Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study:   Differences in methods and reference values

doi:10.1016/j.clinph.2021.12.014

Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study: Differences in methods and reference values

College of Health and Life Sciences

Erasmus University Medical Center
The Hague
Cliniques Universitaires Saint-Luc
Royal Netherlands Academy of Arts and Sciences and University Medical Center Utrecht
King's College Hospital
Bangladesh)
Chiba University Hospital
Hospital Británico
University of Malaya
Università degli Studi di Roma La Sapienza
University Hospital La Timone
Università degli Studi di Milano-Bicocca
Fleni Hospital
University of Tennessee Health Science Center
Valduce Hospital
Columbia University of Physicians and Surg.
Saarland University
Mvz Pfalzklinikum
Hospital Universitari de Bellvitge
National Taiwan University Hospital
The University of Kansas
Hospital Cesar Milstein
Azienda Ospedaliero - Universitaria di Modena Policlinico
Hospital Universitario Infanta Sofia
Aarhus University Hospital
Heinrich-Heine University
Royal Melbourne Hospital
University Hospital of Cologne
Università degli Studi di Napoli Federico II
University hospital Tor Vergata
Complejo Hospitalario Universitario de Santiago
Université de Nantes
St. Joseph's Regional Medical Center
University Hospital Essen
G. d'Annunzio University
Amsterdam Neuroscience
Lahey Clinic Medical Center, Burlington
University of Vermont
Affiliated Hospital of Jining Medical University
University of Pittsburgh Medical Center
The Johns Hopkins University School of Medicine

Research output: Contribution to journal › Article › peer-review

19 Citations (SciVal)

Abstract

Objective: To describe the heterogeneity of electrodiagnostic (EDx) studies in Guillain-Barré syndrome (GBS) patients collected as part of the International GBS Outcome Study (IGOS). Methods: Prospectively collected clinical and EDx data were available in 957 IGOS patients from 115 centers. Only the first EDx study was included in the current analysis. Results: Median timing of the EDx study was 7 days (interquartile range 4–11) from symptom onset. Methodology varied between centers, countries and regions. Reference values from the responding 103 centers were derived locally in 49%, from publications in 37% and from a combination of these in the remaining 15%. Amplitude measurement in the EDx studies (baseline-to-peak or peak-to-peak) differed from the way this was done in the reference values, in 22% of motor and 39% of sensory conduction. There was marked variability in both motor and sensory reference values, although only a few outliers accounted for this. Conclusions: Our study showed extensive variation in the clinical practice of EDx in GBS patients among IGOS centers across the regions. Significance: Besides EDx variation in GBS patients participating in IGOS, this diversity is likely to be present in other neuromuscular disorders and centers. This underlines the need for standardization of EDx in future multinational GBS studies.

Original language	English
Pages (from-to)	231-240
Number of pages	10
Journal	Clinical Neurophysiology
Volume	138
Early online date	13 Jan 2022
DOIs	https://doi.org/10.1016/j.clinph.2021.12.014
Publication status	Published - 1 Jun 2022

Bibliographical note

Keywords

AIDP
AMAN
AMSAN
Electromyography
Nerve conduction studies
Reference values

Access to Document

10.1016/j.clinph.2021.12.014

https://discovery.ucl.ac.uk/id/eprint/10174266/Licence: CC BY 4.0

Cite this

@article{f3fc09ad55764c2da561953b826001db,

title = "Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study: Differences in methods and reference values",

abstract = "Objective: To describe the heterogeneity of electrodiagnostic (EDx) studies in Guillain-Barr{\'e} syndrome (GBS) patients collected as part of the International GBS Outcome Study (IGOS). Methods: Prospectively collected clinical and EDx data were available in 957 IGOS patients from 115 centers. Only the first EDx study was included in the current analysis. Results: Median timing of the EDx study was 7 days (interquartile range 4–11) from symptom onset. Methodology varied between centers, countries and regions. Reference values from the responding 103 centers were derived locally in 49\%, from publications in 37\% and from a combination of these in the remaining 15\%. Amplitude measurement in the EDx studies (baseline-to-peak or peak-to-peak) differed from the way this was done in the reference values, in 22\% of motor and 39\% of sensory conduction. There was marked variability in both motor and sensory reference values, although only a few outliers accounted for this. Conclusions: Our study showed extensive variation in the clinical practice of EDx in GBS patients among IGOS centers across the regions. Significance: Besides EDx variation in GBS patients participating in IGOS, this diversity is likely to be present in other neuromuscular disorders and centers. This underlines the need for standardization of EDx in future multinational GBS studies.",

keywords = "AIDP, AMAN, AMSAN, Electromyography, Nerve conduction studies, Reference values",

