Baris Isak1, Kirsten Pugdahl2, Páll Karlsson3, Hatice Tankisi4, Nanna Brix Finnerup5, Jasna Furtula6, Birger Johnsen7, Niels Sunde8, Johannes Jakobsen9, Anders Fuglsang-Frederiksen10. 1. Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: barisisak@gmail.com. 2. Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: pugdahl@aarhus.rm.dk. 3. Danish Pain Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. Electronic address: pall@clin.au.dk. 4. Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: hatitank@rm.dk. 5. Danish Pain Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. Electronic address: finnerup@clin.au.dk. 6. Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: furtula@gmail.com. 7. Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: birgjohn@rm.dk. 8. Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark. Electronic address: Niels.Sunde@aarhus.rm.dk. 9. Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: johannes.klitgaard.jakobsen@regionh.dk. 10. Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: anders.fuglsang@aarhus.rm.dk.
Abstract
OBJECTIVE: In this prospective study, involvement of sensory nerve fibres in ALS patients was assessed using functional and structural measures in the form of quantitative sensory testing (QST) and skin and nerve biopsies. METHODS: Thirty-two ALS patients and 32 healthy subjects were evaluated with a QST battery comprising thresholds of mechanical detection, mechanical pain, vibration detection, cold detection, warm detection, heat pain, and pinprick sensation. Skin biopsies were evaluated in 31 ALS patients by intraepidermal nerve fibre density (IENFD) and axonal swelling ratios, and growth-associated protein 43 (GAP-43) antibody staining. Sural nerve biopsies were evaluated using teased fibre analysis in eight patients. RESULTS: Mean values for QST parameters and IENFD in ALS patients were within normal range. However, the patients had increased axonal swelling ratios and GAP-43 antibody staining was negative in all patients. CONCLUSIONS: Although QST and IENFD were affected in only a small subset of ALS patients, the axonal swellings observed in all patients indicate that the affection is more frequent, and suggests that IENFD count may not be sufficient. The negative GAP-43 staining suggested an insufficiency of regeneration in small sensory nerve fibres.
OBJECTIVE: In this prospective study, involvement of sensory nerve fibres in ALSpatients was assessed using functional and structural measures in the form of quantitative sensory testing (QST) and skin and nerve biopsies. METHODS: Thirty-two ALSpatients and 32 healthy subjects were evaluated with a QST battery comprising thresholds of mechanical detection, mechanical pain, vibration detection, cold detection, warm detection, heat pain, and pinprick sensation. Skin biopsies were evaluated in 31 ALSpatients by intraepidermal nerve fibre density (IENFD) and axonal swelling ratios, and growth-associated protein 43 (GAP-43) antibody staining. Sural nerve biopsies were evaluated using teased fibre analysis in eight patients. RESULTS: Mean values for QST parameters and IENFD in ALSpatients were within normal range. However, the patients had increased axonal swelling ratios and GAP-43 antibody staining was negative in all patients. CONCLUSIONS: Although QST and IENFD were affected in only a small subset of ALSpatients, the axonal swellings observed in all patients indicate that the affection is more frequent, and suggests that IENFD count may not be sufficient. The negative GAP-43 staining suggested an insufficiency of regeneration in small sensory nerve fibres.
Authors: N W Martinez; A Sánchez; P Diaz; R Broekhuizen; J Godoy; S Mondaca; A Catenaccio; P Macanas; B Nervi; M Calvo; F A Court Journal: Neurobiol Pain Date: 2020-05-22
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