Peripheral nervous system involvement in systemic sclerosis

The median nerve as target structure

S. Lori, M. Matucci-Cerinic, R. Casale, S. Generini, A. Lombardi, A. Pignone, C. Scaletti, P. P. Gangemi, M. Cagnoni

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objectives. To investigate the frequency and the main electrophysiological characteristics of the canalicolar passage nerve involvement in patients with systemic sclerosis (SSc). Methods. Thirty-two SSc patients were enrolled in the study, classified according to the type (diffuse or limited) and the duration (>/<5 years) of the disease. Sensory-motor nerve conduction studies (NCS) of the upper and lower limbs, in particular at the critical canalicolar points, were conducted by recording the Compound Muscular Action Potential (CMAP) and the Sensory Action Potential (sNAP). The following parameters were evaluated: Motor Nerve Conduction Velocity (MNCV) and Sensory Nerve Conduction Velocity; distal and proximal latency of the CMAP and the onset and peak latency of the sNAP; peak-peak amplitude and negative-peak area of the CMAP and sNAP; and the Terminal Latency Index (TLI) (Terminal Distance/MCNV x Distal latency). Results. Four (12.5%) patients had a distal neuropathy of the upper limbs (one with monolateral and two with bilateral involvement of the median nerve and one bilateral involvement of the ulnar nerve). Fourteen (43.%) patients showed a decrement of the median nerve TLI and seven (21.8%) of either the median or the ulnar nerve. Motor and sensitive conduction velocity and latency studies did not show a statistical difference between SSc patients and controls. The amplitude and area of the CMAP (distal and proximal), sNAP and of the median nerve TLI were significantly decreased in patients with respect to controls. Conclusion. Distal mononeuropathy of the median nerve was the most frequent result in our patients. The involvement of the peripheral nervous system seems to be strictly topographical, following the modifcations of the tissues and vascular tone (Raynaud's phenomenon) at the upper acral level. The neurophysiological alterations detected in our study at the wrist level may not be linked merely to a compressive event but also to microvascular involvement. Nerve involvement closely connected with the pathogenesis and distribution of SSc should be considered when peripheral nervous system involvement is the initial symptom of the disease.

Original languageEnglish
Pages (from-to)601-605
Number of pages5
JournalClinical and Experimental Rheumatology
Volume14
Issue number6
Publication statusPublished - Nov 1996

Fingerprint

Systemic Scleroderma
Median Nerve
Peripheral Nervous System
Action Potentials
Neural Conduction
Ulnar Nerve
Mononeuropathies
Raynaud Disease
Wrist
Upper Extremity
Blood Vessels
Lower Extremity
Extremities

Keywords

  • carpal tunnel syndrome
  • peripheral nervous system
  • systemic sclerosis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Lori, S., Matucci-Cerinic, M., Casale, R., Generini, S., Lombardi, A., Pignone, A., ... Cagnoni, M. (1996). Peripheral nervous system involvement in systemic sclerosis: The median nerve as target structure. Clinical and Experimental Rheumatology, 14(6), 601-605.

Peripheral nervous system involvement in systemic sclerosis : The median nerve as target structure. / Lori, S.; Matucci-Cerinic, M.; Casale, R.; Generini, S.; Lombardi, A.; Pignone, A.; Scaletti, C.; Gangemi, P. P.; Cagnoni, M.

In: Clinical and Experimental Rheumatology, Vol. 14, No. 6, 11.1996, p. 601-605.

