Small autonomic and large fiber neuropathy in Parkinson disease and parkinsonismReport as inadecuate




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BMC Neurology

, 16:139

Neuromuscular disorders and peripheral neurology

Abstract

BackgroundRecent studies have reported that peripheral neuropathy PN is common in patients with Parkinson’s disease PD and raised the possibility that levodopa neurotoxicity is the main culprit.

MethodsWe evaluated the presence of large and small autonomic fiber PN in 54 consecutive patients with PD or parkinsonism in a tertiary outpatient clinic from Brazil. Initial PN screening consisted of history-neurological exam and skin wrinkling test SWT. In addition, we also performed Nerve conduction studies-Electromyography NCS-EMG in all patients with PN signs-symptoms and-or abnormal SWT.

ResultsThirty eight patients with PD 10 women, mean age: 63 ± 2.1 years, P < 0.05 versus parkinsonism, mean disease duration: 8 ± 0.8 years and 16 patients with other forms of parkinsonism 7 women, mean age: 50.1 ± 3.9 years, mean disease duration: 6.9 ± 1.1 years completed clinical neuromuscular evaluation. SWT was performed in 48 patients 33 PD, 15 parkinsonism. In the PD group, SWT was abnormal in 57.6 % of the tested patients comprising 50 % of all PD patients. In the parkinsonism group, SWT was abnormal in 37.5 % comprising 35.3 % of all parkinsonism patients. NCS-EMG was performed in 39 patients 26 PD and 13 parkinsonism. Twelve out of the 26 PD 34.2 % of all PD and 4 out of the 13 parkinsonism 23.5 % of all parkinsonism had abnormal NCS-EMG results. Neuropathy prevalence was similar in PD and parkinsonism groups as detected either by NCS-EMG or SWT.

ConclusionsLarge fiber and small autonomic fiber PN are common in patients with PD and parkinsonism. The etiology for the neuropathy was likely to be multifactorial and may be secondary to PD itself.

KeywordsNeuromuscular disorders Parkinson’s disease Parkinsonism Skin Wrinkling test Peripheral neuropathy AbbreviationsCMAPCompound muscle action potential

DMDiabetes mellitus

EMGElectromyography

NCSNerve conduction studies

PDParkinson’s disease

PNPeripheral neuropathy

SFNSmall fiber neuropathy

SNAPSensory nerve action potential

SWTSkin winkling test

Electronic supplementary materialThe online version of this article doi:10.1186-s12883-016-0667-3 contains supplementary material, which is available to authorized users.

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Author: Davi Farias de Araújo - Antônio Pinto de Melo Neto - Ítalo Sérgio Cavalcante Oliveira - Beatriz Soares Brito - Ineusi

Source: https://link.springer.com/



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