A role for peripheral nerve ultrasound in differentiating conduction-slowing diabetic sensorimotor polyneuropathy and chronic inflammatory demyelinating polyradiculoneuropathy.
4 affiliations
- 1Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
- 2Department of Neurology, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan.
- 3Acute Intermittent Porphyria Clinical and Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- 4School of Medicine, College of Life Sciences and Medicine, National Tsing Hua University, Hsinchu, Taiwan.
Abstract
Aims/introduction
Differentiating chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) from conduction-slowing diabetic sensorimotor polyneuropathy (DSPN) is clinically challenging due to overlapping electrophysiological findings and frequent lack of responsiveness in nerve conduction studies (NCS). This study aimed to evaluate the role of high-resolution nerve ultrasound in distinguishing CIDP from conduction-slowing DSPN.Materials and methods
We retrospectively enrolled 22 CIDP and 24 conduction-slowing DSPN patients. All underwent comprehensive NCS and high-resolution nerve ultrasound. Cross-sectional areas (CSA) of multiple peripheral nerves were measured, and composite scores including the ultrasound pattern sum score (UPSS) were calculated. Statistical analyses, including logistic regression and receiver operating characteristic (ROC) curve analysis, were performed to assess diagnostic performance.Results
Significant differences were found between CIDP and conduction-slowing DSPN in both NCS and ultrasound parameters. Patients with CIDP demonstrated greater prolongation of distal latencies of NCS and F-wave latency, reduced conduction velocities, and larger nerve cross-sectional areas compared with those with conduction-slowing DSPN. However, approximately 4.5%-54.5% of patients with CIDP showed no response in NCS. A UPSS score greater than 6 achieved a sensitivity of 0.77, specifically of 0.92, and an area under the curve (AUC) of 0.89 for distinguishing CIDP from conduction-slowing DSPN.Conclusion
High-resolution nerve ultrasound, particularly the UPSS, serves as a valuable adjunct for differentiating CIDP from conduction-slowing DSPN, especially when NCS results are inconclusive.
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BibTeX
@article{hsieh2026role,
title = {{A role for peripheral nerve ultrasound in differentiating conduction-slowing diabetic sensorimotor polyneuropathy and chronic inflammatory demyelinating polyradiculoneuropathy.}},
author = {Pei-Chen Hsieh and Long-Sun Ro and Chun-Che Chu and Ming-Feng Liao and Hong-Shiu Chang and Hung-Chou Kuo},
journal = {Journal of diabetes investigation},
year = {2026},
month = nov,
doi = {10.1111/jdi.70488},
url = {https://europepmc.org/article/MED/43006800},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - A role for peripheral nerve ultrasound in differentiating conduction-slowing diabetic sensorimotor polyneuropathy and chronic inflammatory demyelinating polyradiculoneuropathy.
AU - Pei-Chen Hsieh
AU - Long-Sun Ro
AU - Chun-Che Chu
AU - Ming-Feng Liao
AU - Hong-Shiu Chang
AU - Hung-Chou Kuo
PY - 2026
DA - 2026/11/10
JO - Journal of diabetes investigation
DO - 10.1111/jdi.70488
UR - https://europepmc.org/article/MED/43006800
AB - Aims/introduction Differentiating chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) from conduction-slowing diabetic sensorimotor polyneuropathy (DSPN) is clinically challenging due to overlapping electrophysiological findings and frequent lack of responsiveness in nerve conduction studies (NCS). This study aimed to evaluate the role of high-resolution nerve ultrasound in distinguishing CIDP from conduction-slowing DSPN.Materials and methods We retrospectively enrolled 22 CIDP and 24 conduction-slowing DSPN patients. All underwent comprehensive NCS and high-resolution nerve ultrasound. Cross-sectional areas (CSA) of multiple peripheral nerves were measured, and composite scores including the ultrasound pattern sum score (UPSS) were calculated. Statistical analyses, including logistic regression and receiver operating characteristic (ROC) curve analysis, were performed to assess diagnostic performance.Results Significant differences were found between CIDP and conduction-slowing DSPN in both NCS and ultrasound parameters. Patients with CIDP demonstrated greater prolongation of distal latencies of NCS and F-wave latency, reduced conduction velocities, and larger nerve cross-sectional areas compared with those with conduction-slowing DSPN. However, approximately 4.5%-54.5% of patients with CIDP showed no response in NCS. A UPSS score greater than 6 achieved a sensitivity of 0.77, specifically of 0.92, and an area under the curve (AUC) of 0.89 for distinguishing CIDP from conduction-slowing DSPN.Conclusion High-resolution nerve ultrasound, particularly the UPSS, serves as a valuable adjunct for differentiating CIDP from conduction-slowing DSPN, especially when NCS results are inconclusive.
SN - 2040-1116
SN - 2040-1124
ER -