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Baris Isak, Kirsten Pugdahl, Páll Karlsson, Hatice Tankisi, Nanna Brix Finnerup, Jasna Furtula, Birger Johnsen, Niels Sunde, Johannes Jakobsen, Anders Fuglsang-Frederiksen
OBJECTIVE: In this prospective study, involvement of sensory nerve fibres in ALS patients was assessed using functional and structural measures in the form of quantitative sensory testing (QST) and skin and nerve biopsies. METHODS: Thirty-two ALS patients and 32 healthy subjects were evaluated with a QST battery comprising thresholds of mechanical detection, mechanical pain, vibration detection, cold detection, warm detection, heat pain, and pinprick sensation. Skin biopsies were evaluated in 31 ALS patients by intraepidermal nerve fibre density (IENFD) and axonal swelling ratios, and growth-associated protein 43 (GAP-43) antibody staining...
February 15, 2017: Journal of the Neurological Sciences
Georgios Ponirakis, Maria N Odriozola, Samantha Odriozola, Ioannis N Petropoulos, Shazli Azmi, Maryam Ferdousi, Hassan Fadavi, Uazman Alam, Andrew Marshall, Maria Jeziorska, Anthony Miro, Ahmad Kheyami, Mitra Tavakoli, Ahmed Al-Ahmar, Maria B Odriozola, Ariel Odriozola, Rayaz A Malik
BACKGROUND: Accurate and economic detection of nerve damage in diabetes is key to more widespread diagnosis of patients with diabetic peripheral neuropathy (DPN) and painful diabetic neuropathy. This study examined the diagnostic performance of NerveCheck, an inexpensive ($500) quantitative sensory testing (QST) device. METHODS: One hundred forty-four subjects (74 with and 70 without diabetes) underwent assessment with NerveCheck, neuropathy disability score (NDS), nerve conduction studies (NCS), intraepidermal and corneal nerve fiber density (IENFD and CNFD), and McGill questionnaire for neuropathic pain...
December 2016: Diabetes Technology & Therapeutics
Aleksandra Araszkiewicz, Agnieszka Gandecka, Michał Nowicki, Aleksandra Uruska, Agnieszka Malińska, Katarzyna Kowalska, Bogna Wierusz-Wysocka, Dorota Zozulińska-Ziółkiewicz
INTRODUCTION Advanced glycation end products (AGEs) play a crucial role in the pathogenesis of diabetic peripheral neuropathy (DPN). OBJECTIVES The aim of the study was to assess the skin accumulation of AGEs in patients with long‑lasting type 1 diabetes in relation to the presence of DPN. PATIENTS AND METHODS We evaluated 178 patients with type 1 diabetes (99 men; age, 43 years [interquartile range [IQR], 34-54 years]; disease duration, 25 years [IQR, 18-31 years]). DPN was diagnosed if 2 or more of the following 5 abnormalities were present: symptoms of neuropathy, lack of ankle reflexes, and impaired sensation of touch, temperature, and/or vibration...
November 22, 2016: Polskie Archiwum Medycyny Wewnętrznej
Heung Yong Jin, Na Young Lee, Hyun A Ko, Kyung Ae Lee, Tae Sun Park
Although diabetic peripheral neuropathy (DPN) and chemotherapy-induced peripheral neuropathy (CIPN) are different disease entities, they share similar neuropathic symptoms that impede quality of life for these patients. Despite having very similar downstream effects, there have been no direct comparisons between DPN and CIPN with respect to symptom severity and therapeutic responses. We compared peripheral nerve damage due to hyperglycemia with that caused by paclitaxel (PAC) treatment as represented by biochemical parameters, diverse sensory tests, and immunohistochemistry of cutaneous and sciatic nerves...
September 2016: Somatosensory & Motor Research
Janneke G J Hoeijmakers, Catharina G Faber, Carien J Miedema, Ingemar S J Merkies, Johan S H Vles
Small fiber neuropathy (SFN) is a debilitating condition that often leads to pain and autonomic dysfunction. In the last few decades, SFN has been gaining more attention, particularly in adults. However, literature about SFN in children remains limited. The present article reports the cases of 2 adolescent girls diagnosed with SFN. The first patient (14 years of age) complained about painful itch and tingling in her legs, as well as dysautonomia symptoms for years. She also reported a red/purple-type discoloration of her legs aggravated by warmth and standing, compatible with erythromelalgia...
October 2016: Pediatrics
Janine Leckelt, Pedro Guimarães, Annett Kott, Alfredo Ruggeri, Oliver Stachs, Simone Baltrusch
Small fiber neuropathy is one of the most common and painful long-term complications of diabetes mellitus. Examination of the sub-basal corneal nerve plexus is a promising surrogate marker of diabetic neuropathy. To investigate the efficacy, reliability and reproducibility of in vivo corneal confocal microscopy (IVCCM), we used thy1-YFP mice, which express yellow fluorescence protein (YFP) in nerve fibers. 4 weeks after multiple low-dose injections of streptozotocin, thy1-YFP mice showed manifest diabetes. Subsequent application of insulin-releasing pellets for 8 weeks resulted in a significant reduction of blood glucose concentration and HbA1c, a significant increase in body weight and no further increase in advanced glycation end products (AGEs)...