Research output: Contribution to journalArticle

Lori, S, Matucci-Cerinic, M, Casale, R, Generini, S, Lombardi, A, Pignone, A, Scaletti, C, Gangemi, PP & Cagnoni, M 1996, 'Peripheral nervous system involvement in systemic sclerosis: The median nerve as target structure', Clinical and Experimental Rheumatology, vol. 14, no. 6, pp. 601-605.
Lori S, Matucci-Cerinic M, Casale R, Generini S, Lombardi A, Pignone A et al. Peripheral nervous system involvement in systemic sclerosis: The median nerve as target structure. Clinical and Experimental Rheumatology. 1996 Nov;14(6):601-605.
Lori, S. ; Matucci-Cerinic, M. ; Casale, R. ; Generini, S. ; Lombardi, A. ; Pignone, A. ; Scaletti, C. ; Gangemi, P. P. ; Cagnoni, M. / Peripheral nervous system involvement in systemic sclerosis : The median nerve as target structure. In: Clinical and Experimental Rheumatology. 1996 ; Vol. 14, No. 6. pp. 601-605.
@article{3db289ecc0cc407bae08be16ad090dce,
title = "Peripheral nervous system involvement in systemic sclerosis: The median nerve as target structure",
abstract = "Objectives. To investigate the frequency and the main electrophysiological characteristics of the canalicolar passage nerve involvement in patients with systemic sclerosis (SSc). Methods. Thirty-two SSc patients were enrolled in the study, classified according to the type (diffuse or limited) and the duration (>/<5 years) of the disease. Sensory-motor nerve conduction studies (NCS) of the upper and lower limbs, in particular at the critical canalicolar points, were conducted by recording the Compound Muscular Action Potential (CMAP) and the Sensory Action Potential (sNAP). The following parameters were evaluated: Motor Nerve Conduction Velocity (MNCV) and Sensory Nerve Conduction Velocity; distal and proximal latency of the CMAP and the onset and peak latency of the sNAP; peak-peak amplitude and negative-peak area of the CMAP and sNAP; and the Terminal Latency Index (TLI) (Terminal Distance/MCNV x Distal latency). Results. Four (12.5{\%}) patients had a distal neuropathy of the upper limbs (one with monolateral and two with bilateral involvement of the median nerve and one bilateral involvement of the ulnar nerve). Fourteen (43.{\%}) patients showed a decrement of the median nerve TLI and seven (21.8{\%}) of either the median or the ulnar nerve. Motor and sensitive conduction velocity and latency studies did not show a statistical difference between SSc patients and controls. The amplitude and area of the CMAP (distal and proximal), sNAP and of the median nerve TLI were significantly decreased in patients with respect to controls. Conclusion. Distal mononeuropathy of the median nerve was the most frequent result in our patients. The involvement of the peripheral nervous system seems to be strictly topographical, following the modifcations of the tissues and vascular tone (Raynaud's phenomenon) at the upper acral level. The neurophysiological alterations detected in our study at the wrist level may not be linked merely to a compressive event but also to microvascular involvement. Nerve involvement closely connected with the pathogenesis and distribution of SSc should be considered when peripheral nervous system involvement is the initial symptom of the disease.",
keywords = "carpal tunnel syndrome, peripheral nervous system, systemic sclerosis",
author = "S. Lori and M. Matucci-Cerinic and R. Casale and S. Generini and A. Lombardi and A. Pignone and C. Scaletti and Gangemi, {P. P.} and M. Cagnoni",
year = "1996",
month = "11",
language = "English",
volume = "14",
pages = "601--605",
journal = "Clinical and Experimental Rheumatology",
issn = "0392-856X",
publisher = "Clinical and Experimental Rheumatology S.A.S.",
number = "6",

}

TY - JOUR

T1 - Peripheral nervous system involvement in systemic sclerosis

T2 - The median nerve as target structure

AU - Lori, S.

AU - Matucci-Cerinic, M.

AU - Casale, R.

AU - Generini, S.

AU - Lombardi, A.

AU - Pignone, A.

AU - Scaletti, C.

AU - Gangemi, P. P.

AU - Cagnoni, M.

