Nerve ultrasound as a diagnostic tool for sensory neuronopathy in spinocerebellar ataxia syndrome

Publication date: Available online 19 January 2019

Source: Clinical Neurophysiology

Author(s): Ruth Leadbetter, Mark Weatherall, Luciana Pelosi

Abstract

Objective

The objective was to assess if nerve ultrasound has a role in diagnosing sensory neuronopathy in spinocerebellar ataxia syndrome (SCA) by examining if proposed diagnostic cut-off criteria of ultrasound in sensory neuronopathy caused by cerebellar ataxia neuropathy vestibular areflexia syndrome (CANVAS) were also discriminatory for SCA-related sensory neuronopathy.

Methods

Optimal diagnostic cut-off criteria for nerve size measured by diagnostic ultrasound were developed in 14 patients with CANVAS and 42 healthy controls using six peripheral nerve sites; and logistic regression and receiver operating characteristic (ROC) curves. These proposed cut-off values were tested in seven patients with spinocerebellar ataxia type 2 (SCA2) patients with sensory neuronopathy.

Results

Ultrasound of upper limb nerves was highly accurate in differentiating between CANVAS

and healthy controls with areas under the ROC curves between 0.97 and 0.99. Optimal

cut-off measurements from the CANVAS patients also accurately diagnosed sensory

neuronopathy in all patients with SCA2.

Conclusions

Upper limb ultrasound is a sensitive tool for detecting sensory neuronopathy in

established cases of CANVAS and SCA2.

Significance

Ultrasound could aid the diagnosis of sensory neuronopathy in spinocerebellar ataxias.

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