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Small fiber pathology in autism and clinical implications.
- Source :
-
Neurology [Neurology] 2020 Nov 10; Vol. 95 (19), pp. e2697-e2706. Date of Electronic Publication: 2020 Oct 14. - Publication Year :
- 2020
-
Abstract
- Objective: To investigate small fiber innervation of the skin and its relationships with clinicometry of autism and peripheral afferents for contact heat-evoked potential (CHEP) and psychophysical measures of thermal thresholds.<br />Methods: We recruited 32 men with autism (26.5 ± 5.9 years) and conducted small fiber assessments of skin biopsy with quantifying intraepidermal nerve fiber (IENF) density, CHEP, quantitative sensory testing, and large fiber physiology of nerve conduction studies. Results were compared with age-matched controls and analyzed with clinical measures of autism.<br />Results: Patients with autism showed a lower IENF density than controls (5.53 ± 2.09 vs 11.13 ± 3.49 fibers/mm, p < 0.0001). The IENF density was reduced in 17 (53.1%) men with autism classified as skin denervation group. On psychophysics, 9 (28%) men with autism had elevated thermal thresholds, and the warm threshold of the big toe was negatively correlated with IENF density ( p = 0.0073), indicating functional impairments of small fiber sensory nerves. IENF density was negatively correlated with CHEP amplitude in autism ( p = 0.003), in contrast to the pattern of positive correlation in controls, indicating different processing of nociceptive afferent in autism. Clinically, IENF density was related to distinct tactile symptom patterns in the skin denervation vs normal innervation group, respectively. Furthermore, IENF density was associated with autistic symptoms measured by the Autism Spectrum Quotient in a U-shaped model ( p = 0.014).<br />Conclusions: These observations indicated that a substantial portion of individuals with autism had small fiber pathology, which was associated with tactile and autistic symptoms, providing structural and physiologic evidence for the involvement of peripheral sensory nerves in autism.<br /> (© 2020 American Academy of Neurology.)
- Subjects :
- Adult
Case-Control Studies
Electrodiagnosis
Epidermis innervation
Humans
Male
Pain Threshold
Sensory Thresholds
Young Adult
Autistic Disorder physiopathology
Epidermis pathology
Evoked Potentials, Somatosensory physiology
Hot Temperature
Nerve Fibers pathology
Neural Conduction physiology
Nociception physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1526-632X
- Volume :
- 95
- Issue :
- 19
- Database :
- MEDLINE
- Journal :
- Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 33055277
- Full Text :
- https://doi.org/10.1212/WNL.0000000000010932