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
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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