Prevalence of somatic small fiber neuropathy in elderly: a review

Authors

DOI:

https://doi.org/10.33448/rsd-v12i6.41978

Keywords:

Small fiber neuropathy; Elderly; Neuralgia.

Abstract

Somatic small fiber neuropathy (SSFN) is a neuromuscular disease that affects peripheral nerves and leads to structural and functional changes involving small myelinated (Aδ) and unmyelinated (C) fibers, and whose pathophysiological mechanisms are not well elucidated, but depend on the underlying etiology. Due to the lack of studies on this pathology, it is likely to be underdiagnosed, which is a problem, since this disease in elderly people can lead to multiple negative effects on daily life due to neuropathic pain, paresthesia, and dysautonomia of various systems. The clinical diagnosis of this pathology is based on data from the clinical history and physical examination, as well as some complementary examinations and tests, such as the quantitative sudomotor axon reflex test (QSART). Moreover, the treatment of the disease is still limited and most approaches focus on the control of symptoms, such as neuropathic pain. The present study consists of a narrative review of the literature conducted in Medline databases from 2010 to 2022 on small-fiber neuropathy, the elderly, and neuralgia, using the terminology indicated by the Health Sciences Descriptor System (DeCS), and aims to highlight the relevance of the association of senile comorbidities and the aging process with somatic small-fiber neuropathy. Thus, future studies investigating the pathophysiological mechanisms of SSFN are of utmost importance, as well as studies aimed at developing more effective diagnostic methods.

References

Bakkers, M., Faber, C. G., Hoeijmakers, J. G., Lauria, G., & Merkies, I. S. (2014). Small fibers, large impact: quality of life in small-fiber neuropathy. Muscle & nerve, 49(3), 329–336. https://doi.org/10.1002/mus.23910

Basantsova, N. Y., Starshinova, A. A., Dori, A., Zinchenko, Y. S., Yablonskiy, P. K., & Shoenfeld, Y. (2019). Small-fiber neuropathy definition, diagnosis, and treatment. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 40(7), 1343–1350. https://doi.org/10.1007/s10072-019-03871-x

Birnbaum, J., & Bingham, C. O., 3rd (2014). Non-length-dependent and length-dependent small-fiber neuropathies associated with tumor necrosis factor (TNF)-inhibitor therapy in patients with rheumatoid arthritis: expanding the spectrum of neurological disease associated with TNF-inhibitors. Seminars in arthritis and rheumatism, 43(5), 638–647. https://doi.org/10.1016/j.semarthrit.2013.10.007

Birnbaum, J., Lalji, A., Saed, A., & Baer, A. N. (2019). Biopsy-Proven Small-Fiber Neuropathy in Primary Sjögren's Syndrome: Neuropathic Pain Characteristics, Autoantibody Findings, and Histopathologic Features. Arthritis care & research, 71(7), 936–948. https://doi.org/10.1002/acr.23762

Bitzi, L. M., Lehnick, D., & Wilder-Smith, E. P. (2021). Small fiber neuropathy: Swiss cohort characterization. Muscle & nerve, 64(3), 293–300. https://doi.org/10.1002/mus.27340

Bitzi, L. M., Lehnick, D., & Wilder-Smith, E. P. (2021). Small fiber neuropathy: Swiss cohort characterization. Muscle & nerve, 64(3), 293–300. https://doi.org/10.1002/mus.27340

Brouwer, B. A., de Greef, B. T., Hoeijmakers, J. G., Geerts, M., van Kleef, M., Merkies, I. S., & Faber, C. G. (2015). Neuropathic Pain due to Small Fiber Neuropathy in Aging: Current Management and Future Prospects. Drugs & aging, 32(8), 611–621. https://doi.org/10.1007/s40266-015-0283-8

Brouwer, B. A., van Kuijk, S. M. J., Bouwhuis, A., Faber, C. G., van Kleef, M., Merkies, I. S. J., & Hoeijmakers, J. G. J. (2019). The Pain Dynamics of Small Fiber Neuropathy. The journal of pain, 20(6), 655–663. https://doi.org/10.1016/j.jpain.2018.11.009

Casanova-Molla, J., Morales, M., Planas-Rigol, E., Bosch, A., Calvo, M., Grau-Junyent, J. M., & Valls-Solé, J. (2012). Epidermal Langerhans cells in small fiber neuropathies. Pain, 153(5), 982–989. https://doi.org/10.1016/j.pain.2012.01.021