PY - 1996/11

Y1 - 1996/11

N2 - Objectives. To investigate the frequency and the main electrophysiological characteristics of the canalicolar passage nerve involvement in patients with systemic sclerosis (SSc). Methods. Thirty-two SSc patients were enrolled in the study, classified according to the type (diffuse or limited) and the duration (>/<5 years) of the disease. Sensory-motor nerve conduction studies (NCS) of the upper and lower limbs, in particular at the critical canalicolar points, were conducted by recording the Compound Muscular Action Potential (CMAP) and the Sensory Action Potential (sNAP). The following parameters were evaluated: Motor Nerve Conduction Velocity (MNCV) and Sensory Nerve Conduction Velocity; distal and proximal latency of the CMAP and the onset and peak latency of the sNAP; peak-peak amplitude and negative-peak area of the CMAP and sNAP; and the Terminal Latency Index (TLI) (Terminal Distance/MCNV x Distal latency). Results. Four (12.5%) patients had a distal neuropathy of the upper limbs (one with monolateral and two with bilateral involvement of the median nerve and one bilateral involvement of the ulnar nerve). Fourteen (43.%) patients showed a decrement of the median nerve TLI and seven (21.8%) of either the median or the ulnar nerve. Motor and sensitive conduction velocity and latency studies did not show a statistical difference between SSc patients and controls. The amplitude and area of the CMAP (distal and proximal), sNAP and of the median nerve TLI were significantly decreased in patients with respect to controls. Conclusion. Distal mononeuropathy of the median nerve was the most frequent result in our patients. The involvement of the peripheral nervous system seems to be strictly topographical, following the modifcations of the tissues and vascular tone (Raynaud's phenomenon) at the upper acral level. The neurophysiological alterations detected in our study at the wrist level may not be linked merely to a compressive event but also to microvascular involvement. Nerve involvement closely connected with the pathogenesis and distribution of SSc should be considered when peripheral nervous system involvement is the initial symptom of the disease.

AB - Objectives. To investigate the frequency and the main electrophysiological characteristics of the canalicolar passage nerve involvement in patients with systemic sclerosis (SSc). Methods. Thirty-two SSc patients were enrolled in the study, classified according to the type (diffuse or limited) and the duration (>/<5 years) of the disease. Sensory-motor nerve conduction studies (NCS) of the upper and lower limbs, in particular at the critical canalicolar points, were conducted by recording the Compound Muscular Action Potential (CMAP) and the Sensory Action Potential (sNAP). The following parameters were evaluated: Motor Nerve Conduction Velocity (MNCV) and Sensory Nerve Conduction Velocity; distal and proximal latency of the CMAP and the onset and peak latency of the sNAP; peak-peak amplitude and negative-peak area of the CMAP and sNAP; and the Terminal Latency Index (TLI) (Terminal Distance/MCNV x Distal latency). Results. Four (12.5%) patients had a distal neuropathy of the upper limbs (one with monolateral and two with bilateral involvement of the median nerve and one bilateral involvement of the ulnar nerve). Fourteen (43.%) patients showed a decrement of the median nerve TLI and seven (21.8%) of either the median or the ulnar nerve. Motor and sensitive conduction velocity and latency studies did not show a statistical difference between SSc patients and controls. The amplitude and area of the CMAP (distal and proximal), sNAP and of the median nerve TLI were significantly decreased in patients with respect to controls. Conclusion. Distal mononeuropathy of the median nerve was the most frequent result in our patients. The involvement of the peripheral nervous system seems to be strictly topographical, following the modifcations of the tissues and vascular tone (Raynaud's phenomenon) at the upper acral level. The neurophysiological alterations detected in our study at the wrist level may not be linked merely to a compressive event but also to microvascular involvement. Nerve involvement closely connected with the pathogenesis and distribution of SSc should be considered when peripheral nervous system involvement is the initial symptom of the disease.

KW - carpal tunnel syndrome

KW - peripheral nervous system

KW - systemic sclerosis

UR - http://www.scopus.com/inward/record.url?scp=0030456522&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030456522&partnerID=8YFLogxK

M3 - Article

VL - 14

SP - 601

EP - 605

JO - Clinical and Experimental Rheumatology

JF - Clinical and Experimental Rheumatology

SN - 0392-856X

IS - 6

ER -