A-Delta pf-NCS Efficacy Confirmed by Skin Biopsy:
At the April 8-9, 2011 AASEM Annual Scientific Conference held in Baltimore Maryland, a Philadelphia neurological group reported on a series of 20 neck and back pain patients, all of which had negative EMG studies. However, the
A-delta pf-NCS detected pathology that was confirmed by skin biopsy.
Though skin biopsy is widely held to be the gold standard for proving the existence of small pain fiber pathology, in many cases it fails to demonstrate small fiber loss in otherwise obvious pain cases. This is likely due to the fact that 50% of these pain cases have referred symptoms, which misdirect biopsies and treatments.
This series demonstrates that the A-delta pf-NCS detects pain fiber pathology that EMG-type tests cannot assess, and is as reliable as biopsy. Additionally, the A-delta pf-NCS is far more acceptable to patients than either needle EMG or skin biopsy.
Normal small fibers in a normal patient with a negative pf-NCS (demonstrated below)
Absence of small fibers in the dermatome of a patient with left L4 radiculopathy.