Assessment of chemotherapy‐induced peripheral neuropathy using the LDIFLARE technique: a novel technique to detect neural small fiber dysfunction

Brain and Behavior

Sanjeev Sharma²  Ramachandran Venkitaraman¹  Prashanth R. J. Vas² 

[1] Department of Clinical Oncology, The Ipswich Hospital NHS Trust, Ipswich, UK;Diabetes Research Unit, The Ipswich Hospital NHS Trust, Ipswich, UK

关键词: CIPN;    EORTC;    LDIFLARE;    nerve conduction velocity and amplitude;    QLQ‐CIPN20;   

DOI  :  10.1002/brb3.354

来源: Wiley

【 摘 要 】

Abstract

Introduction

The diagnosis and quantification of chemotherapy-induced peripheral neuropathy (CIPN) remains a challenge. Conventional methods including quantitative sensory testing (QST), nerve conduction tests, and biopsy are unable to detect subclinical changes, and do not consistently correlate with severity of patients' symptoms and functional impairment. This study aims to determine the utility of the LDI (laser Doppler imager) _FLARE technique in the diagnosis of CIPN and whether it correlates with symptom severity.

Materials and Methods

We assessed 24 patients with established CIPN [12 due to platinum analogs (P_A) and 12 to Taxanes (T_X)] and 24 matched healthy controls (H_C). All underwent neurophysiological examination including vibration perception threshold (VPT), sural nerve amplitude (SNAP) and conduction velocity (SNCV), LDI_FLARE, and fasting biochemistry. The QLQ-CIPN20 questionnaire was used to assess symptom severity.

Results

H_C, combined chemotherapy (C_G), P_A, and T_X groups were matched for age, sex, BMI, and blood pressure. The LDI_FLARE was significantly reduced in C_G compared to H_C (P =< 0.0001), whereas SNAP (P = 0.058) and SNCV (P = 0.054) were not. The LDI_FLARE correlated with the QLQ-CIPN20 symptom scores in all three categories namely, C_G (P =< 0.0001), P_A (P = 0.001) and T_X (P = 0.027) whilst, VPT, SNAP, and SNCV did not.

Conclusion

Our findings suggest that the LDI_FLARE technique is more helpful in confirming the diagnosis of CIPN in patients with distal sensory symptoms than current commonly used methods. Moreover, this novel test fulfils the unmet need for a diagnostic test that relates to the severity of symptoms. This may be useful in quantifying early changes in small fibre function indicating early CIPN.

【 授权许可】

CC BY   
© 2015 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

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