Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome
Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome
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DOI：
10.1016/j.pain.2005.03.028
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发表时间：
2005-06-01
期刊：
影响因子：
7.4
通讯作者：
Sapelli, P
中科院分区：
文献类型：
--
作者：
Lauria, G;Majorana, A;Sapelli, P
灼口综合征是一种常见的疾病，经常影响妇女在第5-第7个十年。其特征是持续的疼痛症状，主要涉及舌头的前三分之二。几年来，它一直被归因于心理原因，我们研究了舌上皮的神经支配，以评估周围神经纤维的损伤是否是疾病的发病机制的基础。我们检查了12例临床确诊的灼口综合征患者至少6个月。我们从所有患者和9名健康对照者的舌前三分之二的侧面获得浅表活检组织，进行免疫组织化学和共聚焦显微镜共定位研究与细胞质，细胞骨架电。雪旺氏细胞、髓鞘市场的病理改变。定量上皮神经纤维的密度。与对照组相比，患者的上皮神经纤维密度显著降低，并有与症状持续时间相关的趋势。上皮和乳头状神经纤维表现出弥漫性的形态学变化，反映轴突变性。我们的研究表明灼口综合征是由三叉神经小纤维感觉神经病变引起的，舌的浅表活检有助于评估诊断。这些发现揭示了这种常见疾病的发病机制，并有助于评估患者的靶向治疗，（c）2005年国际疼痛研究协会。Elsevier B. V.出版，保留所有权利。
Burning mouth syndrome is a common disorder that frequently affects women in the 5th-7th decade. It is characterized by persisting painful symptoms mainly involving the anterior two-thirds of the tongue. For several years it has been attributed to Psychological Causes, We investigated the innervation of the epithelium of the tongue to assess whether damage of peripheral nerve fibers underlies the pathogenesis of the disease. We examined 12 patients with clinically definite burning mouth syndrome for at least 6 months. We obtained superficial biopsies of the lateral aspect of the anterior two-thirds of the tongue from all patients and nine healthy controls, Immunohistochemical and confocal microscope co-localization studies were performed with cytoplasmatic, cytoskeletric. Schwann cell, and myelin markets for pathological changes. The density of epithelial nerve fibers was quantified. Patients showed a significantly lower density of epithelial nerve fibers than controls, with a trend toward correlation with the duration of symptoms. Epithelial and sub-papillary nerve fibers showed diffuse morphological changes reflecting axonal degeneration. Our study demonstrates that burning mouth syndrome is caused by a trigeminal small-fiber sensory neuropathy and that superficial biopsy of the tongue can be helpful in assessing the diagnosis. These findings shed light into the pathogenesis of this common disorder and could contribute to evaluate targeted therapies in patients, (c) 2005 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.