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

Samuel Arends; Judith Drenthen; IGOS Consortium; Peter van den Bergh; Hessel Franssen; Robert D M Hadden; Badrul 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; Giuliana Galassi; Gerardo Gutiérrez Gutiérrez; Thomas Harbo; Hans-Peter Hartung; Sung-Tsang Hsieh; Lynette Kiers; Helmar C Lehmann; Fiore Manganelli; Girolama A Marfia; Giorgia Mataluni; Julio Pardo; Yann Péréon; Yusuf A Rajabally; Lucio Santoro; Yukari Sekiguchi; Beth Stein; Mark Stettner; Antonino Uncini; Christine Verboon; Camiel Verhamme; Michal Vytopil; Waqar Waheed; Min Wang; Sasha Zivkovic; Bart 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, IGOS Consortium, Peter van den Bergh, Hessel Franssen, Robert D M Hadden, Badrul 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, Giuliana Galassi, Gerardo Gutiérrez Gutiérrez, Thomas Harbo, Hans-Peter Hartung, Sung-Tsang Hsieh, Lynette Kiers, Helmar C Lehmann, Fiore Manganelli, Girolama A Marfia, Giorgia Mataluni, Julio Pardo, Yann Péréon, Yusuf A Rajabally, Lucio Santoro, Yukari Sekiguchi, Beth Stein, Mark Stettner, Antonino Uncini, Christine Verboon, Camiel Verhamme, Michal Vytopil, Waqar Waheed, Min Wang, Sasha Zivkovic, Bart C Jacobs, David R Cornblath

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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

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Arends, S., Drenthen, J., 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 {IGOS Consortium} and {van den Bergh}, Peter 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 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 Chi-Chao Chao and Dimachkie, {Mazen M} and Fulgenzi, {Ernesto A} and Giuliana Galassi and {Guti{\'e}rrez Guti{\'e}rrez}, Gerardo and Thomas Harbo and Hans-Peter Hartung and Sung-Tsang Hsieh 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, {David R} and Krista Kuitwaard",

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, 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, C-C, Dimachkie, MM, Fulgenzi, EA, Galassi, G, Gutiérrez Gutiérrez, G, Harbo, T, Hartung, H-P, Hsieh, S-T, Kiers, L, Lehmann, HC, Manganelli, F, Marfia, GA, Mataluni, G, Pardo, J, Péréon, Y, Rajabally, YA, Santoro, L, Sekiguchi, Y, Stein, B, Stettner, M, Uncini, A, Verboon, C, Verhamme, C, Vytopil, M, Waheed, W, Wang, M, Zivkovic, S, 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 - IGOS Consortium

AU - van den Bergh, Peter

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, 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 - Galassi, Giuliana

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, David R

AU - Kuitwaard, Krista

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

SN - 1388-2457

VL - 138

SP - 231

EP - 240

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

ER -

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

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