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Table 2 Emerging biomarkers in CIDP

From: Measuring disease activity and predicting response to intravenous immunoglobulin in chronic inflammatory demyelinating polyneuropathy

Investigation Comments
Serum biomarkers
 Paranodal antibodies anti-NF155 IgM Can be seen in GBS, CMT and CIDP
anti-NF155 IgG4 Highly specific for CIDP, often characterised by younger age of disease onset, sensory ataxia and poor response to IVIg
anti-NF186 IgG4  
anti-NF140 IgG4  
anti-CNTN1 IgG4  
 Serologic response to IVIg Change in total IgG level  
IgG dimer index  
Level of sialylated IgG  
Electrophysiology
 Resolution of conduction block Correlate well with longitudinal disease activity unlike most other nerve conduction studies
 Averaged CMAP amplitude
 Accumulation of demyelinating features Predictor of relapse following treatment withdrawal
Imaging
 High resolution ultrasound Cross sectional nerve area  
Nerve echogenicity Role still unclear
Nerve vascularization
 Magnetic resonance neurography Cross sectional nerve area  
Nerve signal change  
 Functional MRI (Diffusion tensor imaging) Fractional anisotropy Correlate well with electrophysiological markers of demyelination
Radial diffusivity Role still unclear
Axial diffusivity
  1. Abbreviations: NF Neurofascin, GBS Guillain Barre Syndrome, CIDP Chronic inflammatory demyelinating polyneuropathy, IVIg intravenous immunoglobulin, CMAP compound motor action potential, MRI: magnetic resonance imaging