The effect of α-lipoic acid on the functional state of peripheral nerve fibers in polyneuropathy of the lower extremities in patients with chronic hemoblastosis

Abstract

The aim: To evaluate the effectiveness of the appointment of α- lipoic acid for correcting electroneuromyographyс indicators polyneuropathy of the lower extremities in patients with hemoblastosis. Materials and methods: The study included 77 patients from hematology department of Poltava Regional Hospital, who were divided into 3 groups according to the underlying disease: Group 1 - patients with chronic myeloid leukemia (CML) (n = 26 ) groups and 2 - patients with chronic lymphocytic leukemia (CLL) (n = 27 ), group 3 - patients with multiple myeloma (MM) ( n = 24 ). For the examined patients were taken electroneuromyographyc researches of distal lower extremities by measuring the following parameters: the amplitude of the M-response from short extensors nerves of the fingers ( MEDB) and abductor of the big toe ( MAH) and the rate of excitation the spread of short extensors nerve of the fingers ( VEDB), thumb abductor ( VAH), superficial shallow ( VSF) and calf ( VC) nerves on both sides (sin/dex ) before and after administration of α- lipoic acid. Results: ENMG examination of the peripheral nerves of the lower extremities in patients with CML and CLL revealed a slight decrease in M-responses at normal values of the rate of conduction of excitation through sensory and motor fibers. In patients with MM, multiple lesions of peripheral nerve fibers of the lower extremities were detected, which is represented by a decrease in the M-response and the rate of excitation through sensory fibers and indicates deeper lesions, namely the axial cylinder, which requires longer treatment. The difference in the dynamics of the studied indicators indicates a different degree of PNP. Administration of α-lipoic acid increased the M-response rate and the rate of excitation of motor fibers in all groups of patients. The rate of excitation through sensory fibers was improved in patients with CLL and MM. Following the use of α-lipoic acid in the complex treatment of patients with MM ENMG, the signs of peripheral nerve fiber damage in the lower extremities were worse due to the severe initial condition, but reached a medium level. The positive effect of α-lipoic acid can be caused by a decrease in oxidative stress and endothelial dysfunction in nerve vessels, and, as a consequence, an improvement in the trophism and functional state of nerve fibers. Conclusions: ENMG signs of defeat of PNP of the lower extremities are more expressed at MM. The appointment of α-lipoic acid in the complex treatment of PNP in patients with chronic hemoblastosis improves the functional state of the peripheral nerve fibers of the lower extremities and may be a component of pathogenetic therapy.