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Characterizing Combined Central and Peripheral Demyelination-Insights From a Multimodal Comparison With Chronic
N Dubuisson1,2, A Kassab1, P Y K Van den Bergh1
1Neuromuscular Reference Centre UCL Saint-Luc, University of Louvain, Brussels, Belgium.
Muscle & Nerve
|July 3, 2026
Summary
Combined central and peripheral demyelination (CCPD) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) show similar peripheral nerve findings on nerve conduction studies and ultrasound. Ultrasound may help screen for peripheral involvement in central nervous system demyelinating syndromes.
Area of Science:
- Neuroimmunology
- Neurology
- Demyelinating Diseases
Background:
- Combined central and peripheral demyelination (CCPD) is a rare dysimmune disorder with overlapping features with multiple sclerosis (MS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).
- Direct comparative studies of central and peripheral nervous system involvement in these conditions are limited.
Purpose of the Study:
- To systematically assess nervous system involvement in CCPD using MRI, nerve ultrasound (US), and nerve conduction studies (NCS).
- To compare these findings with those in MS and CIDP control groups.
Main Methods:
- A descriptive case study involving 4 CCPD patients, 13 CIDP patients, and 10 MS controls.
- Standardized NCS and US protocols were applied to all subjects.
- Brain and spinal cord MRI were performed on MS and CCPD patients; cerebrospinal fluid (CSF) testing was done in 20/27 patients.
Main Results:
- NCS indicated demyelination in all CCPD and CIDP patients, meeting CIDP electrodiagnostic criteria.
- US revealed multifocal nerve enlargement in CCPD and CIDP patients, with mild proximal median nerve enlargement in three MS patients.
- CSF oligoclonal bands were exclusively detected in MS patients.
Conclusions:
- Peripheral diagnostic tools demonstrate significant similarities in electrophysiological and morphological features between CCPD and CIDP, suggesting shared disease mechanisms.
- Distinguishing CCPD and CIDP solely on peripheral nerve assessment poses challenges.
- Ultrasound may serve as a valuable screening tool for peripheral involvement in central demyelinating syndromes, aiding in guiding further electrophysiological testing.
