Development of MRI in inherited neuropathies

Magnetic Resonance Imaging (MRI) Characteristics of Inflammatory Neuropathies - a pilot study

Background

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune mediated condition.

It is characterised by progressive or relapsing motor and sensory defects in arms and legs. It is a treatable condition and often responds to immunomodulatory treatment.

Diagnosis can be difficult as the damaged part of the nerve roots are not easily accessible to clinical examination.

Patients with peripheral nervous system (PNS) disease are currently assessed by:

• clinical examination
• neurophysiological tests
• and nerve biopsy (where there is uncertainty  in the clinical diagnosis)

To reduce the need for invasive procedures such as nerve biopsy, clarification of nerve imaging can be used.

MRI has been widely used in the diagnosis of neurological diseases of the central nervous system, but not so much for the diseases of the PNS.

Research in inflammatory neuropathies has included traditional T1 and T2-weighted sequences. Some more recent work has looked at novel MRI technique such as diffusion tensor imaging.

There is no published data on the use of novel MRI techniques in patients with CIDP. MRI may be a useful non-invasive diagnostic tool.

Study information

Recruitment: 10 patients each with CIDP, multifocal motor neuropathy (MMNCB) and 20 healthy volunteers.

Primary objective

To clarify the use of MRI for the diagnosis of patients with CIDP and MMNCB.

We will use 3T MRI with both conventional and novel quantitative MRI sequences

We will also:

• measure nerve root cross sectional area in cervical and lumbar regions in patients with CIDP, MMN and healthy controls.
• explore imaging characteristics of the sciatic nerve in patients with CIDP versus healthy controls.
• define imaging characteristics at sites of conduction block in nerves of patients with MMNCB.
• compare MRI to pathological findings on nerve biopsy. In a separate group of patients with suspected inflammatory neuropathy