Subclinical peripheral neuropathy in patients with multiple myeloma before chemotherapy is correlated with decreased fingertip innervation density

Alyssa K. Kosturakis, Zijing He, Yan Li, Jessica A. Boyette-Davis, Nina Shah, Sheeba K. Thomas, Haijun Zhang, Elisabeth G. Vichaya, Xin Shelley Wang, Gwen Wendelschafer-Crabb, William R Kennedy, Donald A Simone, Charles S. Cleeland, Patrick M. Dougherty

Research output: Contribution to journalArticle

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Abstract

Purpose: The goal in this study was to determine the incidence of subclinical neuropathy in treatment-naive patients with multiple myeloma (MM) with no history of peripheral neuropathy using quantitative sensory tests (QSTs) and its correlation with innervation density of the extremities using noninvasive laser reflectance confocal microscopy.

Conclusion: Patients with MM commonly present with sensory and sensorimotor deficits before undergoing treatment, and these deficits seem to result from disease-related decreases in peripheral innervation density.

Patients and Methods: QST results were collected for 27 patients with a diagnosis of MM and compared with data collected from 30 age-and sex-matched healthy volunteers. Skin temperature, sensorimotor function (grooved pegboard test), and detection thresholds for temperature, sharpness, and low-threshold mechanical stimuli (von Frey monofilaments and bumps detection test) were measured. Meissner's corpuscle (MC) density in the fingertips was assessed using in vivo laser reflectance confocal microscopy.

Results: Patients showed a high incidence (> 80%) of ≥ one subclinical QST deficit. These included increased von Frey, bumps, and warmth detection thresholds as compared with healthy volunteers. Patients also showed increases in cold pain, sensorimotor deficits (grooved pegboard test), and higher overall neuropathy scores. MC density was significantly lower in patients than controls and showed significant inverse correlation with bumps detection threshold.

Original languageEnglish (US)
Pages (from-to)3156-3162
Number of pages7
JournalJournal of Clinical Oncology
Volume32
Issue number28
DOIs
StatePublished - Oct 1 2014

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Peripheral Nervous System Diseases
Multiple Myeloma
Drug Therapy
Mechanoreceptors
Confocal Microscopy
Healthy Volunteers
Lasers
Skin Temperature
Incidence
Extremities
Pain
Temperature
Therapeutics

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Subclinical peripheral neuropathy in patients with multiple myeloma before chemotherapy is correlated with decreased fingertip innervation density. / Kosturakis, Alyssa K.; He, Zijing; Li, Yan; Boyette-Davis, Jessica A.; Shah, Nina; Thomas, Sheeba K.; Zhang, Haijun; Vichaya, Elisabeth G.; Wang, Xin Shelley; Wendelschafer-Crabb, Gwen; Kennedy, William R; Simone, Donald A; Cleeland, Charles S.; Dougherty, Patrick M.

In: Journal of Clinical Oncology, Vol. 32, No. 28, 01.10.2014, p. 3156-3162.

Research output: Contribution to journalArticle

Kosturakis, AK, He, Z, Li, Y, Boyette-Davis, JA, Shah, N, Thomas, SK, Zhang, H, Vichaya, EG, Wang, XS, Wendelschafer-Crabb, G, Kennedy, WR, Simone, DA, Cleeland, CS & Dougherty, PM 2014, 'Subclinical peripheral neuropathy in patients with multiple myeloma before chemotherapy is correlated with decreased fingertip innervation density', Journal of Clinical Oncology, vol. 32, no. 28, pp. 3156-3162. https://doi.org/10.1200/JCO.2013.54.5418
Kosturakis, Alyssa K. ; He, Zijing ; Li, Yan ; Boyette-Davis, Jessica A. ; Shah, Nina ; Thomas, Sheeba K. ; Zhang, Haijun ; Vichaya, Elisabeth G. ; Wang, Xin Shelley ; Wendelschafer-Crabb, Gwen ; Kennedy, William R ; Simone, Donald A ; Cleeland, Charles S. ; Dougherty, Patrick M. / Subclinical peripheral neuropathy in patients with multiple myeloma before chemotherapy is correlated with decreased fingertip innervation density. In: Journal of Clinical Oncology. 2014 ; Vol. 32, No. 28. pp. 3156-3162.
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abstract = "Purpose: The goal in this study was to determine the incidence of subclinical neuropathy in treatment-naive patients with multiple myeloma (MM) with no history of peripheral neuropathy using quantitative sensory tests (QSTs) and its correlation with innervation density of the extremities using noninvasive laser reflectance confocal microscopy.Conclusion: Patients with MM commonly present with sensory and sensorimotor deficits before undergoing treatment, and these deficits seem to result from disease-related decreases in peripheral innervation density.Patients and Methods: QST results were collected for 27 patients with a diagnosis of MM and compared with data collected from 30 age-and sex-matched healthy volunteers. Skin temperature, sensorimotor function (grooved pegboard test), and detection thresholds for temperature, sharpness, and low-threshold mechanical stimuli (von Frey monofilaments and bumps detection test) were measured. Meissner's corpuscle (MC) density in the fingertips was assessed using in vivo laser reflectance confocal microscopy.Results: Patients showed a high incidence (> 80{\%}) of ≥ one subclinical QST deficit. These included increased von Frey, bumps, and warmth detection thresholds as compared with healthy volunteers. Patients also showed increases in cold pain, sensorimotor deficits (grooved pegboard test), and higher overall neuropathy scores. MC density was significantly lower in patients than controls and showed significant inverse correlation with bumps detection threshold.",
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T1 - Subclinical peripheral neuropathy in patients with multiple myeloma before chemotherapy is correlated with decreased fingertip innervation density

