Neurophysiological, nerve imaging and other techniques to assess chemotherapy-induced peripheral neurotoxicity in the clinical and research settings

Andreas A. Argyriou, Susanna B. Park, Badrul Islam, Stefano Tamburin, Roser Velasco, Paola Alberti, Jordi Bruna, Dimitri Psimaras, Guido Cavaletti, David Cornblath

Research output: Contribution to journalReview article

Abstract

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common dose-limiting side effect of several anticancer medications. CIPN may involve multiple areas of the peripheral nervous system from the autonomic and dorsal root ganglia (DRG) to the axon and any peripheral nerve fibre type. Large diameter sensory myelinated (Aβ) fibres are more frequently involved, but motor, small myelinated (Aδ), unmyelinated (C) or autonomic fibres may also be affected. Here, we review the current evidence on techniques for the CIPN assessment in the clinical and experimental settings. Nerve conduction studies (NCS) may be used at the subclinical and early CIPN stage, to assess the extent of large nerve fibre damage and to monitor long-term outcomes, with the sural or dorsal sural nerve as the most informative. The quantitative sensory neurological examination provides valuable data alongside NCS. Quantitative sensory testing and nerve excitability studies add information regarding pathophysiology. Nerve MRI and ultrasound may provide information on enlarged nerve, increased nerve signal intensity and DRG or spinal cord changes. Skin biopsy, corneal confocal microscopy, laser-evoked potentials, contact heat-related potentials and microneurography may reveal the extent of damage to small unmyelinated nerve fibres that go undetected by NCS. The information on the role of these latter techniques is preliminary. Hence, the use of multimodal testing is recommended as the optimal CIPN assessment strategy, employing objective NCS and other specialised techniques together with subjective patient-reported outcome measures.

Original languageEnglish (US)
JournalJournal of Neurology, Neurosurgery and Psychiatry
DOIs
StatePublished - Jan 1 2019

Fingerprint

Neural Conduction
Drug Therapy
Research
Spinal Ganglia
Nerve Fibers
Sural Nerve
Unmyelinated Nerve Fibers
Peripheral Nervous System
Neurologic Examination
Peripheral Nerves
Confocal Microscopy
Axons
Spinal Cord
Hot Temperature
Biopsy
Skin

Keywords

  • assessment
  • chemotherapy
  • nerve imaging
  • neurophysiology
  • neurotoxicity
  • peripheral neuropathy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Neurophysiological, nerve imaging and other techniques to assess chemotherapy-induced peripheral neurotoxicity in the clinical and research settings. / Argyriou, Andreas A.; Park, Susanna B.; Islam, Badrul; Tamburin, Stefano; Velasco, Roser; Alberti, Paola; Bruna, Jordi; Psimaras, Dimitri; Cavaletti, Guido; Cornblath, David.

In: Journal of Neurology, Neurosurgery and Psychiatry, 01.01.2019.

Research output: Contribution to journalReview article

Argyriou, Andreas A. ; Park, Susanna B. ; Islam, Badrul ; Tamburin, Stefano ; Velasco, Roser ; Alberti, Paola ; Bruna, Jordi ; Psimaras, Dimitri ; Cavaletti, Guido ; Cornblath, David. / Neurophysiological, nerve imaging and other techniques to assess chemotherapy-induced peripheral neurotoxicity in the clinical and research settings. In: Journal of Neurology, Neurosurgery and Psychiatry. 2019.
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AU - Velasco, Roser

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