Assessment of autonomic innervation of the foot in familial amyloid polyneuropathy
| Autor: | Thibaud Damy, S. Ng Wing Tin, Jean-Pascal Lefaucheur, Hela G. Zouari, Abir Wahab |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Laser-Evoked Potentials Neural Conduction Autonomic Nervous System Asymptomatic 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Prealbumin 030212 general & internal medicine Aged Neurologic Examination Amyloid Neuropathies Familial biology Vasomotor business.industry Foot Amyloidosis Galvanic Skin Response Laser Doppler velocimetry Middle Aged medicine.disease Sudomotor Transthyretin Neurology Mutation biology.protein Cardiology Female Neurology (clinical) medicine.symptom business Asymptomatic carrier 030217 neurology & neurosurgery |
| Zdroj: | European journal of neurology. 26(1) |
| ISSN: | 1468-1331 |
| Popis: | BACKGROUND AND PURPOSE Distal involvement of autonomic nerve fibers is critical in familial amyloid polyneuropathy (FAP) due to transthyretin (TTR) mutation. This study compares different methods for assessing autonomic foot innervation in TTR-FAP patients. METHODS Three groups of seven TTR-FAP patients were included, according to disease severity: clinically asymptomatic, moderate or advanced neuropathy. The autonomic investigation included the eutectic mixture of local anesthetics test and laser Doppler flowmetry for vasomotor aspects and the Sudoscan® (measuring electrochemical skin conductance) and Neuropad® test for sudomotor aspects. Somatic innervation was assessed by performing nerve conduction studies, quantitative sensory testing [including vibration, cold and warm detection threshold (WDT) measurements] and laser evoked potentials. RESULTS The results of all neurophysiological tests varied according to TTR-FAP severity (P ≤ 0.01, Kruskal-Wallis test), except for the eutectic mixture of local anesthetics test and laser Doppler flowmetry variables. In addition, the sudomotor tests (Sudoscan or Neuropad) or WDT measurement provided early markers of neuropathy in two of the seven asymptomatic carriers. Finally, all neurophysiological results correlated with the Neuropathy Impairment Score (r values between -0.88 and -0.66, P |
| Databáze: | OpenAIRE |
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