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New definitions will increase the significance of teased-fibre studies from both pathophysiological and diagnostic viewpoints
Although nerve biopsy is a classical approach, it still plays a role in the diagnosis and elucidation of the pathophysiology of neuropathy.1 There are two major techniques used to assess the morphology of nerve fibres in the longitudinal direction; one involves cutting glutaraldehyde-fixed epoxy-resin-embedded specimens into longitudinal sections and the other involves teasing the nerve fibres. Longitudinal sections are suitable for fine structural assessments using transmission electron microscopy to demonstrate, for example, paranodal pathology in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) displaying anti-neurofascin 155 antibodies.2 However, longitudinal sections are not useful for viewing complete pictures of long lesions that extend over several nodes of Ranvier.
Conversely, teased-fibre preparations enable observations of long nerve fibre …
Contributors HK wrote the first draft and all authors critically evaluated the manuscript.
Funding This work was supported by grants from the Ministry of Health, Labor and Welfare (Research on Rare and Intractable Diseases, H29-022) and the Ministry of Education, Culture, Sports, Science and Technology (17K09777) of Japan.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Commissioned; internally peer reviewed.
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