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Biopsy of the posterior interosseous nerve: a low morbidity method for assessment of peripheral nerve disorders.

Thomsen, Niels LU ; Mojaddidi, M; Malik, R A and Dahlin, Lars LU (2009) In Diabetic medicine : a journal of the British Diabetic Association 26(1). p.100-104
Abstract
AIMS: The sural nerve is the commonest peripheral nerve biopsied to help in the diagnosis of peripheral neuropathy of unknown cause. However, associated complications limit its use. The aim was, as an alternative, to asses biopsy of the terminal branch of the posterior interosseous nerve (PIN) in the forearm. METHODS: PIN pathology was morphometrically quantified in 10 male patients with Type 2 diabetes and compared with six PIN biopsy specimens taken post mortem from male cadavers with no history of neuropathy or trauma. RESULTS: The PIN biopsy procedure provides a long (approximately 3 cm) mono- or bifascicular nerve biopsy with generous epineurial tissue and adjacent vessels. Our results show a significantly lower myelinated fibre... (More)
AIMS: The sural nerve is the commonest peripheral nerve biopsied to help in the diagnosis of peripheral neuropathy of unknown cause. However, associated complications limit its use. The aim was, as an alternative, to asses biopsy of the terminal branch of the posterior interosseous nerve (PIN) in the forearm. METHODS: PIN pathology was morphometrically quantified in 10 male patients with Type 2 diabetes and compared with six PIN biopsy specimens taken post mortem from male cadavers with no history of neuropathy or trauma. RESULTS: The PIN biopsy procedure provides a long (approximately 3 cm) mono- or bifascicular nerve biopsy with generous epineurial tissue and adjacent vessels. Our results show a significantly lower myelinated fibre density in subjects with diabetes [5782 (3332-9060)/mm(2)] compared with autopsy control material [9256 (6593-12,935)/mm(2), P < 0.007]. No postoperative discomfort or complications were encountered. CONCLUSIONS: A reduction in myelinated fibre density has previously been shown to be a clinically meaningful measure of neuropathy in diabetic patients. We demonstrate similar findings using the PIN biopsy. The PIN biopsy procedure fulfils the criteria for nerve biopsy and was well tolerated by the patients. It may be a possible alternative to sural nerve biopsy to allow for diagnosis of neuropathy. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetic medicine : a journal of the British Diabetic Association
volume
26
issue
1
pages
100 - 104
publisher
Wiley-Blackwell
external identifiers
  • WOS:000262223700018
  • PMID:19125770
  • Scopus:58149267962
ISSN
1464-5491
DOI
10.1111/j.1464-5491.2008.02629.x
language
English
LU publication?
yes
id
3e7f7306-d196-42dd-a0a5-5c2be87cd36b (old id 1289909)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19125770?dopt=Abstract
date added to LUP
2009-02-03 10:22:24
date last changed
2017-01-01 07:53:28
@article{3e7f7306-d196-42dd-a0a5-5c2be87cd36b,
  abstract     = {AIMS: The sural nerve is the commonest peripheral nerve biopsied to help in the diagnosis of peripheral neuropathy of unknown cause. However, associated complications limit its use. The aim was, as an alternative, to asses biopsy of the terminal branch of the posterior interosseous nerve (PIN) in the forearm. METHODS: PIN pathology was morphometrically quantified in 10 male patients with Type 2 diabetes and compared with six PIN biopsy specimens taken post mortem from male cadavers with no history of neuropathy or trauma. RESULTS: The PIN biopsy procedure provides a long (approximately 3 cm) mono- or bifascicular nerve biopsy with generous epineurial tissue and adjacent vessels. Our results show a significantly lower myelinated fibre density in subjects with diabetes [5782 (3332-9060)/mm(2)] compared with autopsy control material [9256 (6593-12,935)/mm(2), P &lt; 0.007]. No postoperative discomfort or complications were encountered. CONCLUSIONS: A reduction in myelinated fibre density has previously been shown to be a clinically meaningful measure of neuropathy in diabetic patients. We demonstrate similar findings using the PIN biopsy. The PIN biopsy procedure fulfils the criteria for nerve biopsy and was well tolerated by the patients. It may be a possible alternative to sural nerve biopsy to allow for diagnosis of neuropathy.},
  author       = {Thomsen, Niels and Mojaddidi, M and Malik, R A and Dahlin, Lars},
  issn         = {1464-5491},
  language     = {eng},
  number       = {1},
  pages        = {100--104},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic medicine : a journal of the British Diabetic Association},
  title        = {Biopsy of the posterior interosseous nerve: a low morbidity method for assessment of peripheral nerve disorders.},
  url          = {http://dx.doi.org/10.1111/j.1464-5491.2008.02629.x},
  volume       = {26},
  year         = {2009},
}