Side and time variability of intraepidermal nerve fiber density

Giuseppe Lauria, Patrizia Dacci, Raffaella Lombardi, Daniele Cazzato, Carla Porretta-Serapiglia, Michela Taiana, Jenny Sassone, Eleonora Dalla Bella, Sara Rinaldo, Christian Lettieri, Roberto Eleopra, Grazia Devigili

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: To assess the right-to-left and short-term variability of intraepidermal nerve fiber density (IENFD) at the distal site of the leg. Methods: Patients with possible or probable small fiber neuropathy (SFN) and healthy volunteers (HVs) underwent skin biopsies at the right and left distal leg. A subgroup of participants underwent follow-up biopsies 20 days later. Biopsies were immunostained by polyclonal anti-protein gene product 9.5 antibodies, and IENFD was quantified in nonconsecutive sections following published guidelines by operators blinded to the participants' condition (diagnosis, side, and time of biopsy). Findings were referred to sex-and age-adjusted normative values. Results: Forty patients and 17 HVs underwent bilateral skin biopsies; 15 patients and 8 HVs underwent follow-up skin biopsies. Sural nerve and dorsal sural nerve conduction studies were normal in all participants. Interside IENFD did not differ both in patients (median 2.45 IENF/mm ± 1.45 SD right; 2.2 IENF/mm ± 1.32 SD left) and HVs (median 6.3 IENF/mm ± 2.81 right; 6.2 IENF/mm ± 2.3 SD left). The right-to-left correlation coefficients were excellent (Pearson 0.95 in SFN and 0.97 in HVs). The analysis of IENFD at 20-day follow-up biopsy showed no difference between sides in both groups and yielded excellent correlation coefficients. Conclusions: The diagnosis of SFN can be reliably ascertained by unilateral skin biopsy at the distal site of the leg, and IENFD is not expected to vary within 3 weeks.

Original languageEnglish
Pages (from-to)2368-2371
Number of pages4
JournalNeurology
Volume84
Issue number23
DOIs
Publication statusPublished - Jun 9 2015

Fingerprint

Nerve Fibers
Biopsy
Healthy Volunteers
Leg
Sural Nerve
Skin
Neural Conduction
Guidelines
Antibodies
Small Fiber Neuropathy
Proteins

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Lauria, G., Dacci, P., Lombardi, R., Cazzato, D., Porretta-Serapiglia, C., Taiana, M., ... Devigili, G. (2015). Side and time variability of intraepidermal nerve fiber density. Neurology, 84(23), 2368-2371. https://doi.org/10.1212/WNL.0000000000001666

Side and time variability of intraepidermal nerve fiber density. / Lauria, Giuseppe; Dacci, Patrizia; Lombardi, Raffaella; Cazzato, Daniele; Porretta-Serapiglia, Carla; Taiana, Michela; Sassone, Jenny; Dalla Bella, Eleonora; Rinaldo, Sara; Lettieri, Christian; Eleopra, Roberto; Devigili, Grazia.

In: Neurology, Vol. 84, No. 23, 09.06.2015, p. 2368-2371.

Research output: Contribution to journalArticle

Lauria, G, Dacci, P, Lombardi, R, Cazzato, D, Porretta-Serapiglia, C, Taiana, M, Sassone, J, Dalla Bella, E, Rinaldo, S, Lettieri, C, Eleopra, R & Devigili, G 2015, 'Side and time variability of intraepidermal nerve fiber density', Neurology, vol. 84, no. 23, pp. 2368-2371. https://doi.org/10.1212/WNL.0000000000001666
Lauria G, Dacci P, Lombardi R, Cazzato D, Porretta-Serapiglia C, Taiana M et al. Side and time variability of intraepidermal nerve fiber density. Neurology. 2015 Jun 9;84(23):2368-2371. https://doi.org/10.1212/WNL.0000000000001666
Lauria, Giuseppe ; Dacci, Patrizia ; Lombardi, Raffaella ; Cazzato, Daniele ; Porretta-Serapiglia, Carla ; Taiana, Michela ; Sassone, Jenny ; Dalla Bella, Eleonora ; Rinaldo, Sara ; Lettieri, Christian ; Eleopra, Roberto ; Devigili, Grazia. / Side and time variability of intraepidermal nerve fiber density. In: Neurology. 2015 ; Vol. 84, No. 23. pp. 2368-2371.
@article{d5385fcc14d34490b5589933c19bcc70,
title = "Side and time variability of intraepidermal nerve fiber density",
abstract = "Objective: To assess the right-to-left and short-term variability of intraepidermal nerve fiber density (IENFD) at the distal site of the leg. Methods: Patients with possible or probable small fiber neuropathy (SFN) and healthy volunteers (HVs) underwent skin biopsies at the right and left distal leg. A subgroup of participants underwent follow-up biopsies 20 days later. Biopsies were immunostained by polyclonal anti-protein gene product 9.5 antibodies, and IENFD was quantified in nonconsecutive sections following published guidelines by operators blinded to the participants' condition (diagnosis, side, and time of biopsy). Findings were referred to sex-and age-adjusted normative values. Results: Forty patients and 17 HVs underwent bilateral skin biopsies; 15 patients and 8 HVs underwent follow-up skin biopsies. Sural nerve and dorsal sural nerve conduction studies were normal in all participants. Interside IENFD did not differ both in patients (median 2.45 IENF/mm ± 1.45 SD right; 2.2 IENF/mm ± 1.32 SD left) and HVs (median 6.3 IENF/mm ± 2.81 right; 6.2 IENF/mm ± 2.3 SD left). The right-to-left correlation coefficients were excellent (Pearson 0.95 in SFN and 0.97 in HVs). The analysis of IENFD at 20-day follow-up biopsy showed no difference between sides in both groups and yielded excellent correlation coefficients. Conclusions: The diagnosis of SFN can be reliably ascertained by unilateral skin biopsy at the distal site of the leg, and IENFD is not expected to vary within 3 weeks.",
author = "Giuseppe Lauria and Patrizia Dacci and Raffaella Lombardi and Daniele Cazzato and Carla Porretta-Serapiglia and Michela Taiana and Jenny Sassone and {Dalla Bella}, Eleonora and Sara Rinaldo and Christian Lettieri and Roberto Eleopra and Grazia Devigili",
year = "2015",
month = "6",
day = "9",
doi = "10.1212/WNL.0000000000001666",
language = "English",
volume = "84",
pages = "2368--2371",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "23",

