Postural balance and visual dependence in patients with demyelinating neuropathies differ between acquired and hereditary etiologies

L Dupont; L Defebvre; J-B Davion; A Delval; C Tard

doi:10.1016/j.neurol.2024.10.002

Postural balance and visual dependence in patients with demyelinating neuropathies differ between acquired and hereditary etiologies

Rev Neurol (Paris). 2024 Oct 26:S0035-3787(24)00623-4. doi: 10.1016/j.neurol.2024.10.002. Online ahead of print.

Authors

L Dupont¹, L Defebvre², J-B Davion³, A Delval², C Tard³

Affiliations

¹ Inserm, UMR-S1172 - LilNCog (Lille Neuroscience & Cognition), université de Lille, CHU de Lille, 59000 Lille, France. Electronic address: loic.dupont@chu-lille.fr.
² Inserm, UMR-S1172 - LilNCog (Lille Neuroscience & Cognition), université de Lille, CHU de Lille, 59000 Lille, France.
³ Inserm, UMR-S1172 - LilNCog (Lille Neuroscience & Cognition), université de Lille, CHU de Lille, 59000 Lille, France; Centre de référence des maladies neuromusculaires Nord/Est/Île-de-France, Lille, France.

PMID: 39462724
DOI: 10.1016/j.neurol.2024.10.002

Abstract

Background: Demyelinating polyneuropathies affect posture and can be either hereditary, as in Charcot-Marie-Tooth type 1A (CMT1A), or autoimmune, as in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Clinical differentiation between these two neuropathies can be challenging and biomarkers are lacking. No comparative analysis of their balance profiles has been conducted.

Methods: The postural balance of 23 patients with CIDP and 23 patients with CMT1A, matched for age, sex, and functional scores, were recorded using a force platform under various conditions. The effects of visual dependence were examined based on center of pressure velocity, 90% confidence ellipse area, and the Romberg quotient which represents the ratio between posturography with eyes closed and eyes open.

Results: With eyes open, the two groups exhibited similar area and velocity. They increased their postural sway when visual input was eliminated. Nevertheless, the increase in postural sway was less pronounced in CMT1A patients than in patients with CIDP, who then had a higher Romberg quotient.

Conclusion: Patients with CMT1A appear to have developed compensatory mechanisms over time resulting in reduced visual dependence. Further studies are necessary to explore other compensatory mechanisms of equilibrium that could be targeted by rehabilitation for patients with CIDP.

Keywords: Balance impairment; CIDP; CMT1A; Charcot-Marie-Tooth 1A; Chronic inflammatory demyelinating polyradiculoneuropathy; Demyelinating neuropathy; Hereditary neuropathy; Romberg; Visual dependence.