Functional and structural markers of peripheral microvascular autonomic neuropathy

TY - JOUR

T1 - Functional and structural markers of peripheral microvascular autonomic neuropathy

AU - Rasmussen, Thorsten K

AU - Karlsson, Páll

AU - Finnerup, Nanna B

AU - Jensen, Troels S

AU - Nyengaard, Jens R

AU - Terkelsen, Astrid J

N1 - This article is protected by copyright. All rights reserved.

PY - 2023/2

Y1 - 2023/2

N2 - Introduction/Aims: Autonomic dysfunction is a common complication of small-fiber neuropathy (SFN). In this study we aimed to assess the applicability of autonomic microvascular indices as a potential marker for SFN assessment. Methods: Fifteen patients with confirmed SFN (idiopathic neuropathy [n = 10], chemotherapy-induced peripheral neuropathy [n = 2], impaired glucose tolerance [n = 1], hereditary transthyretin amyloidosis (hATTR) [n = 1], pulmonary sarcoidosis [n = 1]) and 15 matched control subjects underwent assessment of vascular skin responses assessed through laser Doppler flowmetry and evaluation of microvascular vessel and nerve density in skin biopsies. All participants underwent peripheral autonomic evaluation by quantitative sudomotor axon reflex testing (QSART). Results: We found no significant differences in vascular skin responses, or in any microvascular skin biopsy markers, when comparing SFN with control subjects. We found no correlation between vascular skin responses and skin biopsy indices. We saw no significant difference in any microvascular indices when comparing subjects with and without impaired sudomotor function. Discussion: Our findings suggest markers of peripheral microvascular innervation and function are not associated with the diagnosis of SFN. Furthermore, we saw no association between microvascular markers and sudomotor function, suggesting that these are independent and unrelated components of the autonomic nervous system.

AB - Introduction/Aims: Autonomic dysfunction is a common complication of small-fiber neuropathy (SFN). In this study we aimed to assess the applicability of autonomic microvascular indices as a potential marker for SFN assessment. Methods: Fifteen patients with confirmed SFN (idiopathic neuropathy [n = 10], chemotherapy-induced peripheral neuropathy [n = 2], impaired glucose tolerance [n = 1], hereditary transthyretin amyloidosis (hATTR) [n = 1], pulmonary sarcoidosis [n = 1]) and 15 matched control subjects underwent assessment of vascular skin responses assessed through laser Doppler flowmetry and evaluation of microvascular vessel and nerve density in skin biopsies. All participants underwent peripheral autonomic evaluation by quantitative sudomotor axon reflex testing (QSART). Results: We found no significant differences in vascular skin responses, or in any microvascular skin biopsy markers, when comparing SFN with control subjects. We found no correlation between vascular skin responses and skin biopsy indices. We saw no significant difference in any microvascular indices when comparing subjects with and without impaired sudomotor function. Discussion: Our findings suggest markers of peripheral microvascular innervation and function are not associated with the diagnosis of SFN. Furthermore, we saw no association between microvascular markers and sudomotor function, suggesting that these are independent and unrelated components of the autonomic nervous system.

KW - autonomic nervous system

KW - microvascular

KW - skin biopsy

KW - small-fiber neuropathy

KW - sympathetic

KW - Autonomic Nervous System Diseases/etiology

KW - Humans

KW - Small Fiber Neuropathy/pathology

KW - Amyloid Neuropathies, Familial/pathology

KW - Autonomic Nervous System

KW - Skin/pathology

KW - Neural Conduction/physiology

U2 - 10.1002/mus.27770

DO - 10.1002/mus.27770

M3 - Journal article

C2 - 36504143

SN - 0148-639X

VL - 67

SP - 146

EP - 153

JO - Muscle & Nerve

JF - Muscle & Nerve

IS - 2

ER -