489
VL - 27
SP - 197
EP - 205
JO - Journal of the peripheral nervous system
JF - Journal of the peripheral nervous system
IS - 3
ER -