Prospective evaluation of somatic and autonomic small fibers in selected autonomic neuropathies

Wolfgang Singer, J. M. Spies, J. McArthur, J. Low, J. W. Griffin, K. K. Nickander, V. Gordon, Phillip Anson Low

Research output: Contribution to journalArticle

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Abstract

Background: There are a number of distal and generalized small-fiber neuropathies. The neuropathologgic basis is poorly understood as somatic and autonomic C fibers are not usually studied in the same region of the body. Objective: To evaluate prospective somatic and autonomic C-fiber function in 11 healthy control subjects and 38 patients with different clinical patterns of neuropathy. Methods: Distal small-fiber neuropathy (DSFN), peripheral neuropathy (PN), diabetic neuropathy (DN), neuropathic postural tachycardia syndrome (POTS), and idiopathic autonomic neuropathy (IAN) were evaluated. Intraepidermal nerve fiber density was used to evaluate distal somatic C fibers. Both quantitative sudomotor axon reflex test and skin norepinephrine content were measured for the biopsy site to assess distal autonomic C-fiber function. Postganglionic sudomotor, adrenergic, and cardiovagal functions were evaluated by autonomic reflex testing and quantified using a Composite Autonomic Severity Scale. Results: Skin norepinephrine concentration was significantly related to CASS. DN was associated with somatic and autonomic C-fiber impairment with good agreement. POTS was associated with selective distal autonomic deficit. DSFN had combined distal somatic and C-fiber impairment. IAN showed combined and selective distal and generalized autonomic C-fiber impairment. The somatic neuropathies had C-fiber impairment affecting both populations to varying degrees. Conclusion: Although a general agreement exists between the loss of somatic C fibers and autonomic deficits, selective involvement occurs for specific autonomic neuropathies.

Original languageEnglish (US)
Pages (from-to)612-618
Number of pages7
JournalNeurology
Volume62
Issue number4
StatePublished - Feb 24 2004

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Unmyelinated Nerve Fibers
Postural Orthostatic Tachycardia Syndrome
Diabetic Neuropathies
Reflex
Norepinephrine
Body Regions
Peripheral Nervous System Diseases
Skin Tests
Nerve Fibers
Adrenergic Agents
Axons
Healthy Volunteers
Biopsy
Skin

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Singer, W., Spies, J. M., McArthur, J., Low, J., Griffin, J. W., Nickander, K. K., ... Low, P. A. (2004). Prospective evaluation of somatic and autonomic small fibers in selected autonomic neuropathies. Neurology, 62(4), 612-618.

Prospective evaluation of somatic and autonomic small fibers in selected autonomic neuropathies. / Singer, Wolfgang; Spies, J. M.; McArthur, J.; Low, J.; Griffin, J. W.; Nickander, K. K.; Gordon, V.; Low, Phillip Anson.

In: Neurology, Vol. 62, No. 4, 24.02.2004, p. 612-618.

Research output: Contribution to journalArticle

Singer, W, Spies, JM, McArthur, J, Low, J, Griffin, JW, Nickander, KK, Gordon, V & Low, PA 2004, 'Prospective evaluation of somatic and autonomic small fibers in selected autonomic neuropathies', Neurology, vol. 62, no. 4, pp. 612-618.
Singer W, Spies JM, McArthur J, Low J, Griffin JW, Nickander KK et al. Prospective evaluation of somatic and autonomic small fibers in selected autonomic neuropathies. Neurology. 2004 Feb 24;62(4):612-618.
Singer, Wolfgang ; Spies, J. M. ; McArthur, J. ; Low, J. ; Griffin, J. W. ; Nickander, K. K. ; Gordon, V. ; Low, Phillip Anson. / Prospective evaluation of somatic and autonomic small fibers in selected autonomic neuropathies. In: Neurology. 2004 ; Vol. 62, No. 4. pp. 612-618.
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