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Studying the Cytoskeleton

The cytoskeletal architecture can be studied using different microscopic and biochemical techniques. Electron microscopy was instrumental in discovering the cytoskeletal architecture around the 1960s, which allowed obtaining structural information at a high-resolution level. However, the sample preparation procedure often limits this ability in biological samples. Several protocols have been developed over the years to optimize sample preparation. In one of the protocols known as rotary...

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Small Fiber Morphology and Function in Inclusion Body Myositis-A Multimodal Assessment Including Confocal Corneal

Dietrich Sturm1,2, Anne-Katrin Güttsches2,3, Matthias Vorgerd2,3

  • 1Department of Neurology, Agaplesion Bethesda Krankenhaus, Wuppertal, Germany.

European Journal of Neurology
|July 29, 2025
PubMed
Summary

Small nerve fiber pathology is common in inclusion body myositis (IBM), detected in most skin biopsies. Corneal confocal microscopy (CCM) showed lower sensitivity for diagnosing small fiber damage in IBM patients.

Keywords:
corneal confocal microscopyinclusion body myositisquantitative sensory testingskin biopsysmall fiber neuropathy

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Area of Science:

  • Neurology
  • Ophthalmology
  • Pathology

Background:

  • Inclusion body myositis (IBM) is a progressive neuromuscular disorder.
  • The extent of peripheral nerve involvement, particularly small nerve fibers, in IBM is not fully understood.
  • This study investigated small nerve fiber involvement in IBM using novel diagnostic techniques.

Purpose of the Study:

  • To evaluate small nerve fiber pathology in IBM patients.
  • To compare the diagnostic utility of skin biopsy, quantitative sensory testing, and corneal confocal microscopy (CCM) for small fiber assessment in IBM.
  • To explore the relationship between small fiber involvement and patient-reported pain and quality of life.

Main Methods:

  • Nineteen IBM patients underwent clinical and electrophysiological assessments.
  • Multimodal small fiber examination included skin biopsy, quantitative sensory testing, and CCM.
  • Standardized questionnaires assessed pain and quality of life.

Main Results:

  • Large fiber neuropathy was found in 67% of IBM patients.
  • Skin biopsy revealed small fiber pathology in 72% of cases, while CCM identified it in 32%.
  • Quantitative sensory testing primarily indicated large fiber damage (61%), with only 12% showing small fiber pathology.

Conclusions:

  • Small nerve fiber pathology is prevalent in IBM, particularly detectable via skin biopsy.
  • Corneal confocal microscopy (CCM) demonstrated lower sensitivity compared to skin biopsy for diagnosing small fiber pathology in IBM.
  • Further research is needed to optimize diagnostic strategies for small fiber involvement in IBM.