author = "Samuel Arends and Judith Drenthen and \{van den Bergh\}, P. and Hessel Franssen and Hadden, \{Robert D.M.\} and Badrul Islam and Satoshi Kuwabara and Reisin, \{Ricardo C.\} and Nortina Shahrizaila and Hiroshi Amino and G. Antonini and S. Attarian and Claudia Balducci and Barroso, \{F. A.\} and Bertorini, \{T. E.\} and Davide Binda and Brannagan, \{T. H.\} and Jan Buermann and Carlos Casasnovas and Guido Cavaletti and Chao, \{Chi Chao\} and Dimachkie, \{M. M.\} and Fulgenzi, \{E. A.\} and G. Galassi and \{Guti{\'e}rrez Guti{\'e}rrez\}, Gerardo and Thomas Harbo and Hartung, \{Hans Peter\} and Hsieh, \{Sung Tsang\} and Lynette Kiers and Lehmann, \{Helmar C.\} and Fiore Manganelli and Marfia, \{Girolama A.\} and Giorgia Mataluni and Julio Pardo and Yann P{\'e}r{\'e}on and Rajabally, \{Yusuf A.\} and Lucio Santoro and Yukari Sekiguchi and Beth Stein and Mark Stettner and Antonino Uncini and Christine Verboon and Camiel Verhamme and Michal Vytopil and Waqar Waheed and Min Wang and Sasha Zivkovic and Jacobs, \{Bart C.\} and Cornblath, \{D. R.\} and Addington, \{J. M.\} and S. Ajroud-Driss and H. Andersen and G. Antonini and S. Attarian and Badrising, \{U. A.\} and G. Balloy and Barroso, \{F. A.\} and K. Bateman and Bella, \{I. R.\} and L. Benedetti and \{van den Bergh\}, P. and Bertorini, \{T. E.\} and R. Bhavaraju-Sanka and M. Bianco and Brannagan, \{T. H.\} and C. Briani and Buerrmann and M. Busby and S. Butterworth and C. Casasnovas and Chao, \{C. C.\} and G. Chavada and S. Chen and Claeys, \{K. G.\} and Conti, \{M. E.\} and Cornblath, \{D. R.\} and Cosgrove, \{J. S.\} and Dalakas, \{M. C.\} and \{van Damme\}, P. and E. Dardiotis and A. Davidson and Derejko, \{M. A.\} and \{van Dijk\}, \{G. W.\} and Dimachkie, \{M. M.\} and \{van Doorn\}, \{P. A.\} and \{Dornonville de la Cour\}, C. and A. Echaniz-Laguna and F. Eftimov and Faber, \{C. G.\} and R. Fazio and Feasby, \{T. E.\} and C. Fokke and T. Fujioka and Fulgenzi, \{E. A.\} and G. Galassi and T. Garcia-Sobrino and Miller, \{J. A.L.\} and Roberts, \{R. C.\} and Y. Song and Wang, \{Y. Z.\}",

note = "{\textcopyright} open access article under the CC BY licence",

year = "2022",

month = jun,

day = "1",

doi = "10.1016/j.clinph.2021.12.014",

language = "English",

volume = "138",

pages = "231--240",

journal = "Clinical Neurophysiology",

issn = "1388-2457",

publisher = "Elsevier",

}

TY - JOUR

T1 - Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study

T2 - Differences in methods and reference values

AU - Arends, Samuel

AU - Drenthen, Judith

AU - van den Bergh, P.

AU - Franssen, Hessel

AU - Hadden, Robert D.M.

AU - Islam, Badrul

AU - Kuwabara, Satoshi

AU - Reisin, Ricardo C.

AU - Shahrizaila, Nortina

AU - Amino, Hiroshi

AU - Antonini, G.

AU - Attarian, S.

AU - Balducci, Claudia

AU - Barroso, F. A.

AU - Bertorini, T. E.

AU - Binda, Davide

AU - Brannagan, T. H.

AU - Buermann, Jan

AU - Casasnovas, Carlos

AU - Cavaletti, Guido

AU - Chao, Chi Chao

AU - Dimachkie, M. M.

AU - Fulgenzi, E. A.

AU - Galassi, G.

AU - Gutiérrez Gutiérrez, Gerardo

AU - Harbo, Thomas

AU - Hartung, Hans Peter

AU - Hsieh, Sung Tsang

AU - Kiers, Lynette

AU - Lehmann, Helmar C.

AU - Manganelli, Fiore

AU - Marfia, Girolama A.

AU - Mataluni, Giorgia

AU - Pardo, Julio

AU - Péréon, Yann

AU - Rajabally, Yusuf A.

