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USE OF NEUROMUSCULAR ULTRASOUND FOR THE EVALUATION OF CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY

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abstract
Chemotherapy induced peripheral neuropathy (CIPN) is one of the most common and debilitating survivorship conditions for cancer patients. Currently, there are few effective therapies available to treat CIPN and thus oncologists must frequently dose-reduce or discontinue potentially life-saving chemotherapy to avoid irreversible neurotoxicity. Early detection is critical but few reliable, non-invasive tools are available that can be deployed today in the clinic to diagnose, monitor, and track CIPN. Neuromuscular ultrasound (NMUS) is a non-invasive diagnostic tool that has been pioneered at Wake Forest School of Medicine for the evaluation of peripheral nerve pathology. Few prior studies have assessed the role of NMUS in CIPN. To address this gap, a cross-sectional cohort study was designed of breast cancer patients with clinically documented CIPN. Patients underwent comprehensive neurodiagnostic evaluation including both standard of care (e.g. physician grade, clinical exam, nerve conduction study, skin biopsy for intraepidermal nerve fiber density) and NMUS. Peripheral nerve pathology was assessed by measuring the cross-sectional area (CSA) of three relevant peripheral nerves including the sural, tibial, and median nerves and comparing to previously collected data from healthy controls. In this study, we show that sural but not tibial nerve assessments CSA is significantly smaller in taxane CIPN compared to healthy controls supporting a sensory predominant neuropathy expected in these patients. These data support further development of NMUS in CIPN.
subject
Breast cancer
Chemotherapy induced peripheral neuropathy
Neuropathy
Ultrasound
contributor
Strowd, Roy Ervin (author)
Lesser, Glenn J (committee chair)
Hsu, Fang-Chi (committee member)
Cartwright, Michael S (committee member)
date
2020-05-29T08:36:05Z (accessioned)
2021-05-28T08:30:13Z (available)
2020 (issued)
degree
Clinical and Population Translational Sciences (discipline)
embargo
2021-05-28 (terms)
identifier
http://hdl.handle.net/10339/96836 (uri)
language
en (iso)
publisher
Wake Forest University
title
USE OF NEUROMUSCULAR ULTRASOUND FOR THE EVALUATION OF CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY
type
Thesis

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