Review ArticlePeripheral neuropathy in idiopathic Parkinson's disease: A systematic review
Introduction
The term peripheral neuropathy (PN) refers to any disorder of the peripheral nervous system including single and multiple mononeuropathies (i.e. mononeuritis multiplex), symmetrical involvement of many nerves (polyneuropathy) or isolated involvement of sensory ganglia (ganglionopathies) [1]. Further classification depends on a mixture of phenomenological, neurophysiological, pathological and aetiological parameters [2]. There is sparse robust epidemiological data on polyneuropathies of any cause in the general population, the current estimates being between 2.4% and 8.0% [3], [4], [5]. Population-based studies have shown that prevalence of PN increases with age [5], being a common cause of chronic pain in the elderly [6].
An association between PN and Parkinson's disease (PD) has been described in some rare genetic forms of PD, such as in patients with PARK2 mutations [7] and has also been linked to levodopa exposure [8].
The aim of this work was systematically to review available studies on PN in idiopathic Parkinson's disease (IPD) in an attempt to clarify causal mechanisms of peripheral nervous system involvement in IPD.
Section snippets
Literature search strategy
A systematic computer-based literature search was conducted on April 9th, 2017 using the PubMed database. For the search we used two Medical Subject Headings (MeSH) terms in title or abstract. Term A was “Parkinson” or “Parkinson's” and Term B was “neuropathy” OR “polyneuropathy”. Limitations included human species, English language and full text available. We also perused the reference lists of the papers in order to find papers not identified through the search strategy.
Inclusion and exclusion criteria
To be included in the
Search results
This search strategy resulted in the identification of 278 articles. After the eligibility assessment, 243 articles were excluded and 35 met the inclusion criteria. Scanning the reference lists 3 more papers were identified. In total, 38 papers were used for this review. Table 1 summarizes the characteristics of these papers (full details for each study are available as an online Supplement). Fig. 1 illustrates the study selection process.
Epidemiology of large fiber neuropathy
Large fiber neuropathy occurs when the Aα and Aβ
Conclusion
The pooled estimate of the prevalence of large fiber neuropathy in idiopathic PD is estimated to be 16.3%. This is significantly higher compared to the prevalence of PN in the general population. However, this figure should be interpreted with caution, given the heterogeneity of the study populations and the fact that in some studies patients with risk factors such as diabetes and excessive alcohol consumption were excluded. Therefore, the prevalence of PN in PD might be even greater. In
Disclosures
Nothing to disclose.
Conflict of interest
None.
Author contributions
PZ and KRC have conceptualized the review. PZ carried out the systematic literature review and wrote the manuscript. RAG, KRC, and MH revised the manuscript.
The following is the supplementary data related to this article.
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