{"title":"Identification of small fiber neuropathy in neuronal intranuclear inclusion disease: A clinicopathological study","authors":"Minglei Liu, Ruoyu Liu, Yanpeng Yuan, Xiaojing Liu, Lanjun Li, Yangyang Wang, Jing Yuan, Ke Zhang, Shuo Li, Ting Yang, Yanlin Wang, Yuan Gao, Han Liu, Yinge Xue, Lin Cheng, Tianyuan Yang, Ying Kong, Chen Liu, Yanjiang Wang, Yuming Xu, Jing Yang","doi":"10.1002/alz.14596","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> INTRODUCTION</h3>\n \n <p>Neuronal intranuclear inclusion disease (NIID) manifests as dementia combined with other neurological symptoms. However, small fiber neuropathy (SFN) and pathology remain unknown in NIID.</p>\n </section>\n \n <section>\n \n <h3> METHODS</h3>\n \n <p>A total of 294 subjects, including patients with NIID, Parkinson's disease, Alzheimer's disease, diabetic peripheral neuropathy, and healthy controls (HCs), were included. Clinical scales, sensory and autonomic function testing, and skin biopsy were performed.</p>\n </section>\n \n <section>\n \n <h3> RESULTS</h3>\n \n <p>NIID patients had more severe sensory and autonomic dysfunction than other groups. Substantial reductions in intraepidermal, sweat gland, and pilomotor nerve fiber densities were observed in NIID patients, with a non–length dependent pattern. Detailed analysis revealed marked reductions in noradrenergic, cholinergic, peptidergic, and regenerative nerve fibers. Small fiber densities showed high diagnostic accuracy in distinguishing NIID from HCs and other diseases.</p>\n </section>\n \n <section>\n \n <h3> DISCUSSION</h3>\n \n <p>This study is the first to reveal wide and severe loss of small fibers in NIID, suggesting the involvement of SFN in the pathogenesis of NIID.</p>\n </section>\n \n <section>\n \n <h3> Highlights</h3>\n \n <div>\n <ul>\n \n <li>Our study is the first to identify wide and severe non–length dependent small fiber neuropathy in neuronal intranuclear inclusion disease (NIID) patients.</li>\n \n <li>Approximately 50% of NIID patients exhibited pure small fiber neuropathy without large fiber or mixed neuropathy.</li>\n \n <li>NIID patients showed a significant reduction in noradrenergic, cholinergic, peptidergic, and regenerative fiber innervation.</li>\n \n <li>Small fiber densities, especially intraepidermal nerve fiber density, demonstrated high diagnostic accuracy in distinguishing NIID patients from healthy controls and other disease groups.</li>\n \n <li>Findings suggest that small fiber neuropathy may play a role in the pathogenesis of NIID.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 2","pages":""},"PeriodicalIF":13.0000,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.14596","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer's & Dementia","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/alz.14596","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Identification of small fiber neuropathy in neuronal intranuclear inclusion disease: A clinicopathological study
INTRODUCTION
Neuronal intranuclear inclusion disease (NIID) manifests as dementia combined with other neurological symptoms. However, small fiber neuropathy (SFN) and pathology remain unknown in NIID.
METHODS
A total of 294 subjects, including patients with NIID, Parkinson's disease, Alzheimer's disease, diabetic peripheral neuropathy, and healthy controls (HCs), were included. Clinical scales, sensory and autonomic function testing, and skin biopsy were performed.
RESULTS
NIID patients had more severe sensory and autonomic dysfunction than other groups. Substantial reductions in intraepidermal, sweat gland, and pilomotor nerve fiber densities were observed in NIID patients, with a non–length dependent pattern. Detailed analysis revealed marked reductions in noradrenergic, cholinergic, peptidergic, and regenerative nerve fibers. Small fiber densities showed high diagnostic accuracy in distinguishing NIID from HCs and other diseases.
DISCUSSION
This study is the first to reveal wide and severe loss of small fibers in NIID, suggesting the involvement of SFN in the pathogenesis of NIID.
Highlights
Our study is the first to identify wide and severe non–length dependent small fiber neuropathy in neuronal intranuclear inclusion disease (NIID) patients.
Approximately 50% of NIID patients exhibited pure small fiber neuropathy without large fiber or mixed neuropathy.
NIID patients showed a significant reduction in noradrenergic, cholinergic, peptidergic, and regenerative fiber innervation.
Small fiber densities, especially intraepidermal nerve fiber density, demonstrated high diagnostic accuracy in distinguishing NIID patients from healthy controls and other disease groups.
Findings suggest that small fiber neuropathy may play a role in the pathogenesis of NIID.
期刊介绍:
Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.