In vivo confocal microscopy of Meissner corpuscles as a novel sensory measure in CMT1A
In vivo confocal microscopy of Meissner corpuscles as a novel sensory measure in CMT1A
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DOI：
10.1111/j.1529-8027.2011.00342.x
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发表时间：
2011-09-01
影响因子：
3.8
通讯作者：
Herrmann, David N.
中科院分区：
文献类型：
--
作者：
Almodovar, Jorge L.;Ferguson, Michele;Herrmann, David N.
在治疗发展的新兴时代，针对腓骨肌萎缩症 (CMT) 神经病不同方面的可靠、有效且反应灵敏的结果变得越来越重要。 CMT 感觉成分的测量尤其有限。一种可能适用于 CMT 的新方法是迈斯纳小体 (MC) 的非侵入性体内反射共焦显微镜 (RCM)。在这项前瞻性研究中，我们使用 RCM 评估了 1A 型腓骨肌萎缩症 (CMT1A) 受试者的 MC 密度、触摸压力和振动感觉阈值，并与健康对照进行比较。 CMT1A 受试者的指尖（数字 V）处的 MC 密度低于对照（2.59 +/- 2.73 MCs/mm(2) 与 6.77 +/- 3.68 MCs/mm(2)，p = 0.001），但在鱼际隆起处的 MC 密度并不更近。 CMT1A 中 V 指 (p = 0.002) 和鱼际隆起 (p = 0.0001) 处的触摸压力阈值高于对照组。 CMT1A 数字 V 处的振动阈值也高于对照组 (p = 0.0001)。数字 V 处较低的 MC 密度与较高的整体 CMT 严重程度相关，如夏科-玛丽-图思神经病变评分 (CMTNS) (r = -0.76，p = 0.004) 和神经病变损伤评分 (NIS) (r = -0.73，p = 0.007) 所反映。同样，指尖（数字 V）的触摸压力阈值越差，与 CMTNS（r = 0.71，p = 0.009）和 NIS（r = 0.70，p = 0.011）上更严重的 CMT1A 相关。数字 V 处的振动阈值与 CMTNS（r = 0.11，p = 0.74）或 NIS（r = 0.21，p = 0.52）无关。手部 MC 密度的非侵入性体内 RCM 和触摸压力阈值的评估显示出作为 CMT1A 感觉结构和功能测量的前景。
Reliable, valid, and responsive outcomes for different aspects of Charcot-Marie- Tooth (CMT) neuropathy have become increasingly important in an emerging era of therapy development. Measures of the sensory component of CMT in particular are limited. One novel approach with potential applicability to CMT is non-invasive in vivo reflectance confocal microscopy (RCM) of Meissner corpuscles (MCs). In this prospective study, we evaluated MC densities using RCM, and touch-pressure and vibration sensation thresholds in a cohort of Charcot-Marie-Tooth type 1A (CMT1A) subjects with comparison to healthy controls. MC density was lower in CMT1A subjects than in controls at the fingertip (digit V) (2.59 +/- 2.73 MCs/mm(2) vs. 6.77 +/- 3.68 MCs/mm(2), p = 0.001), but not more proximally at the thenar eminence. Touch-pressure thresholds were higher in CMT1A than in controls at digit V (p = 0.002) and at the thenar eminence (p = 0.0001). Vibration thresholds in CMT1A at digit V were also higher than in controls (p = 0.0001). A lower MC density at digit V was associated with greater global CMT severity as reflected by the Charcot-Marie-Tooth neuropathy score (CMTNS) (r = -0.76, p = 0.004) and the Neuropathy impairment score (NIS) (r = -0.73, p = 0.007). Similarly, worse touch-pressure thresholds at the fingertip (digit V) were associated with more severe CMT1A on the CMTNS (r = 0.71, p = 0.009) and NIS (r = 0.70, p = 0.011). Vibration thresholds at digit V were not associated with either the CMTNS (r = 0.11, p = 0.74) or NIS (r = 0.21, p = 0.52). Non-invasive in vivo RCM of MC density at the hand and the evaluation of touch-pressure thresholds show promise as measures of sensory structure and function in CMT1A.