Review of clinical application of peripheral neuropathy scales

doi:10.3969/j.issn.1674-8115.2021.11.018

Abstract

Abstract:

Peripheral neuropathy (PN) refers to a group of diseases caused by the dysfunction and structural changes of peripheral motor, sensory and autonomic nerves. Scales for screening and assessing PN are continuously being used in clinical practice. This article summarizes PN score scales for four kinds of PN, including chronic inflammatory demyelinating polyradiculoneuropathy, Charcot-Marie-Tooth disease, diabetic PN and neuropathic pain, aiming to improve medical staff's understanding and application ability of the PN assessment scale.

Key words: assessment scale, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), Charcot-Marie-Tooth disease (CMT), diabetic peripheral neuropathy (DPN), neuropathic pain (NP)

CLC Number:

R745

Qun-feng WANG, Li CAO, Xing-hua LUAN. Review of clinical application of peripheral neuropathy scales[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(11): 1518-1523.

Figures/Tables 2

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References 53

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Scale	Sensitivity/%	Specificity/%	Accuracy/%	Reference
MNSI	78.00	92.00	83.00	［26］
MDNS	92.90	51.60	82.90	［25］
NSC	85.96	77.03	80.92	［19］
NIS	59.65	98.65	81.68	［19］
TCSS	77.60	87.10	79.80	［25］

Scale	Sensitivity/%	Specificity/%	Accuracy/%	Reference
MNSI	78.00	92.00	83.00	［26］
MDNS	92.90	51.60	82.90	［25］
NSC	85.96	77.03	80.92	［19］
NIS	59.65	98.65	81.68	［19］
TCSS	77.60	87.10	79.80	［25］

Type of PN	Scale	Evaluation item	Average completion time/min	Clinical application	Pros and cons	Reference
CIDP	I-RODS	24 items	2–3	Applicable to all CIDP	Advantages： high responsiveness， can accurately distinguish the degree of disability， there is no floor effect， and the slightest recurrence can be captured. Disadvantage： there is a ceiling effect	［5， 8］
	ONLS	An arm disability scale and a leg disability scale	4–5	CIDP degree of disability	Advantages： fast， simple， good content validity， small upper limit effect	［11］
CMT	CMTNS	9 items	3	Length-dependent motor and sensory impairments in hereditary neuropathy， quantifying CMT disability	Advantages： reliability， effectiveness. Disadvantages： there are limitations in the use of length-independent multifocal diseases； changes in age will increase the score	［14-16］
	CMTNS2	9 items	3	Quantify CMT disability and standardize assessment	Advantages： the upper and lower limit effects are low， and the sensitivity of detection over time is high	［15］
DPN	MNSI	15 questions and 8 physical examinations	4–5	Early large-scale screening to monitor the progress of the disease	Advantages： simple， fast， and feasible. Disadvantages： unable to identify subclinical and autonomic neuropathy	［27-30，33］
	MDNS	20 items	15	Diagnosis and staging	Advantages： fast and sensitive	［33-34］
	TCSS	13 items	11	Early screening and diagnosis， early DPN treatment evaluation	Advantages： early monitoring methods	［20］
	COMPASS-31	31 items	10	Early detection and management of CAN	Advantages： short time， convenient and high sensitivity	［36，38-39］
NP	DN4	10 items	2.5	Neuropathic pain screening	Advantages： strong screening ability	［41-44，49］

Type of PN	Scale	Evaluation item	Average completion time/min	Clinical application	Pros and cons	Reference
CIDP	I-RODS	24 items	2–3	Applicable to all CIDP	Advantages： high responsiveness， can accurately distinguish the degree of disability， there is no floor effect， and the slightest recurrence can be captured. Disadvantage： there is a ceiling effect	［5， 8］
	ONLS	An arm disability scale and a leg disability scale	4–5	CIDP degree of disability	Advantages： fast， simple， good content validity， small upper limit effect	［11］
CMT	CMTNS	9 items	3	Length-dependent motor and sensory impairments in hereditary neuropathy， quantifying CMT disability	Advantages： reliability， effectiveness. Disadvantages： there are limitations in the use of length-independent multifocal diseases； changes in age will increase the score	［14-16］
	CMTNS2	9 items	3	Quantify CMT disability and standardize assessment	Advantages： the upper and lower limit effects are low， and the sensitivity of detection over time is high	［15］
DPN	MNSI	15 questions and 8 physical examinations	4–5	Early large-scale screening to monitor the progress of the disease	Advantages： simple， fast， and feasible. Disadvantages： unable to identify subclinical and autonomic neuropathy	［27-30，33］
	MDNS	20 items	15	Diagnosis and staging	Advantages： fast and sensitive	［33-34］
	TCSS	13 items	11	Early screening and diagnosis， early DPN treatment evaluation	Advantages： early monitoring methods	［20］
	COMPASS-31	31 items	10	Early detection and management of CAN	Advantages： short time， convenient and high sensitivity	［36，38-39］
NP	DN4	10 items	2.5	Neuropathic pain screening	Advantages： strong screening ability	［41-44，49］