Electrophysiological Evaluation of Motor Dysfunction in Liver Cirrhotic Patients

Browse trials for

• Liver Cirrhosis 1,642
• Peripheral Nervous System Diseases 1,003

Keywords

• Liver cirrhotic patients- Motor Dysfunction-Fatigue.

Liver Cirrhosis

1,642 studies on the registry are indexed under Liver Cirrhosis; 358 are open to participants now.

This study's enrollment of 56 is below the median of 151 across 587 observational studies indexed under Liver Cirrhosis.

Lead sponsor

Kasr El Aini Hospital is the lead sponsor of 273 studies on the registry; 32 are open to participants now.

Study population

Groups and cohorts

• Manifested Group

  Manifested Group , enrolled patients who had any of the following manifestations(Fatigue,muscle cramps or numbness)

  Diagnostic Test: Nerve conduction studies and Quantitative EMG ( MUNE and IPA)

• Non-Manifested Group

  Non-manifested group in which enrolled patients didn't report any of the following manifestations

  Diagnostic Test: Nerve conduction studies and Quantitative EMG ( MUNE and IPA)

Interventions

• Diagnostic testNerve conduction studies and Quantitative EMG ( MUNE and IPA)

  Nerve Conduction Studies: Electrophysiological method that tests the presence/absence of peripheral neuropathy. MUNE: Electrophysiological technique that assess number of motor units. IPA: Electrophysiological method that assess interference pattern and hence, borderline cases of neuropathy/ myopathy

Primary outcomes

1. Early detection of peripheral neuropathy among liver cirrhotic patients.

   * Using nerve conduction studies of the: left ulnar,left posterior tibial and right deep peroneal motor nerves;assess their distal latency (measured in milliseconds) ,amplitude (measured in millivolts) and conduction velocities (measured in m/s).In addition , to sensory studies of the left ulnar and right sural sensory nerves; assessment of peak latency (measured in milliseconds) , amplitude (measured in microvolts) and their conduction velocities(measured in m/s) . * Compare the values with our normative values. * Detect evidence of peripheral neuropathy ( increased in distal latency above the upper limit of its normal value, decreased conduction velocity below the lower limit of its normal value and decreased amplitude below lower limit of its normal value). * A minimum of three variables in two or more nerves are required to diagnose polyneuropathy as referenced by (Meulstee \& Van Der Meche , 1995).

   Time frame: baseline

Secondary outcomes

1. Detection of correlation between neuropathy and severity of liver cirrhosis.

   Finding out any correlation between peripheral neuropathy and severity of liver cirrhosis: * Comparing between patients with evidence of peripheral neuropathy (as detected by nerve conduction studies) and those without evidence of peripheral neuropathy versus the severity of their liver disease ( as assessed by Child-Pugh class) using Mann Whitney U test; to find out if their is statistical difference between them or not; denoting the presence/absence of correlation between peripheral neuropathy and the severity of the liver disease.

   Time frame: baseline

2. Motor unit number estimation using Spike-Triggered method.

   * Estimation of motor unit number using Spike-Triggered method in liver cirrhotic patients and age/gender healthy controls to find out of there is statistical difference between them. * Decline in MUNE values denotes loss of motor neurons.

   Time frame: Baseline

3. Correlation of MUNE values to fatigue

   * Comparing between liver cirrhotic patients who reported fatigue(as part of their neurological symptoms) versus those who didn't report fatigue, regarding their MUNE values; using Mann Whitney U test. * If there is statistical difference between them; there would be correlation between loss of motor units and fatigue reported by the patients(this assumption was based on (Heckman \& Enoka, 2012) \&(Mota et al., 2020) conclusions that there is positive correlation between fatigability and loss of motor units.

   Time frame: Baseline

Publications

• • Abdel-Razek, W., Hassany, M., Kabil, K., Ammar, I., Dabous, H., Doss, W., ... & El-Serafy, M. (2019). The World's Largest Hepatitis C Screening Program in Egypt. Journal of Hepatology (Vol. 70, pp. 144-145). • Abrams, G. A., Concato, J., & Fallon, M. B. (1996). Muscle cramps in patients with cirrhosis. American Journal of Gastroenterology, 91(7). • Aggarwal A, Nicholson G. (2002).Detection of preclinical motor neurone loss in SOD1 mutation carriers using motor unit number estimation. Journal of Neurology, Neurosurgery & Psychiatry; 73(2):199-201. • Amodio, P., & Gatta, A. (2005). Neurophysiological investigation of hepatic encephalopathy. Metabolic brain disease, 20(4), 369-379. • Arabadzhiev, T. I., Dimitrov, G. V., Dimitrov, A. G., Chakarov, V. E., & Dimitrova, N. A. (2008). Factors affecting the turns analysis of the interference EMG signal. Biomedical Signal Processing and Control, 3(2), 145-153. • Barkhaus, P. E. (2001). Motor Unit Action Potential Quantitation. In An AAEM workshop. Rochester, Minn: American Association of Electrodiagnostic Medicine (Vol. 2). • Bessou, P., Emonet-Dénand, F., & Laporte, Y. (1965). Motor fibres innervating extrafusal and intrafusal muscle fibres in the cat. The Journal of Physiology, 180(3), 649-672. • Blok, J. H., van Dijk, J. P., Drost, G., Zwarts, M. J., & Stegeman, D. F. (2002). A high-density multichannel surface electromyography system for the characterization of single motor units. Review of Scientific Instruments, 73(4), 1887-1897.