角膜共焦显微镜检查可识别吉兰-巴雷综合征患者的角膜神经损伤。

Corneal Confocal Microscopy Identifies Corneal Nerve Loss in Patients With Guillain-Barré Syndrome.

作者信息

Khan Adnan, Alhatou Mohammed, Ali Liaquat, Adeli Gholam, Ponirakis Georgios, Gad Hoda, Safan Abeer Sabry, Aldabbagh Rashaa K M, Petropoulos Ioannis N, Alsalahat Ali, Malik Rayaz A

机构信息

Faculty of Health Sciences, Khyber Medical University, Peshawar, Pakistan.

Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar.

出版信息

Muscle Nerve. 2025 Jul;72(1):119-123. doi: 10.1002/mus.28408. Epub 2025 Apr 1.

DOI:10.1002/mus.28408

PMID:40166899

Abstract

INTRODUCTION/AIMS: Patients with Guillain-Barré syndrome (GBS) commonly present with sensory loss and weakness, but they may also have neuropathic pain, elevated thermal thresholds, and intraepidermal nerve fiber loss. The primary aim of this study was to assess for evidence of small nerve fiber damage in patients with GBS. METHODS: Nine patients with GBS and 15 age-matched healthy controls underwent CCM to quantify corneal nerve fiber density (CNFD), corneal nerve fiber length (CNFL), and corneal nerve branch density (CNBD), Douleur Neuropathique en 4 (DN4) to assess neuropathic pain, electrochemical skin conductance (ESC), vibration perception threshold (VPT), and nerve conduction studies.

RESULTS

CNFD (p = 0.008), CNFL (p = 0.011), CNBD (p = 0.005), and ESC on the hands (p = 0.024) and the feet (p = 0.046) were lower, whereas DN4 (p = 0.007) was higher in patients with GBS compared to healthy controls.

DISCUSSION

Patients with GBS have evidence of small nerve fiber damage as evidenced by corneal nerve fiber loss, neuropathic pain, and sudomotor dysfunction. CCM may add to the toolbox for the evaluation of small nerve fiber involvement in patients with GBS.

摘要

引言/目的：吉兰-巴雷综合征（GBS）患者通常表现为感觉丧失和肌无力，但也可能出现神经性疼痛、热阈值升高和表皮内神经纤维缺失。本研究的主要目的是评估GBS患者小神经纤维损伤的证据。方法：9例GBS患者和15例年龄匹配的健康对照者接受共焦角膜显微镜检查（CCM）以量化角膜神经纤维密度（CNFD）、角膜神经纤维长度（CNFL）和角膜神经分支密度（CNBD），采用神经病理性疼痛4问卷（DN4）评估神经性疼痛，进行电化学皮肤电导（ESC）、振动觉阈值（VPT）和神经传导研究。结果：与健康对照者相比，GBS患者的CNFD（p = 0.008）、CNFL（p = 0.011）、CNBD（p = 0.005）以及手部（p = 0.024）和足部（p = 0.046）的ESC较低，而DN4（p = 0.007）较高。讨论：GBS患者存在小神经纤维损伤的证据，表现为角膜神经纤维缺失、神经性疼痛和汗腺功能障碍。CCM可能会成为评估GBS患者小神经纤维受累情况的工具之一。