title: Hereditary sensory and autonomic neuropathy types 4 and 5: Review and proposal of a new rehabilitation method.
abstract: Although pain is unpleasant, it should serve as a reminder for individuals to avoid similar damaging incidents in the future. Hereditary sensory and autonomic neuropathy (HSAN) includes genetic disorders involving various sensory and autonomic dysfunctions. They are classified by the mode of inheritance, clinical features, and related genes. HSAN type 4 (HSAN-4) and type 5 (HSAN-5) are characterized by insensitivity to pain and thermal sensation. Further, HSAN-4 is accompanied by decreased sweating and intellectual disabilities. These characteristics of HSAN-4 and -5 result in many clinical features, such as pediatric, psychiatric, orthopedic, oral, dermatological, and ophthalmological problems. Orthopedic problems include destructive injuries such as multiple fractures and joint dislocation. Studies on gait have shown greater speed and higher heel contact angular velocity in HSAN-4 and -5 patients compared with controls. Studies on grasp-lift-holding tasks have shown higher grasp force and fluctuations in acceleration of the object. We believe that these findings represent outcomes of deficient motor learning. We propose a new rehabilitation method for patients with HSAN-4 and -5, with the aim of decreasing their destructive injuries.
authors.affiliation: Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: yodu-jscn@umin.net.
authors.forename: Arito
authors.initials: A
authors.lastname: Yozu
authors.affiliation: Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Haga
authors.affiliation: Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo 182-8585, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Funato
authors.affiliation: Research Institute of Electrical Communication, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai 980-8577, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Owaki
authors.affiliation: Research Center for Brain Function and Medical Engineering, Asahikawa Medical University, 1-1-1 Midorigaoka-higashi-nijyou, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Chiba
authors.affiliation: Research into Artifacts, Center for Engineering, The University of Tokyo, 5-1-5, Kashiwanoha, Kashiwa, Chiba 277-8568, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Ota
mesh_terms: D009477:Hereditary Sensory and Autonomic Neuropathies / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans
keywords: Congenital insensitivity to pain; Hereditary sensory and autonomic neuropathy (HSAN); Motor learning; Multiple fractures; Nerve growth factor (NGF); Rehabilitation