Exploring Small Fiber Neuropathy in Multiple Sclerosis: Implications for Understanding Neuropathic Pain and Autonomic Symptoms
Research presented at AAN 2024 aims to characterize the presentation of small fiber neuropathy (SFN) in people with multiple sclerosis (pwMS) experiencing neuropathic pain and/or dysautonomia, as previous research has primarily focused on central lesions and large fiber peripheral neuropathies in this population.
Twenty-eight patients with MS and neuropathic pain and/or autonomic symptoms were evaluated for SFN at a single center. Skin samples were taken from both proximal and distal sites in the lower extremity for analysis of nerve fiber density, with symptoms assessed using the MGH Small-Fiber Symptom Survey (MGH SSS).
Eighteen people had significantly reduced nerve fiber density in 1 of the biopsied sites, while 2 had low-normal values, and 8 had normal densities. The majority of those with reduced nerve fiber density were female, with an average disease duration of 5 years. Symptom severity scores ranged from 17 to 85, according to MGH SSS results.
“This small case series indicates small fiber neuropathy as a potential cause of neuropathic pain and dysautonomia in pwMS,” said researchers. “Symptoms of SFN and dysautonomia have a wide range of manifestations in this population. A larger study population is needed to further characterize the true prevalence of SFN in pwMS with neuropathic pain and dysautonomia, and to investigate potential mechanisms.”
Reference
Reyes K, Kelley M, Ahmed S, Freeman L. Characteristics of small fiber neuropathy in a cohort of multiple sclerosis patients with neuropathic pain and/or autonomic dysfunction. Presented at: the American Academy of Neurology 2024 Annual Meeting; October 25-27; Paradise, NV; Abstract S7.010.
