Corneal confocal microscopy in chronic inflammatory demyelinating polyneuropathy

Mark Stettner, Lena Hinrichs, Rainer Guthoff, Silja Bairov, Ioannis N. Petropoulos, Clemens Warnke, Hans Peter Hartung, Rayaz Malik, Bernd C. Kieseier

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective: There is an unmet need for better diagnostic tools to further delineate clinical subsets of heterogeneous chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) to facilitate treatment decisions. Corneal confocal microscopy (CCM) is a noninvasive and reproducible nerve imaging technique. This study evaluates the potential of CCM as a diagnostic surrogate in CIDP and MMN. Methods: In a cross-sectional prospective approach, 182 patients and healthy controls were studied using CCM to quantify corneal nerve damage and immune cell infiltration. Results: Patients with CIDP and MMN had a reduction in corneal nerve fiber (CNF) measures and an increase in corneal immune cell infiltrates. In CIDP, CNF parameters decreased with increasing duration of disease. The number of dendritic cells in proximity to CNFs was increased in patients with early disease and correlated with the degree of motor affection. A further reduction in CNF parameters and an increase in nondendritic cells were observed in patients with painful neuropathy. In CIDP patients with antineuronal antibodies the number of nondendritic cells was increased. Interpretation: Our findings suggest that CNF loss may reflect severity of neuropathy and quantification of distinct cells around the CNF plexus may help in stratifying CIDP subtypes, clinical course, and disease activity. However, further longitudinal studies are required before CCM can be considered as a valid surrogate endpoint for patients with CIDP and MMN.

Original languageEnglish
Pages (from-to)88-100
Number of pages13
JournalAnnals of Clinical and Translational Neurology
Volume3
Issue number2
DOIs
Publication statusPublished - 1 Feb 2016

    Fingerprint

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Stettner, M., Hinrichs, L., Guthoff, R., Bairov, S., Petropoulos, I. N., Warnke, C., Hartung, H. P., Malik, R., & Kieseier, B. C. (2016). Corneal confocal microscopy in chronic inflammatory demyelinating polyneuropathy. Annals of Clinical and Translational Neurology, 3(2), 88-100. https://doi.org/10.1002/acn3.275