Small fiber neuropathy in the post-COVID condition and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical significance and diagnostic challenges

Background Patients with post-COVID condition (PCC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) experience symptoms potentially associated with small fiber neuropathy (SFN). Methods A sample of 90 participants, comprising 30 PCC patients, 30 ME/CFS patients, and 30 healthy contro...

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Detalles Bibliográficos
Autores: Azcue González, Naiara, Teijeira Portas, Sara, Acera Gil, María Ángeles, Fernández Valle, Tamara, Ayala Fernández, Unai, Barrenechea, Maitane, Murueta-Goyena Larrañaga, Ane, Lafuente Sánchez, José Vicente, López de Munain Arregui, Adolfo José, Ruiz Irastorza, Guillermo, Martín Iglesias, Daniel, Gabilondo Cuellar, Iñigo, Gómez Esteban, Juan Carlos, Del Pino Sáez, Rocío
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/72676
Acceso en línea:http://hdl.handle.net/10810/72676
Access Level:acceso abierto
Palabra clave:Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
post-COVID condition
small fiber neuropathy
Descripción
Sumario:Background Patients with post-COVID condition (PCC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) experience symptoms potentially associated with small fiber neuropathy (SFN). Methods A sample of 90 participants, comprising 30 PCC patients, 30 ME/CFS patients, and 30 healthy controls (HC), matched by sex and age, was assessed. Neuropathic, autonomic, and fatigue symptoms were measured with TaskForce Monitor, the Sudoscan, heat and cold evoked potentials, In Vivo Corneal Confocal Microscopy (IVCCM), and specialized questionaries. Results PCC and ME/CFS patients demonstrated significantly higher levels of autonomic symptoms (H = 39.89, p < 0.001), neuropathic symptoms (H = 48.94, p < 0.001), and fatigue (H = 49.29, p < 0.001) compared to HC. Quantitative sensory testing revealed significant differences in heat detection thresholds between PCC patients and HC (F = 4.82; p < 0.01). Regarding corneal small fiber tortuosity, there were statistically significant differences between patients and HC (F = 6.80; p < 0.01), indicating pathological responses in patients. Small fiber tortuosity in IVCCM was identified as the main discriminator between patients and HC (AUC = 0.720; p < 0.01). Conclusion PCC and ME/CFS patients demonstrated sensory SFN, as evidenced by impaired heat detection and increased tortuosity of small fibers in the central corneal subbasal plexus. The findings underscore the importance of a multimodal approach to comprehensively detect and characterize SFN. This study provides valuable scientific insights into the neuropathic manifestations associated with these conditions.

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