Corneal Confocal Microscopy Detects Small Fibre Neuropathy in Patients with Upper Gastrointestinal Cancer and Nerve Regeneration in Chemotherapy Induced Peripheral Neuropathy.

Ferdousi, Maryam ORCID: 0000-0002-7989-8233, Azmi, Shazli ORCID: 0000-0002-1789-6988, Petropoulos, Ioannis Nikolaos, Fadavi, Hassan, Ponirakis, Georgios ORCID: 0000-0002-6936-1248, Marshall, Andrew ORCID: 0000-0001-8273-7089, Tavakoli, Mitra ORCID: 0000-0003-2319-1543, Malik, Imaan, Mansoor, Wasat and Malik, Rayaz Ahmed (2015) Corneal Confocal Microscopy Detects Small Fibre Neuropathy in Patients with Upper Gastrointestinal Cancer and Nerve Regeneration in Chemotherapy Induced Peripheral Neuropathy. PloS one, 10 (10). e0139394-.

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Official URL: http://dx.doi.org/10.1371/journal.pone.0139394

Abstract

There are multiple neurological complications of cancer and its treatment. This study assessed the utility of the novel non-invasive ophthalmic technique of corneal confocal microscopy in identifying neuropathy in patients with upper gastrointestinal cancer before and after platinum based chemotherapy. In this study, 21 subjects with upper gastrointestinal (oesophageal or gastric) cancer and 21 healthy control subjects underwent assessment of neuropathy using the neuropathy disability score, quantitative sensory testing for vibration perception threshold, warm and cold sensation thresholds, cold and heat induced pain thresholds, nerve conduction studies and corneal confocal microscopy. Patients with gastro-oesophageal cancer had higher heat induced pain (P = 0.04) and warm sensation (P = 0.03) thresholds with a significantly reduced sural sensory (P<0.01) and peroneal motor (P<0.01) nerve conduction velocity, corneal nerve fibre density (CNFD), nerve branch density (CNBD) and nerve fibre length (CNFL) (P<0.0001). Furthermore, CNFD correlated significantly with the time from presentation with symptoms to commencing chemotherapy (r = -0.54, P = 0.02), and CNFL (r = -0.8, P<0.0001) and CNBD (r = 0.63, P = 0.003) were related to the severity of lymph node involvement. After the 3rd cycle of chemotherapy, there was no change in any measure of neuropathy, except for a significant increase in CNFL (P = 0.003). Corneal confocal microscopy detects a small fibre neuropathy in this cohort of patients with upper gastrointestinal cancer, which was related to disease severity. Furthermore, the increase in CNFL after the chemotherapy may indicate nerve regeneration.

Item Type:	Article
Uncontrolled Keywords:	Nerve Fibers, Cornea, Humans, Esophageal Neoplasms, Stomach Neoplasms, Liver Neoplasms, Hyperalgesia, Erythromelalgia, Cisplatin, Organoplatinum Compounds, Epirubicin, Antineoplastic Agents, Alkylating, Antineoplastic Combined Chemotherapy Protocols, Microscopy, Confocal, Pain Threshold, Nerve Regeneration, Neural Conduction, Vibration, Aged, Middle Aged, Female, Male, Cold Temperature, Hot Temperature, Capecitabine, Trastuzumab, Oxaliplatin
Depositing User:	Symplectic Admin
Date Deposited:	25 Jul 2019 09:30
Last Modified:	15 Mar 2024 19:36
DOI:	10.1371/journal.pone.0139394
Open Access URL:	https://journals.plos.org/plosone/article?id=10.13...
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3050276