Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Neuronal involvement in cisplatin neuropathy: prospective clinical and neurophysiological studies

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Hyperpolarization through ATP-sensitive potassium channels; relevance to migraine pathology

    Research output: Contribution to journalLetterResearchpeer-review

  2. Reply: Hyperpolarization through ATP-sensitive potassium channels; relevance to migraine pathology

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. The first step towards personalized risk prediction for common epilepsies

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Transcriptome analysis in patients with temporal lobe epilepsy

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Locus coeruleus imaging as a biomarker for noradrenergic dysfunction in neurodegenerative diseases

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Improved Survival of Children, Adolescents, and Young Adults With Head and Neck Soft Tissue Sarcomas in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Community-based football in men with prostate cancer: 1-year follow-up on a pragmatic, multicentre randomised controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Eribulin versus dacarbazine in patients with leiomyosarcoma: subgroup analysis from a phase 3, open-label, randomised study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Neurologiske Sygdomme

    Research output: Chapter in Book/Report/Conference proceedingBook chapterEducation

View graph of relations
Although it is well known that cisplatin causes a sensory neuropathy, the primary site of involvement is not established. The clinical symptoms localized in a stocking-glove distribution may be explained by a length dependent neuronopathy or by a distal axonopathy. To study whether the whole neuron or the distal axon was primarily affected, we have carried out serial clinical and electrophysiological studies in 16 males with testicular cancer before or early and late during and after treatment with cisplatin, etoposide and bleomycin at limited (400 mg/m2 cisplatin) doses. At cumulative doses of cisplatin higher than 300 mg/m2 the patients lost distal tendon and H-reflexes and displayed reduced vibration sense in the feet and the fingers. The amplitudes of sensory nerve action potentials (SNAP) from the fingers innervated by the median nerve and the dorsolateral side of the foot innervated by the sural nerve were 50-60% reduced, whereas no definite changes occurred at lower doses. The SNAP conduction velocities were reduced by 10-15% at cumulative doses of 400-700 mg/m2 consistent with loss of large myelinated fibres. SNAPs from primarily Pacinian corpuscles in digit 3 and the dorsolateral side of the foot evoked by a tactile probe showed similar changes to those observed in SNAPs evoked by electrical stimulation. At these doses, somatosensory evoked potentials (SEPs) from the tibial nerve had increased latencies of peripheral, spinal and central responses suggesting loss of central processes of large dorsal root ganglion cells. Motor conduction studies, autonomic function and warm and cold temperature sensation remained unchanged at all doses of cisplatin treatment. The results of these studies are consistent with degeneration of large sensory neurons whereas there was no evidence of distal axonal degeneration even at the lowest toxic doses of cisplatin.
Original languageEnglish
JournalBrain
Volume130
Issue numberPt 4
Pages (from-to)1076-88
Number of pages13
ISSN0006-8950
DOIs
Publication statusPublished - 2007

    Research areas

  • Action Potentials, Adult, Antineoplastic Agents, Bleomycin, Carcinoma, Embryonal, Cisplatin, Etoposide, Evoked Potentials, Somatosensory, Humans, Longitudinal Studies, Male, Middle Aged, Neural Conduction, Neurons, Afferent, Peripheral Nervous System Diseases, Prospective Studies, Reflex, Seminoma, Sensation Disorders, Sensory Thresholds, Testicular Neoplasms, Touch

ID: 36747306