Corneal Confocal Microscopy Identifies Corneal Nerve Loss in Patients With Guillain–Barré Syndrome
Corresponding Author
Adnan Khan
Faculty of Health Sciences, Khyber Medical University, Peshawar, Pakistan
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Correspondence:
Adnan Khan ([email protected])
Rayaz A. Malik ([email protected])
Contribution: Conceptualization, Investigation, Methodology, Writing - original draft, Writing - review & editing, Funding acquisition, Data curation, Formal analysis, Software, Validation, Visualization
Search for more papers by this authorMohammed Alhatou
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Investigation, Data curation
Search for more papers by this authorLiaquat Ali
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Investigation, Data curation
Search for more papers by this authorGholam Adeli
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Investigation
Search for more papers by this authorGeorgios Ponirakis
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Contribution: Writing - review & editing
Search for more papers by this authorHoda Gad
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Contribution: Writing - review & editing
Search for more papers by this authorAbeer Sabry Safan
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Data curation
Search for more papers by this authorRashaa K. M. Aldabbagh
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Data curation
Search for more papers by this authorIoannis N. Petropoulos
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Contribution: Writing - review & editing
Search for more papers by this authorAli Alsalahat
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Data curation
Search for more papers by this authorCorresponding Author
Rayaz A. Malik
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Correspondence:
Adnan Khan ([email protected])
Rayaz A. Malik ([email protected])
Contribution: Conceptualization, Project administration, Funding acquisition, Resources, Writing - review & editing, Validation, Supervision, Methodology, Visualization
Search for more papers by this authorCorresponding Author
Adnan Khan
Faculty of Health Sciences, Khyber Medical University, Peshawar, Pakistan
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Correspondence:
Adnan Khan ([email protected])
Rayaz A. Malik ([email protected])
Contribution: Conceptualization, Investigation, Methodology, Writing - original draft, Writing - review & editing, Funding acquisition, Data curation, Formal analysis, Software, Validation, Visualization
Search for more papers by this authorMohammed Alhatou
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Investigation, Data curation
Search for more papers by this authorLiaquat Ali
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Investigation, Data curation
Search for more papers by this authorGholam Adeli
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Investigation
Search for more papers by this authorGeorgios Ponirakis
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Contribution: Writing - review & editing
Search for more papers by this authorHoda Gad
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Contribution: Writing - review & editing
Search for more papers by this authorAbeer Sabry Safan
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Data curation
Search for more papers by this authorRashaa K. M. Aldabbagh
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Data curation
Search for more papers by this authorIoannis N. Petropoulos
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Contribution: Writing - review & editing
Search for more papers by this authorAli Alsalahat
Department of Neurology, Neuroscience Institute, Hamad General Hospital, Doha, Qatar
Contribution: Data curation
Search for more papers by this authorCorresponding Author
Rayaz A. Malik
Weill Cornell Medicine-Qatar, Research Division, Doha, Qatar
Correspondence:
Adnan Khan ([email protected])
Rayaz A. Malik ([email protected])
Contribution: Conceptualization, Project administration, Funding acquisition, Resources, Writing - review & editing, Validation, Supervision, Methodology, Visualization
Search for more papers by this authorFunding: This work was supported by GBS/CIDP Foundation International.
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.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| mus28408-sup-0001-TableS1.docxWord 2007 document , 15 KB |
TABLE S1. Patient classification according to the Brighton criteria. |
| mus28408-sup-0002-TableS2.docxWord 2007 document , 21.7 KB |
TABLE S2. Diagnostic criteria for Guillain–Barré syndrome patients. |
| mus28408-sup-0003-TableS3.docxWord 2007 document , 30.8 KB |
TABLE S3. Nerve conduction studies in the Guillain–Barré syndrome patients. |
| mus28408-sup-0004-TableS4.docxWord 2007 document , 21.1 KB |
TABLE S4. Corneal nerve parameters in healthy controls and patients with Guillain–Barré syndrome. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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