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Small-fiber degeneration in alcohol-related peripheral neuropathy.
Alcohol Clin Exp Res. 2014 Jul; 38(7):1965-72.AC

Abstract

BACKGROUND

Alcohol-related peripheral neuropathy (ALN) is generally characterized as an axonal large-fiber polyneuropathy caused by thiamine deficiency. We hypothesized, based on clinical observations, that ALN is associated with a small-fiber polyneuropathy that can be diagnosed with skin biopsy in heavy alcohol drinking subjects with normal thiamine status.

METHODS

Eighteen individuals (9 heavy alcohol drinking subjects and 9 healthy control subjects) were assessed for the potential utility of skin biopsies in detecting ALN-associated small nerve fiber degeneration. Heavy drinking was defined as greater than 4 drinks/d and 5 drinks/d in women and men, respectively, as determined by the Timeline Follow-Back and lifetime drinking history. All subjects underwent neurological examination, nerve conduction studies, and skin biopsies to quantify end nerve fiber densities (ENFD). Other causes of neuropathy were excluded and thiamine status was assessed.

RESULTS

Average ENFD were significantly decreased at the calf in the alcohol group as compared with control group (p < 0.0001). Histological sections demonstrated striking attrition and architectural simplification of intraepidermal nerve fibers in the heavy alcohol drinking subjects. There were no significant intergroup differences with respect to clinical assessments of neuropathy or thiamine status.

CONCLUSIONS

ALN is associated with a small-fiber neuropathy that can be detected with skin biopsy in heavy alcohol drinking individuals with normal thiamine status. Skin biopsy is a useful, minimally invasive biomarker that could extend studies to understand the effect of alcohol on the peripheral nerves and to evaluate potential therapeutic agents in larger clinical trials.

Authors+Show Affiliations

Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, Rhode Island.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24961481

Citation

Mellion, Michelle L., et al. "Small-fiber Degeneration in Alcohol-related Peripheral Neuropathy." Alcoholism, Clinical and Experimental Research, vol. 38, no. 7, 2014, pp. 1965-72.
Mellion ML, Silbermann E, Gilchrist JM, et al. Small-fiber degeneration in alcohol-related peripheral neuropathy. Alcohol Clin Exp Res. 2014;38(7):1965-72.
Mellion, M. L., Silbermann, E., Gilchrist, J. M., Machan, J. T., Leggio, L., & de la Monte, S. (2014). Small-fiber degeneration in alcohol-related peripheral neuropathy. Alcoholism, Clinical and Experimental Research, 38(7), 1965-72. https://doi.org/10.1111/acer.12470
Mellion ML, et al. Small-fiber Degeneration in Alcohol-related Peripheral Neuropathy. Alcohol Clin Exp Res. 2014;38(7):1965-72. PubMed PMID: 24961481.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small-fiber degeneration in alcohol-related peripheral neuropathy. AU - Mellion,Michelle L, AU - Silbermann,Elizabeth, AU - Gilchrist,James M, AU - Machan,Jason T, AU - Leggio,Lorenzo, AU - de la Monte,Suzanne, Y1 - 2014/06/24/ PY - 2014/02/20/received PY - 2014/04/10/accepted PY - 2014/6/26/entrez PY - 2014/6/26/pubmed PY - 2015/4/15/medline KW - Alcohol KW - Nerve KW - Peripheral Neuropathy KW - Small Fiber SP - 1965 EP - 72 JF - Alcoholism, clinical and experimental research JO - Alcohol Clin Exp Res VL - 38 IS - 7 N2 - BACKGROUND: Alcohol-related peripheral neuropathy (ALN) is generally characterized as an axonal large-fiber polyneuropathy caused by thiamine deficiency. We hypothesized, based on clinical observations, that ALN is associated with a small-fiber polyneuropathy that can be diagnosed with skin biopsy in heavy alcohol drinking subjects with normal thiamine status. METHODS: Eighteen individuals (9 heavy alcohol drinking subjects and 9 healthy control subjects) were assessed for the potential utility of skin biopsies in detecting ALN-associated small nerve fiber degeneration. Heavy drinking was defined as greater than 4 drinks/d and 5 drinks/d in women and men, respectively, as determined by the Timeline Follow-Back and lifetime drinking history. All subjects underwent neurological examination, nerve conduction studies, and skin biopsies to quantify end nerve fiber densities (ENFD). Other causes of neuropathy were excluded and thiamine status was assessed. RESULTS: Average ENFD were significantly decreased at the calf in the alcohol group as compared with control group (p < 0.0001). Histological sections demonstrated striking attrition and architectural simplification of intraepidermal nerve fibers in the heavy alcohol drinking subjects. There were no significant intergroup differences with respect to clinical assessments of neuropathy or thiamine status. CONCLUSIONS: ALN is associated with a small-fiber neuropathy that can be detected with skin biopsy in heavy alcohol drinking individuals with normal thiamine status. Skin biopsy is a useful, minimally invasive biomarker that could extend studies to understand the effect of alcohol on the peripheral nerves and to evaluate potential therapeutic agents in larger clinical trials. SN - 1530-0277 UR - https://www.unboundmedicine.com/medline/citation/24961481/Small_fiber_degeneration_in_alcohol_related_peripheral_neuropathy_ L2 - https://doi.org/10.1111/acer.12470 DB - PRIME DP - Unbound Medicine ER -