Differential sensitivity of thick and thin fibers to HIV and therapy-induced neuropathy

• Published in: Autonomic neuroscience 2007-10, Vol.136 (1), p.90-95
• Main Authors: Kokotis, Panagiotis, Schmelz, Martin, Skopelitis, Elias E, Kordossis, Theodore, Karandreas, Nikolaos
• Format: Article
• Language: English
• Subjects: Adult; Advanced Basic Science; Aged; Antiretroviral Therapy, Highly Active - adverse effects; Antiviral Agents - adverse effects; Biological and medical sciences; Disease Progression; Electrodiagnosis; Female; Fundamental and applied biological sciences. Psychology; Galvanic Skin Response - drug effects; Galvanic Skin Response - physiology; HAART; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - immunology; Humans; Male; Medical Education; Middle Aged; Myelin Sheath; Nerve Degeneration - chemically induced; Nerve Degeneration - physiopathology; Nerve Degeneration - virology; Nerve Fibers, Myelinated - drug effects; Nerve Fibers, Myelinated - pathology; Nerve Fibers, Myelinated - virology; Nerve Fibers, Unmyelinated - drug effects; Nerve Fibers, Unmyelinated - pathology; Nerve Fibers, Unmyelinated - virology; Neural Conduction - drug effects; Neural Conduction - physiology; Neurons, Afferent; Nociceptors - drug effects; Nociceptors - pathology; Nociceptors - virology; Peripheral Nervous System Diseases - chemically induced; Peripheral Nervous System Diseases - physiopathology; Peripheral Nervous System Diseases - virology; Peripheral nervous system. Autonomic nervous system. Neuromuscular transmission. Ganglionic transmission. Electric organ; Sympathetic Fibers, Postganglionic - drug effects; Sympathetic Fibers, Postganglionic - pathology; Sympathetic Fibers, Postganglionic - virology; Thick fiber neuropathy; Thin fiber neuropathy; Vertebrates: nervous system and sense organs
• ISSN: 1566-0702; 1872-7484
• DOI: 10.1016/j.autneu.2007.01.012

Abstract The study assessed HIV-related and anti-retroviral therapy-induced neuropathy in myelinated and unmyelinated nerve fibers. One hundred consecutive HIV patients were examined clinically and standard nerve conduction velocities were measured. In addition, electrically induced sympathetic skin response (SSR) was assessed in the palms and soles. The difference in delay of SSR in palms and soles (ΔSSR) was calculated as an indirect measure of C-fiber conduction velocity. Thick fiber conduction velocities significantly decreased with age and increasing stage of the disease, whereas no effect of stage was found for ΔSSR ( p = 0.6). In contrast, medication of at least one of the most known neurotoxic drugs zalcitabine, stavudine, or didanosine did not result in significantly lower conduction velocities in thick fibers (51.29 ± 3.4 m/s vs. 50.86 ± 3.5 m/s), but was related to an increased ΔSSR. ΔSSR allows an indirect measurement of C-fiber conduction velocity. In HIV this measure of unmyelinated sympathetic fibers was most sensitive to anti-viral treatment whereas conduction velocity of myelinated somatic fibers was more sensitive to disease-related neuropathy. The results suggest that HIV neuropathy preferably affects myelinated and anti-retroviral therapy unmyelinated fibers.