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Diagnostic validity of epidermal nerve fiber densities in painful sensory neuropathies.
Muscle Nerve. 2008 Jan; 37(1):50-60.MN

Abstract

In this prospective study, intraepidermal nerve fiber densities (IENFD) and subepidermal nerve plexus densities (SENPD) were quantified by immunostaining in skin punch biopsies from the distal calf in 99 patients with clinical symptoms of painful sensory neuropathy and from 37 age-matched healthy volunteers. The clinical diagnosis was based on history and abnormal thermal thresholds on quantitative sensory testing (QST). In patients with neuropathy, IENFD and SENPD were reduced to about 50% of controls. Elevated warm detection thresholds on QST correlated with IENFD but not with SENPD. Using receiver-operating characteristic (ROC) curve analysis of IENFD values, the diagnostic sensitivity for detecting neuropathy was 0.80 and the specificity 0.82. For SENPD, sensitivity was 0.81 and specificity 0.88. With ROC analysis of both IENFD and SENPD together, the diagnostic sensitivity was further improved to 0.92. The combined examination of IENFD and SENPD is a highly sensitive and specific diagnostic tool in patients suspected to suffer from painful sensory neuropathies but with normal values on clinical neurophysiological studies.

Authors+Show Affiliations

Department of Neurology, University Hospital Brno, Jihlavska 20, 62500 Brno, Czech Republic.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17763459

Citation

Vlcková-Moravcová, Eva, et al. "Diagnostic Validity of Epidermal Nerve Fiber Densities in Painful Sensory Neuropathies." Muscle & Nerve, vol. 37, no. 1, 2008, pp. 50-60.
Vlcková-Moravcová E, Bednarík J, Dusek L, et al. Diagnostic validity of epidermal nerve fiber densities in painful sensory neuropathies. Muscle Nerve. 2008;37(1):50-60.
Vlcková-Moravcová, E., Bednarík, J., Dusek, L., Toyka, K. V., & Sommer, C. (2008). Diagnostic validity of epidermal nerve fiber densities in painful sensory neuropathies. Muscle & Nerve, 37(1), 50-60.
Vlcková-Moravcová E, et al. Diagnostic Validity of Epidermal Nerve Fiber Densities in Painful Sensory Neuropathies. Muscle Nerve. 2008;37(1):50-60. PubMed PMID: 17763459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic validity of epidermal nerve fiber densities in painful sensory neuropathies. AU - Vlcková-Moravcová,Eva, AU - Bednarík,Josef, AU - Dusek,Ladislav, AU - Toyka,Klaus V, AU - Sommer,Claudia, PY - 2007/9/1/pubmed PY - 2008/2/26/medline PY - 2007/9/1/entrez SP - 50 EP - 60 JF - Muscle & nerve JO - Muscle Nerve VL - 37 IS - 1 N2 - In this prospective study, intraepidermal nerve fiber densities (IENFD) and subepidermal nerve plexus densities (SENPD) were quantified by immunostaining in skin punch biopsies from the distal calf in 99 patients with clinical symptoms of painful sensory neuropathy and from 37 age-matched healthy volunteers. The clinical diagnosis was based on history and abnormal thermal thresholds on quantitative sensory testing (QST). In patients with neuropathy, IENFD and SENPD were reduced to about 50% of controls. Elevated warm detection thresholds on QST correlated with IENFD but not with SENPD. Using receiver-operating characteristic (ROC) curve analysis of IENFD values, the diagnostic sensitivity for detecting neuropathy was 0.80 and the specificity 0.82. For SENPD, sensitivity was 0.81 and specificity 0.88. With ROC analysis of both IENFD and SENPD together, the diagnostic sensitivity was further improved to 0.92. The combined examination of IENFD and SENPD is a highly sensitive and specific diagnostic tool in patients suspected to suffer from painful sensory neuropathies but with normal values on clinical neurophysiological studies. SN - 0148-639X UR - https://www.unboundmedicine.com/medline/citation/17763459/Diagnostic_validity_of_epidermal_nerve_fiber_densities_in_painful_sensory_neuropathies_ L2 - https://doi.org/10.1002/mus.20889 DB - PRIME DP - Unbound Medicine ER -