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Improving the clinical usefulness of skin biopsy in small fiber neuropathy: examining the intraepidermal nerve fiber density dynamic longitudinally and the importance of adding the proximal/distal ratio

Improving the clinical usefulness of skin biopsy in small fiber neuropathy: examining the intraepidermal nerve fiber density dynamic longitudinally and the importance of adding the proximal/distal ratio - Improving the clinical usefulness of skin biopsy in small fiber neuropathy

Status
Active, not recruiting
Phases
Unknown
Study type
Observational
Source
NL-OMON
Registry ID
NL-OMON53010
Enrollment
280
Registered
2016-12-28
Start date
2018-11-26
Completion date
Unknown
Last updated
2026-06-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

small fiber neuropathy

Interventions

None listed

Sponsors

Medisch Universitair Ziekenhuis Maastricht
Lead Sponsor

Eligibility

Age
18 Years to 99 Years

Inclusion criteria

Inclusion criteria: Group 1 (n=40) Idiopathic SFN, with normal IENFD: a) Male and female subjects of 18 years or older. b) >=2 positive answers on the SFN-SIQ, not otherwise explained. c) Normal IENFD and abnormal TTT, according to the international normative values,3,23 during the regular visit in our clinical center at least one year ago. d) Written informed consent.Group 2 (n = 40) Sodium channelopathy-related SFN, with normal IENFD: a) Male and female subjects of 18 years or older. b) >=2 positive answers on the SFN-SIQ, not otherwise explained. c) Normal IENFD and abnormal TTT, according to the international normative values,3,23 during the regular visit in our clinical center at least one year ago. d) Possibly pathogenic, probably pathogenic or pathogenic NaV1.7, Nav1.8 and/or NaV1.9 variant a) Written informed consent.Group 3 (n=140) Healthy subjects (only proximal/distal IENFD ratio study) a) Male and female subjects of 18 years or older. b) Written informed consent.Group 4 (n = 20) Idiopathic SFN, with abnormal IENFD (only proximal/distal IENFD ratio study) a) Male and female subjects of 18 years or older. b) >=2 positive answers on the SFN-SIQ, not otherwise explained. c) Abnormal IENFD, according to the international normative values, during the regular visit in our clinical center at least one year ago. d) Written informed consent.When it appears that the proximal/distal ratio is abnormal in patients with an abnormal TTT, but normal IENFD, the study will be extended with an extra group of patients:Group 5 (n=40) Idiopathic clinical SFN, with both normal IENFD and TTT a) Male and female subjects of 18 years or older. b) >=5 positive answers on the SFN-SIQ, not otherwise explained. c) Patients with a normal IENFD and normal TTT, according to the international normative values, during the regular visit in our clinical center at least one year ago.

Exclusion criteria

Exclusion criteria: All patient groups: a) Underlying cause of SFN (diabetes, hypothyroidism, renal failure, vitamin B12 deficiency, monoclonal gammopathy, alcohol abuse (more than 5 IU/day), malignancies, drugs that cause neuropathy (e.g. chemotherapy, amiodarone, propafenone)). b) Large nerve fiber involvement (i.e. weakness, loss of vibration sense, hypo-/areflexia, abnormal nerve conduction studies).Groups 1, 4 and 5 a) Possibly pathogenic, probably pathogenic or pathogenic NaV1.7, Nav1.8 and/or NaV1.9 variant.Healthy subjects a) >1 positive answer on the SFN-SIQ. b) A history of peripheral neuropathy. c) Signs of peripheral neuropathy in neurological examination.nt claCC

Design outcomes

Primary

MeasureTime frame
- Current IENFD at the ankle compared with the IENFD that has been taken during the regular visit, at least one year before. The degree of IENFD decrease or increase over time (corrected for expected age-dependent decline) will be computed. Furthermore, the percentage of IENFD results that turn from normal into abnormal will be calculated. - Proximal/distal IENFD ratio normative values. - The proximal/distal IENFD ratio compared between SFN patients and healthy subjects.

Secondary

MeasureTime frame
- Change in number of complaints on the SFN-SIQ related to IENFD alteration. - Number of complaints on the SFN-SIQ related to proximal/distal IENFD ratio. - Change in VAS related to IENFD alteration. - VAS-score related to proximal/distal IENFD ratio. - Changes on NPS related to IENFD alteration. - NPS-score related to proximal/distal IENFD ratio. - The value of abnormal TTT at baseline as predictor of abnormal IENFD in future.

Countries

Netherlands

Outcome results

None listed

Source: NL-OMON (via WHO ICTRP) · Data processed: Jun 27, 2026