scholarly journals Corneal nerve fiber size adds utility to the diagnosis and assessment of therapeutic response in patients with small fiber neuropathy

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Michael Brines ◽  
Daniel A. Culver ◽  
Maryam Ferdousi ◽  
Martijn R. Tannemaat ◽  
Monique van Velzen ◽  
...  
Keyword(s):  
Nerve Fiber ◽  
Therapeutic Response ◽  
Small Fiber Neuropathy ◽  
Small Fiber ◽  
Fiber Size ◽  
Corneal Nerve

Corneal nerve quantification predicts the severity of symptoms in sarcoidosis patients with painful neuropathy

TECHNOLOGY ◽  
2013 ◽  
Vol 01 (01) ◽  
pp. 20-26 ◽  
Author(s):  
M. Brines ◽  
M. Swartjes ◽  
M.R. Tannemaat ◽  
A. Dunne ◽  
M. van Velzen ◽  
...  
Keyword(s):  
Nerve Fiber ◽  
Adult Population ◽  
Brief Pain Inventory ◽  
The United States ◽  
Fiber Density ◽  
Painful Neuropathy ◽  
Small Fiber ◽  
Corneal Confocal Microscopy ◽  
Fiber Number ◽  
Corneal Nerve

Small fiber neuropathy (SFN) is a debilitating condition characterized by chronic pain as well as sensory and autonomic dysfunction. SFN is an increasingly recognized component of a large number of diseases, including sarcoidosis. Although affecting an estimated 2–3% of the adult population in the United States, it often remains undiagnosed. Skin biopsy for evaluating intra-epidermal nerve fiber density (IENFD) and more recently corneal confocal microscopy (CCM) have been used to identify small fiber damage in patients with neuropathy. We demonstrate a significant reduction in IENFD, corneal nerve fiber number and length, with no change in the number of branches in patients with painful sarcoid neuropathy. Moreover, unlike IENFD, corneal nerve fiber number and length inversely correlate with the degree to which pain interferes with activities of daily living as assessed by the Brief Pain Inventory questionnaire. CCM thus constitutes an accurate, non-invasive assessment technique to aid in the diagnosis of SFN, as well as an objective marker of symptoms in patients with painful sarcoid neuropathy.

scholarly journals Presence of Decreased Intraepidermal Nerve Fiber Density Consistent with Small Fiber Neuropathy in Patients with Central Post-Stroke Pain

Pain Medicine ◽  
2016 ◽  
Vol 17 (8) ◽  
pp. 1569-1571 ◽  
Author(s):  
Yefim Cavalier ◽  
Phillip J. Albrecht ◽  
Colum Amory ◽  
Gary L. Bernardini ◽  
Charles E. Argoff
Keyword(s):  
Nerve Fiber ◽  
Small Fiber Neuropathy ◽  
Fiber Density ◽  
Post Stroke ◽  
Small Fiber ◽  
Intraepidermal Nerve Fiber Density ◽  
Nerve Fiber Density ◽  
Intraepidermal Nerve Fiber

Small-Fiber Neuropathy Is Associated With Corneal Nerve and Dendritic Cell Alterations

Cornea ◽  
2015 ◽  
Vol 34 (9) ◽  
pp. 1114-1119 ◽  
Author(s):  
Franziska Bucher ◽  
Christian Schneider ◽  
Tobias Blau ◽  
Claus Cursiefen ◽  
Gereon R. Fink ◽  
...  
Keyword(s):  
Dendritic Cell ◽  
Small Fiber Neuropathy ◽  
Small Fiber ◽  
Corneal Nerve ◽  
Cell Alterations

scholarly journals Corneal Confocal Microscopy in the Diagnosis of Small Fiber Neuropathy: Faster, Easier, and More Efficient Than Skin Biopsy?

2021 ◽  
Vol 29 (1) ◽  
pp. 1-8
Author(s):  
Mariia V. Lukashenko ◽  
Natalia Y. Gavrilova ◽  
Anna V. Bregovskaya ◽  
Lidiia A. Soprun ◽  
Leonid P. Churilov ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Skin Biopsy ◽  
Nerve Fiber ◽  
Small Fiber Neuropathy ◽  
Fiber Damage ◽  
Advantages And Disadvantages ◽  
Small Fiber ◽  
Corneal Confocal Microscopy ◽  
Common Causes ◽  
Small Nerve

Chronic pain may affect 30–50% of the world’s population and an important cause is small fiber neuropathy (SFN). Recent research suggests that autoimmune diseases may be one of the most common causes of small nerve fiber damage. There is low awareness of SFN among patients and clinicians and it is difficult to diagnose as routine electrophysiological methods only detect large fiber abnormalities, and specialized small fiber tests, like skin biopsy and quantitative sensory testing, are not routinely available. Corneal confocal microscopy (CCM) is a rapid, non-invasive, reproducible method for quantifying small nerve fiber degeneration and regeneration, and could be an important tool for diagnosing SFN. This review considers the advantages and disadvantages of CCM and highlights the evolution of this technique from a research tool to a diagnostic test for small fiber damage, which can be a valuable contribution to the study and management of autoimmune disease.

