Summary
Quantitative histological studies were made on sural nerve biopsies from 123 patients with various neurological disorders. The myelinated fibre density, nuclear density, and the thickness of the perineurium were measured and compared with the average and standard deviation of control material in different age groups.
Specimens from chronic polyneuritis and heredodegenerative neuropathy showed a reduction of myelinated fibres and an increase of nuclei, the decrease of large myelinated fibres being greater than that of small myelinated fibres.
In acute polyneuritis the large and small myelinated fibres decreased equally in number. In the sensory type of SMON, small myelinated fibres decreased more than large myelinated fibres, while in the sensorimotor type of SMON, the change was the reverse. Nuclear population remained unchanged in these diseases.
In spinocerebellar degeneration there was a close correlation between the decrease in myelinated fibres and the clinical findings such as sensory disturbance and diminished tendon reflexes, suggesting the presence of peripheral nerve involvement.
Myelinated fibres were reduced in cases of neurological diseases hitherto considered to be free of pathological changes in sensory nerves, including motor neurone disease, myopathy, tumours or vascular diseases of the brain and spinal cord. In motor neurone disease and myopathy the large fibres were decreased more than small fibres, and nuclear population was increased. In tumours or vascular disease of the central nervous system, the large and small fibres were decreased equally in number, and the nuclear population was within normal range.
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Tohgi, H., Tsukagoshi, H. & Toyokura, Y. Quantitative changes of sural nerves in various neurological diseases. Acta Neuropathol 38, 95–101 (1977). https://doi.org/10.1007/BF00688554
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DOI: https://doi.org/10.1007/BF00688554