Abstract Details

Title Autonomic Evaluation Is Independent of Somatic Evaluation for Small Fiber Neuropathy

Topic Peripheral Nerve

Presentation(s) S26 - (-)

Poster/Presentation
Number 002

Objective

Background In a prior study, adding QSART (autonomic evaluation) to a combination of clinical examination, QST and IENFD (somatic evaluation) significantly increased diagnostic sensitivity for SFN. These findings suggested that autonomic and somatic assessment for SFN may be complementary. To support this hypothesis, it is important to demonstrate that 'autonomic' and 'somatic' evaluation of SFN are independent of each other.

Design/Methods 73 patients with clinically suspected sensory neuropathy without motor weakness but normal nerve conduction studies underwent blinded QSART, QST and skin biopsy for diagnosis of SFN. Linear regression analysis was performed to assess the association between the values of QSART (uL/cm2), QST (JND) and IENFD (fibers/mm). For QST, the comparison was done separately between vibration JND, cooling JND, HP 0.5 JND, HP 5.0-0.5 JND and HP 5.0 JND.

Results There was a linear but inverse correlation between vibration JND and ankle IENFD (r = -0.37; p=0.018) and cooling JND and ankle IENFD (r = -0.30; p=0.03). However, there was no association between HP 0.5, HP 5.0-0.5 or HP 5.0 and ankle IENFD. There was also no correlation between foot QSART and ankle IENFD, leg QSART and thigh IENFD or foot QSART and heat pain measures.

Conclusions There was no significant association between 'autonomic' and 'somatic' components of small nerve fibers. This supports the concept that assessment of autonomic and somatic functions of SFN is complementary and should be done concurrently. However, various modalities of 'somatic' functions are not independent.

Authors/Disclosures
Pariwat Thaisetthawatkul, MD, FAAN (University of Nebraska Medical Center) PRESENTER	Dr. Thaisetthawatkul has nothing to disclose.
Jose E. Cavazos, MD, PhD (U Texas Health San Antonio)	Dr. Cavazos has received stock or an ownership interest from Brain Sentinel . The institution of Dr. Cavazos has received research support from NIH.
J. Americo M. Fernandes, Jr., MD, FAAN (University of Nebraska Medical Center)	Dr. Fernandes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Columbia University. The institution of Dr. Fernandes has received research support from MGH philanthropy (Clene, Seelos, UCB, Biohaven, Prilenia, Denali Therapeutics, Calico Life Sciences. The institution of Dr. Fernandes has received research support from Columbia University. The institution of Dr. Fernandes has received research support from PTC Therapeutics. The institution of Dr. Fernandes has received research support from Clene.
David N. Herrmann, MD, FAAN (University of Rochester Medical Center)	Dr. Herrmann has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acceleron. Dr. Herrmann has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint global. Dr. Herrmann has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG. Dr. Herrmann has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Dr. Herrmann has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sarepta. Dr. Herrmann has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Regenacy. Dr. Herrmann has received intellectual property interests from a discovery or technology relating to health care.

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