Sural nerve biopsy may predict future nerve dysfunction

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Acta Neurol Scand. 2008 Dec 22. [Epub ahead of print]

Sural nerve biopsy may predict future nerve dysfunction.

Thrainsdottir S, Malik RA, Rosén I, Jakobsson F, Bakhtadze E, sson J,

Sundkvist G, Dahlin LB.

Department of Clinical Sciences and Neurology, Lund University, Lund,

Sweden.

Objective - Sural nerve pathology in peripheral neuropathy shows

correlation with clinical findings and neurophysiological tests. The

aim was to investigate progression of nerve dysfunction over time in

relation to a baseline nerve biopsy.

Methods - Baseline myelinated nerve fiber density (MNFD) was assessed

in sural nerve biopsies from 10 men with type 2 diabetes, 10 with

impaired and 10 with normal glucose tolerance. Nerve conduction and

quantitative perception thresholds were estimated at baseline and

follow-up (7-10 years later).

Results - Subjects with low MNFD (</= 4700 fibers/mm(2)) showed

decline of peroneal amplitude (P < 0.02) and conduction velocity (P <

0.04), as well as median nerve sensory amplitude (P < 0.05) and motor

conduction velocity (P < 0.04) from baseline to follow-up.

In linear regression analyses, diabetes influenced decline of nerve

conduction. MNFD correlated negatively with body mass index (r = -

0.469; P < 0.02).

Conclusion - Low MNFD may predict progression of neurophysiological

dysfunction and links obesity to myelinated nerve fiber loss.