Premium
Neurophysiological techniques to detect early small‐fiber dysfunction in transthyretin amyloid polyneuropathy
Author(s) -
Conceição Isabel,
Costa João,
Castro José,
Carvalho Mamede
Publication year - 2014
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23901
Subject(s) - transthyretin , medicine , asymptomatic , sural nerve , polyneuropathy , nerve fiber , population , pathology , gastroenterology , anatomy , environmental health
: Transthyretin familial amyloid polyneuropathy (TTR‐FAP) is characterized by early selective involvement of small nerve fibers. Initial clinical diagnosis is complicated by psychosocial factors. We evaluated diagnostic accuracy of sural sensory nerve action potentials, plantar sympathetic skin response (SSR), and cortical laser‐evoked potentials (LEP) to dorsal foot stimulation in the early diagnosis of TTR‐FAP. Methods : Sixty‐three subjects with TTR‐FAP (Val30Met) mutation were split into 2 groups (asymptomatic carriers and early‐symptomatic patients) and compared with 33 healthy controls. Results : The diagnostic accuracy of plantar SSR amplitude and LEP N2 latency was similar; all had very high specificity (94 to 97%) but low sensitivity (22 to 32%) in distinguishing controls from carriers and early‐symptomatic patients. No control had abnormal results on both tests. Conclusions : Plantar SSR and LEPs have similar diagnostic performance in detecting small‐fiber dysfunction in early TTR‐FAP; we propose that both tests should be used to investigate this population. Muscle Nerve 49 : 181–186, 2014