C-Fiber loss as a possible cause of neuropathic pain in schwannomatosis
Autor: | Markus Glatzel, Martin U. Schuhmann, Michael Hauck, Christian Hagel, Victor-Felix Mautner, Martin Bendszus, Philipp Bäumer, Hildegard Kehrer-Sawatzki, Reinhard E Friedrich, Christian Gerloff, Jan Luhmann, Alexander Schulz, Said Farschtschi, Anna-Lena Hannekum, Helen Morrison, Mathias Gelderblom, Tina Mainka |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
Skin Neoplasms Nervous System Neoplasms lcsh:Chemistry Nerve Fibers Whole Body Imaging pain Schwannomatosis lcsh:QH301-705.5 Spectroscopy medicine.diagnostic_test Chronic pain General Medicine Middle Aged Magnetic Resonance Imaging Nervous system Diagnostic imaging Computer Science Applications medicine.anatomical_structure Neuropathic pain MR-neurography Female Radiology Chronic Pain Small fiber neuropathy Schmerz Neurilemmoma fascicular microlesions Adult medicine.medical_specialty Neurofibromatoses Pain Nerve fiber Neurological examination Catalysis Article Inorganic Chemistry Peripheral Nervous System Neoplasms medicine Humans ddc:610 Physical and Theoretical Chemistry Neurofibromatosis Molecular Biology Aged business.industry Magnetic resonance neurography Organic Chemistry Neurofibromatose Magnetic resonance imaging medicine.disease small-fiber neuropathy lcsh:Biology (General) lcsh:QD1-999 Mutation Neuralgia business DDC 610 / Medicine & health Transcription Factors |
Zdroj: | International Journal of Molecular Sciences Volume 21 Issue 10 International Journal of Molecular Sciences, Vol 21, Iss 3569, p 3569 (2020) |
Popis: | Schwannomatosis is the third form of neurofibromatosis and characterized by the occurrence of multiple schwannomas. The most prominent symptom is chronic pain. We aimed to test whether pain in schwannomatosis might be caused by small-fiber neuropathy. Twenty patients with schwannomatosis underwent neurological examination and nerve conduction studies. Levels of pain perception as well as anxiety and depression were assessed by established questionnaires. Quantitative sensory testing (QST) and laser-evoked potentials (LEP) were performed on patients and controls. Whole-body magnetic resonance imaging (wbMRI) and magnetic resonance neurography (MRN) were performed to quantify tumors and fascicular nerve lesions skin biopsies were performed to determine intra-epidermal nerve fiber density (IENFD). All patients suffered from chronic pain without further neurological deficits. The questionnaires indicated neuropathic symptoms with significant impact on quality of life. Peripheral nerve tumors were detected in all patients by wbMRI. MRN showed additional multiple fascicular nerve lesions in 16/18 patients. LEP showed significant faster latencies compared to normal controls. Finally, IENFD was significantly reduced in 13/14 patients. Our study therefore indicates the presence of small-fiber neuropathy, predominantly of unmyelinated C-fibers. Fascicular nerve lesions are characteristic disease features that are associated with faster LEP latencies and decreased IENFD. Together these methods may facilitate differential diagnosis of schwannomatosis. |
Databáze: | OpenAIRE |
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