OSCR

Leprosy neuropathy and demyelinating impairment: How should we interpret this neurophysiological pattern?

Overview

Authors: Diogo Fernandes dos Santos1,2, Iago Resende Carvalho1, Isabella Sabião Borges1, Pedro Henrique Sirotheau Corrêa Alves12, Fernanda de Oliveira Cirino1,2, Douglas Eulálio Antunes1, Raquel Campos Pereira1, Marcus Vinicius Magno Gonçalves3, Isabela Maria Bernardes Goulart1,2
ORCID iDs: Iago Resende Carvalho, Isabela Maria Bernardes Goulart
  1. National Reference Center for Sanitary Dermatology and Leprosy, Clinics’ Hospital, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerai, Brazil
  2. Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerai, Brazil
  3. Professor of Neurology, School of Medicine, University of the Joinville (UNIVILLE), Joinville, South Carolina, Brazil
Institutions: Universidade Federal de Uberlândia (Brazil); Universidade da Região de Joinville (Brazil)
Journal: PloS one, volume 21, issue 4, article e0343962
Dates: received 7 April 2025; accepted 11 February 2026; published online 8 April 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.1371/journal.pone.0343962 · PMID 41950267 · PMCID PMC13061207 · OpenAlex W7152084320
Open access: gold, a free copy (OpenAlex)
Status: data only
Categories: human (organism), other condition (population), multiple sclerosis (population), clinical / translational (subfield)
Methods: Statistics, Machine learning
MeSH: Demyelinating Diseases*, Leprosy*, Peripheral Nervous System Diseases*, Adolescent, Adult, Aged, Brazil, Female, Humans, Male, Middle Aged, Mycobacterium leprae, Nerve Conduction Studies, Neural Conduction, Retrospective Studies, Young Adult (* major topic)
Topic: Leprosy Research and Treatment (Infectious Diseases, Medicine), according to OpenAlex
Citations: cited by 1 paper (Europe PMC); 36 references in the paper

Abstract

Introduction/Aims: Leprosy neuropathy (LN) may cause demyelination that worsens during the leprosy reactions (LR). Type-1 LR (T1LR) occurs in patients with cell-mediated immune response against M. leprae, and Type-2 LR (T2LR) occurs in multibacillary cases. The patterns of nerve impairment need to be clarified, as both demyelination and axonal degeneration are commonly observed. This study aimed to describe how to interpret the demyelinating impairment in LN.

Methods: Retrospective observational analysis of leprosy patients in a National Reference Center in Brazil between 2014–2023.

Results: 494 participants were included in this study. 3952 nerves were evaluated, with an average of 5.1 (±5.4) nerves affected per patient. 23.5% (116/494) of patients showed a demyelinating pattern defined by standard criteria, and 20.7% (24/116) presented exclusively demyelinating abnormalities without evidence of secondary axonal loss. 81% (94/116) presented conduction block, and 95.7% (111/116) temporal dispersion, with both conditions concomitant in 76.7% (89/116) of patients. 83.6% (97/116) demonstrated prolonged distal motor latency, and 99.1% (115/116) reduction in conduction velocity. 46.1% had T1LR and 17.9% T2LR. The comparison between patients with and without LR showed higher bacillary load, conduction block, and temporal dispersion in LR patients. 93.1% (108/116) of patients fulfilled neurophysiological criteria for chronic inflammatory demyelinating polyneuropathy (CIDP). Among them, 46.3% presented clinical criteria for atypical CIDP.

Discussion: Leprosy is a spectral disease in which neural damage can manifest in different phenotypes. Demyelinating impairment is frequent and varies according to the clinical form and presence of LR. Although demyelinating impairment is common in the studied population, it does not reflect active disease. LN can also be misdiagnosed as other peripheral neuropathies, especially CIDP, in non-endemic areas.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

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Data

Datasets cited

Data Availability

The full anonymized database can be found at https://doi.org/10.5281/zenodo.17297693.

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 1, 29 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 9 authors, 16 MeSH terms, 34 references.

Cite

This paper

dos Santos, D. F., Carvalho, I. R., Borges, I. S., Alves1, P. H. S. C., de Oliveira Cirino, F., Antunes, D. E., Pereira, R. C., Gonçalves, M. V. M., & Bernardes Goulart, I. M. (2026). Leprosy neuropathy and demyelinating impairment: How should we interpret this neurophysiological pattern? PloS one, 21(4), e0343962. https://doi.org/10.1371/journal.pone.0343962

BibTeX

@article{dossantos2026leprosy,
author = {dos Santos, Diogo Fernandes and Carvalho, Iago Resende and Borges, Isabella Sabião and Alves1, Pedro Henrique Sirotheau Corrêa and de Oliveira Cirino, Fernanda and Antunes, Douglas Eulálio and Pereira, Raquel Campos and Gonçalves, Marcus Vinicius Magno and Bernardes Goulart, Isabela Maria},
title = {{Leprosy neuropathy and demyelinating impairment: How should we interpret this neurophysiological pattern?}},
journal = {PloS one},
year = {2026},
month = apr,
volume = {21},
number = {4},
pages = {e0343962},
publisher = {PLOS},
issn = {1932-6203},
doi = {10.1371/journal.pone.0343962},
url = {https://doi.org/10.1371/journal.pone.0343962},
pmid = {41950267},
pmcid = {PMC13061207}
}

RIS

TY - JOUR
AU - dos Santos, Diogo Fernandes
AU - Carvalho, Iago Resende
AU - Borges, Isabella Sabião
AU - Alves1, Pedro Henrique Sirotheau Corrêa
AU - de Oliveira Cirino, Fernanda
AU - Antunes, Douglas Eulálio
AU - Pereira, Raquel Campos
AU - Gonçalves, Marcus Vinicius Magno
AU - Bernardes Goulart, Isabela Maria
TI - Leprosy neuropathy and demyelinating impairment: How should we interpret this neurophysiological pattern?
T2 - PloS one
J2 - PLoS One
PY - 2026
DA - 2026/04/08
VL - 21
IS - 4
SP - e0343962
SN - 1932-6203
PB - PLOS
DO - 10.1371/journal.pone.0343962
UR - https://doi.org/10.1371/journal.pone.0343962
LA - en
ER -

CSL-JSON

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