3603 Multimodal non-invasive neurophysiological testing of small fibre neuropathy in long COVID
Anthony Khoo, Kisani Manuel, David Lynn, Maria Crotty
Background
Long COVID is associated with a diverse range of debilitating neuropathic and autonomic symptoms that may indicate small fibre neuropathy (SFN). We aimed to assess the utility of multimodal non-invasive electrodiagnostic techniques in evaluating symptomatic individuals.
Methods
People with confirmed Long COVID who scored >10 points on the Small Fibre Neuropathy Screening List (SFNSL) questionnaire underwent neurophysiological testing. Individuals with at least two abnormal results in: a) Sympathetic Skin Responses, b) Cutaneous Silent Period, c) Quantitative Thermal Thresholds, or d) Electrochemical Skin Conductance (Sudoscan®) were considered to have neurophysiological evidence of SFN. Clinical and demographic information was collected on all individuals, who also underwent routine nerve conduction testing and comprehensive physical and psychometric evaluation, including a 6-minute-walk test, NASA Lean Test, Composite Autonomic Symptom Score-31 (COMPASS-31), EuroQoL Questionnaire (ED-5D-5L), Modified Fatigue Impact Scale (MFIS) score, and Patient Health (depression) Questionnaire (PHQ-9).
Results
We assessed nine (6 female, 3 male) individuals recruited from the Flinders Medical Centre Long COVID clinic. Median age was 47.8 (range 26.3–67.6) years, median duration from COVID-19 infection 23.0 (range 8.5–35.7) months and median SFNSL 34/84. Three (33%) had neurophysiological evidence of SFN. There was no significant difference across symptom scores between people with and without SFN, with both groups scoring highly in disability measures (median EQ-5D-5L 40/100; MFIS 69/84; PHQ-9 18/27).
Conclusion
Long COVID continues to be associated with functional disability and reduced quality of life. Individuals with neuropathic or autonomic symptoms may have evidence of SFN that can be identified with non-invasive neurophysiological testing.
Web | PDF | BMJ Neurology Open | Abstract only
Anthony Khoo, Kisani Manuel, David Lynn, Maria Crotty
Background
Long COVID is associated with a diverse range of debilitating neuropathic and autonomic symptoms that may indicate small fibre neuropathy (SFN). We aimed to assess the utility of multimodal non-invasive electrodiagnostic techniques in evaluating symptomatic individuals.
Methods
People with confirmed Long COVID who scored >10 points on the Small Fibre Neuropathy Screening List (SFNSL) questionnaire underwent neurophysiological testing. Individuals with at least two abnormal results in: a) Sympathetic Skin Responses, b) Cutaneous Silent Period, c) Quantitative Thermal Thresholds, or d) Electrochemical Skin Conductance (Sudoscan®) were considered to have neurophysiological evidence of SFN. Clinical and demographic information was collected on all individuals, who also underwent routine nerve conduction testing and comprehensive physical and psychometric evaluation, including a 6-minute-walk test, NASA Lean Test, Composite Autonomic Symptom Score-31 (COMPASS-31), EuroQoL Questionnaire (ED-5D-5L), Modified Fatigue Impact Scale (MFIS) score, and Patient Health (depression) Questionnaire (PHQ-9).
Results
We assessed nine (6 female, 3 male) individuals recruited from the Flinders Medical Centre Long COVID clinic. Median age was 47.8 (range 26.3–67.6) years, median duration from COVID-19 infection 23.0 (range 8.5–35.7) months and median SFNSL 34/84. Three (33%) had neurophysiological evidence of SFN. There was no significant difference across symptom scores between people with and without SFN, with both groups scoring highly in disability measures (median EQ-5D-5L 40/100; MFIS 69/84; PHQ-9 18/27).
Conclusion
Long COVID continues to be associated with functional disability and reduced quality of life. Individuals with neuropathic or autonomic symptoms may have evidence of SFN that can be identified with non-invasive neurophysiological testing.
Web | PDF | BMJ Neurology Open | Abstract only