}

TY - JOUR

T1 - Side and time variability of intraepidermal nerve fiber density

AU - Lauria, Giuseppe

AU - Dacci, Patrizia

AU - Lombardi, Raffaella

AU - Cazzato, Daniele

AU - Porretta-Serapiglia, Carla

AU - Taiana, Michela

AU - Sassone, Jenny

AU - Dalla Bella, Eleonora

AU - Rinaldo, Sara

AU - Lettieri, Christian

AU - Eleopra, Roberto

AU - Devigili, Grazia

PY - 2015/6/9

Y1 - 2015/6/9

N2 - Objective: To assess the right-to-left and short-term variability of intraepidermal nerve fiber density (IENFD) at the distal site of the leg. Methods: Patients with possible or probable small fiber neuropathy (SFN) and healthy volunteers (HVs) underwent skin biopsies at the right and left distal leg. A subgroup of participants underwent follow-up biopsies 20 days later. Biopsies were immunostained by polyclonal anti-protein gene product 9.5 antibodies, and IENFD was quantified in nonconsecutive sections following published guidelines by operators blinded to the participants' condition (diagnosis, side, and time of biopsy). Findings were referred to sex-and age-adjusted normative values. Results: Forty patients and 17 HVs underwent bilateral skin biopsies; 15 patients and 8 HVs underwent follow-up skin biopsies. Sural nerve and dorsal sural nerve conduction studies were normal in all participants. Interside IENFD did not differ both in patients (median 2.45 IENF/mm ± 1.45 SD right; 2.2 IENF/mm ± 1.32 SD left) and HVs (median 6.3 IENF/mm ± 2.81 right; 6.2 IENF/mm ± 2.3 SD left). The right-to-left correlation coefficients were excellent (Pearson 0.95 in SFN and 0.97 in HVs). The analysis of IENFD at 20-day follow-up biopsy showed no difference between sides in both groups and yielded excellent correlation coefficients. Conclusions: The diagnosis of SFN can be reliably ascertained by unilateral skin biopsy at the distal site of the leg, and IENFD is not expected to vary within 3 weeks.

AB - Objective: To assess the right-to-left and short-term variability of intraepidermal nerve fiber density (IENFD) at the distal site of the leg. Methods: Patients with possible or probable small fiber neuropathy (SFN) and healthy volunteers (HVs) underwent skin biopsies at the right and left distal leg. A subgroup of participants underwent follow-up biopsies 20 days later. Biopsies were immunostained by polyclonal anti-protein gene product 9.5 antibodies, and IENFD was quantified in nonconsecutive sections following published guidelines by operators blinded to the participants' condition (diagnosis, side, and time of biopsy). Findings were referred to sex-and age-adjusted normative values. Results: Forty patients and 17 HVs underwent bilateral skin biopsies; 15 patients and 8 HVs underwent follow-up skin biopsies. Sural nerve and dorsal sural nerve conduction studies were normal in all participants. Interside IENFD did not differ both in patients (median 2.45 IENF/mm ± 1.45 SD right; 2.2 IENF/mm ± 1.32 SD left) and HVs (median 6.3 IENF/mm ± 2.81 right; 6.2 IENF/mm ± 2.3 SD left). The right-to-left correlation coefficients were excellent (Pearson 0.95 in SFN and 0.97 in HVs). The analysis of IENFD at 20-day follow-up biopsy showed no difference between sides in both groups and yielded excellent correlation coefficients. Conclusions: The diagnosis of SFN can be reliably ascertained by unilateral skin biopsy at the distal site of the leg, and IENFD is not expected to vary within 3 weeks.

UR - http://www.scopus.com/inward/record.url?scp=84930705686&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930705686&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000001666

DO - 10.1212/WNL.0000000000001666

M3 - Article

C2 - 25972491

AN - SCOPUS:84930705686

VL - 84

SP - 2368

EP - 2371

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 23

ER -