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August 26, 2026Discovery MedicineOpen Access

Combined neurophysiological model achieves ~0.88 AUC for detecting chemotherapy-induced peripheral neuropathy.

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Why the study?

Early detection of chemotherapy-induced peripheral neuropathy remains challenging due to the lack of objective assessment tools.

Does multimodal neurophysiological assessment improve the diagnosis of chemotherapy-induced peripheral neuropathy in cancer patients?

Population

40 cancer patients undergoing platinum- or taxane-based chemotherapy and 40 healthy controls

Comparison

Before vs after chemotherapy completion or three weeks following neurological symptom onset

Design

Prospective diagnostic accuracy study

Key result

A combined diagnostic model incorporating upper limb sympathetic skin response amplitude and medial plantar nerve sensory conduction velocity achieved an AUC of 0.881 for detecting chemotherapy-induced peripheral neuropathy.

Authors

XSXiaohe ShiKLKaixin LiYLYinliang Liu

Discussion

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Overview

Supports multimodal neurophysiological testing for early chemotherapy-induced peripheral neuropathy detection; leaves open whether routine implementation improves.

Key Points

  • To assess dynamic changes in multimodal neurophysiological parameters before and after chemotherapy and determine their diagnostic value in detecting clinical and subclinical chemotherapy-induced peripheral neuropathy.
  • Prospectively enrolled 40 cancer patients receiving platinum- or taxane-based chemotherapy and 40 healthy controls.
  • Administered nerve conduction studies (NCS), sympathetic skin response (SSR), and tibial nerve somatosensory evoked potentials (tSEP) before and after chemotherapy completion or three weeks post-symptom onset.
  • Evaluated diagnostic accuracy for clinical CIPN (NCI-CTCAE grade ≥1 plus electrophysiological deterioration) and subclinical CIPN (NCI-CTCAE grade 0 with abnormal electrophysiology).
  • Clinical CIPN developed in 70.0% of patients (n=28/40) and subclinical CIPN in 12.5% (n=5/40), with significant post-treatment reductions in plantar sensory conduction velocity (SCV), sensory nerve action potentials, SSR amplitude, and tSEP N9 wave amplitude (all p < 0.001).
  • Upper limb SSR amplitude had the highest individual diagnostic accuracy (AUC = 0.844, 95% CI: 0.721–0.967), while combining SSR amplitude with medial plantar nerve SCV (specificity 92%, AUC = 0.798) increased overall diagnostic accuracy to an AUC of 0.881 (95% CI: 0.772–0.990).
  • In an exploratory analysis of five subclinical CIPN cases, SSR testing alone detected all five cases (McNemar's exact test, p = 1.00).

Study Design

Type

Observational (n=80)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does multimodal neurophysiological assessment improve the diagnosis of chemotherapy-induced peripheral neuropathy in cancer patients?

P
Population
80 participants, including 40 adult cancer patients (mean age 59.1 years, 55% female) undergoing platinum- or taxane-based chemotherapy and 40 matched healthy controls, evaluated for chemotherapy-induced peripheral neuropathy.
E
Exposure
Multimodal neurophysiological assessment including conventional nerve conduction studies (NCS), sympathetic skin response (SSR), and tibial nerve somatosensory evoked potential (tSEP) administered before and after chemotherapy.
C
Comparator
Pre-chemotherapy baseline measurements and 40 healthy controls for reference ranges.
O
Outcome
Diagnostic accuracy (sensitivity, specificity, AUC) of neurophysiological parameters for detecting CIPN, defined by a composite endpoint of NCI-CTCAE grade ≥1 combined with electrophysiological deterioration.composite

Main Result

Effect estimate: AUC 0.881 (95% CI 0.772-0.990)

Absolute Event Rate: 0.881% vs 0.844%

p-value: p=0.041

The combination of sympathetic skin response amplitude and medial plantar nerve sensory conduction velocity shows promising diagnostic performance for detecting chemotherapy-induced peripheral neuropathy.

Limitations

  • Single-center design
  • Relatively small sample size (n = 40)
  • Incorporation bias due to using a composite endpoint that includes electrophysiological deterioration
  • extremely small sample size for subclinical CIPN analysis
  • requires validation in independent cohorts
  • needs a truly independent reference standard

Cite This Study

Shi et al. (2026) conducted an observational in Chemotherapy-induced peripheral neuropathy (n=80). Combined upper limb sympathetic skin response (SSR) amplitude and medial plantar nerve sensory conduction velocity (SCV) vs. Upper limb SSR amplitude alone was evaluated on Diagnostic accuracy (Area Under the Curve) for chemotherapy-induced peripheral neuropathy (AUC 0.881, 95% CI 0.772-0.990, p=0.041). A combined diagnostic model incorporating upper limb sympathetic skin response amplitude and medial plantar nerve sensory conduction velocity achieved an AUC of 0.881 for detecting chemotherapy-induced peripheral neuropathy.

synapsesocial.com/papers/6a8e9b92451774b83f3b465bhttps://doi.org/10.24976/discov.med.202638211.204
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