Accumulation of non-compressive fascicular lesions underlies NF2 polyneuropathy.
Standard
Accumulation of non-compressive fascicular lesions underlies NF2 polyneuropathy. / Bäumer, P; Mautner, Viktor Felix; Bäumer, Tobias; Schuhmann, M U; Tatagiba, M; Heiland, S; Kaestel, T; Bendszus, M; Pham, M.
In: J NEUROL, Vol. 260, No. 1, 1, 2013, p. 38-46.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Accumulation of non-compressive fascicular lesions underlies NF2 polyneuropathy.
AU - Bäumer, P
AU - Mautner, Viktor Felix
AU - Bäumer, Tobias
AU - Schuhmann, M U
AU - Tatagiba, M
AU - Heiland, S
AU - Kaestel, T
AU - Bendszus, M
AU - Pham, M
PY - 2013
Y1 - 2013
N2 - A distinct polyneuropathy (PNP) syndrome affects up to 66 % of patients with neurofibromatosis II (NF2). Whether this is primarily a diffuse PNP or due to single, surgically amenable mass lesions has not yet been conclusively demonstrated. We aimed to solve this question by investigating the pathomorphological MR imaging correlate of this rare disorder. Eight patients with NF2-PNP were characterized by clinical examination, electrophysiological studies, and genetic analysis. All patients additionally underwent extended peripheral nerve imaging by a novel protocol of large-coverage high-resolution MRI. Quantitative analyses were performed by separately evaluating cross-sectional images, and by categorizing lesions into non-compressive fascicular microlesions (<2 mm), intermediate lesions (2-5 mm), and compressive macrolesions (>5 mm). The predominant imaging findings were non-compressive fascicular microlesions and intermediate lesions. Proximal-to-distal cumulative lesion burden of these lesions correlated strongly with the severity of clinical symptoms of NF2-PNP. In contrast, compressive macrolesions were not found at all in several symptomatic extremities. We conclude that proximal-to-distal accumulation of non-compressive fascicular lesions instead of compressive mass lesions predominantly underlies the clinical manifestation and severity of NF2-associated PNP. Diagnostic management may now be assisted by large-coverage high-resolution imaging of plexus and peripheral nerves. Additionally, the results underscore the feasibility of this new method, which may open up new diagnostic and investigative possibilities for other disseminated disorders of the peripheral nervous system.
AB - A distinct polyneuropathy (PNP) syndrome affects up to 66 % of patients with neurofibromatosis II (NF2). Whether this is primarily a diffuse PNP or due to single, surgically amenable mass lesions has not yet been conclusively demonstrated. We aimed to solve this question by investigating the pathomorphological MR imaging correlate of this rare disorder. Eight patients with NF2-PNP were characterized by clinical examination, electrophysiological studies, and genetic analysis. All patients additionally underwent extended peripheral nerve imaging by a novel protocol of large-coverage high-resolution MRI. Quantitative analyses were performed by separately evaluating cross-sectional images, and by categorizing lesions into non-compressive fascicular microlesions (<2 mm), intermediate lesions (2-5 mm), and compressive macrolesions (>5 mm). The predominant imaging findings were non-compressive fascicular microlesions and intermediate lesions. Proximal-to-distal cumulative lesion burden of these lesions correlated strongly with the severity of clinical symptoms of NF2-PNP. In contrast, compressive macrolesions were not found at all in several symptomatic extremities. We conclude that proximal-to-distal accumulation of non-compressive fascicular lesions instead of compressive mass lesions predominantly underlies the clinical manifestation and severity of NF2-associated PNP. Diagnostic management may now be assisted by large-coverage high-resolution imaging of plexus and peripheral nerves. Additionally, the results underscore the feasibility of this new method, which may open up new diagnostic and investigative possibilities for other disseminated disorders of the peripheral nervous system.
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Middle Aged
KW - Young Adult
KW - Child
KW - Magnetic Resonance Imaging
KW - Phenotype
KW - Image Processing, Computer-Assisted
KW - Electromyography
KW - Reflex/physiology
KW - Chromosomes, Human, Pair 22/genetics
KW - Ankle/pathology/physiopathology
KW - Extremities/pathology/physiopathology
KW - Neural Conduction/physiology
KW - Neurofibromatosis 2/complications/genetics/pathology
KW - Peripheral Nerves/pathology/physiopathology
KW - Peripheral Nervous System Diseases/complications/genetics/pathology
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Middle Aged
KW - Young Adult
KW - Child
KW - Magnetic Resonance Imaging
KW - Phenotype
KW - Image Processing, Computer-Assisted
KW - Electromyography
KW - Reflex/physiology
KW - Chromosomes, Human, Pair 22/genetics
KW - Ankle/pathology/physiopathology
KW - Extremities/pathology/physiopathology
KW - Neural Conduction/physiology
KW - Neurofibromatosis 2/complications/genetics/pathology
KW - Peripheral Nerves/pathology/physiopathology
KW - Peripheral Nervous System Diseases/complications/genetics/pathology
M3 - SCORING: Journal article
VL - 260
SP - 38
EP - 46
JO - J NEUROL
JF - J NEUROL
SN - 0340-5354
IS - 1
M1 - 1
ER -
