title: Quick, non-invasive and quantitative assessment of small fiber neuropathy in patients receiving chemotherapy.
abstract: Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common, potentially severe and dose-limiting adverse effect; however, it is poorly investigated at an early stage due to the lack of a simple assessment tool. As sweat glands are innervated by small autonomic C-fibers, sudomotor function testing has been suggested for early screening of peripheral neuropathy. This study aimed to evaluate Sudoscan, a non-invasive and quantitative method to assess sudomotor function, in the detection and follow-up of CIPN. Eighty-eight patients receiving at least two infusions of Oxaliplatin only (45.4%), Paclitaxel only (14.8%), another drug only (28.4%) or two drugs (11.4%) were enrolled in the study. At each chemotherapy infusion the accumulated dose of chemotherapy was calculated and the Total Neuropathy Score clinical version (TNSc) was carried out. Small fiber neuropathy was assessed using Sudoscan (a 3-min test). The device measures the Electrochemical Skin Conductance (ESC) of the hands and feet expressed in microSiemens (µS). For patients receiving Oxaliplatin mean hands ESC changed from 73 ± 2 to 63 ± 2 and feet ESC from 77 ± 2 to 66 ± 3 µS (p < 0.001) while TNSc changed from 2.9 ± 0.5 to 4.3 ± 0.4. Similar results were observed in patients receiving Paclitaxel or another neurotoxic chemotherapy. During the follow-up, ESC values of both hands and feet with a corresponding TNSc < 2 were 70 ± 2 and 73 ± 2 µS respectively while they were 59 ± 1.4 and 64 ± 1.5 µS with a corresponding TNSc ≥ 6 (p < 0.0001 and p = 0.0003 respectively). This preliminary study suggests that small fiber neuropathy could be screened and followed using Sudoscan in patients receiving chemotherapy.
authors.affiliation: Cognac-G UMR-MD4 8257, Service de Santé des Armées, Université Paris Descartes, 74, boulevard de Port-Royal, 75005, Paris, France. saad.med.mehdi@gmail.com.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Saad
authors.affiliation: Assistance Publique-Hôpitaux de Paris, La Pitié-Salpêtrière Hospital, Service de Neurologie Mazarin, Paris, France.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Psimaras
authors.affiliation: Neurology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Tafani
authors.affiliation: Neurology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Sallansonnet-Froment
authors.affiliation: Impeto Medical, Paris, France.
authors.forename: Jean-Henri
authors.initials: JH
authors.lastname: Calvet
authors.affiliation: Impeto Medical, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Vilier
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin-Port-Royal, Université Paris-Descartes, Service de Cancérologie, Paris, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Tigaud
authors.affiliation: Neurology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Flavie
authors.initials: F
authors.lastname: Bompaire
authors.affiliation: Neurology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Lebouteux
authors.affiliation: Neurology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: de Greslan
authors.affiliation: Oncology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Ceccaldi
authors.affiliation: Oncology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Poirier
authors.affiliation: Oncology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: François-Régis
authors.initials: FR
authors.lastname: Ferrand
authors.affiliation: Oncology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Sylvestre
authors.initials: S
authors.lastname: Le Moulec
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin-Port-Royal, Université Paris-Descartes, Service de Cancérologie, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huillard
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin-Port-Royal, Université Paris-Descartes, Service de Cancérologie, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Goldwasser
authors.affiliation: Neurology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Taillia
authors.affiliation: Assistance Publique-Hôpitaux de Paris, La Pitié-Salpêtrière Hospital, Unité de Neurophysiologie Clinique, Paris, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Maisonobe
authors.affiliation: Cognac-G UMR-MD4 8257, Service de Santé des Armées, Université Paris Descartes, 74, boulevard de Port-Royal, 75005, Paris, France.|Neurology Department, HIA du Val-de-Grâce, Paris, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Ricard
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005712:Galvanic Skin Response / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D000071075:Small Fiber Neuropathy / Q000139:chemically induced / Q000175:diagnosis*; D015996:Survival Rate
keywords: Autonomic neuropathy; Chemotherapy-induced peripheral neuropathy; Nerve fiber impairment assessment; Sudomotor function