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MRI detects peripheral nerve and adjacent muscle pathology in non-systemic vasculitic neuropathy (NSVN)

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Abstract

Background

Diagnosis and disease monitoring of non-systemic vasculitic neuropathy (NSVN) are based on electrophysiological and clinical measures. However, these methods are insensitive to detect subtle differences of axonal injury. We here assessed the utility of a multiparametric MRI protocol to quantify axonal injury and neurogenic muscle damage in NSVN.

Methods

Ten NSVN patients and ten age-matched controls were investigated in this single-center prospective study. All participants were assessed by diffusion tensor imaging (DTI) of the tibial nerve and multiecho Dixon MRI of soleus and gastrocnemius muscles. These data were correlated with clinical and electrophysiological data.

Results

DTI scans of the tibial nerves of patients with NSVN showed significantly lower mean fractional anisotropy (FA) values (0.32 ± 0.02) compared to healthy controls (0.42 ± 0.01). FA values of NSVN patients correlated negatively with clinical measures of pain. Multiecho Dixon MRI scans revealed significantly higher intramuscular fat fractions in the soleus muscle (19.86 ± 6.18% vs. 5.86 ± 0.74%, p = 0.0015) and gastrocnemius muscle (26.09 ± 6.21% vs. 3.59 ± 0.82%, p = 0.0002) in NSVN patients compared to healthy controls.

Conclusion

Our data provide a proof of concept that MRI can render information about nerve integrity and muscle pathology in NSVN. Further studies are warranted to evaluate DTI and multiecho Dixon MRI as surrogate markers in NSVN.

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Acknowledgements

We thank Jan Borggrefe for support in statistical analysis of interrater agreement and Claudia Müller for technical assistance.

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Author notes

  1. Christian Schneider and Alina Sprenger shared first co-authorship.

Authors and Affiliations

  1. Department of Neurology, University Hospital of Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany

    Christian Schneider, Alina Sprenger, Gereon R. Fink & Helmar C. Lehmann

  2. Department of Radiology, University of Cologne, Cologne, Germany

    Karin Slebocki, David Maintz, Tobias D. Henning & Thorsten Lichtenstein

  3. Philips Healthcare, Hamburg, Germany

    Kilian Weiss

  4. Institute of Neuroscience and Medicine (INM-3), Research Centre Juelich, Juelich, Germany

    Gereon R. Fink

  5. Department of Neuroradiology, Krankenhaus der Barmherzigen Brüder Trier, Trier, Germany

    Tobias D. Henning

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  1. Christian Schneider
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  2. Alina Sprenger
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  4. Karin Slebocki
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Contributions

CS: study concept, conducting the study, data interpretation, drafting the manuscript. AS: study concept, conducting the study, analysis of data, drafting the manuscript. KW: study concept, technical assistance. KS: analysis of data. DM: study concept, drafting the manuscript for content. GRF: study concept, drafting the manuscript for content. TH: study concept. HCL: study concept, drafting the manuscript for content. TL: study concept, data analysis, drafting the manuscript.

Corresponding author

Correspondence to Helmar C. Lehmann.

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Conflicts of interest

KW is an employee of Philips Healthcare Germany since 10/2014. He reports personal fees from Philips Healthcare Germany, during the conduct of the study and personal fees from Philips Healthcare Germany, outside the submitted work. The other authors state that there is no conflict of interest.

Ethical standards

All procedures involving human participants were in accordance with the ethical standards of the institutional research committee and the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all the individual participants included in the study.

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Schneider, C., Sprenger, A., Weiss, K. et al. MRI detects peripheral nerve and adjacent muscle pathology in non-systemic vasculitic neuropathy (NSVN). J Neurol 266, 975–981 (2019). https://doi.org/10.1007/s00415-019-09224-0

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  • DOI: https://doi.org/10.1007/s00415-019-09224-0

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