November 2016: Journal of Endocrinology
Patricia M Kluding, J Robinson Singleton, Mamatha Pasnoor, Mazen M Dimachkie, Richard J Barohn, A Gordon Smith, Robin L Marcus
BACKGROUND: Half of all patients with diabetes develop diabetic peripheral neuropathy (DPN), a complication leading to reduced mobility and quality of life. Although there are no proven pharmacologic approaches to reduce DPN risk or slow its progression, evidence suggests that physical activity may improve symptoms and enhance peripheral nerve regeneration. OBJECTIVE: The aim of the study will be to determine the impact of an intense lifestyle intervention on neuropathy progression and quality of life in individuals with DPN...
July 14, 2016: Physical Therapy
Quratul-Ain Altaf Altaf, Asad Ali, Milan K Piya, Neil T Raymond, Abd A Tahrani
BACKGROUND: Obstructive sleep apnea (OSA) is associated with increased nitrosative stress, endothelial dysfunction, and peripheral neuropathy in patients with type 2 diabetes. We hypothesized that OSA is associated with Poly ADP ribose polymerase (PARP) activation, lower intra-epidermal nerve fiber density (IENFD), and diabetic foot ulceration (DFU). METHODS: A cross-sectional study of adults with type 2 diabetes recruited from a secondary care hospital in the UK...
September 2016: Journal of Diabetes and its Complications
Daniele Cazzato, Marco Castori, Raffaella Lombardi, Francesca Caravello, Eleonora Dalla Bella, Antonio Petrucci, Paola Grammatico, Chiara Dordoni, Marina Colombi, Giuseppe Lauria
OBJECTIVE: To investigate the involvement of small nerve fibers in Ehlers-Danlos syndrome (EDS). METHODS: Patients diagnosed with EDS underwent clinical, neurophysiologic, and skin biopsy assessment. We recorded sensory symptoms and signs and evaluated presence and severity of neuropathic pain according to the Douleur Neuropathique 4 (DN4) and ID Pain questionnaires and the Numeric Rating Scale (NRS). Sensory action potential amplitude and conduction velocity of sural nerve was recorded...
July 12, 2016: Neurology
Ken Ohyama, Haruki Koike, Rina Hashimoto, Mie Takahashi, Yuichi Kawagashira, Masahiro Iijima, Masahisa Katsuno, Gen Sobue
OBJECTIVE: To examine intraepidermal nerve fibre densities (IENFDs) in patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin change (POEMS) syndrome. METHODS: The IENFDs of 11 patients with POEMS syndrome were estimated. We determined whether IENFD was associated with patient clinical features or the estimated number of nerve fibres on complete cross-sections of biopsied sural nerves. RESULTS: IENFD was significantly reduced (9...
June 15, 2016: Journal of the Neurological Sciences
Mohammad A Khoshnoodi, Shaun Truelove, Ahmet Burakgazi, Ahmet Hoke, Andrew L Mammen, Michael Polydefkis
IMPORTANCE: Few data are available on the natural history of small fiber neuropathy (SNF). Peripheral neuropathy typically follows a length-dependent pattern, leading us to hypothesize that patients with SFN would lose intraepidermal nerve fibers at the distal leg more quickly than at more proximal thigh sites. OBJECTIVE: To compare the longitudinal rate and pattern of intraepidermal nerve fiber density (IENFD) change in idiopathic SFN (iSFN), impaired glucose tolerance-associated SFN (IGT-SFN), and diabetes mellitus-associated SFN (DM-SFN)...
June 1, 2016: JAMA Neurology
Hubertus Axer, Alexander Grimm, Christine Pausch, Ulrike Teschner, Jan Zinke, Sven Eisenach, Sindy Beck, Orlando Guntinas-Lichius, Frank M Brunkhorst, Otto W Witte
BACKGROUND: A decrease of small nerve fibers in skin biopsies during the course of critical illness has been demonstrated recently. However, the diagnostic use of skin biopsies in sepsis and its time course is not known. METHODS: Patients (n=32) with severe sepsis or septic shock were examined using skin biopsies, neurological examination, nerve conduction studies, and sympathetic skin response in the first week after onset of sepsis, 2 weeks and 4 months later and compared to gender- and age-matched healthy controls...
March 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
Ivana Kovalova, Eva Vlckova, Josef Bednarik
PURPOSE: Intraepidermal nerve fiber density (IENFD) is useful in the evaluation of small-fiber neuropathy (SFN). Recent guidelines recommend extending the spectrum of controls for IENFD assessment by evaluation of patients whose clinical picture mimics that of SFN. The aim of this study was to broaden the spectrum of IENFD controls by the assessment of patients with cervical spondylotic myelopathy (CSM) and painful feet. METHODS: Evaluation of IENFD from skin biopsy samples and quantitative sensory testing (QST) were performed in a cohort of 14 CSM patients (eight men, median age: 58; range: 46-63 years), with painful feet, exhibiting no clinical or electrophysiological signs of large-fiber polyneuropathy, and no risk factors for peripheral neuropathies...
