University of Twente Student Theses


Characterization of chemotherapy and sarcoidosis induced peripheral neuropathy through combined nociceptive detection thresholds and brain responses

Rienks, L.J. (2021) Characterization of chemotherapy and sarcoidosis induced peripheral neuropathy through combined nociceptive detection thresholds and brain responses.

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Abstract:Introduction. Small fiber neuropathies (SFN) are a diverse group of disorders affecting thinly myelinated Aδ-fibres and unmyelinated C-Fibres. The cause of SFN up to 50% of the cases remains unknown. An intriguing candidate for this purpose is a novel measurement approach ('NDT-EP'), which allows for the evaluation of tracked reactions and evoked potentials (EP) in response to intraepidermal electrical stimuli. The preliminary results of the MTT-EP technique in diabetic patients with SFN are encouraging. As a result, the feasibility and efficacy of this technique in CIPN and sarcoidosis patients were studied. Methods. The participants were split into four groups. The first group was made up of two groups of persons who were both healthy and pain-free. The second case involved CIPN patients. The third group consisted of sarcoidosis patients with SFN symptoms. The EPs and stimulus detection probabilities were obtained by stimulating the dorsa of the hands. Data from prior research of healthy persons was utilized as a control. (Generalized) linear mixed regression was used to compare measurement outcomes between study groups. Results. The study included 18 healthy patients matched to the CIPN group (average age: 56.3 ± 11.1 years, 18 females), 18 CIPN patients (average age: 58 ± 10.1, 18 females), 19 sarcoidosis patients (average age: 50.2 ± 12.5, 12 females), and sarcoidosis patients (average age: 49.6 ± 10.9, 12 females). There were no significant differences in detection probability between CIPN patients and healthy control data. Sarcoidosis patients had a significant decreased detection probability (P < 0.05) when compared to healthy control data. EPs produced equivalent results, with smaller amplitudes for CIPN (P < 0.05 for Double pulses with a 10ms inter-pulse interval) and sarcoidosis (P < 0.05 for Double pulses). Conclusions. According to the study, NDT-EP assessments are generally accurate and so appear to be feasible in CIPN and sarcoidosis patients with a variety of neuropathic symptoms. They reveal that patient outcomes differ from healthy controls in terms of latency and amplitude anomalies, as well as modified nociceptive detection thresholds. On the other hand, there is currently limited evidence that altered detection probabilities reflect the same condition. Overall, our findings suggest that (parts of) this technique may be useful in the future search for quantitative small fiber diagnostic markers. More study is needed to investigate demographic characteristics, experiment with other measurement settings, and test the approach in other diseases defined by SFN and chronic pain syndromes.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:02 science and culture in general, 42 biology, 44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
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