To develop normative values for Meissner’s Corpuscle (MC) density and area in the hand and foot using non-invasive, in-vivo reflectance confocal microscopy (RCM).   

RCM of MC density using in-vivo RCM is a non-invasive and sensitive measure of sensory polyneuropathies.  However, age-based normal values for MC density and area using RCM are lacking.

Sixty-two individuals without signs or symptoms of peripheral neuropathy or history of a condition or exposure that predisposes to peripheral neuropathy underwent evaluation of MC density and MC cross-sectional area via in-vivo RCM at the arch of the foot, volar surface of the distal phalanx of the fifth hand digit (DV), and thenar eminence (TE). Monofilament (MF) touch pressure thresholds were also assessed at imaging sites.

Subjects were 9 to 89 years old with a mean (Std. Dev.) age of 43.42 (23.97). 34 were women (57 %).  MC’s were identified in >98% of all sites imaged. Mean (Std. Dev.) MC densities (MCs/mm²) were 6.4 (4.7) at DV, 3.4 (2.5) at TE, and 1.4 (1.5) at the arch. MC areas (mm²) were 1173.7 (543.5) at DV, 1059.6 (426.2) at TE, and 1269.9 (349.2) at arch.  Linear regression models assessing effects of age, gender, height, weight, hand/foot area on MC measurements only revealed an inverse effect of age on MC density at all imaging sites, and on MC area at the arch.  MC densities correlated with corresponding MF thresholds (DV r=-0.39, TE r=-0.39, arch r=-0.73).

MC imaging via in-vivo RCM is feasible in individuals aged 9 to 89 years. MC densities decline with age, although without a clear floor effect up to age 89 at the sites imaged. MC densities are higher in the hand than the foot. Age adjusted normal values for RCM of MC density and area will be presented.