Evidence for small fiber neuropathy in early Parkinson's disease
| Autor: | Oksana Suchowersky, Kenneth Romanchuk, Thomas E. Feasby, Peter Podgorny |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Levodopa Pathology medicine.medical_specialty Parkinson's disease Small Fiber Neuropathy Central nervous system Neural Conduction Neurological examination Cornea 03 medical and health sciences 0302 clinical medicine medicine Humans Aged Microscopy Confocal medicine.diagnostic_test business.industry Surrogate endpoint Parkinson Disease Middle Aged medicine.disease Peripheral neuropathy medicine.anatomical_structure Neurology Peripheral nervous system Case-Control Studies Skin biopsy 030221 ophthalmology & optometry Female Neurology (clinical) Geriatrics and Gerontology Epidermis business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Parkinsonismrelated disorders. 28 |
| ISSN: | 1873-5126 |
| Popis: | Introduction Parkinson's disease (PD) is neurodegenerative movement disorder affecting primarily the central nervous system with several recognized non-motor symptoms that can occur at various stages of the disease. Recently it has been shown that patients with PD may be prone to peripheral nervous system pathology in the form of a peripheral neuropathy (PN). It is unclear if PN is an inherent feature of PD or if it is an iatrogenic effect of the mainstay PD treatment Levodopa. Methods To determine if peripheral neuropathy occurs in early untreated PD we employed a case-control study design using gold standard tests for PN, including neurological examination according to the Utah Early Neuropathy Scale (UENS) and nerve conduction studies, as well as new, more sensitive and informative tests for PN including the skin biopsy and corneal confocal microscopy (CCM). Results We studied 26 patients with PD and 22 controls using the neurological examination and nerve conduction studies (NCS) and found no significant difference between groups except for some reduced vibration sense in the PD group. Epidermal nerve densities in the skin biopsies were similar between our cohorts. However, using CCM – a more sensitive test and a surrogate marker of small fiber damage in PN, we found that patients with PD had significantly reduced corneal nerve fiber densities and lengths as compared to controls. Conclusions We conclude that our positive CCM results provide evidence of preclinical PN in newly diagnosed PD patients. |
| Databáze: | OpenAIRE |
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