Document Detail

In vivo confocal microscopy of Meissner corpuscles as a novel sensory measure in CMT1A.
MedLine Citation:
PMID:  22003930     Owner:  NLM     Status:  In-Data-Review    
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.
Jorge L Almodovar; Michele Ferguson; Michael P McDermott; Richard A Lewis; Michael E Shy; David N Herrmann
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the peripheral nervous system : JPNS     Volume:  16     ISSN:  1529-8027     ISO Abbreviation:  J. Peripher. Nerv. Syst.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9704532     Medline TA:  J Peripher Nerv Syst     Country:  United States    
Other Details:
Languages:  eng     Pagination:  169-74     Citation Subset:  IM    
Copyright Information:
© 2011 Peripheral Nerve Society.
Department of Neurology Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA Department of Neurology, Wayne State University, Detroit, MI, USA Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA.
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