Noninvasive and minimally invasive detection and monitoring of peripheral neuropathies.
Noninvasive and minimally invasive detection and monitoring of peripheral neuropathies.
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DOI：
10.1586/14737175.8.12.1807
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发表时间：
2008-12-01
影响因子：
4.3
通讯作者：
Herrmann, David N
中科院分区：
文献类型：
--
作者：
Herrmann, David N
周围神经病变多种多样，需要在临床和研究环境中采用多维方法进行检测和监测。这篇综述描述了远端感觉性多发性神经病（DSP）的无创和微创治疗方法，DSP是最常见的神经病形式。临床和电生理学评估与神经传导研究 (NCS) 的结合足以检测和表征大多数 DSP。 NCS 对主要影响小直径感觉神经纤维 (SFN) 和促进疼痛和热感觉的皮神经末梢的 DSP 变体不敏感。通过评估表皮神经纤维密度进行皮肤活检可以客观地检测和监测 SFN。传统的临床和 NCS 测量作为 DSP 实验治疗的结果存在局限性。对于临床试验，表皮神经支配的活检评估和新兴的无创成像方法（角膜神经支配和皮肤迈斯纳小体的体内共聚焦显微镜）有望作为替代标记物，与传统 DSP 测量相补充。
Peripheral neuropathies are diverse and require a multidimensional approach for detection and monitoring in a clinical and research setting. This review describes non- and minimally-invasive measures of distal predominantly sensory polyneuropathy (DSP), the most common form of neuropathy. A combination of clinical and electrophysiologic assessment with nerve-conduction studies (NCSs) suffices for the detection and characterization of most DSPs. NCS are insensitive to variants of DSP that predominantly affect small diameter sensory nerve fibers (SFNs) and cutaneous nerve terminals that subserve pain and thermal sensation. Skin biopsy with assessment of epidermal nerve fiber density permits objective detection and monitoring of SFNs. Conventional clinical and NCS measures have limitations as outcomes in experimental therapeutics in DSP. For clinical trials, biopsy evaluation of epidermal innervation and emerging noninvasive imaging approaches (in vivo confocal microscopy of corneal innervation and of Meissner corpuscles in the skin) hold promise as surrogate markers that are complementary to traditional DSP measures.