Journal ArticleDOI
Intraepidermal nerve fiber density at the distal leg: a worldwide normative reference study
Giuseppe Lauria,Mayienne Bakkers,Christoph Schmitz,Raffaella Lombardi,Paola Penza,Grazia Devigili,A. Gordon Smith,Sung Tsieh Hsieh,Svein Ivar Mellgren,Thirugnanam Umapathi,Dan Ziegler,Catharina G. Faber,Ingemar S. J. Merkies +12 more
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TLDR
A multicenter study to assess the normative values of intraepidermal nerve fiber (IENF) density at distal leg stratified by age deciles found a significant age‐dependent decrease of IENF density in both genders.Abstract:
The diagnostic reliability of skin biopsy in small fiber neuropathy depends on the availability of normative reference values We performed a multicenter study to assess the normative values of intraepidermal nerve fiber (IENF) density at distal leg stratified by age deciles Eight skin biopsy laboratories from Europe, USA, and Asia submitted eligible data Inclusion criteria of raw data were healthy subjects 18 years or older; known age and gender; 3-mm skin biopsy performed 10-cm above the lateral malleolus; bright-field immunohistochemistry protocol, and quantification of linear IENF density in three 50-µm sections according to published guidelines Data on height and weight were recorded, and body mass index (BMI) was calculated in subjects with both available data Normative IENF density reference values were calculated through quantile regression analysis; influence of height, weight, or BMI was determined by regression analyses IENF densities from 550 participants (285 women, 265 men) were pooled We found a significant age-dependent decrease of IENF density in both genders (women p < 0001; men p = 0002) Height, weight, or BMI did not influence the calculated 5th percentile IENF normative densities in both genders Our study provides IENF density normative reference values at the distal leg to be used in clinical practiceread more
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Journal ArticleDOI
Diabetic Neuropathy: A Position Statement by the American Diabetes Association
Rodica Pop-Busui,Andrew J.M. Boulton,Eva L. Feldman,Vera Bril,Roy Freeman,Rayaz A. Malik,Jay M. Sosenko,Dan Ziegler +7 more
TL;DR: Although screening for rarer atypical forms of diabetic neuropathy may be warranted, DSPN and autonomic neuropathy are the most common forms encountered in practice and the strongest available evidence regarding treatment pertains to these forms.
Journal ArticleDOI
Gain-of-function Nav1.8 mutations in painful neuropathy
Catharina G. Faber,Giuseppe Lauria,Ingemar S. J. Merkies,Xiaoyang Cheng,Xiaoyang Cheng,Chongyang Han,Chongyang Han,Hye Sook Ahn,Hye Sook Ahn,Anna Karin Persson,Anna Karin Persson,Janneke G. J. Hoeijmakers,Monique M. Gerrits,Tiziana Pierro,Raffaella Lombardi,Dimos Kapetis,Sulayman D. Dib-Hajj,Sulayman D. Dib-Hajj,Stephen G. Waxman,Stephen G. Waxman +19 more
TL;DR: Observations suggest that mutations of Nav1.8 contribute to painful peripheral neuropathy by enhancing the channel’s response to depolarization and producing hyperexcitability in DRG neurons.
Journal ArticleDOI
The Effect of Exercise on Neuropathic Symptoms, Nerve Function, and Cutaneous Innervation in People with Diabetic Peripheral Neuropathy
Patricia M. Kluding,Mamatha Pasnoor,Rupali Singh,Stephen Jernigan,Kevin L. Farmer,Jason Rucker,Neena K. Sharma,Douglas E. Wright +7 more
TL;DR: Improvements in neuropathic and cutaneous nerve fiber branching following supervised exercise in people with diabetic peripheral neuropathy are described, particularly promising given the short duration of the intervention.
Journal ArticleDOI
Early Detection of Nerve Fiber Loss by Corneal Confocal Microscopy and Skin Biopsy in Recently Diagnosed Type 2 Diabetes
Dan Ziegler,Nikolaos Papanas,Andrey Zhivov,Stephan Allgeier,Karsten Winter,Iris Ziegler,Jutta Brüggemann,Alexander Strom,Sabine Peschel,Bernd Köhler,Oliver Stachs,Rudolf F. Guthoff,Michael Roden +12 more
TL;DR: CCM and skin biopsy both detect nerve fiber loss in recently diagnosed type 2 diabetes, but largely in different patients, suggesting a patchy manifestation pattern of small fiber neuropathy.
Journal ArticleDOI
Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation
Mitra Tavakoli,Maria Mitu-Pretorian,Ioannis N. Petropoulos,Hassan Fadavi,Omar Asghar,Uazman Alam,Georgios Ponirakis,Maria Jeziorska,Andrew Marshall,Nathan Efron,Andrew J.M. Boulton,Titus Augustine,Rayaz A. Malik +12 more
TL;DR: Corneal confocal microscopy (CCM) shows a significant improvement in nerve morphology, providing a novel noninvasive means to establish early nerve repair that is missed by currently advocated assessment techniques.
References
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Journal ArticleDOI
The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology
Grazia Devigili,Valeria Tugnoli,Paola Penza,Francesca Camozzi,Raffaella Lombardi,Giorgia Melli,Laura Broglio,Enrico Granieri,Giuseppe Lauria +8 more
TL;DR: Patients with pure SFN were identified using a new diagnostic ‘gold standard’, based on the presence of at least two abnormal results at clinical, QST and skin biopsy examination, and a significant inverse correlation between IENF density and both cold and warm thresholds at the leg was found.
Journal ArticleDOI
Influence of aging on peripheral nerve function and regeneration.
TL;DR: Age-related changes are not linearly progressive with age; the capabilities for axonal regeneration and reinnervation are maintained throughout life, but tend to be delayed and less effective with aging.
Journal ArticleDOI
Epidermal Nerve Fiber Density Normative Reference Range and Diagnostic Efficiency
TL;DR: A reference range for intraepidermal nerve fiber density in normal humans is established by means of a simple quantitation method based on enumeration of individual intraepidersmal nerve fibers on vertical sections of punch skin biopsy specimens stained with the sensitive panaxonal marker anti-protein gene product 9.5.
Journal ArticleDOI
EFNS guidelines on the use of skin biopsy in the diagnosis of peripheral neuropathy
Giuseppe Lauria,David R. Cornblath,Olle Johansson,Justin C. McArthur,Svein Ivar Mellgren,Maria Nolano,N. Rosenberg,Claudia Sommer +7 more
TL;DR: Punch skin biopsy is a safe and reliable technique andConfocal microscopy may be particularly useful to investigate myelinated nerve fibres, dermal receptors and dermal annex innervation and to assess the potential usefulness of skin biopsies as an outcome measure in peripheral neuropathy trials.
Journal ArticleDOI
European Federation of Neurological Societies/Peripheral Nerve Society guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society
Guseppe Lauria,Sung-Tsang Hsieh,Olle Johansson,William R. Kennedy,Jean Marc Léger,Svein Ivar Mellgren,Maria Nolano,Ingenar S.J. Merkies,Michael Polydefkis,A. Gordon Smith,Claludia Sommer,J. Valls-Solé +11 more
TL;DR: This revision focuses on the use of skin biopsy with quantification of the linear density of intraepidermal nerve fibers (IENF) to assess small fiber neuropathy (SFN), a subtype of neuropathy for which the diagnosis was first developed through skinBiopsy examination.