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Konfokale Mikroskopie zur Detektion von Schäden an den Nervenfasern der Kornea bei chronischer inflammatorischer demyelinisierender Polyneuropathie

dc.contributor.advisorSchmidt, Jens Prof. Dr.
dc.contributor.authorSchipper, Jan-Hendrik
dc.format.extentXXX Seitende
dc.titleKonfokale Mikroskopie zur Detektion von Schäden an den Nervenfasern der Kornea bei chronischer inflammatorischer demyelinisierender Polyneuropathiede
dc.title.translatedConfocal Microscopy for Detection of Corneal Nerve Damages in Chronic Inflammatory Demyelinating Polyneuropathyde
dc.contributor.refereeSchmidt, Jens Prof. Dr.
dc.description.abstractengChronic inflammatory demyelinating polyneuropathy (CIDP) is an autoinflammatory disease of the peripheral nerve system typically leading to weakness and sensory symptoms. Moreover, small fiber neuropathy associated with dysesthesia and neuropathic pain regularly occurs in CIDP. So far, validated biomarkers longitudinally evaluating the impairment of small fibers to potentially assess disease progression and therapy effects are lacking. Corneal confocal microscopy (CCM) non-invasively examines the subbasal nerve plexus of the cornea consisting of Aδ and C fibers of trigeminal nerve branches. Recent studies showed alterations of the corneal nerve fibers in patients suffering from polyneuropathies. The aim of this study was to assess the diagnostic utility of CCM in the longitudinal evaluation of small fiber neuropathy in CIDP. Besides, impairment of small fibers apart from the corneal nerves was further characterized. Corneal nerve fiber parameters were compared between CIDP patients and a healthy control group. To evaluate the longitudinal alterations of these parameters, CIDP patients underwent two CCMs at an interval of approximately 8 months. The obtained changes were compared to the longitudinal development of clinical scores, nerve-conduction studies and measurements of grip strength and walking distance in the same period. Moreover, small fiber dysfunction was characterized by quantitative sensory testing (QST), evaluation of sudomotor function and measurement of intraepidermal nerve fiber density (IENFD). Although CCM showed a good reproducibility, it was not eligible for a longitudinal evaluation of small fiber involvement in CIDP. Corneal nerve fiber parameters did not differ between 16 CIDP patients and 13 healthy controls enrolled in this study. Longitudinal alterations of these parameters did not correlate with changes of clinical scores, electrophysiological parameters or measurements of grip strength and walking distance in CIDP. However, this study revealed a relevant involvement of small fibers outside of the cornea with altered QSTs, impaired skin conductance and reduced IENFDs. Further studies should analyze the potential of non-invasive small fiber examinations to serve as biomarkers in
dc.contributor.coRefereevan Oterendorp, Christian PD Dr.
dc.contributor.thirdRefereeMeyer, Thomas Prof. Dr.
dc.subject.engCorneal Confocal Microscopyde
dc.subject.engChronic Inflammatory Demyelinating Polyneuropathyde
dc.subject.engSmall Fiber Neuropathyde
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullNeurologie - Allgemein- und Gesamtdarstellungen (PPN619876247)de
dc.notes.confirmationsentConfirmation sent 2023-04-18T13:15:01de

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