Chao, C. C., Tseng, M. T., Lin, Y. J., Yang, W. S., Hsieh, S. C., Lin, Y. H., Chiu, M. J., Chang, Y. C., & Hsieh, S. T. (2010). Pathophysiology of neuropathic pain in type 2 diabetes: skin denervation and contact heat-evoked potentials. Diabetes care, 33(12), 2654–2659. https://doi.org/10.2337/dc10-1135

Dalla Bella, E., Lombardi, R., Porretta-Serapiglia, C., Ciano, C., Gellera, C., Pensato, V., Cazzato, D., & Lauria, G. (2016). Amyotrophic lateral sclerosis causes small fiber pathology. European journal of neurology, 23(2), 416–420. https://doi.org/10.1111/ene.12936

de Greef, B. T. A., Hoeijmakers, J. G. J., Gorissen-Brouwers, C. M. L., Geerts, M., Faber, C. G., & Merkies, I. S. J. (2018). Associated conditions in small fiber neuropathy - a large cohort study and review of the literature. European journal of neurology, 25(2), 348–355. https://doi.org/10.1111/ene.13508

Devigili, G., Rinaldo, S., Lettieri, C., & Eleopra, R. (2016). Levodopa/carbidopa intestinal gel therapy for advanced Parkinson Disease: AN early toxic effect for small nerve fibers?. Muscle & nerve, 54(5), 970–972. https://doi.org/10.1002/mus.25377

Devigili, G., Rinaldo, S., Lombardi, R., Cazzato, D., Marchi, M., Salvi, E., Eleopra, R., & Lauria, G. (2019). Diagnostic criteria for small fibre neuropathy in clinical practice and research. Brain : a journal of neurology, 142(12), 3728–3736. https://doi.org/10.1093/brain/awz333

Eijkenboom, I., Sopacua, M., Hoeijmakers, J. G. J., de Greef, B. T. A., Lindsey, P., Almomani, R., Marchi, M., Vanoevelen, J., Smeets, H. J. M., Waxman, S. G., Lauria, G., Merkies, I. S. J., Faber, C. G., & Gerrits, M. M. (2019). Yield of peripheral sodium channels gene screening in pure small fibre neuropathy. Journal of neurology, neurosurgery, and psychiatry, 90(3), 342–352. https://doi.org/10.1136/jnnp-2018-319042

Freeman, R., Chase, K. P., & Risk, M. R. (2003). Quantitative sensory testing cannot differentiate simulated sensory loss from sensory neuropathy. Neurology, 60(3), 465–470. https://doi.org/10.1212/wnl.60.3.465

Galosi, E., Di Pietro, G., La Cesa, S., Di Stefano, G., Leone, C., Fasolino, A., Di Lionardo, A., Leonetti, F., Buzzetti, R., Mollica, C., Cruccu, G., & Truini, A. (2021). Differential involvement of myelinated and unmyelinated nerve fibers in painful diabetic polyneuropathy. Muscle & nerve, 63(1), 68–74. https://doi.org/10.1002/mus.27080

Ghasemi, M., & Rajabally, Y. A. (2020). Small fiber neuropathy in unexpected clinical settings: a review. Muscle & nerve, 62(2), 167–175. https://doi.org/10.1002/mus.26808

Giannoccaro, M. P., Donadio, V., Incensi, A., Avoni, P., & Liguori, R. (2014). Small nerve fiber involvement in patients referred for fibromyalgia. Muscle & nerve, 49(5), 757–759. https://doi.org/10.1002/mus.24156

Gibbons C. H. (2014). Small fiber neuropathies. Continuum (Minneapolis, Minn.), 20(5 Peripheral Nervous System Disorders), 1398–1412. https://doi.org/10.1212/01.CON.0000455874.68556.02

Gibbons, C. H., Griffin, J. W., Polydefkis, M., Bonyhay, I., Brown, A., Hauer, P. E., & McArthur, J. C. (2006). The utility of skin biopsy for prediction of progression in suspected small fiber neuropathy. Neurology, 66(2), 256–258. https://doi.org/10.1212/01.wnl.0000194314.86486.a2

Guimarães-Costa, R., Schoindre, Y., Metlaine, A., Lefaucheur, J. P., Camdessanché, J. P., Maisonobe, T., & Léger, J. M. (2018). N-hexane exposure: a cause of small fiber neuropathy. Journal of the peripheral nervous system : JPNS, 23(2), 143–146. https://doi.org/10.1111/jns.12261

Güneş, H. N., Bekircan-Kurt, C. E., Tan, E., & Erdem-Özdamar, S. (2018). The histopathological evaluation of small fiber neuropathy in patients with vitamin B12 deficiency. Acta neurologica Belgica, 118(3), 405–410. https://doi.org/10.1007/s13760-017-0847-y

