Raffaele Dubbioso, MD, PhD, University of Naples Federico II, Naples, Italy, discusses his work assessing peripheral sensory abnormalities in amyotrophic lateral sclerosis (ALS) and how these correlate with the severity and prognosis of the disease. ALS has long been described as motor neuron disease, but more recently, numerous non-motor symptoms have been recognized. These include cognitive and autonomic symptoms, as well as sensory involvement. Using the Small Fiber Neuropathy Symptoms Inventory Questionnaire (SFN-SIQ), it was found that around 35% of ALS patients report sensory symptoms. Small-fibre sensory disturbances like burning pain were the most frequent. Skin biopsies showed large sensory denervation, with different patterns depending on the stage of disease. In patients with later stage disease, profound loss of Meissner’s corpuscle density was found, however, a regeneration pattern was found in intraepidermal nerve fibres. Patients with more aggressive disease showed higher regeneration. Dr Dubbioso highlights the potential use of skin innervation as a non-invasive prognostic biomarker. This interview took place at the European Academy of Neurology (EAN) Annual Meeting 2024 in Helsinki, Finland.
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