Faculty Opinions recommendation of High density of small nerve fibres in the functional layer of the endometrium in women with endometriosis.

Diabetic peripheral neuropathy (DPN) is the most common complication of both type 1 and 2 diabetes. As a result, neuropathic pain, diabetic foot ulcers and lower-limb amputations impact drastically on quality of life, contributing to the individual, societal, financial and healthcare burden of diabetes. DPN is diagnosed at a late, often pre-ulcerative stage due to a lack of early systematic screening and the endorsement of monofilament testing which identifies advanced neuropathy only. Compared to the success of the diabetic eye and kidney screening programmes there is clearly an unmet need for an objective reliable biomarker for the detection of early DPN. This article critically appraises research and clinical methods for the diagnosis or screening of early DPN. In brief, functional measures are subjective and are difficult to implement due to technical complexity. Moreover, skin biopsy is invasive, expensive and lacks diagnostic laboratory capacity. Indeed, point-of-care nerve conduction tests are convenient and easy to implement however questions are raised regarding their suitability for use in screening due to the lack of small nerve fibre evaluation. Corneal confocal microscopy (CCM) is a rapid, non-invasive, and reproducible technique to quantify small nerve fibre damage and repair which can be conducted alongside retinopathy screening. CCM identifies early sub-clinical DPN, predicts the development and allows staging of DPN severity. Automated quantification of CCM with AI has enabled enhanced unbiased quantification of small nerve fibres and potentially early diagnosis of DPN. Improved screening tools will prevent and reduce the burden of foot ulceration and amputations with the primary aim of reducing the prevalence of this common microvascular complication.

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Immunocytochemical and radioimmunometrical demonstration of serotonin- and neuropeptide-immunoreactivities in the adult rat tapeworm,Hymenolepis diminuta(Cestoda, Cyclophyllidea)

Parasitology ◽

10.1017/s0031182000059552 ◽

1991 ◽

Vol 103 (2) ◽

pp. 275-289 ◽

Cited By ~ 31

Author(s):

D. M. McKay ◽

I. Fairweather ◽

C. F. Johnston ◽

C. Shaw ◽

D. W. Halton

Keyword(s):

Nerve Cell ◽

Peptide Yy ◽

Hymenolepis Diminuta ◽

Epifluorescence Microscopy ◽

Confocal Scanning Laser Microscopy ◽

Nerve Fibres ◽

Cerebral Ganglia ◽

Longitudinal Nerve ◽

Small Nerve ◽

Nerve Cords

Standard indirect immunocytochemical techniques have been interfaced with confocal scanning laser microscopy (for whole-mount preparations) and epifluorescence microscopy (for cryosections) to investigate the occurrence and distribution of serotoninergic and peptidergic nerve elements in adultH. diminuta. Serotonin (5-HT)-immunoreactivity (IR) was widespread throughout the worm, occurring in the paired cerebral ganglia, transverse commissure, the 10 longitudinal nerve cords and in a plethora of small nerve fibres of the peripheral nervous system. An abundance of serotoninergic nerve cell bodies was found in association with the lateral nerve cords. The genital atrium and accessory reproductive ducts were richly innervated with serotoninergic nerve fibres. Thirty-five antisera to 20 vertebrate regulatory peptides and 1 invertebrate peptide (FMRFamide) were used to screen the worm for neuropeptide IR. Immunostaining was obtained with antisera raised to pancreatic polypeptide (PP), peptide YY (PYY), neuropeptide Y (NPY), substance P (SP), peptide histidine isoleucine (PHI), xenopsin (XP) and FMRFamide. The most extensive pattern of IR occurred with antisera to PP and PYY, IR being evident in the cerebral ganglia, transverse commissure, longitudinal nerve cords and in small nerve fibres that ramified throughout the parenchyma. A series of bipolar nerve cell bodies between the median nerve cords displayed PP/PYY-IR. The distribution of FMRFamide-IR was reminiscent of the PP/PYY pattern but was less extensive. Comparison of the serotoninergic and peptidergic nervous systems has revealed general similarities and some distinct differences, especially with regard to the distribution of immunoreactive nerve cell bodies. Quantitative data are presented on the levels of PP-, SP-, PH1-, and gastrin-releasing peptide (GRP)-immunoreactivities demonstrable in acid-alcohol extracts of whole worms. The highest level of peptide IR determined was recorded for PP.

