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Epidermal nerve fiber density: normative reference range and diagnostic efficiency

J C McArthur1, E A Stocks, P Hauer

  • 1Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. jm@jhmi.edu

Archives of Neurology
|December 29, 1998
PubMed
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This study establishes a reference range for epidermal nerve fiber density using skin biopsies. The method effectively diagnoses sensory neuropathies with 88% efficiency.

Area of Science:

  • Neurology
  • Dermatology
  • Histology

Background:

  • Neuron-specific antibodies enable identification of small unmyelinated nerve fibers in skin.
  • Quantitative assessment of these fibers is crucial for diagnosing neuropathies.

Purpose of the Study:

  • To establish a human reference range for epidermal nerve fiber density.
  • To evaluate the diagnostic efficiency of this measurement for sensory neuropathies.

Main Methods:

  • Ninety-eight healthy controls underwent neurologic exams and quantitative sensory testing.
  • Skin punch biopsies from thigh and leg were stained for protein gene product 9.5.
  • Intraepidermal nerve fiber linear density was quantified and validated against stereology.

Main Results:

Related Experiment Videos

  • A normative reference range for epidermal nerve fiber density was established.
  • Density was significantly reduced in patients with sensory neuropathies (P = .001).
  • The technique demonstrated 88% diagnostic efficiency for sensory neuropathies.

Conclusions:

  • A reliable reference range for intraepidermal nerve fiber density was established using skin biopsies.
  • This method provides high diagnostic efficiency for sensory neuropathies.
  • Skin biopsy analysis can assess peripheral nerve disease distribution and treatment response.