Heij, L., Niesters, M., Swartjes, M., Hoitsma, E., Drent, M., Dunne, A., Grutters, J. C., Vogels, O., Brines, M., Cerami, A., & Dahan, A. (2012). Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study. Molecular medicine (Cambridge, Mass.), 18(1), 1430–1436. https://doi.org/10.2119/molmed.2012.00332

Hoeijmakers, J. G., Faber, C. G., Lauria, G., Merkies, I. S., & Waxman, S. G. (2012). Small-fibre neuropathies--advances in diagnosis, pathophysiology and management. Nature reviews. Neurology, 8(7), 369–379. https://doi.org/10.1038/nrneurol.2012.97

Hong, J., Barnes, M., & Kessler, N. (2013). Case study: use of vibration therapy in the treatment of diabetic peripheral small fiber neuropathy. Journal of bodywork and movement therapies, 17(2), 235–238. https://doi.org/10.1016/j.jbmt.2012.08.007

Hovaguimian, A., & Gibbons, C. H. (2011). Diagnosis and treatment of pain in small-fiber neuropathy. Current pain and headache reports, 15(3), 193–200. https://doi.org/10.1007/s11916-011-0181-7

Illigens, B. M., & Gibbons, C. H. (2009). Sweat testing to evaluate autonomic function. Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 19(2), 79–87. https://doi.org/10.1007/s10286-008-0506-8

Johnson, S. A., Shouman, K., Shelly, S., Sandroni, P., Berini, S. E., Dyck, P. J. B., Hoffman, E. M., Mandrekar, J., Niu, Z., Lamb, C. J., Low, P. A., Singer, W., Mauermann, M. L., Mills, J., Dubey, D., Staff, N. P., & Klein, C. J. (2021). Small Fiber Neuropathy Incidence, Prevalence, Longitudinal Impairments, and Disability. Neurology, 97(22), e2236–e2247. https://doi.org/10.1212/WNL.0000000000012894

Khan, A., Petropoulos, I. N., Ponirakis, G., Menzies, R. A., Chidiac, O., Pasquier, J., Abi Khalil, C., Talal, T. K., & Malik, R. A. (2018). Corneal confocal microscopy detects severe small fiber neuropathy in diabetic patients with Charcot neuroarthropathy. Journal of diabetes investigation, 9(5), 1167–1172. https://doi.org/10.1111/jdi.12806

Kopf, S., Groener, J. B., Kender, Z., Fleming, T., Bischoff, S., Jende, J., Schumann, C., Ries, S., Bendszus, M., Schuh-Hofer, S., Treede, R. D., & Nawroth, P. P. (2018). Deep phenotyping neuropathy: An underestimated complication in patients with pre-diabetes and type 2 diabetes associated with albuminuria. Diabetes research and clinical practice, 146, 191–201. https://doi.org/10.1016/j.diabres.2018.10.020

Kraychete, D. C., & Sakata, R. K. (2011). Painful peripheral neuropathies. Revista brasileira de anestesiologia, 61(5), 641–360. https://doi.org/10.1016/S0034-7094(11)70075-7

Kuo, M. C., Huang, J. C., Wu, P. Y., Mai, H. C., Chen, S. C., Chiu, Y. W., Chang, J. M., & Chen, H. C. (2020). Associations of Small Fiber Neuropathy with Geriatric Nutritional Risk Index and Arterial Stiffness in Hemodialysis. Disease markers, 2020, 1694218. https://doi.org/10.1155/2020/1694218

Lauria, G., Dacci, P., Lombardi, R., Cazzato, D., Porretta-Serapiglia, C., Taiana, M., Sassone, J., Dalla Bella, E., Rinaldo, S., Lettieri, C., Eleopra, R., & Devigili, G. (2015). Side and time variability of intraepidermal nerve fiber density. Neurology, 84(23), 2368–2371. https://doi.org/10.1212/WNL.0000000000001666

Leite-Cavalcanti, C., Rodrigues-Gonçalves, Mda. C., Rios-Asciutti, L. S., Leite-Cavalcanti, A. (2009). Prevalência de doenças crônicas e estado nutricional em um grupo de idosos brasileiros. Rev Salud Publica, 11(6), 865-877. https://doi.org/10.1590/s0124-00642009000600003

Low, V. A., Sandroni, P., Fealey, R. D., & Low, P. A. (2006). Detection of small-fiber neuropathy by sudomotor testing. Muscle & nerve, 34(1), 57–61. https://doi.org/10.1002/mus.20551

McArthur J. C. (2012). Painful small fiber neuropathies. Continuum (Minneapolis, Minn.), 18(1), 106–125. https://doi.org/10.1212/01.CON.0000411570.79827.25

