Audrey Cheung1, Peter Podgorny, Jose A Martinez, Cynthia Chan, Cory Toth. 1. Department of Clinical Neurosciences, HMRB 155, Foothills Hospital, University of Calgary, Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
Abstract
INTRODUCTION: The pathophysiology of neuropathic pain (NeP) in diabetic peripheral neuropathy (DPN) is unclear. A potential pathological feature associated with intraepidermal nerve fiber density (IENFD) loss in DPN is axonal swellings. METHODS: We determined the prevalence of intraepidermal axonal swellings in DPN patients with or without NeP and compared the findings with diabetes patients without DPN, patients with idiopathic neuropathy with NeP, and control subjects. The primary outcome measure was the ratio of axonal swellings to IENFD. Secondary outcome measures included clinical neuropathy severity and assessment for messenger RNA for voltage-gated sodium and calcium channels. RESULTS: IENFD was depressed in DPN (with/without pain) and in idiopathic neuropathy patients. Axonal swelling ratios were similar for DPN subjects with and without pain. There was no overexpression of voltage-gated ion channels in epidermis from DPN patients. Clinical neuropathy severity was only related to IENFD. CONCLUSIONS: There was no clinical relationship to pain or clinical neuropathy severity for axonal swellings in DPN.
INTRODUCTION: The pathophysiology of neuropathic pain (NeP) in diabetic peripheral neuropathy (DPN) is unclear. A potential pathological feature associated with intraepidermal nerve fiber density (IENFD) loss in DPN is axonal swellings. METHODS: We determined the prevalence of intraepidermal axonal swellings in DPNpatients with or without NeP and compared the findings with diabetespatients without DPN, patients with idiopathic neuropathy with NeP, and control subjects. The primary outcome measure was the ratio of axonal swellings to IENFD. Secondary outcome measures included clinical neuropathy severity and assessment for messenger RNA for voltage-gated sodium and calcium channels. RESULTS: IENFD was depressed in DPN (with/without pain) and in idiopathic neuropathypatients. Axonal swelling ratios were similar for DPN subjects with and without pain. There was no overexpression of voltage-gated ion channels in epidermis from DPNpatients. Clinical neuropathy severity was only related to IENFD. CONCLUSIONS: There was no clinical relationship to pain or clinical neuropathy severity for axonal swellings in DPN.
Authors: Troels S Jensen; Pall Karlsson; Sandra S Gylfadottir; Signe T Andersen; David L Bennett; Hatice Tankisi; Nanna B Finnerup; Astrid J Terkelsen; Karolina Khan; Andreas C Themistocleous; Alexander G Kristensen; Mustapha Itani; Søren H Sindrup; Henning Andersen; Morten Charles; Eva L Feldman; Brian C Callaghan Journal: Brain Date: 2021-07-28 Impact factor: 13.501
Authors: Alise Kalteniece; Maryam Ferdousi; Shazli Azmi; Saif Ullah Khan; Anne Worthington; Andrew Marshall; Catharina G Faber; Giuseppe Lauria; Andrew J M Boulton; Handrean Soran; Rayaz A Malik Journal: Eur J Neurol Date: 2021-10-13 Impact factor: 6.288
Authors: Pall Karlsson; Sandra S Gylfadottir; Alexander G Kristensen; Juan D Ramirez; Pedro Cruz; Nhu Le; Pallai R Shillo; Solomon Tesfaye; Andrew S C Rice; Hatice Tankisi; Nanna B Finnerup; Jens R Nyengaard; Troels S Jensen; David L H Bennett; Andreas C Themistocleous Journal: Diabetologia Date: 2021-01-23 Impact factor: 10.122