scholarly journals Alpha-synuclein oligomers and small nerve fiber pathology in skin are potential biomarkers of Parkinson’s disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Elena Vacchi ◽  
Camilla Senese ◽  
Giacomo Chiaro ◽  
Giulio Disanto ◽  
Sandra Pinton ◽  
...  
Keyword(s):  
Skin Biopsy ◽  
Nerve Fiber ◽  
Temporal Dynamics ◽  
Alpha Synuclein ◽  
Small Fiber Neuropathy ◽  
Proximity Ligation Assay ◽  
Anatomical Site ◽  
Small Fiber ◽  
Intraepidermal Nerve Fiber Density ◽  
Small Nerve

AbstractThe proximity ligation assay (PLA) is a specific and sensitive technique for the detection of αSyn oligomers (αSyn-PLA), early and toxic species implicated in the pathogenesis of PD. We aimed to evaluate by skin biopsy the diagnostic and prognostic capacity of αSyn-PLA and small nerve fiber reduction in PD in a longitudinal study. αSyn-PLA was performed in the ankle and cervical skin biopsies of PD (n = 30), atypical parkinsonisms (AP, n = 23) including multiple system atrophy (MSA, n = 12) and tauopathies (AP-Tau, n = 11), and healthy controls (HC, n = 22). Skin biopsy was also analyzed for phosphorylated αSyn (P-αSyn) and 5G4 (αSyn-5G4), a conformation-specific antibody to aggregated αSyn. Intraepidermal nerve fiber density (IENFD) was assessed as a measure of small fiber neuropathy. αSyn-PLA signal was more expressed in PD and MSA compared to controls and AP-Tau. αSyn-PLA showed the highest diagnostic accuracy (PD vs. HC sensitivity 80%, specificity 77%; PD vs. AP-Tau sensitivity 80%, specificity 82%), however, P-αSyn and 5G4, possible markers of later phases, performed better when considering the ankle site alone. A small fiber neuropathy was detected in PD and MSA. A progression of denervation not of pathological αSyn was detected at follow-up and a lower IENFD at baseline was associated with a greater cognitive and motor decline in PD. A skin biopsy-derived compound marker, resulting from a linear discrimination analysis model of αSyn-PLA, P-αSyn, αSyn-5G4, and IENFD, stratified patients with accuracy (77.8%), including the discrimination between PD and MSA (84.6%). In conclusion, the choice of pathological αSyn marker and anatomical site influences the diagnostic performance of skin biopsy and can help in understanding the temporal dynamics of αSyn spreading in the peripheral nervous system during the disease. Skin denervation, not pathological αSyn is a potential progression marker for PD.

scholarly journals Small fiber neuropathy for assessment of disease severity in amyotrophic lateral sclerosis: corneal confocal microscopy findings

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Jiayu Fu ◽  
Ji He ◽  
Yixuan Zhang ◽  
Ziyuan Liu ◽  
Haikun Wang ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Dendritic Cell ◽  
Confocal Microscopy ◽  
Disease Severity ◽  
Peripheral Region ◽  
Small Fiber Neuropathy ◽  
Small Fiber ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve ◽  
Lateral Sclerosis

Abstract Background Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder with progressive motor system impairment, and recent evidence has identified the extra-motor involvement. Small fiber neuropathy reflecting by sensory and autonomic disturbances in ALS has been reported to accompany the motor damage. However, non-invasive assessment of this impairment and its application in disease evaluation of ALS is scarce. We aim to evaluate the use of corneal confocal microscopy (CCM) to non-invasively quantify the corneal small fiber neuropathy in ALS and explore its clinical value in assessing disease severity of ALS. Methods Sixty-six patients with ALS and 64 healthy controls were included in this cross-sectional study. Participants underwent detailed clinical assessments and corneal imaging with in vivo CCM. Using ImageJ, the following parameters were quantified: corneal nerve length (IWL) and dendritic cell density (IWDC) in the inferior whorl region and corneal nerve fiber length (CNFL), nerve fiber density (CNFD), nerve branch density (CNBD), and dendritic cell density (CDC) in the peripheral region. Disease severity was evaluated using recognized scales. Results Corneal nerve lengths (IWL and CNFL) were lower while dendritic cell densities (IWDC and CDC) were higher in patients with ALS than controls in peripheral and inferior whorl regions (p < 0.05). Additionally, corneal nerve complexity in the peripheral region was greater in patients than controls with higher CNBD (p = 0.040) and lower CNFD (p = 0.011). IWL was significantly associated with disease severity (p < 0.001) and progression (p = 0.002) in patients with ALS. Patients with bulbar involvement showed significantly lower IWL (p = 0.014) and higher IWDC (p = 0.043) than patients without bulbar involvement. Conclusions CCM quantified significant corneal neuropathy in ALS, and alterations in the inferior whorl region were closely associated with disease severity. CCM could serve as a noninvasive, objective imaging tool to detect corneal small fiber neuropathy for clinical evaluation in ALS.

Correlation Between Corneal Nerve Density and Symptoms of Small Fiber Neuropathy in Patients With Fibromyalgia

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Manuel Ramírez ◽  
Arturo Guerra-Juárez ◽  
Daniel-Yoshiro Miyake ◽  
Christian Sebastian-Arellano ◽  
Aranza-Guadalupe Estrada-Mata ◽  
...  
Keyword(s):  
Small Fiber Neuropathy ◽  
Small Fiber ◽  
Corneal Nerve
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