Tags

Type your tag names separated by a space and hit enter

Epidermal nerve fiber density and sural nerve morphometry in peripheral neuropathies.
Neurology. 1999 Nov 10; 53(8):1634-40.Neur

Abstract

OBJECTIVE

To study intraepidermal nerve fiber (IENF) density in distal leg skin biopsies, sural nerve morphometry, electrophysiology, and clinical features in patients with peripheral neuropathies.

METHODS

We studied 26 patients with neuropathic complaints who had undergone clinical evaluation, nerve conduction studies, distal leg skin biopsy, and sural nerve biopsy. We quantified densities of IENF and of myelinated and unmyelinated fibers in the sural nerve. Associations among skin and sural nerve morphometric measures and sensory nerve action potential (SNAP) amplitudes were examined nonparametrically. Morphometric measures were examined with respect to diagnostic category of neuropathy.

RESULTS

IENF density correlated with the densities of sural nerve total myelinated (r = 0.57, p = 0.0011), small myelinated (r = 0.53, p = 0.0029), and large myelinated fibers (r = 0.49, p = 0.0054). There was a trend toward an association between IENF and sural nerve unmyelinated fiber densities (r = 0.32, p = 0.054). Sural SNAP amplitude and large myelinated fiber densities were highly correlated (r = 0.87, p < 0.0001). IENF density and sural nerve small fiber measures were concordant in 73% of patients. Reduced IENF density was the only indicator of small fiber depletion in 23% of cases. It was usually normal in acquired demyelinating neuropathies and where clinical suspicion for neuropathy was low.

CONCLUSIONS

Distal leg Intraepidermal nerve (IENF) density may be more sensitive than sural nerve biopsy in identifying small fiber sensory neuropathies. Assessments of IENF density and large fiber measures on biopsy and electrophysiology are both useful for characterizing sensory and sensorimotor neuropathies.

Authors+Show Affiliations

Department of Neurology, University of Rochester, NY 14642, USA. David_Herrmann@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10563605

Citation

Herrmann, D N., et al. "Epidermal Nerve Fiber Density and Sural Nerve Morphometry in Peripheral Neuropathies." Neurology, vol. 53, no. 8, 1999, pp. 1634-40.
Herrmann DN, Griffin JW, Hauer P, et al. Epidermal nerve fiber density and sural nerve morphometry in peripheral neuropathies. Neurology. 1999;53(8):1634-40.
Herrmann, D. N., Griffin, J. W., Hauer, P., Cornblath, D. R., & McArthur, J. C. (1999). Epidermal nerve fiber density and sural nerve morphometry in peripheral neuropathies. Neurology, 53(8), 1634-40.
Herrmann DN, et al. Epidermal Nerve Fiber Density and Sural Nerve Morphometry in Peripheral Neuropathies. Neurology. 1999 Nov 10;53(8):1634-40. PubMed PMID: 10563605.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidermal nerve fiber density and sural nerve morphometry in peripheral neuropathies. AU - Herrmann,D N, AU - Griffin,J W, AU - Hauer,P, AU - Cornblath,D R, AU - McArthur,J C, PY - 1999/11/24/pubmed PY - 1999/11/24/medline PY - 1999/11/24/entrez SP - 1634 EP - 40 JF - Neurology JO - Neurology VL - 53 IS - 8 N2 - OBJECTIVE: To study intraepidermal nerve fiber (IENF) density in distal leg skin biopsies, sural nerve morphometry, electrophysiology, and clinical features in patients with peripheral neuropathies. METHODS: We studied 26 patients with neuropathic complaints who had undergone clinical evaluation, nerve conduction studies, distal leg skin biopsy, and sural nerve biopsy. We quantified densities of IENF and of myelinated and unmyelinated fibers in the sural nerve. Associations among skin and sural nerve morphometric measures and sensory nerve action potential (SNAP) amplitudes were examined nonparametrically. Morphometric measures were examined with respect to diagnostic category of neuropathy. RESULTS: IENF density correlated with the densities of sural nerve total myelinated (r = 0.57, p = 0.0011), small myelinated (r = 0.53, p = 0.0029), and large myelinated fibers (r = 0.49, p = 0.0054). There was a trend toward an association between IENF and sural nerve unmyelinated fiber densities (r = 0.32, p = 0.054). Sural SNAP amplitude and large myelinated fiber densities were highly correlated (r = 0.87, p < 0.0001). IENF density and sural nerve small fiber measures were concordant in 73% of patients. Reduced IENF density was the only indicator of small fiber depletion in 23% of cases. It was usually normal in acquired demyelinating neuropathies and where clinical suspicion for neuropathy was low. CONCLUSIONS: Distal leg Intraepidermal nerve (IENF) density may be more sensitive than sural nerve biopsy in identifying small fiber sensory neuropathies. Assessments of IENF density and large fiber measures on biopsy and electrophysiology are both useful for characterizing sensory and sensorimotor neuropathies. SN - 0028-3878 UR - https://www.unboundmedicine.com/medline/citation/10563605/Epidermal_nerve_fiber_density_and_sural_nerve_morphometry_in_peripheral_neuropathies_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=10563605 DB - PRIME DP - Unbound Medicine ER -