RT Journal Article
SR Electronic
T1 Quantitative sensory testing predicts histological small fiber neuropathy in postural tachycardia syndrome
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP 428
OP 434
DO 10.1212/CPJ.0000000000000770
VO 10
IS 5
A1 Billig, Sophia C.I.
A1 Schauermann, Joana C.
A1 Rolke, Roman
A1 Katona, Istvan
A1 Schulz, Jörg B.
A1 Maier, Andrea
YR 2020
UL http://cp.neurology.org/content/10/5/428.abstract
AB Background Retrospective investigation of the somatosensory profile and prediction of histologic small fiber neuropathy (SFN) in postural orthostatic tachycardia syndrome (POTS) was performed using quantitative sensory testing (QST) as a standardized noninvasive test.Methods In this investigation, full data sets from 30 patients (age: 34.03 ± 10.82 years, n = 6 males), including results of autonomic function testing, norepinephrine values, skin biopsy, and QST, were retrospectively analyzed. The QST data were compared with healthy controls (HCs) (age: 34.20 ± 10.5 years, n = 6 males, t test: 0.95).Results The evaluation of all QST parameters in POTS compared with HCs yielded differences in all thermal parameters (cold detection threshold: p < 0.05, warm detection threshold: p < 0.001, thermal sensory limen: p < 0.001, cold pain threshold: p < 0.05, and heat pain threshold: p < 0.001) and in paradoxical heat sensations (p < 0.05). Differences in nonpainful stimuli (mechanical detection threshold: p < 0.05 and vibration detection threshold: p < 0.001) were also detected. All patients who had clinical signs of SFN in combination with impairment of small fibers in QST also had SFN on skin biopsy.Conclusion These results suggest that a non–region-specific SFN in POTS compared with controls can be detected by noninvasive QST that predicts histologic small fiber pathology.