Evidence for small fiber neuropathy in early Parkinson's disease

Podgorny, Peter; Suchowersky, Oksana; Romanchuk, Kenneth; Feasby, Thomas E.

doi:10.1016/j.parkreldis.2016.04.033

Cited by 65 publications

(59 citation statements)

References 28 publications

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“…5 The rates of IENFD decrease over time do not differ between idiopathic SFN, diabetic SFN, and impaired glucose tolerance SFN. 5 IENFD has been reported to be reduced also in other painful conditions, such as Guillain-Barré syndrome, 36 meralgia paraesthestica, 37 notalgia, 38 Ehlers-Danlos syndrome, 39 and fibromyalgia 40 and nonpainful disorders, such as Parkinson disease and related disorders, [41][42][43] Key points…”

Section: Skin Biopsymentioning

confidence: 99%

“…IENFD has been reported to be reduced also in other painful conditions, such as Guillain‐Barré syndrome, meralgia paraesthestica, notalgia, Ehlers‐Danlos syndrome, and fibromyalgia and non‐painful disorders, such as Parkinson disease and related disorders, amyotrophic lateral sclerosis, critical illness, and peripheral arterial disease …”

Section: Epidemiologymentioning

confidence: 99%

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Small‐fiber neuropathy: Expanding the clinical pain universe

Sopacua

Hoeijmakers

Merkies

et al. 2019

J Peripheral Nervous Sys

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Small‐fiber neuropathy (SFN) is a disorder of thinly myelinated Aδ and unmyelinated C fibers. SFN is clinically dominated by neuropathic pain and autonomic complaints, leading to a significant reduction in quality of life. According to international criteria, the diagnosis is established by the assessment of intraepidermal nerve fiber density and/or quantitative sensory testing. SFN is mainly associated with autoimmune diseases, sodium channel gene variants, diabetes mellitus, and vitamin B12 deficiencies, although in more than one half of patients no etiology can be identified. Recently, gain‐of‐function variants in the genes encoding for the Nav1.7, Nav1.8 and Nav1.9 sodium channel subunits have been discovered in SFN patients, enlarging the spectrum of underlying conditions. Sodium channel gene variants associated with SFN can lead to a diversity of phenotypes, including different pain distributions and presence or absence of autonomic symptoms. This suggests that SFN is part of a clinical continuum. New assessments might contribute to a better understanding of the cellular and molecular substrates of SFN and might provide improved diagnostic methods and trial designs in the future. Identification of the underlying mechanisms may inform the development of drugs that more effectively address neuropathic pain and autonomic symptoms of SFN.

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Section: Skin Biopsymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Small‐fiber neuropathy: Expanding the clinical pain universe

Sopacua

Hoeijmakers

Merkies

et al. 2019

J Peripheral Nervous Sys

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“…A more recent study also revealed even preclinical small nerve neuropathy in newly diagnosed PD patients. 75 Significant reduction in total corneal nerve fiber density, which was associated with clinical severity 76 and reduced corneal nerve measures and increased dendritic cell density in patients with multiple sclerosis, 77 has been described in recent CCM studies.…”

Section: Potential Areas For Future Exploration Morphology Of the Cormentioning

confidence: 87%

Ocular Biomarkers of Alzheimer's Disease: The Role of Anterior Eye and Potential Future Directions

Dehghani

Frost

Jayasena

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…In our previous study of patients with PD using corneal confocal microscopy and skin biopsy, we have demonstrated that enhanced degeneration and regeneration is a pathological hallmark of Parkinson's disease [9]. Podgorny and colleagues demonstrated SFPN in early drug naïve PD [25]. Nolano et al in a longitudinal study suggested that a reduced capacity for nerve regeneration with disease progression correlates with worsening symptoms and deficits [20].…”

mentioning

confidence: 89%

Small Fibre Neuropathy in Parkinson’s Disease: Comparison of Skin Biopsies from the More Affected and Less Affected Sides

Jeziorska

Atkinson

Kass-Iliyya

et al. 2019

JPD

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We assessed small nerve fibre degeneration and regeneration in more and less affected sides in Parkinson's disease (PD). Bilateral skin biopsies from 23 PD patients were immunostained for PGP9.5 for Intraepidermal Nerve Fibre Density (IENFD) and GAP-43 for mean axonal length (MAL), total epidermal (TNFL) and subepidermal nerve fibre length (SKTNFL). IENFD (p < 0.001) and SKTNFL (p < 0.001) were lower, whilst MAL (p < 0.001) and TNFL (p < 0.05) were higher in more affected versus less affected side. These results suggest increased small nerve fibre degeneration accompanied by enhanced nerve regeneration on the side more affected by PD and GAP-43 usefulness in skin biopsy assessment.

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Evidence for small fiber neuropathy in early Parkinson's disease

Cited by 65 publications

References 28 publications

Small‐fiber neuropathy: Expanding the clinical pain universe

Small‐fiber neuropathy: Expanding the clinical pain universe

Ocular Biomarkers of Alzheimer's Disease: The Role of Anterior Eye and Potential Future Directions

Small Fibre Neuropathy in Parkinson’s Disease: Comparison of Skin Biopsies from the More Affected and Less Affected Sides

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