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dc.contributor.authorKrämer, Heidrun H.
dc.contributor.authorBücker, Patrick
dc.contributor.authorJeibmann, Astrid
dc.contributor.authorRichter, Henning
dc.contributor.authorRosenbohm, Angela
dc.contributor.authorJeske, Johanna
dc.contributor.authorBaka, Panoraia
dc.contributor.authorGeber, Christian
dc.contributor.authorWassenberg, Matthias
dc.contributor.authorFangerau, Tanja
dc.contributor.authorKarst, Uwe
dc.contributor.authorSchänzer, Anne
dc.contributor.authorvan Thriel, Christoph
dc.date.accessioned2024-02-06T15:09:16Z
dc.date.available2024-02-06T15:09:16Z
dc.date.issued2023
dc.identifier.urihttps://jlupub.ub.uni-giessen.de//handle/jlupub/18954
dc.identifier.urihttp://dx.doi.org/10.22029/jlupub-18315
dc.description.abstractSmall fiber neuropathy (SFN) affects unmyelinated and thinly myelinated nerve fibers causing neuropathic pain with distal distribution and autonomic symptoms. In idiopathic SFN (iSFN), 30% of the cases, the underlying aetiology remains unknown. Gadolinium (Gd)-based contrast agents (GBCA) are widely used in magnetic resonance imaging (MRI). However, side-effects including musculoskeletal disorders and burning skin sensations were reported. We investigated if dermal Gd deposits are more prevalent in iSFN patients exposed to GBCAs, and if dermal nerve fiber density and clinical parameters are likewise affected. 28 patients (19 females) with confirmed or no GBCA exposure were recruited in three German neuromuscular centers. ISFN was confirmed by clinical, neurophysiological, laboratory and genetic investigations. Six volunteers (two females) served as controls. Distal leg skin biopsies were obtained according to European recommendations. In these samples Gd was quantified by elemental bioimaging and intraepidermal nerve fibers (IENF) density via immunofluorescence analysis. Pain phenotyping was performed in all patients, quantitative sensory testing (QST) only in a subset (15 patients; 54%). All patients reported neuropathic pain, described as burning (n = 17), jabbing (n = 16) and hot (n = 11) and five QST scores were significantly altered. Compared to an equal distribution significantly more patients reported GBCA exposures (82%), while 18% confirmed no exposures. Compared to unexposed patients/controls significantly increased Gd deposits and lower z-scores of the IENF density were confirmed in exposed patients. QST scores and pain characteristics were not affected. This study suggests that GBCA exposure might alter IENF density in iSFN patients. Our results pave the road for further studies investigating the possible role of GBCA in small fiber damage, but more investigations and larger samples are needed to draw firm conclusions.
dc.language.isoen
dc.rightsNamensnennung 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subject.ddcddc:610
dc.titleGadolinium contrast agents: dermal deposits and potential effects on epidermal small nerve fibers
dc.typearticle
local.affiliationFB 11 - Medizin
local.source.spage3981
local.source.epage3991
local.source.journaltitleJournal of neurology
local.source.volume270
local.source.urihttps://doi.org/10.1007/s00415-023-11740-z


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