title: New technologies for the assessment of neuropathies.
abstract: Technical advances are rapidly changing the clinical and instrumental approach to peripheral nerve diseases. Magnetic resonance neurography, diffusion tensor imaging and nerve ultrasonography are increasingly entering the diagnostic workup of peripheral neuropathies as tools that complement neurophysiology and enable investigation of proximal structures, such as plexuses and roots. Progress in the design of magnetic resonance scanners and sequences, and the development of high-frequency ultrasound probes mean that high-resolution peripheral nerve imaging is possible, enabling detailed examination of nerve size, morphology and internal fascicular structure that can integrate nerve conduction studies into clinical practice. In the growing field of small-fibre neuropathy, in which traditional nerve conduction studies are of little or no use, skin biopsy has become a reliable tool for diagnosis. Corneal confocal microscopy, nociceptive evoked potentials and microneurography are emerging techniques that are mainly used in clinical research settings, but have increasing relevance to clinical practice. We review these new and emerging techniques and their effects on diagnosis, treatment strategies and prognosis in a variety of peripheral neuropathies, including entrapments, brachial plexopathies, immune and inherited neuropathies, and small-fibre neuropathies. We discuss the most promising research findings and their potential for future application in clinical practice.
authors.affiliation: Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Neuroradiology Unit, Spedali Civili, Piazza Spedali Civili 1-25123 Brescia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gasparotti
authors.affiliation: Catholic University, Department of Geriatrics, Neurology, Orthopedics and Rehabilitation, Largo Agostino Gemelli 8, 0630151, Rome, Italy.|Fondazione Don Gnocchi, P.le R. Morandi 6, 20121 Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
authors.affiliation: Department of Neurosciences, University of Padova, Via Giustiniani 5, 35128 Padova, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Briani
authors.affiliation: Neuroalgology Unit and Skin Biopsy, Peripheral Neuropathy and Neuropathic Pain Laboratory, IRCCS Foundation "Carlo Besta" Neurological Institute, Via Celoria 11, 20133 Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lauria
mesh_terms: D005071:Evoked Potentials; D006801:Humans; D008279:Magnetic Resonance Imaging; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography