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Advances in Peripheral Neuropathy: Clinical Symptoms, Risk Factors, Diagnosis, and...
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Advances in Peripheral Neuropathy: Clinical Symptoms, Risk Factors, Diagnosis, and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 14523

Special Issue Editors

Prof. Dr. Augusto Fusco

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Guest Editor
UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
Interests: brain injury; tDCS; virtual reality; rehabilitation; motor imagery
Special Issues, Collections and Topics in MDPI journals
Dr. Luca Padua

E-Mail Website
Guest Editor
UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
Interests: peripheral neuropathy; ultrasonography; rehabilitation; electromyography; brain iniury
Dr. Silvia Giovannini

E-Mail Website
Guest Editor
UOS Riabilitazione Post-Acuzie, Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
Interests: aging; internal medicine; geriatrics; rehabilitation; physical medicine; personalized medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Peripheral neuropathies have been widely explored across several decades in the scientific literature. During the last 20 years, researchers have provided particular attention to the recognition of the different clinical conditions inherent to peripheral neuropathies, accurate methods of diagnosis, and additional data about therapeutic possibilities. Finally, a new chapter in the topic has been traced with the SARS-Cov2 infection, which renewed scientific interest. However, despite numerous efforts to date, the data obtained in the different fields of this topic do not always result as clear or comprehensive in clinical practice. We believe that it is essential to try to order these data on the topic and also with the implications in daily practice for the different clinicians involved in the care of peripheral neuropathies.

Our Special Issue in the Journal of Clinical Medicine will aim to collect studies regarding all the aspects of peripheral neuropathy (etiology, diagnosis, treatment), in order to provide evidence (clinical studies, randomized controlled trials, review, meta-analysis) applicable to clinical practice. In particular, we aim to cover the following aspects:

  • Etiology in the peripheral neuropathies;
  • Animal studies for etiological and therapeutic interaction in the peripheral neuropathies;
  • Neuropathic pain;
  • Chemotherapy-induced peripheral neuropathy;
  • Sars-Cov2-induced peripheral neuropathy;
  • Clinical phenotypes of peripheral neuropathies;
  • Diabetes and peripheral neuropathy;
  • Traumatic peripheral neuropathies;
  • New treatment for peripheral neuropathies;
  • Rehabilitation for peripheral neuropathies;
  • New applications of diagnostic methods for peripheral neuropathies;
  • Role of physical therapies for peripheral neuropathies;
  • Minimally invasive treatments for peripheral neuropathies;
  • Dietary supplements for peripheral neuropathies;
  • Integrative medicine for clinical neuropathies.

Dr. Augusto Fusco
Dr. Luca Padua
Dr. Silvia Giovannini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • peripheral neuropathies
  • neuromotor rehabilitation
  • diagnostic techniques
  • dietary supplementation
  • physical therapies
  • minimally invasive treatments
  • etiology
  • neuropathic pain

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Published Papers (6 papers)

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Research

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10 pages, 712 KiB  
Article
No Major Nerve Regeneration Seems to Occur during Recovery of Ulnar Neuropathy at the Elbow
by Simon Podnar
J. Clin. Med. 2023, 12(12), 3906; https://doi.org/10.3390/jcm12123906 - 7 Jun 2023
Cited by 2 | Viewed by 1378
Abstract
Introduction: There are three main potential mechanisms of recovery after nerve lesion: (1) resolution of conduction block, (2) collateral reinnervation, and (3) nerve regeneration. Their relative contributions in recovery after focal neuropathies are not well established. Methods: In a group of previously reported [...] Read more.
Introduction: There are three main potential mechanisms of recovery after nerve lesion: (1) resolution of conduction block, (2) collateral reinnervation, and (3) nerve regeneration. Their relative contributions in recovery after focal neuropathies are not well established. Methods: In a group of previously reported prospective cohort of patients with ulnar neuropathy at the elbow (UNE), I performed a post-hoc analysis of their clinical and electrodiagnostic findings. I compared amplitudes of the compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) on ulnar nerve stimulation, as well as qualitative concentric needle electromyography (EMG) findings in the abductor digiti minimi muscle on the initial and follow-up examinations several years later. Results: Altogether, 111 UNE patients (114 arms) were studied. During median follow-up period of 880 days (range: 385–1545 days), CMAP amplitude increased (p = 0.02), and conduction block in the elbow segment recovered (from median 17% to 7%; p < 0.001). By contrast, SNAP amplitude did not change (p = 0.89). On needle EMG, spontaneous denervation activity diminished (p < 0.001), motor unit potential (MUP) amplitude increased (p < 0.001), and MUP recruitment remained unchanged (p = 0.43). Conclusions: Findings of the present study indicate that nerve function in chronic focal compression/entrapment neuropathies seems to improve mainly due to the resolution of the conduction block and collateral reinnervation. Contribution of nerve regeneration seems to be minor; the majority of axons lost in chronic focal neuropathies probably never recover. Further studies using quantitative methods are needed to validate present findings. Full article
(This article belongs to the Special Issue Advances in Peripheral Neuropathy: Clinical Symptoms, Risk Factors, Diagnosis, and Treatment)
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12 pages, 1111 KiB  
Article
The Role of Technological Rehabilitation in Patients with Intensive Care Unit Weakness: A Randomized Controlled Pilot Study
by Letizia Castelli, Chiara Iacovelli, Augusto Fusco, Vincenza Amoruso, Cristina Cuccagna, Claudia Loreti, Silvia Giovannini and Luca Padua
J. Clin. Med. 2023, 12(7), 2612; https://doi.org/10.3390/jcm12072612 - 30 Mar 2023
Cited by 9 | Viewed by 2768
Abstract
Intensive-Care-Unit-Acquired Weakness (ICU-AW) is the most common neuromuscular impairment in critically ill patients and can have a significant impact on long-term disability. Early rehabilitation has been suggested to facilitate the natural recovery process. This is a pilot, randomized, single-blind study that aimed to [...] Read more.
Intensive-Care-Unit-Acquired Weakness (ICU-AW) is the most common neuromuscular impairment in critically ill patients and can have a significant impact on long-term disability. Early rehabilitation has been suggested to facilitate the natural recovery process. This is a pilot, randomized, single-blind study that aimed to evaluate the effectiveness of intensive combined technological rehabilitation treatment including focal muscle vibration and non-immersive virtual reality for patients with severe acquired brain injury (sABI) and ICU-AW. Twenty-four patients were randomized into the conventional group, which performed only conventional rehabilitation, and the experimental group, which also performed technological treatment. At baseline and after 3 weeks of treatment, assessments of motor function, autonomy, disability and quality of life were conducted. At the end of the intervention, both groups showed significant improvements. However, patients in the experimental group achieved greater improvements in disability (p = 0.001) and quality of life (p = 0.001). The results show that intensive structured rehabilitation is effective in improving the motor function, disability and quality of life of patients with severe acquired brain injury and acquired weakness. The combination of non-immersive virtual reality training and focal muscle vibration can result in a significant improvement in overall disability and quality of life compared with conventional treatment alone. Full article
(This article belongs to the Special Issue Advances in Peripheral Neuropathy: Clinical Symptoms, Risk Factors, Diagnosis, and Treatment)
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11 pages, 722 KiB  
Article
A Prospective, Randomized, Placebo-Controlled Study Assessing the Efficacy of Chinese Herbal Medicine (Huangqi Guizhi Wuwu Decoction) in the Treatment of Albumin-Bound Paclitaxel-Induced Peripheral Neuropathy
by Yue Chai, Fang Zhao, Peizhi Ye, Fei Ma, Jiayu Wang, Pin Zhang, Qing Li, Jiani Wang, Wenna Wang, Qiao Li and Binghe Xu
J. Clin. Med. 2023, 12(2), 505; https://doi.org/10.3390/jcm12020505 - 7 Jan 2023
Cited by 6 | Viewed by 2766
Abstract
Objective: This study aimed to evaluate the efficacy and safety of Huangqi Guizhi Wuwu decoction (HGWD), which is composed of five crude drugs (Astragali Radix, Cinnamomi Ramulus, Paeoniae Radix Alba, Zingiberis Rhizoma Recens, and Jujubae Fructus), in the treatment of albumin-bound paclitaxel (nab-PTX)-induced [...] Read more.
Objective: This study aimed to evaluate the efficacy and safety of Huangqi Guizhi Wuwu decoction (HGWD), which is composed of five crude drugs (Astragali Radix, Cinnamomi Ramulus, Paeoniae Radix Alba, Zingiberis Rhizoma Recens, and Jujubae Fructus), in the treatment of albumin-bound paclitaxel (nab-PTX)-induced peripheral neuropathy (PN) in Chinese patients with breast cancer (BC). Methods: This trial was conducted at the National Cancer Center in China from January 2020 to June 2022. The eligible participants were assigned randomly in a 1:1 ratio to an HGWD group or a control group. The outcome measure was EORTC QLQ-CIPN20 questionnaire. Results: 92 patients diagnosed with BC were enrolled and randomized to either HGWD group (n = 46) or control group (n = 46). There were no significant differences in baseline characteristics between the two groups (p > 0.05). A statistical analysis of the sensory and motor functions of the EORTC QLQ-CIPN20 scores showed that patients in the HGWD group reported a larger decrease in CIPN sensory scores than those in the control group (p < 0.001). The EORTC QLQ-CIPN20 autonomic scores showed no statistical significance between the two groups (p > 0.05). Conclusions: HGWD packs could significantly improve patients’ nab-PTX-induced PN, increase the tolerance for nab-PTX-containing chemotherapy, and further improve the quality of life of patients with BC. Full article
(This article belongs to the Special Issue Advances in Peripheral Neuropathy: Clinical Symptoms, Risk Factors, Diagnosis, and Treatment)
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12 pages, 1044 KiB  
Article
Guillain–Barré Syndrome in Northern China: A Retrospective Analysis of 294 Patients from 2015 to 2020
by Qiongqiong Zhai, Cheng Guo, Fang Xue, Jing Qiang, Chaonan Li and Li Guo
J. Clin. Med. 2022, 11(21), 6323; https://doi.org/10.3390/jcm11216323 - 26 Oct 2022
Cited by 4 | Viewed by 1693
Abstract
Objectives: Acute motor axonal neuropathy (AMAN) was first reported to be the main subtype of Guillain–Barré syndrome (GBS) in northern China in the 1990s. About 30 years has passed, and it is unknown whether the disease spectrum has changed over time in northern [...] Read more.
Objectives: Acute motor axonal neuropathy (AMAN) was first reported to be the main subtype of Guillain–Barré syndrome (GBS) in northern China in the 1990s. About 30 years has passed, and it is unknown whether the disease spectrum has changed over time in northern China. We aimed to study the epidemiological, clinical, and electrophysiological features of GBS in northern China in recent years. Methods: We retrospectively analyzed the medical records of GBS patients admitted to the Second Hospital of Hebei Medical University in northern China from 2015 to 2020. Results: A total of 294 patients with GBS were enrolled, with median age 53 years and 60.5% of participants being male, and a high incidence in summer and autumn. AMAN was still the predominant subtype in northern China (40.1%). The AMAN patients had shorter time to nadir, longer hospitalization time, and a more severe HFGS score at discharge than acute inflammatory demyelinating polyneuropathies (AIDP) (p < 0.05). With SPSS multivariable logistic regression analysis, we found the GBS disability score (at admission), dysphagia, and dysautonomia were independent risk factors for GBS patients requiring MV (p < 0.05). In comparison with other regions, the proportion of AMAN in northern China (40.1%) was higher than in eastern (35%) and southern (19%) China. Conclusions: AMAN is still the predominant subtype in northern China after 30 years, but there have been changes over time in the GBS spectrum since the 1990s. There are regional differences in GBS in China. Full article
(This article belongs to the Special Issue Advances in Peripheral Neuropathy: Clinical Symptoms, Risk Factors, Diagnosis, and Treatment)
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Review

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12 pages, 1327 KiB  
Review
Rehabilitation of Peripheral Neuropathies: From Lexical Analysis of the Literature to Identification of Clinical Protocols
by Daniele Coraci, Marcello Romano, Lisa Ragazzo, Domenico Antonio Restivo, Martina Cipriani, Federica Gottardello, Martina Pizzolato, Maria Chiara Maccarone and Stefano Masiero
J. Clin. Med. 2023, 12(18), 5879; https://doi.org/10.3390/jcm12185879 - 10 Sep 2023
Cited by 1 | Viewed by 2332
Abstract
Peripheral nervous system diseases are a complex and heterogenous group of diseases affecting the different nerves with various severity and impact on quality of life. The current literature does not provide a structured guide for the rehabilitation of these conditions. We performed a [...] Read more.
Peripheral nervous system diseases are a complex and heterogenous group of diseases affecting the different nerves with various severity and impact on quality of life. The current literature does not provide a structured guide for the rehabilitation of these conditions. We performed a lexical literature evaluation based on graph theory to clarify this topic. We performed a search on PubMed and calculated the frequencies of the words indicating rehabilitation approaches, nerves, and diseases. We found the usefulness of exercises and different physical agents, like laser and ultrasound therapy and neuromuscular stimulation vibration therapy. Orthoses are useful for entrapment, trauma, and hereditary diseases. Correct knowledge and assessment of the neuropathies are fundamental for the therapeutic decision and to guide rehabilitation. Despite the usefulness shown by the different approaches to modulating pain, improving muscle strength and endurance, and ameliorating balance and the sensory system, further studies are needed to define the best-personalized protocols. Full article
(This article belongs to the Special Issue Advances in Peripheral Neuropathy: Clinical Symptoms, Risk Factors, Diagnosis, and Treatment)
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Other

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13 pages, 4155 KiB  
Case Report
Nerve MR in the Differential Diagnosis of Neuropathies: A Case Series from a Single Center
by Carolina Giordano, Maria Ausilia Sciarrone, Francesca Vitali, Angela Romano, Giulia Guerri, Valentina Perlangeli, Simona Gaudino and Marco Luigetti
J. Clin. Med. 2023, 12(15), 5009; https://doi.org/10.3390/jcm12155009 - 30 Jul 2023
Cited by 2 | Viewed by 1579
Abstract
In the present study, through a case series, we highlighted the role of magnetic resonance (MR) in the identification and diagnosis of peripheral neuropathies. MR neurography allows the evaluation of the course of nerves through 2D and 3D STIR sequences with an isotropic [...] Read more.
In the present study, through a case series, we highlighted the role of magnetic resonance (MR) in the identification and diagnosis of peripheral neuropathies. MR neurography allows the evaluation of the course of nerves through 2D and 3D STIR sequences with an isotropic voxel, whereas the relationship between nerves, vessels, osteo-ligamentous and muscular structures can be appraised with T1 sequences. Currently, DTI and tractography are mainly used for experimental purposes. MR neurography can be useful in detecting subtle nerve alterations, even before the onset of symptoms. However, despite being sensitive, MR neurography is not specific in detecting nerve injury and requires careful interpretation. For this reason, MR information should always be supported by instrumental clinical tests. Full article
(This article belongs to the Special Issue Advances in Peripheral Neuropathy: Clinical Symptoms, Risk Factors, Diagnosis, and Treatment)
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