Correlation between nerve conduction velocity abnormality patterns and clinical severity grading in...

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating adverse effect of neurotoxic chemotherapy, yet the longitudinal relationship between nerve conduction study (NCS) changes and clinical severity remains insufficiently defined.

In this retrospective cohort of 186 patients undergoing serial clinical and electrophysiological assessment at baseline, mid-treatment, end-of-treatment, and follow-up, sural sensory nerve action potential (SNAP) amplitude showed the strongest inverse association with end-of-treatment NCI-CTCAE severity (r = -0.724, P < 0.001).

Absolute end-of-treatment sural SNAP amplitude identified Grade ≥2 CIPN with an area under the curve (AUC) of 0.856, while a relative decline from baseline of ≥35% yielded an AUC of 0.872. Patients requiring neurotoxicity-related dose modification had larger early sural SNAP reductions from baseline to mid-treatment than those without treatment change (34.8% ± 13.2% vs. 17.6% ± 11.4%, P < 0.001). Four electrophysiological phenotypes were observed and were associated with differential clinical severity and recovery trajectories.

These findings support serial large-fiber NCS, particularly sural SNAP amplitude and its percentage change from baseline, as objective correlates of CIPN severity and treatment tolerance in routine clinical practice.