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Abstract：
To elucidate Aδ-fiber dysfunction at the trunk in patients with hereditary transthyretin (ATTRm) amyloidosis using intra-epidermal electrical stimulation (IES).
In 16 patients with ATTRm amyloidosis and 18 healthy subjects, sensory thresholds using IES and cooling detection thresholds using the Computer-Aided Sensory Evaluation (CASE IV) system, were assessed to investigate Aδ-fiber functions at the Th10 level of the anterior, lateral, and posterior trunk. Furthermore, evoked potentials (EPs) following electrical stimulation using IES at the anterior and posterior trunk were evaluated.
In patients with ATTRm amyloidosis, both IES and CASE IV sensory thresholds tended to be higher at the anterior trunk than at the lateral and posterior trunks. The amplitudes of EPs following electrical stimulation at the anterior trunk were lower than those at the posterior trunk. Aδ-fiber dysfunction at the anterior trunk was conspicuous in patients with more intense polyneuropathy at the limbs. In healthy subjects, there were no differences in both sensory thresholds and EP amplitudes among any examination sites. Sensory thresholds with IES and CASE IV were correlated.
Evaluation using IES demonstrated length-dependent Aδ-fiber dysfunction at the trunk in patients with ATTRm amyloidosis.
IES may be a useful clinical tool for investigating Aδ-fiber dysfunction at various parts of the body in patients with neuropathy.
In 16 patients with ATTRm amyloidosis and 18 healthy subjects, sensory thresholds using IES and cooling detection thresholds using the Computer-Aided Sensory Evaluation (CASE IV) system, were assessed to investigate Aδ-fiber functions at the Th10 level of the anterior, lateral, and posterior trunk. Furthermore, evoked potentials (EPs) following electrical stimulation using IES at the anterior and posterior trunk were evaluated.
In patients with ATTRm amyloidosis, both IES and CASE IV sensory thresholds tended to be higher at the anterior trunk than at the lateral and posterior trunks. The amplitudes of EPs following electrical stimulation at the anterior trunk were lower than those at the posterior trunk. Aδ-fiber dysfunction at the anterior trunk was conspicuous in patients with more intense polyneuropathy at the limbs. In healthy subjects, there were no differences in both sensory thresholds and EP amplitudes among any examination sites. Sensory thresholds with IES and CASE IV were correlated.
Evaluation using IES demonstrated length-dependent Aδ-fiber dysfunction at the trunk in patients with ATTRm amyloidosis.
IES may be a useful clinical tool for investigating Aδ-fiber dysfunction at various parts of the body in patients with neuropathy.
摘要：
使用表皮内电刺激（IES）阐明遗传性甲状腺素运载蛋白（ATTRm）淀粉样变性患者躯干的Aδ纤维功能障碍。
在16例ATTRm淀粉样变性患者和18例健康受试者中，使用IES的感觉阈值和使用计算机辅助感觉评估（案例IV）系统的冷却检测阈值，进行了评估，以调查Aδ-纤维功能在前，Th10水平，横向,和后躯干。此外，评估了在前躯干和后躯干使用IES进行电刺激后的诱发电位（EP）。
在ATTRm淀粉样变性患者中，IES和CASEIV感觉阈值在前躯干的倾向高于外侧和后躯干。前躯干电刺激后EP的幅度低于后躯干。在四肢多发性神经病更严重的患者中，前躯干的Aδ纤维功能障碍很明显。在健康的受试者中，所有检查部位的感觉阈值和EP振幅均无差异.感觉阈值与IES和CASEIV相关。
使用IES进行的评估显示了ATTRm淀粉样变性患者躯干的长度依赖性Aδ纤维功能障碍。
IES可能是研究神经病变患者身体各个部位的Aδ-纤维功能障碍的有用临床工具。
在16例ATTRm淀粉样变性患者和18例健康受试者中，使用IES的感觉阈值和使用计算机辅助感觉评估（案例IV）系统的冷却检测阈值，进行了评估，以调查Aδ-纤维功能在前，Th10水平，横向,和后躯干。此外，评估了在前躯干和后躯干使用IES进行电刺激后的诱发电位（EP）。
在ATTRm淀粉样变性患者中，IES和CASEIV感觉阈值在前躯干的倾向高于外侧和后躯干。前躯干电刺激后EP的幅度低于后躯干。在四肢多发性神经病更严重的患者中，前躯干的Aδ纤维功能障碍很明显。在健康的受试者中，所有检查部位的感觉阈值和EP振幅均无差异.感觉阈值与IES和CASEIV相关。
使用IES进行的评估显示了ATTRm淀粉样变性患者躯干的长度依赖性Aδ纤维功能障碍。
IES可能是研究神经病变患者身体各个部位的Aδ-纤维功能障碍的有用临床工具。