Medici, C., Barraza, G., Castillo, C. D., Morales, M., Schestatsky, P., Casanova-Mollà, J., & Valls-Sole, J. (2013). Disturbed sensory perception of changes in thermoalgesic stimuli in patients with small fiber neuropathies. Pain, 154(10), 2100–2107. https://doi.org/10.1016/j.pain.2013.06.034

Nolano, M., Provitera, V., Manganelli, F., Iodice, R., Stancanelli, A., Caporaso, G., Saltalamacchia, A., Califano, F., Lanzillo, B., Picillo, M., Barone, P., & Santoro, L. (2017). Loss of cutaneous large and small fibers in naive and l-dopa-treated PD patients. Neurology, 89(8), 776–784. https://doi.org/10.1212/WNL.0000000000004274

Pál, E., Fülöp, K., Tóth, P., Deli, G., Pfund, Z., Janszky, J., & Komoly, S. (2020). Small Fiber Neuropathy: Clinicopathological Correlations. Behavioural neurology, 2020, 8796519. https://doi.org/10.1155/2020/8796519

Parambil, J. G., Tavee, J. O., Zhou, L., Pearson, K. S., & Culver, D. A. (2011). Efficacy of intravenous immunoglobulin for small fiber neuropathy associated with sarcoidosis. Respiratory medicine, 105(1), 101–105. https://doi.org/10.1016/j.rmed.2010.09.015

Peltier, A., Smith, A. G., Russell, J. W., Sheikh, K., Bixby, B., Howard, J., Goldstein, J., Song, Y., Wang, L., Feldman, E. L., & Singleton, J. R. (2009). Reliability of quantitative sudomotor axon reflex testing and quantitative sensory testing in neuropathy of impaired glucose regulation. Muscle & nerve, 39(4), 529–535. https://doi.org/10.1002/mus.21210

Peters, M. J., Bakkers, M., Merkies, I. S., Hoeijmakers, J. G., van Raak, E. P., & Faber, C. G. (2013). Incidence and prevalence of small-fiber neuropathy: a survey in the Netherlands. Neurology, 81(15), 1356–1360. https://doi.org/10.1212/WNL.0b013e3182a8236e

Piscosquito, G., Provitera, V., Mozzillo, S., Caporaso, G., Borreca, I., Stancanelli, A., Manganelli, F., Santoro, L., & Nolano, M. (2021). The analysis of epidermal nerve fibre spatial distribution improves the diagnostic yield of skin biopsy. Neuropathology and applied neurobiology, 47(2), 210–217. https://doi.org/10.1111/nan.12651

Provitera, V., Gibbons, C. H., Wendelschafer-Crabb, G., Donadio, V., Vitale, D. F., Loavenbruck, A., Stancanelli, A., Caporaso, G., Liguori, R., Wang, N., Santoro, L., Kennedy, W. R., & Nolano, M. (2018). The role of skin biopsy in differentiating small-fiber neuropathy from ganglionopathy. European journal of neurology, 25(6), 848–853. https://doi.org/10.1111/ene.13608

Raasing, L. R. M., Vogels, O. J. M., Veltkamp, M., van Swol, C. F. P., & Grutters, J. C. (2021). Current View of Diagnosing Small Fiber Neuropathy. Journal of neuromuscular diseases, 8(2), 185–207. https://doi.org/10.3233/JND-200490

Saperstein D. S. (2020). Small Fiber Neuropathy. Neurologic clinics, 38(3), 607–618. https://doi.org/10.1016/j.ncl.2020.04.001

Schaefer, C., Mann, R., Sadosky, A., Daniel, S., Parsons, B., Nalamachu, S., Stacey, B. R., Tuchman, M., Anschel, A., & Nieshoff, E. (2014). Health status, function, productivity, and costs among individuals with idiopathic painful peripheral neuropathy with small fiber involvement in the United States: results from a retrospective chart review and cross-sectional survey. Journal of medical economics, 17(6), 394–407. https://doi.org/10.3111/13696998.2014.909439

Sène D. (2018). Small fiber neuropathy: Diagnosis, causes, and treatment. Joint bone spine, 85(5), 553–559. https://doi.org/10.1016/j.jbspin.2017.11.002

Teoh, H. L., Chow, A., & Wilder-Smith, E. P. (2008). Skin wrinkling for diagnosing small fibre neuropathy: comparison with epidermal nerve density and sympathetic skin response. Journal of neurology, neurosurgery, and psychiatry, 79(7), 835–837. https://doi.org/10.1136/jnnp.2007.140947

