Unveiling the Role of Nerve Conduction Studies (NCS) in Detecting Subclinical Peripheral Neuropathy in Autoimmune Disorders: A Cross-Sectional Study

Introduction: Peripheral neuropathy, characterized by nerve damage, often presents with symptoms like pain, tingling, and muscle weakness. However, in its subclinical form, these symptoms may be subtle or absent, making early detection challenging. This is particularly concerning in patients with autoimmune connective tissue disorders (ACTDs), where the immune system attacks the body's tissues, potentially leading to nerve damage. Early identification and management are crucial to prevent the progression from subclinical to clinical neuropathy, which can significantly impair quality of life.

Materials and methods: This prospective cross-sectional study involved 100 patients with ACTDs of three or more years' duration, conducted at Saveetha Medical College over 15 months. Nerve conduction studies (NCS) were performed on bilateral ulnar, radial, sural, peroneal, and tibial nerves.

Results: Peripheral neuropathy was present in 18 (18%) of the study participants. Carpal tunnel syndrome was the most prevalent type, affecting 10 (55.56%) of those with neuropathy. Significant differences were found in the left peroneal motor nerve (p = 0.003) and right tibial nerve (p = 0.03) conduction times. Additionally, significant associations were observed between rheumatoid factor positivity (p = 0.011), anti-cyclic citrullinated peptide (anti-CCP) antibody status (p = 0.032), and the presence of peripheral neuropathy.

Conclusion: This study underscores the importance of early detection and intervention for peripheral neuropathy in patients with ACTDs. The study's findings align with existing literature, suggesting that a substantial proportion of patients with ACTDs are at risk for peripheral neuropathy, particularly in older patients and those with specific autoimmune markers. Regular NCS assessments are recommended to identify at-risk individuals, potentially mitigating the progression of neuropathy and improving patient outcomes. Future research should include larger, more diverse populations and longitudinal studies to further validate these findings.