Percutaneous stimulation of mechanoreceptors and peripheral neural transmission

Caruso, Giovanni

doi:10.1016/s0013-4694(97)87970-2

Cited by 2 publications

(5 citation statements)

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“…In a preliminary project on Meissner corpuscles in FA patients,25 observation of a marked reduction of ENFs in fingertips promoted the present study on cutaneous innervation in more body sites and in more subjects.…”

Section: Discussionmentioning

confidence: 65%

Small fibers involvement in Friedreich's ataxia

Nolano

Provitera

Crisci

et al. 2001

Annals of Neurology

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Although the involvement of large myelinated sensory fibers in Friedreich's ataxia (FA) is well documented, an impairment of unmyelinated fibers has not been described. We demonstrate an involvement of cutaneous unmyelinated sensory and autonomic nerve fibers in FA patients. We performed a morphological and functional study of cutaneous nerve fibers in 14 FA patients and in a population of control subjects. We used immunohistochemical techniques and confocal microscopy applied to punch skin biopsies from thigh, distal leg, and fingertip, and compared the density of epidermal nerve fibers (ENFs) with the results of mechanical pain sensation and thermal and tactile thresholds performed on hand dorsum, thigh, distal leg, and foot dorsum. We observed in our patients a statistically significant loss of ENFs, a reduced innervation of sweat glands, arrector pilorum muscles and arterioles, and an impairment of thermal and tactile thresholds and mechanical pain detection.

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Section: Discussionmentioning

confidence: 65%

Small fibers involvement in Friedreich's ataxia

Nolano

Provitera

Crisci

et al. 2001

Annals of Neurology

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“…The predominant pathological involvement in the PNS occurs at the dorsal root ganglion resulting in a sensory neuronopathy . Histological studies demonstrate peripheral sensory nerve hypoplasia with superimposed degeneration of predominantly large sensory nerve axons and associated mechanoreceptors, including Meissner’s corpuscles . Small unmyelinated epidermal nerve fibers are also reduced, but to a lesser extent .…”

Section: Discussionmentioning

confidence: 99%

“…Nerve conduction study outcomes, ENFDs, monofilament touch‐pressure thresholds, vibration thresholds and cooling thresholds were compared between individuals with FRDA and unaffected controls using ANCOVA based on ranks with a significance level of 5% (two‐tailed) . Given prior evidence that ENFDs may be affected at more advanced stages of the disease, comparisons of ENFDs between the two groups were also conducted among individuals with moderate to severe FRDA (FARS > 60) and matched controls using ANCOVA based on ranks with a significance level of 5% (two‐tailed) . Covariates in these ANCOVA models included age and sex.…”

Section: Methodsmentioning

confidence: 99%

“…In FRDA, sensory nerve action potentials are commonly unobtainable or low in amplitude while motor conduction studies are often normal or only mildly abnormal, raising concerns for floor and ceiling effects, respectively . ENFDs appear to be reduced in FRDA, although studies to date have been small and limited to more severely affected individuals than may be ideal for inclusion in clinical trials . Further systematic evaluation of these peripheral nerve measures in individuals with FRDA is necessary to determine their potential utility as PNS markers for clinical trial application.…”

Section: Introductionmentioning

confidence: 99%

“…Meissner’s corpuscle (MC) densities, the main touch‐pressure sensory receptor in glabrous skin (hands and feet), are also reduced in FRDA, but have not been widely measured, as glabrous skin biopsies are invasive and not suitable for serial monitoring . In‐vivo reflectance confocal microscopy (RCM) of skin is a noninvasive way to quantify MC density, which has recently emerged as a sensitive measure of sensory polyneuropathies and has potential utility as a marker of large sensory nerve fiber involvement in FRDA …”

Section: Introductionmentioning

confidence: 99%

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Measuring peripheral nerve involvement in Friedreich’s ataxia

Creigh

Mountain

Sowden

et al. 2019

Ann Clin Transl Neurol

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Objective Experimental therapies under development for Friedreich’s Ataxia (FRDA) require validated biomarkers. In‐vivo reflectance confocal microscopy (RCM) of skin is a noninvasive way to quantify Meissner’s corpuscle (MC) density and has emerged as a sensitive measure of sensory polyneuropathies. We conducted a prospective, cross‐sectional study evaluating RCM of MCs and conventional peripheral nerve measures as candidate peripheral nerve markers in FRDA. Methods Sixteen individuals with FRDA and 16 age‐ and gender‐matched controls underwent RCM of MC density and morphology, skin biopsies for epidermal nerve fiber density (ENFD), nerve conduction studies (NCS), and quantitative sensory testing (QST) including touch, vibration, and cooling thresholds. Results MC densities were measurable in all participants with FRDA, and were lower at digit V (hand), thenar eminence, and arch (foot) compared to controls. By contrast, sensory NCS showed floor effects and were obtainable in only 13% of FRDA participants. QST thresholds for touch, vibration, and cooling were higher at the hand and foot in FRDA than controls. Reductions in ENFDs were present in more severely affected individuals with FRDA (Friedreich’s Ataxia Rating Scale (FARS) >60) compared to matched controls, although skin biopsies were not well tolerated in children. MC densities, ENFDs, and touch and vibration thresholds were associated with clinical disease severity (FARS and modified FARS) and duration since symptom onset. Interpretation MC density, ENFD, and QST thresholds provide structural and physiologic markers of sensory involvement in FRDA. Longitudinal evaluation is needed to determine whether these measures can identify changes associated with disease progression or treatment.

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Percutaneous stimulation of mechanoreceptors and peripheral neural transmission

Cited by 2 publications

References 0 publications

Small fibers involvement in Friedreich's ataxia

Small fibers involvement in Friedreich's ataxia

Measuring peripheral nerve involvement in Friedreich’s ataxia

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