AU - Kosturakis, Alyssa K.

AU - He, Zijing

AU - Li, Yan

AU - Boyette-Davis, Jessica A.

AU - Shah, Nina

AU - Thomas, Sheeba K.

AU - Zhang, Haijun

AU - Vichaya, Elisabeth G.

AU - Wang, Xin Shelley

AU - Wendelschafer-Crabb, Gwen

AU - Kennedy, William R

AU - Simone, Donald A

AU - Cleeland, Charles S.

AU - Dougherty, Patrick M.

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N2 - Purpose: The goal in this study was to determine the incidence of subclinical neuropathy in treatment-naive patients with multiple myeloma (MM) with no history of peripheral neuropathy using quantitative sensory tests (QSTs) and its correlation with innervation density of the extremities using noninvasive laser reflectance confocal microscopy.Conclusion: Patients with MM commonly present with sensory and sensorimotor deficits before undergoing treatment, and these deficits seem to result from disease-related decreases in peripheral innervation density.Patients and Methods: QST results were collected for 27 patients with a diagnosis of MM and compared with data collected from 30 age-and sex-matched healthy volunteers. Skin temperature, sensorimotor function (grooved pegboard test), and detection thresholds for temperature, sharpness, and low-threshold mechanical stimuli (von Frey monofilaments and bumps detection test) were measured. Meissner's corpuscle (MC) density in the fingertips was assessed using in vivo laser reflectance confocal microscopy.Results: Patients showed a high incidence (> 80%) of ≥ one subclinical QST deficit. These included increased von Frey, bumps, and warmth detection thresholds as compared with healthy volunteers. Patients also showed increases in cold pain, sensorimotor deficits (grooved pegboard test), and higher overall neuropathy scores. MC density was significantly lower in patients than controls and showed significant inverse correlation with bumps detection threshold.

AB - Purpose: The goal in this study was to determine the incidence of subclinical neuropathy in treatment-naive patients with multiple myeloma (MM) with no history of peripheral neuropathy using quantitative sensory tests (QSTs) and its correlation with innervation density of the extremities using noninvasive laser reflectance confocal microscopy.Conclusion: Patients with MM commonly present with sensory and sensorimotor deficits before undergoing treatment, and these deficits seem to result from disease-related decreases in peripheral innervation density.Patients and Methods: QST results were collected for 27 patients with a diagnosis of MM and compared with data collected from 30 age-and sex-matched healthy volunteers. Skin temperature, sensorimotor function (grooved pegboard test), and detection thresholds for temperature, sharpness, and low-threshold mechanical stimuli (von Frey monofilaments and bumps detection test) were measured. Meissner's corpuscle (MC) density in the fingertips was assessed using in vivo laser reflectance confocal microscopy.Results: Patients showed a high incidence (> 80%) of ≥ one subclinical QST deficit. These included increased von Frey, bumps, and warmth detection thresholds as compared with healthy volunteers. Patients also showed increases in cold pain, sensorimotor deficits (grooved pegboard test), and higher overall neuropathy scores. MC density was significantly lower in patients than controls and showed significant inverse correlation with bumps detection threshold.

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