Small-fiber neuropathy with cardiac denervation in postural tachycardia syndrome
Carl-Albrecht Haensch1, Marco Tosch, Istvan Katona
1Department of Neurology, Kliniken Maria Hilf Mönchengladbach, Faculty of Health, University of Witten/Herdecke, Viersenerstrasse 450, D-41063, Mönchengladbach, Germany.
Introduction:
Postural tachycardia syndrome (POTS) is a disorder of orthostatic intolerance characterized by excessive tachycardia of unknown etiology. Our objective in this study was to evaluate the correlation between C-fiber involvement as shown by skin biopsy and adrenergic cardiac metaiodobenzylguanadine (MIBG) uptake in POTS patients.
Methods:
Skin biopsies of 84 patients with POTS were examined by Protein Gene Product 9.5 (PGP9.5) immunohistochemistry and were compared with MIBG myocardial scintigraphy imaging data.
Results:
Mean intraepidermal nerve fiber (IENF) density was in the lower normal age-adjusted range, 7.2 ± 2.9/mm (normal ≥ 7/mm), and was slightly below the normal range in 45% of POTS patients. MIBG uptake was reduced in 21% of patients. Low IENF density correlated with reduced cardiac MIBG uptake (r = 0.39, P = 0.001).
Conclusions:
A subset of neuropathic POTS patients may harbor mild small fiber neuropathy with abnormalities of unmyelinated nerve fibers in the skin associated with reduced myocardial postganglionic sympathetic innervation.
More Related Videos
07:12Studying the Coding Profiles of Somatic Stimulation on Cardiac-locked Neuronal Responses in the Rat Spinal Dorsal Horn
Published on: May 23, 2025
08:33Targeting Alpha Synuclein Aggregates in Cutaneous Peripheral Nerve Fibers by Free-floating Immunofluorescence Assay
Published on: June 25, 2019
Related Concept Videos
Diabetic Neuropathy
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Disorders of the Autonomic Nervous System
Raynaud's disease, also known as Raynaud's...
Dysrhythmias II: Classification of Tachyarrhythmias
Heart Failure II: Pathophysiology
Local Anesthetics: Differential Sensitivity of Nerve Fibers
