title: Quality of life in polyneuropathy: association with biomarkers of small fiber impairment.
abstract: BACKGROUND
  Polyneuropathy presumably lowers quality of life (QoL). However, there is a lack of systematic studies that assess QoL changes and biomarkers of polyneuropathy as determinants of QoL. We aimed to investigate the relationship between every specific aspect of QoL and the clinical parameters used to assess the impairment of motor, sensory (large and small fibers), and autonomic nerves in polyneuropathy.
  
  
  METHODS
  Polyneuropathy patients were recruited from September 2013 to March 2014; QoL was assessed using (1) the WHO Quality of Life-BREF (WHOQoL), (2) the European Quality of Life-5 Dimensions, and (3) the Brief Pain Inventory Short Form. Neuropathy examinations included nerve conduction studies, autonomic function tests, quantitative sensory testing (QST), and intraepidermal nerve fiber (IENF) density assessment of skin biopsies.
  
  
  RESULTS
  There were 61 polyneuropathy patients (male/female = 38/23, mean age 58.14 ± 12.95 years). Patients had a lower QoL than age-and gender-matched controls in the physical and psychological domains of the WHOQoL. Among the biomarkers for different nerve fiber categories, only the small fiber neuropathy assessments were significantly related to all domains of the WHOQoL. In contrast, the parameters of the large fiber neuropathy were independent of QoL. Patients with abnormal temperature thresholds and a lower IENF density had lower WHOQoL scores compared to patients with normal thresholds and IENF densities. Warm threshold of the foot in QST was linearly correlated with all domains of the WHOQoL.
  
  
  CONCLUSIONS
  QoL scores were reduced in polyneuropathy, and biomarkers of small fiber neuropathy, i.e., warm threshold and IENF density were discriminating predictors of QoL.
authors.affiliation: School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. b96401093@ntu.edu.tw.
authors.forename: Meng-Ting
authors.initials: MT
authors.lastname: Lin
authors.affiliation: Department of Neurology, National Taiwan University Hospital, 7 Chung-Shan S Road, Taipei, 10002, Taiwan. lukaslee@nhri.org.tw.|National Institute of Environmental Medicine Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, 35053, Taiwan. lukaslee@nhri.org.tw.
authors.forename: Lukas Jyuhn-Hsiarn
authors.initials: LJ
authors.lastname: Lee
authors.affiliation: Department of Neurology, National Taiwan University Hospital, 7 Chung-Shan S Road, Taipei, 10002, Taiwan. ccchao@ntu.edu.tw.
authors.forename: Chi-Chao
authors.initials: CC
authors.lastname: Chao
authors.affiliation: Department of Neurology, National Taiwan University Hospital, 7 Chung-Shan S Road, Taipei, 10002, Taiwan. shsieh@ntu.edu.tw.|Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, 10051, Taiwan. shsieh@ntu.edu.tw.|Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, 10051, Taiwan. shsieh@ntu.edu.tw.
authors.forename: Sung-Tsang
authors.initials: ST
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000502:physiology*; D009460:Neurologic Examination; D010147:Pain Measurement; D010523:Peripheral Nervous System Diseases / Q000523:psychology; D011115:Polyneuropathies / Q000523:psychology*; D011597:Psychomotor Performance / Q000502:physiology*; D011788:Quality of Life / Q000523:psychology*; D012107:Research Design
chemical_list: D015415:Biomarkers