AU - Santoro, Lucio

AU - Sekiguchi, Yukari

AU - Stein, Beth

AU - Stettner, Mark

AU - Uncini, Antonino

AU - Verboon, Christine

AU - Verhamme, Camiel

AU - Vytopil, Michal

AU - Waheed, Waqar

AU - Wang, Min

AU - Zivkovic, Sasha

AU - Jacobs, Bart C.

AU - Cornblath, D. R.

AU - Addington, J. M.

AU - Ajroud-Driss, S.

AU - Andersen, H.

AU - Antonini, G.

AU - Attarian, S.

AU - Badrising, U. A.

AU - Balloy, G.

AU - Barroso, F. A.

AU - Bateman, K.

AU - Bella, I. R.

AU - Benedetti, L.

AU - van den Bergh, P.

AU - Bertorini, T. E.

AU - Bhavaraju-Sanka, R.

AU - Bianco, M.

AU - Brannagan, T. H.

AU - Briani, C.

AU - Buerrmann,

AU - Busby, M.

AU - Butterworth, S.

AU - Casasnovas, C.

AU - Chao, C. C.

AU - Chavada, G.

AU - Chen, S.

AU - Claeys, K. G.

AU - Conti, M. E.

AU - Cornblath, D. R.

AU - Cosgrove, J. S.

AU - Dalakas, M. C.

AU - van Damme, P.

AU - Dardiotis, E.

AU - Davidson, A.

AU - Derejko, M. A.

AU - van Dijk, G. W.

AU - Dimachkie, M. M.

AU - van Doorn, P. A.

AU - Dornonville de la Cour, C.

AU - Echaniz-Laguna, A.

AU - Eftimov, F.

AU - Faber, C. G.

AU - Fazio, R.

AU - Feasby, T. E.

AU - Fokke, C.

AU - Fujioka, T.

AU - Fulgenzi, E. A.

AU - Galassi, G.

AU - Garcia-Sobrino, T.

AU - Miller, J. A.L.

AU - Roberts, R. C.

AU - Song, Y.

AU - Wang, Y. Z.

PY - 2022/6/1

Y1 - 2022/6/1

N2 - Objective: To describe the heterogeneity of electrodiagnostic (EDx) studies in Guillain-Barré syndrome (GBS) patients collected as part of the International GBS Outcome Study (IGOS). Methods: Prospectively collected clinical and EDx data were available in 957 IGOS patients from 115 centers. Only the first EDx study was included in the current analysis. Results: Median timing of the EDx study was 7 days (interquartile range 4–11) from symptom onset. Methodology varied between centers, countries and regions. Reference values from the responding 103 centers were derived locally in 49%, from publications in 37% and from a combination of these in the remaining 15%. Amplitude measurement in the EDx studies (baseline-to-peak or peak-to-peak) differed from the way this was done in the reference values, in 22% of motor and 39% of sensory conduction. There was marked variability in both motor and sensory reference values, although only a few outliers accounted for this. Conclusions: Our study showed extensive variation in the clinical practice of EDx in GBS patients among IGOS centers across the regions. Significance: Besides EDx variation in GBS patients participating in IGOS, this diversity is likely to be present in other neuromuscular disorders and centers. This underlines the need for standardization of EDx in future multinational GBS studies.

AB - Objective: To describe the heterogeneity of electrodiagnostic (EDx) studies in Guillain-Barré syndrome (GBS) patients collected as part of the International GBS Outcome Study (IGOS). Methods: Prospectively collected clinical and EDx data were available in 957 IGOS patients from 115 centers. Only the first EDx study was included in the current analysis. Results: Median timing of the EDx study was 7 days (interquartile range 4–11) from symptom onset. Methodology varied between centers, countries and regions. Reference values from the responding 103 centers were derived locally in 49%, from publications in 37% and from a combination of these in the remaining 15%. Amplitude measurement in the EDx studies (baseline-to-peak or peak-to-peak) differed from the way this was done in the reference values, in 22% of motor and 39% of sensory conduction. There was marked variability in both motor and sensory reference values, although only a few outliers accounted for this. Conclusions: Our study showed extensive variation in the clinical practice of EDx in GBS patients among IGOS centers across the regions. Significance: Besides EDx variation in GBS patients participating in IGOS, this diversity is likely to be present in other neuromuscular disorders and centers. This underlines the need for standardization of EDx in future multinational GBS studies.

KW - AIDP

KW - AMAN

KW - AMSAN

KW - Electromyography

KW - Nerve conduction studies

KW - Reference values

UR - https://www.scopus.com/pages/publications/85123384705

UR - https://www.sciencedirect.com/science/article/pii/S1388245722000116

U2 - 10.1016/j.clinph.2021.12.014

DO - 10.1016/j.clinph.2021.12.014

M3 - Article

C2 - 35078730

AN - SCOPUS:85123384705

SN - 1388-2457

VL - 138

SP - 231

EP - 240

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

ER -