The researchers found, as expected, that the healthy volunteers had many more Meissner corpuscles in the tip of the pinkie finger about 12 such structures per square millimeter, compared to a mean of 2.8 in people with neuropathy. Patients with neuropathy also had fewer of the structures at the base of the thumb.
While the results were not surprising, attaining them so easily was. Volunteers simply held their pinkie finger under a microscope for a few minutes. No pain, no blood, no tissue preparation.
In an editorial about the research, Peter J. Dyck, M.D., of the Mayo Clinic wrote in the journal, The approach may find use as the gold standard of tactile sensation and of large fiber sensorimotor polyneuropathy. But he also pointed out some limitations of the work. Dyck said the technique needs to be tested in greater numbers of people, pointed out that the equipment needed for reflectance confocal microscopy is expensive, and mentioned the need to differentiate between healthy and abnormal Meissner corpuscles.
An advance in screening would be appreciated by millions of patients. More than half of people with diabetes will eventually develop neuropathy. Most of them wont feel pain theyll simply lose sensation in their feet, making them vulnerable to wounds that can result in severe infections. Oftentimes sensation slips away so gradually that patients dont even notice. A new screening tool would help doctors monitor patients more closely so that both they and patients are aware of nerve damage and can do everything they can to prevent further damage.
Neuropathy is very difficult to treat, and part of the reason is that currently, we usually identify it too late, after there has been significant damage, said Herrmann, director of the Peripheral Neuropathy Service at Strong Memorial Hospital. Treatments might be more beneficial if we could detect the
|Contact: Tom Rickey|
University of Rochester Medical Center