Assessment of Autonomic Nervous System Functions in Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy: An Electrodiagnostic Study

AKU Student

no

Authors

Raghda Nidal Hathal, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq
Farqad Bader Hamdan, College of Medicine, Al-Nahrain University, Baghdad, Iraq
Akram M. Al-Mahdawi, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq

Document Type

Original Article

Abstract

Background and Objective: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronic immune-mediated neuropathy predominantly affecting the peripheral nervous system including the nerve roots. The objectives of this study were to assess autonomic dysfunction in patients with CIDP using electrodiagnostic techniques and to examine its relationship with clinical and demographic characteristics, COMPASS-31 scores, and the Hughes disability scale.

Methods: This case–control observational study included 25 patients with CIDP and 26 age- and sex-matched healthy controls and was conducted at the Neurophysiology Unit of Baghdad Teaching Hospital, Baghdad from February to November, 2024. All participants underwent autonomic function assessment, including Ewing’s cardiovascular tests and sympathetic skin response (SSR). COMPASS-31 and Hughes disability scores were recorded for clinical correlation. The independent Student’s t-test was applied to normally distributed quantitative variables, while non-normally distributed variables were assessed using the Mann–Whitney U test. Categorical variables were analyzed with the chi-square test. Associations between variables were examined using Pearson’s correlation coefficient for parametric data and Spearman’s rank correlation coefficient for non-parametric data.

Results: CIDP patients exhibited significantly reduced heart rate variability and exaggerated blood pressure fluctuations, along with prolonged SSR latencies and decreased amplitudes compared to controls. Autonomic dysfunction involved both parasympathetic and sympathetic systems. Significant correlations were found between autonomic parameters and age, disease duration, COMPASS-31 score, Hughes score, and sex.

Conclusion: Autonomic dysfunction in CIDP is common, typically mild to moderate, and affects both divisions of the ANS. Clinical and demographic variables may influence the pattern and severity of dysfunction.

Recommended Citation

Hathal, Raghda Nidal; Hamdan, Farqad Bader; and Al-Mahdawi, Akram M. (2025) "Assessment of Autonomic Nervous System Functions in Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy: An Electrodiagnostic Study," Pakistan Journal of Neurological Sciences (PJNS): Vol. 20: Iss. 1, Article 9.
Available at: https://ecommons.aku.edu/pjns/vol20/iss1/9