title: Evaluation of dermal myelinated nerve fibers in diabetes mellitus.
abstract: Skin biopsies have primarily been used to study the non-myelinated nerve fibers of the epidermis in a variety of neuropathies. In this study, we have expanded the skin biopsy technique to glabrous, non-hairy skin to evaluate myelinated nerve fibers in the most highly prevalent peripheral nerve disease, diabetic polyneuropathy (DPN). Twenty patients with DPN (Type I, n = 9; Type II, n = 11) and 16 age-matched healthy controls (age 29-73) underwent skin biopsy of the index finger, nerve conduction studies (NCS), and composite neuropathy scoring. In patients with DPN, we found a statistically significant reduction of both mechanoreceptive Meissner corpuscles (MCs) and their afferent myelinated nerve fibers (p = 0.01). This myelinated nerve fiber loss was correlated with the decreased amplitudes of sensory/motor responses in NCS. This study supports the utilization of skin biopsy to quantitatively evaluate axonal loss of myelinated nerve fibers in patients with DPN.
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA. amanda.peltier@vanderbilt.edu
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Peltier
authors.forename: M Iliza
authors.initials: MI
authors.lastname: Myers
authors.forename: Kay J
authors.initials: KJ
authors.lastname: Artibee
authors.forename: Audra D
authors.initials: AD
authors.lastname: Hamilton
authors.forename: Qing
authors.initials: Q
authors.lastname: Yan
authors.forename: Jiasong
authors.initials: J
authors.lastname: Guo
authors.forename: Yaping
authors.initials: Y
authors.lastname: Shi
authors.forename: Lily
authors.initials: L
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003929:Diabetic Neuropathies / Q000473:pathology*; D005260:Female; D005385:Fingers / Q000294:innervation / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009431:Neural Conduction; D012867:Skin / Q000294:innervation / Q000473:pathology