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J Neurooncol. 2016 Apr;127(2):373-80. doi: 10.1007/s11060-015-2049-x. Epub 2016 Jan 9.

Quick, non-invasive and quantitative assessment of small fiber neuropathy in patients receiving chemotherapy.

Author information

1
Cognac-G UMR-MD4 8257, Service de Santé des Armées, Université Paris Descartes, 74, boulevard de Port-Royal, 75005, Paris, France. saad.med.mehdi@gmail.com.
2
Assistance Publique-Hôpitaux de Paris, La Pitié-Salpêtrière Hospital, Service de Neurologie Mazarin, Paris, France.
3
Neurology Department, HIA du Val-de-Grâce, Paris, France.
4
Impeto Medical, Paris, France.
5
Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin-Port-Royal, Université Paris-Descartes, Service de Cancérologie, Paris, France.
6
Oncology Department, HIA du Val-de-Grâce, Paris, France.
7
Assistance Publique-Hôpitaux de Paris, La Pitié-Salpêtrière Hospital, Unité de Neurophysiologie Clinique, Paris, France.
8
Cognac-G UMR-MD4 8257, Service de Santé des Armées, Université Paris Descartes, 74, boulevard de Port-Royal, 75005, Paris, France.

Abstract

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common, potentially severe and dose-limiting adverse effect; however, it is poorly investigated at an early stage due to the lack of a simple assessment tool. As sweat glands are innervated by small autonomic C-fibers, sudomotor function testing has been suggested for early screening of peripheral neuropathy. This study aimed to evaluate Sudoscan, a non-invasive and quantitative method to assess sudomotor function, in the detection and follow-up of CIPN. Eighty-eight patients receiving at least two infusions of Oxaliplatin only (45.4%), Paclitaxel only (14.8%), another drug only (28.4%) or two drugs (11.4%) were enrolled in the study. At each chemotherapy infusion the accumulated dose of chemotherapy was calculated and the Total Neuropathy Score clinical version (TNSc) was carried out. Small fiber neuropathy was assessed using Sudoscan (a 3-min test). The device measures the Electrochemical Skin Conductance (ESC) of the hands and feet expressed in microSiemens (µS). For patients receiving Oxaliplatin mean hands ESC changed from 73 ± 2 to 63 ± 2 and feet ESC from 77 ± 2 to 66 ± 3 µS (p < 0.001) while TNSc changed from 2.9 ± 0.5 to 4.3 ± 0.4. Similar results were observed in patients receiving Paclitaxel or another neurotoxic chemotherapy. During the follow-up, ESC values of both hands and feet with a corresponding TNSc < 2 were 70 ± 2 and 73 ± 2 µS respectively while they were 59 ± 1.4 and 64 ± 1.5 µS with a corresponding TNSc ≥ 6 (p < 0.0001 and p = 0.0003 respectively). This preliminary study suggests that small fiber neuropathy could be screened and followed using Sudoscan in patients receiving chemotherapy.

KEYWORDS:

Autonomic neuropathy; Chemotherapy-induced peripheral neuropathy; Nerve fiber impairment assessment; Sudomotor function

PMID:
26749101
DOI:
10.1007/s11060-015-2049-x
[Indexed for MEDLINE]

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