Introduction Poor balance is a common and debilitating feature in patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP). Posturography is an objective method of assessing balance. Intravenous Immunoglobulin (IVIG) exerts clinical benefits in CIDP, including improving balance, although this is difficult to quantify. The present study used posturography as a biomarker for determining IVIG efficacy in CIDP.
Methods Eighteen patients with CIDP established on IVIG were compared with healthy controls. Five conditions were used to assess balance: Feet 16cm apart with eyes open and closed, feet together with eyes open and closed (Romberg’s test), and tandem stance. Centre of pressure (COP) was sampled for 15 seconds at 100Hz using a Kistler force platform, and the total path travelled by the COP was calculated (sway path). Testing was performed on the day of IVIG, corresponding to a trough, and at the mid-point of treatment, corresponding to a peak.
Results At baseline, there was a significant increase in the sway path in CIDP patients compared with healthy controls (average performance 1191 ± 104mm vs 724 ± 26mm, P<0.001). Treatment with IVIG resulted in a significant reduction in the sway path when assessing Romberg’s test (1759 ± 324mm vs 1081 ± 134mm, P=0.019) and tandem stance (1775 ± 290mm vs 1152 ± 113mm, P=0.027). In contrast, clinical markers of neuropathy were unchanged, and repeat assessments in healthy controls were stable.
Conclusion The present study shows that objective assessment of balance using posturography may serve as a biomarker of IVIG efficacy in patients with CIDP.
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