Thaisetthawatkul, P., Lyden, E., Americo Fernandes, J., Jr, & Herrmann, D. N. (2020). Prediabetes, diabetes, metabolic syndrome, and small fiber neuropathy. Muscle & nerve, 61(4), 475–479. https://doi.org/10.1002/mus.26825

Treister, R., Lodahl, M., Lang, M., Tworoger, S. S., Sawilowsky, S., & Oaklander, A. L. (2017). Initial Development and Validation of a Patient-Reported Symptom Survey for Small-Fiber Polyneuropathy. The journal of pain, 18(5), 556–563. https://doi.org/10.1016/j.jpain.2016.12.014

Truini, A., Spallone, V., Morganti, R., Tamburin, S., Zanette, G., Schenone, A., De Michelis, C., Tugnoli, V., Simioni, V., Manganelli, F., Dubbioso, R., Lauria, G., Lombardi, R., Jann, S., De Toni Franceschini, L., Tesfaye, S., Fiorelli, M., Spagnoli, A., Cruccu, G., & Neuropathic Pain Special Interest Group of the Italian Society of Neurology (2018). A cross-sectional study investigating frequency and features of definitely diagnosed diabetic painful polyneuropathy. Pain, 159(12), 2658–2666. https://doi.org/10.1097/j.pain.0000000000001378

Üçeyler, N., He, L., Schönfeld, D., Kahn, A. K., Reiners, K., Hilz, M. J., Breunig, F., & Sommer, C. (2011). Small fibers in Fabry disease: baseline and follow-up data under enzyme replacement therapy. Journal of the peripheral nervous system : JPNS, 16(4), 304–314. https://doi.org/10.1111/j.1529-8027.2011.00365.x

Uçeyler, N., Kafke, W., Riediger, N., He, L., Necula, G., Toyka, K. V., & Sommer, C. (2010). Elevated proinflammatory cytokine expression in affected skin in small fiber neuropathy. Neurology, 74(22), 1806–1813. https://doi.org/10.1212/WNL.0b013e3181e0f7b3

Uçeyler, N., Kafke, W., Riediger, N., He, L., Necula, G., Toyka, K. V., & Sommer, C. (2010). Elevated proinflammatory cytokine expression in affected skin in small fiber neuropathy. Neurology, 74(22), 1806–1813. https://doi.org/10.1212/WNL.0b013e3181e0f7b3

Veras, R. P., & Oliveira, M. (2018). Aging in Brazil: the building of a healthcare model. Envelhecer no Brasil: a construção de um modelo de cuidado. Ciencia & saude coletiva, 23(6), 1929–1936. https://doi.org/10.1590/1413-81232018236.04722018

Wu, S. W., Wang, Y. C., Hsieh, P. C., Tseng, M. T., Chiang, M. C., Chu, C. P., Feng, F. P., Lin, Y. H., Hsieh, S. T., & Chao, C. C. (2017). Biomarkers of neuropathic pain in skin nerve degeneration neuropathy: contact heat-evoked potentials as a physiological signature. Pain, 158(3), 516–525. https://doi.org/10.1097/j.pain.0000000000000791

Zhou L. (2019). Small Fiber Neuropathy. Seminars in neurology, 39(5), 570–577. https://doi.org/10.1055/s-0039-1688977

Zouari, H. G., Wahab, A., Ng Wing Tin, S., Sène, D., & Lefaucheur, J. P. (2019). The Clinical Features of Painful Small-Fiber Neuropathy Suggesting an Origin Linked to Primary Sjögren's Syndrome. Pain practice : the official journal of World Institute of Pain, 19(4), 426–434. https://doi.org/10.1111/papr.12763

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09/06/2023

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AGUIAR, A. B. .; DUARTE, I. A. .; NASCIMENTO, G. R. M. do .; JUCÁ NETO, J. de R. B. .; AGUIAR, A. B. .; LIMA, M. P. P. .; SANTIAGO, R. B. .; FERNANDES, A. C. .; SANTOS, J. C. C. dos . Prevalence of somatic small fiber neuropathy in elderly: a review. Research, Society and Development, [S. l.], v. 12, n. 6, p. e8412641978, 2023. DOI: 10.33448/rsd-v12i6.41978. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/41978. Acesso em: 3 may. 2024.

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Copyright (c) 2023 Alan Bessa Aguiar; Isabella Araujo Duarte; Gabriel Romão Mesquita do Nascimento; José de Ribamar Barroso Jucá Neto; André Bessa Aguiar; Micael Porto Portela Lima; Ruan Braga Santiago;. Alexandre Chaves Fernandes; Júlio César Claudino dos Santos

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