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

Samuel Arends; Judith Drenthen; the IGOS Consortium; Peter van den Bergh; Hessel Franssen; Robert D.M. Hadden; B. Islam; Satoshi Kuwabara; Ricardo C. Reisin; Nortina Shahrizaila; Hiroshi Amino; Giovanni Antonini; Shahram Attarian; Claudia Balducci; Fabio Barroso; Tulio Bertorini; Davide Binda; Thomas H. Brannagan; Jan Buermann; Carlos Casasnovas; Guido Cavaletti; Chi Chao Chao; Mazen M. Dimachkie; Ernesto A. Fulgenzi; Christine Verboon; B. C. Jacobs; David R. Cornblath

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

Samuel Arends^*, Judith Drenthen, the IGOS Consortium, Peter van den Bergh, Hessel Franssen, Robert D.M. Hadden, B. Islam, Satoshi Kuwabara, Ricardo C. Reisin, Nortina Shahrizaila, Hiroshi Amino, Giovanni Antonini, Shahram Attarian, Claudia Balducci, Fabio Barroso, Tulio Bertorini, Davide Binda, Thomas H. Brannagan, Jan Buermann, Carlos CasasnovasGuido Cavaletti, Chi Chao Chao, Mazen M. Dimachkie, Ernesto A. Fulgenzi, Christine Verboon, B. C. Jacobs, David R. Cornblath

^*Corresponding author for this work

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

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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
DOIs	https://doi.org/10.1016/j.clinph.2021.12.014
Publication status	Published - Jun 2022

Bibliographical note

Funding Information:
The IGOS was funded by the -CIDP Foundation International, gain, University Medical Center, Glasgow University, Prinses Beatrix Spierfonds, CSL Behring, Grifols, Annexon and Hansa Biopharma. Study sponsors had no involvement in data collection, analysis, interpretation and/or writing of the manuscript.

Publisher Copyright:
© 2022 International Federation of Clinical Neurophysiology

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Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome StudyFinal published version, 551 KBLicence: CC BY

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Arends, S., Drenthen, J., the IGOS Consortium, van den Bergh, P., Franssen, H., Hadden, R. D. M., Islam, B., Kuwabara, S., Reisin, R. C., Shahrizaila, N., Amino, H., Antonini, G., Attarian, S., Balducci, C., Barroso, F., Bertorini, T., Binda, D., Brannagan, T. H., Buermann, J., ... Cornblath, D. R. (2022). Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study: Differences in methods and reference values. Clinical Neurophysiology, 138, 231-240. https://doi.org/10.1016/j.clinph.2021.12.014

@article{ef8f56854d5e43cc96a92aaa315e7f58,

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.",

author = "Samuel Arends and Judith Drenthen and {the IGOS Consortium} and {van den Bergh}, Peter and Hessel Franssen and Hadden, {Robert D.M.} and B. Islam and Satoshi Kuwabara and Reisin, {Ricardo C.} and Nortina Shahrizaila and Hiroshi Amino and Giovanni Antonini and Shahram Attarian and Claudia Balducci and Fabio Barroso and Tulio Bertorini and Davide Binda and Brannagan, {Thomas H.} and Jan Buermann and Carlos Casasnovas and Guido Cavaletti and Chao, {Chi Chao} and Dimachkie, {Mazen M.} and Fulgenzi, {Ernesto A.} and Christine Verboon and Jacobs, {B. C.} and Cornblath, {David R.}",

note = "Funding Information: The IGOS was funded by the -CIDP Foundation International, gain, University Medical Center, Glasgow University, Prinses Beatrix Spierfonds, CSL Behring, Grifols, Annexon and Hansa Biopharma. Study sponsors had no involvement in data collection, analysis, interpretation and/or writing of the manuscript. Publisher Copyright: {\textcopyright} 2022 International Federation of Clinical Neurophysiology",

year = "2022",

month = jun,

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

language = "English",

volume = "138",

pages = "231--240",

journal = "Clinical Neurophysiology",

issn = "1388-2457",

publisher = "Elsevier Ireland Ltd",

}

Arends, S, Drenthen, J, the IGOS Consortium, van den Bergh, P, Franssen, H, Hadden, RDM, Islam, B, Kuwabara, S, Reisin, RC, Shahrizaila, N, Amino, H, Antonini, G, Attarian, S, Balducci, C, Barroso, F, Bertorini, T, Binda, D, Brannagan, TH, Buermann, J, Casasnovas, C, Cavaletti, G, Chao, CC, Dimachkie, MM, Fulgenzi, EA, Verboon, C , Jacobs, BC & Cornblath, DR 2022, 'Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study: Differences in methods and reference values', Clinical Neurophysiology, vol. 138, pp. 231-240. https://doi.org/10.1016/j.clinph.2021.12.014

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 - the IGOS Consortium

AU - van den Bergh, Peter

AU - Franssen, Hessel

AU - Hadden, Robert D.M.

AU - Islam, B.

AU - Kuwabara, Satoshi

AU - Reisin, Ricardo C.

AU - Shahrizaila, Nortina

AU - Amino, Hiroshi

AU - Antonini, Giovanni

AU - Attarian, Shahram

AU - Balducci, Claudia

AU - Barroso, Fabio

AU - Bertorini, Tulio

AU - Binda, Davide

AU - Brannagan, Thomas H.

AU - Buermann, Jan

AU - Casasnovas, Carlos

AU - Cavaletti, Guido

AU - Chao, Chi Chao

AU - Dimachkie, Mazen M.

AU - Fulgenzi, Ernesto A.

AU - Verboon, Christine

AU - Jacobs, B. C.

AU - Cornblath, David R.

N1 - Funding Information: The IGOS was funded by the -CIDP Foundation International, gain, University Medical Center, Glasgow University, Prinses Beatrix Spierfonds, CSL Behring, Grifols, Annexon and Hansa Biopharma. Study sponsors had no involvement in data collection, analysis, interpretation and/or writing of the manuscript. Publisher Copyright: © 2022 International Federation of Clinical Neurophysiology

PY - 2022/6

Y1 - 2022/6

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.

UR - http://www.scopus.com/inward/record.url?scp=85123384705&partnerID=8YFLogxK

U2 - 10.1016/j.clinph.2021.12.014

DO - 10.1016/j.clinph.2021.12.014

M3 - Article

C2 - 35078730

AN - SCOPUS:85123384705

VL - 138

SP - 231

EP - 240

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

SN - 1388-2457

ER -

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

Abstract

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