Peripheral nerve disease in SARS:

Chao, Chun-Chieh; Tsai, Li-Kai; Chiou, Yan-Kai; Tseng, Ming-Tsung; Hsieh, Sung‐Tsang; Chang, Shan‐Chwen; Chang, Yang-Chyuan

doi:10.1212/01.wnl.0000099171.26943.d0

Cited by 54 publications

(47 citation statements)

References 6 publications

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“…Previously identi ed coronaviruses, including SARS-CoV1 and MERS, were associated with GBS. [61] In our review, neuromuscular disorders are the second most commonly encountered neurological complication of COVID-19 infection (28%), especially GBS. The mechanisms of GBS related to SARS-CoV-2 are still incompletely understood.…”

Section: Discussionmentioning

confidence: 95%

Neurological Involvement of Coronavirus Disease 2019: A Systematic Review

Ghannam

Alshaer

Al-Chalabi

et al. 2020

Preprint

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Background: In December 2019, unexplained cases of pneumonia emerged in Wuhan, China, which were found to be secondary to the novel coronavirus SARS-CoV-2. On March 11, 2020, the WHO declared the Coronavirus Disease 2019 (COVID-2019) outbreak, a pandemic. Although the most common presentations of COVID-19 are fever, cough and shortness of breath, several clinical observations indicate that COVID-19 does affect the central and peripheral nervous system. Methods: We conducted a systematic literature search from December 01, 2019 to May 14, 2020 using multiple combinations of keywords from PubMed and Ovid Medline databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included articles with cases of COVID-19 that were evident for neurological involvement. Results: We were able to identify 82 cases of COVID-19 with neurological complications. The mean age was 62.28 years. 37.8% of the patients were women (n = 31). 48.8% of the patients (n=40) had cerebrovascular insults, 28% (n=23) had neuromuscular disorders, 18.3% of the patients (n=15) had encephalitis or encephalopathy, and 2.4% (n=2) presented with status epilepticus. Conclusions: Neurological manifestations of COVID-19 infection are not rare, especially large vessel stroke, Guillain barre syndrome and meningoencephalitis. Moving forward, further studies are needed to clarify the prevalence of the neurological complications of COVID-19, investigate their biological backgrounds, and test treatment options. Physicians should be cautious not to overlook other neurological diagnoses that can mimic COVID-19 during the pandemic.

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Section: Discussionmentioning

confidence: 95%

Neurological Involvement of Coronavirus Disease 2019: A Systematic Review

Ghannam

Alshaer

Al-Chalabi

et al. 2020

Preprint

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“…Studied nerves included the sural, peroneal, median, and ulnar nerves. Abnormal results in the NCS were defined as having reduced amplitude of the compound muscle action potential (CMAP) or sensory action potential (SAP), prolonged distal latencies, or slowing of the nerve conduction velocity …”

Section: Methodsmentioning

confidence: 99%

Skin nerve pathology: Biomarkers of premanifest and manifest amyloid neuropathy

Chao

Hsueh

Kan

et al. 2019

Annals of Neurology

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Objective: Small-fiber sensory and autonomic symptoms are early presentations of familial amyloid polyneuropathy (FAP) with transthyretin (TTR) mutations. This study aimed to explore the potential of skin nerve pathologies as early and disease-progression biomarkers and their relationship with skin amyloid deposits. Methods: Skin biopsies were performed in patients and carriers to measure intraepidermal nerve fiber (IENF) density, sweat gland innervation index of structural protein gene product 9.5 (SGII[PGP9.5]) and peptidergic vasoactive intestinal peptide (SGII[VIP]), and cutaneous amyloid index. These skin pathologies were analyzed with clinical disability assessed by FAP stage score (stage 0-4) and compared to neurophysiological and psychophysical tests. Results: There were 70 TTR-mutant subjects (22 carriers and 48 patients), and 66 cases were TTR-A97S. Skin nerve pathologies were distinct according to stage. In carriers, both skin denervation and peptidergic sudomotor denervation were evident: (1) IENF density was gradually reduced from stage 0 through 4, and (2) SGII(VIP) was markedly reduced from stage 1 to 2. In contrast, SGII(PGP9.5) was similar between carriers and controls, but it declined in patients from stage 2. Skin amyloids were absent in carriers and became detectable from stage 1. Cutaneous amyloid index was correlated with SGII(PGP9.5) and stage in a multivariate mixed-effect model. When all tests were compared, only IENF density, SGII(PGP9.5), and cutaneous amyloid index were correlated with stage, and IENF density had the highest abnormal rate in carriers. Interpretation: Biomarkers of sensory and sudomotor innervation exhibited a stage-dependent progression pattern, with sensory nerve degeneration as the early skin nerve pathology.

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“…25 Bilateral sural, peroneal, and tibial nerves were studied. Abnormal results in NCS were defined as having reduced amplitude of compound motor action potential (CMAP) or sensory action potential (SAP), prolonged distal latencies, slowing of the nerve conduction velocity.…”

Section: Methodsmentioning

confidence: 99%

Pathophysiology of Small-Fiber Sensory System in Parkinson's Disease

Lin

Chao

et al. 2016

Medicine

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Sensory symptoms are frequent nonmotor complaints in patients with Parkinson's disease (PD). However, few investigations integrally explored the physiology and pathology of the thermonociceptive pathway in PD. We aim to investigate the involvement of the thermonociceptive pathway in PD.Twenty-eight PD patients (16 men, with a mean age and standard deviation of 65.6 ± 10.7 years) free of neuropathic symptoms and systemic disorders were recruited for the study and compared to 23 age- and gender-matched control subjects (12 men, with a mean age and standard deviation of 65.1 ± 9.9 years). We performed skin biopsy, contact heat-evoked potential (CHEP), and quantitative sensory tests (QST) to study the involvement of the thermonociceptive pathway in PD.The duration of PD was 7.1 ± 3.2 (range 2–17 years) years and the UPDRS part III score was 25.6 ± 9.7 (range 10–48) during the off period. Compared to control subjects, PD patients had reduced intra-epidermal nerve fiber (IENF) density (2.48 ± 1.65 vs 6.36 ± 3.19 fibers/mm, P < 0.001) and CHEP amplitude (18.02 ± 10.23 vs 33.28 ± 10.48 μV, P < 0.001). Twenty-three patients (82.1%) had abnormal IENF densities and 18 (64.3%) had abnormal CHEP. Nine patients (32.1%) had abnormal thermal thresholds in the feet. In total 27 patients (96.4%) had at least 1 abnormality in IENF, CHEP, or thermal thresholds of the foot, indicating dysfunctions in the small-fiber nerve system. In control subjects, CHEP amplitude linearly correlated with IENF density (P < 0.001). In contrast, this relationship disappeared in PD (P = 0.312) and CHEP amplitude was negatively correlated with motor severity of PD independent of age, gender, and anti-PD medication dose (P = 0.036), suggesting the influences of central components on thermonociceptive systems in addition to peripheral small-fiber nerves in PD.The present study suggested impairment of small-fiber sensory system at both peripheral and central levels is an intrinsic feature of PD, and skin biopsy, CHEP, and QST provided an integral approach for assessing such dysfunctions.

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Peripheral nerve disease in SARS:

Cited by 54 publications

References 6 publications

Neurological Involvement of Coronavirus Disease 2019: A Systematic Review

Neurological Involvement of Coronavirus Disease 2019: A Systematic Review

Skin nerve pathology: Biomarkers of premanifest and manifest amyloid neuropathy

Pathophysiology of Small-Fiber Sensory System in Parkinson's Disease

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