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Mammalian model study of selective activation of small nerve fibres using biphasic pulses with monopolar electrode

Proceedings of the First Joint BMES/EMBS Conference. 1999 IEEE Engineering in Medicine and Biology 21st Annual Conference and the 1999 Annual Fall Meeting of the Biomedical Engineering Society (Cat. No.99CH37015) ◽

10.1109/iembs.1999.802676 ◽

2003 ◽

Author(s):

Qiang Shen ◽

Changfeng Tai ◽

Dazong Jiang

Keyword(s):

Nerve Fibres ◽

Selective Activation ◽

Monopolar Electrode ◽

Model Study ◽

Small Nerve

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Further study of efferent small-nerve fibres to mammalian muscle spindles. Multiple spindle innervation and activity during contraction

The Journal of Physiology ◽

10.1113/jphysiol.1951.sp004572 ◽

1951 ◽

Vol 113 (2-3) ◽

pp. 283-297 ◽

Cited By ~ 91

Author(s):

Carlton C. Hunt ◽

Stephen W. Kuffler

Keyword(s):

Muscle Spindles ◽

Nerve Fibres ◽

Mammalian Muscle ◽

Multiple Spindle ◽

Small Nerve

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A case of sporadic erythromelalgia presenting with small fibre neuropathy

BMJ Case Reports ◽

10.1136/bcr-2019-230549 ◽

2019 ◽

Vol 12 (10) ◽

pp. e230549 ◽

Cited By ~ 1

Author(s):

Pavan Patel ◽

Yan Zhang ◽

Lynne H Unikel ◽

Christopher Edwards

Keyword(s):

Physical Activity ◽

General Population ◽

Treatment Options ◽

Specific Treatment ◽

Nerve Biopsy ◽

Nerve Conduction Studies ◽

Nerve Fibres ◽

Small Fibre Neuropathy ◽

Small Fibre ◽

Small Nerve

Erythromelalgia (EM) is a rare disorder of small nerve fibres that leads to painful flushing and burning paresthesisas of the distal extremities and is typically associated with heat or physical activity; relief is found using cooling measures. Its effects are often debilitating in the general population, but this patient had an excellent response to specific treatment options and continues to maintain employment, something many individuals suffering from EM are unable to do. His presentation was also unique in that he had isolated, proximal involvement as his condition progressed whereas typically only the distal extremities are affected. Routine electromyography and nerve conduction studies were normal, whereas nerve biopsy demonstrated findings of small fibre neuropathy. Ultimately, his condition was managed with carbamazepine and his symptoms have almost entirely resolved to date.

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Diagnostic criteria for small fibre neuropathy in clinical practice and research

Brain ◽

10.1093/brain/awz333 ◽

2019 ◽

Vol 142 (12) ◽

pp. 3728-3736 ◽

Cited By ~ 13

Author(s):

Grazia Devigili ◽

Sara Rinaldo ◽

Raffaella Lombardi ◽

Daniele Cazzato ◽

Margherita Marchi ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Practice ◽

Diagnostic Criteria ◽

Combined Approach ◽

Nerve Fibres ◽

Structural Assessment ◽

Small Fibre Neuropathy ◽

Small Fibre ◽

Small Nerve

Definitive diagnostic criteria for small fibre neuropathy have yet to be established, with implications both for clinical practice and for the design of clinical trials. Devigili et al. demonstrate that a combined approach – with clinical, functional and structural assessment of small nerve fibres – improves the reliability of diagnosis.

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