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

Jeziorska, Maria; Atkinson, Andrew; Kass-Iliyya, Lewis; Kobylecki, Christopher; Gosal, David; Malik, Rayaz A.; Silverdale, Monty

doi:10.3233/jpd-191697

Cited by 15 publications

(13 citation statements)

References 27 publications

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“…However, the main aim of this study was to assess whether SFN is overrepresented in PD+RLS relative to PD−RLS, and thus we believe our main finding was not affected by the smaller control group. Considering reports of asymmetrical presentations of SFN in PD 18,25 , the unilateral QST, in contrast to the bilateral UENS, might have underestimated SFN in PD. Since the tested side was randomly chosen, this should not have affected comparisons between PD groups but rather comparisons relative to controls.…”

Section: Discussionmentioning

confidence: 97%

“…SFN has been demonstrated in skin biopsies from L-dopa naïve patients 18 . Furthermore, cutaneous SFN in PD has, in some studies, been reported as asymmetrical, lateralizing with the side more affected by parkinsonism 18,25 . Considering these studies, together with the reported findings of α-syn deposits in autonomic and somatosensory small nerve fibers, the concept of peripheral neurodegeneration intrinsic to PD has been suggested 15 .…”

Section: Discussionmentioning

confidence: 99%

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Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study

Andréasson

Lagali

Badian

et al. 2021

npj Parkinsons Dis.

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Small fiber neuropathy (SFN) has been suggested as a trigger of restless legs syndrome (RLS). An increased prevalence of peripheral neuropathy has been demonstrated in Parkinson’s disease (PD). We aimed to investigate, in a cross-sectional manner, whether SFN is overrepresented in PD patients with concurrent RLS relative to PD patients without RLS, using in vivo corneal confocal microscopy (IVCCM) and quantitative sensory testing (QST) as part of small fiber assessment. Study participants comprised of age- and sex-matched PD patients with (n = 21) and without RLS (n = 21), and controls (n = 13). Diagnosis of RLS was consolidated with the sensory suggested immobilization test. Assessments included nerve conduction studies (NCS), Utah Early Neuropathy Scale (UENS), QST, and IVCCM, with automated determination of corneal nerve fiber length (CNFL) and branch density (CNBD) from wide-area mosaics of the subbasal nerve plexus. Plasma neurofilament light (p-NfL) was determined as a measure of axonal degeneration. No significant differences were found between groups when comparing CNFL (p = 0.81), CNBD (p = 0.92), NCS (p = 0.82), and QST (minimum p = 0.54). UENS scores, however, differed significantly (p = 0.001), with post-hoc pairwise testing revealing higher scores in both PD groups relative to controls (p = 0.018 and p = 0.001). Analysis of all PD patients (n = 42) revealed a correlation between the duration of l-dopa therapy and CNBD (ρ = −0.36, p = 0.022), and p-NfL correlated with UENS (ρ = 0.35, p = 0.026) and NCS (ρ = −0.51, p = 0.001). Small and large fiber neuropathy do not appear to be associated with RLS in PD. Whether peripheral small and/or large fiber pathology associates with central neurodegeneration in PD merits further longitudinal studies.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study

Andréasson

Lagali

Badian

et al. 2021

npj Parkinsons Dis.

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“…The study found IENFD did not differ in more affected versus less affected side of PD patients and healthy controls [57]. But Jeziorska et al found IENFD was lower in more affected versus less affected side in PD patients [58]. However, the study by Nolano et al showed decreased IENFD in the more affected at baseline, but more nerve fiber loss in the less affected side with longer disease duration [52].…”

Section: Side-specific Relationship Between Ccm and Motor Symptomsmentioning

confidence: 93%

Potential use of corneal confocal microscopy in the diagnosis of Parkinson’s disease associated neuropathy

Che

Yang

2020

Transl Neurodegener

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Parkinson's disease (PD) is a chronic, progressive neurodegenerative disease affecting about 2-3% of population above the age of 65. In recent years, Parkinson's research has mainly focused on motor and non-motor symptoms while there are limited studies on neurodegeneration which is associated with balance problems and increased incidence of falls. Corneal confocal microscopy (CCM) is a real-time, non-invasive, in vivo ophthalmic imaging technique for quantifying nerve damage in peripheral neuropathies and central neurodegenerative disorders. CCM has shown significantly lower corneal nerve fiber density (CNFD) in patients with PD compared to healthy controls. Reduced CNFD is associated with decreased intraepidermal nerve fiber density in PD. This review provides an overview of the ability of CCM to detect nerve damage associated with PD.

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“…Some studies found reduced thermal detection thresholds after STN-DBS (Deep Bran Stimulation of the Subthalamic Nucleus) [3,11,14,16,20,21], suggesting that central pathology plays a role in abnormal thermal sensation. Peripheral deafferentation probably also plays a role [15,17], as small ber neuropathy has been con rmed on skin biopsies in PD patients [6,7].…”

Section: Introductionmentioning

confidence: 93%

“…Patients often describe coldness and tingling or tightening of the muscles without objective evidence of sensory loss [1][2][3]. There have been several studies concerning peripheral nerve pathology in PD, such as polyneuropathy [4,5], small bre neuropathy [6,7] or motor neuron disease [8,9]; some sensory symptoms are supposed to be caused by central pathology [10].…”

Section: Introductionmentioning

confidence: 99%

Temperature Sensation in Parkinson’s Disease Measured by Quantitative Sensory Testing

Kaiserová

Grambalova

Otruba

et al. 2020

Preprint

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BackgroundThe pathophysiology of abnormal temperature sensation in Parkinson’s disease (PD) remains unclear. Abnormal thermal detection does not seem to depend on the dopaminergic deficit, suggesting that other systems play a role in these changes, probably both central and peripheral.MethodsWe measured thermal detection thresholds (TDT) using quantitative sensory testing (QST) in 28 patients with PD and compared them with 15 healthy controls.ResultsOf 28 patients, 21 % had increased TDT according to the normative data. TDT were higher on the dominant side. No correlation between TDT and disease duration, severity of motor impairment, and dopaminergic therapy was observed. 50 % of the patients had difficulty differentiating between warm and cold stimuli, as TDT were within the normal range in most of these patients.ConclusionsThese results suggest that abnormal thermal detection may be present from early stages of the disease and is more pronounced on the dominant side. Abnormal differentiation between the thermal stimuli suggest impaired central processing of thermal information.

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

Cited by 15 publications

References 27 publications

Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study

Parkinson’s disease with restless legs syndrome—an in vivo corneal confocal microscopy study

Potential use of corneal confocal microscopy in the diagnosis of Parkinson’s disease associated neuropathy

Temperature Sensation in Parkinson’s Disease Measured by Quantitative Sensory Testing

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