March 2016: Brain and Behavior
A Puhakka, H Forssell, S Soinila, A Virtanen, M Röyttä, M Laine, O Tenovuo, T Teerijoki-Oksa, S K Jääskeläinen
OBJECTIVE: The pathophysiology of primary burning mouth syndrome (BMS) has remained enigmatic, but recent studies suggest pathology within the nervous system at multiple levels. This study aimed to investigate in detail the contribution of either focal or generalized alterations within the peripheral nervous system (PNS) in the etiopathogenesis of BMS. SUBJECTS AND METHODS: Intraepithelial nerve fiber density (IENFD) of tongue mucosa was assessed in 10 carefully characterized BMS, and the results were compared to 19 age- and gender-matched cadaver controls, 6 with lifetime diabetes...
May 2016: Oral Diseases
Arada Wongmek, Susan Shin, Lan Zhou
INTRODUCTION: Meralgia paresthetica is a focal neuropathy caused by compression of the lateral femoral cutaneous nerve (LFCN). The disease can be difficult to assess by neurophysiological or imaging studies. METHODS: We studied 5 patients who presented to our neuromuscular clinic from April 2012 to December 2014 with a clinical suspicion of meralgia paresthetica and had skin biopsies with intraepidermal nerve fiber density (IENFD) evaluation. RESULTS: The mean age at onset was 37...
April 2016: Muscle & Nerve
Jessica R Lakritz, Jake A Robinson, Michael J Polydefkis, Andrew D Miller, Tricia H Burdo
BACKGROUND: Peripheral neuropathy (PN) continues to be a major complication of human immunodeficiency virus (HIV) infection despite successful anti-retroviral therapy. Human HIV-PN can be recapitulated in a CD8-depleted, simian immunodeficiency virus (SIV)-infected rhesus macaque animal model, characterized by a loss of intraepidermal nerve fiber density (IENFD) and damage to the dorsal root ganglia (DRG). Increased monocyte traffic to the DRG has previously been associated with severe DRG pathology, as well as a loss in IENFD...
2015: Journal of Neuroinflammation
Sissel Løseth, Erik V Stålberg, Sigurd Lindal, Edel Olsen, Rolf Jorde, Svein I Mellgren
The purpose of this study was to evaluate progression of diabetic polyneuropathy and differences in the spectrum and evolution of large- and small-fiber involvement in patients with diabetes type 1 and 2 over 5 years. Fifty-nine patients (35 type 1 and 24 type 2) were included. Nerve conduction studies (NCS), quantitative sensory testing, skin biopsy for quantification of intraepidermal nerve fiber density (IENFD), symptom scoring and clinical evaluations were performed. Z-scores were calculated to adjust for the physiologic effects of age and height/gender...
March 2016: Journal of the Peripheral Nervous System: JPNS
Kentaro Tsuboi, Hiroki Mizukami, Wataru Inaba, Masayuki Baba, Soroku Yagihashi
Incretin-related therapy was found to be beneficial for experimental diabetic neuropathy, but its mechanism is obscure. The purpose of this study is to explore the mechanism through which dipeptidyl peptidase IV inhibitor, vildagliptin (VG), influences neuropathy in diabetic rodents. To this end, non-obese type 2 diabetic Goto-Kakizaki rats (GK) and streptozotocin (STZ)-induced diabetic mice were treated with VG orally. Neuropathy was evaluated by nerve conduction velocity (NCV) in both GK and STZ-diabetic mice, whereas calcitonin-gene-related peptide (CGRP) expressions, neuronal cell size of dorsal root ganglion (DRG) and intraepidermal nerve fiber density (IENFD) were examined in GK...
November 25, 2015: Journal of Neurochemistry
S Divisova, E Vlckova, I Srotova, S Kincova, M Skorna, L Dusek, P Dubovy, J Bednarik
AIMS: This paper aims to investigate whether intraepidermal nerve-fibre density (IENFD) may be used as a marker of the course of neuropathy in patients with Type 2 diabetes mellitus. METHODS: Skin biopsies from the distal leg were serially evaluated in a group of 30 patients with Type 2 diabetes mellitus (median age 60 years, 17 men) with a short duration of diabetes (< 3 years) and good glucose control, and in 23 age- and sex-matched controls. The time intervals between biopsies were > 2 years (median 33...
May 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Hamid Ebadi, Hafsah Siddiqui, Sepehr Ebadi, MyLan Ngo, Ari Breiner, Vera Bril
Routine nerve conduction studies are normal in patients with small fiber neuropathy (SFN), and a definitive diagnosis is based on skin biopsy revealing reduced intra-epidermal nerve fiber density (IENFD). In large fiber polyneuropathy, ultrasound (US) parameters indicate enlargement in cross-sectional area (CSA). This study was aimed at determining if similar changes in large fibers on US are apparent in patients with SFN. Twenty-five patients with SFN diagnosed by reduced IENFD and 25 age- and body mass index (BMI)-matched healthy controls underwent US studies of sural and superficial peroneal sensory nerves...
November 2015: Ultrasound in Medicine & Biology
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