Author: Herrmann, David N

Source: Expert Review of Neurotherapeutics, Volume 8, Number 12, December 2008 , pp. 1807-1816(10)

Publisher: Expert Reviews

Abstract:

Peripheral neuropathies are diverse and require a multidimensional approach for detection and monitoring in a clinical and research setting. This review describes non- and minimally-invasive measures of distal predominantly sensory polyneuropathy (DSP), the most common form of neuropathy. A combination of clinical and electrophysiologic assessment with nerve-conduction studies (NCSs) suffices for the detection and characterization of most DSPs. NCS are insensitive to variants of DSP that predominantly affect small diameter sensory nerve fibers (SFNs) and cutaneous nerve terminals that subserve pain and thermal sensation. Skin biopsy with assessment of epidermal nerve fiber density permits objective detection and monitoring of SFNs. Conventional clinical and NCS measures have limitations as outcomes in experimental therapeutics in DSP. For clinical trials, biopsy evaluation of epidermal innervation and emerging noninvasive imaging approaches (in vivo confocal microscopy of corneal innervation and of Meissner corpuscles in the skin) hold promise as surrogate markers that are complementary to traditional DSP measures.

Keywords: clinical trial; corneal confocal microscopy; diagnosis; epidermal nerve fiber density; evoked potential; in vivo reflectance confocal microscopy; Meissner corpuscle; nerve-conduction study; noninvasive; outcome measure; peripheral neuropathy; quantitative sensory testing; skin biopsy

Document Type: Research article

DOI: http://dx.doi.org/10.1586/14737175.8.12.1807

Affiliations: 1: Associate Professor of Neurology and Pathology, Director, Peripheral Neuropathy Clinic and Cutaneous Innervation Laboratory, University of Rochester Medical Center, 601 Elmwood Avenue, Box 673, Rochester, NY 14642-8673, USA., Email: david_herrman

Publication date: 2008-12-01

More about this publication?

• Expert Review of Neurotherapeutics provides expert commentary on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer's and Parkinson's.
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