{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:32:21Z","timestamp":1788330741965,"version":"build-2803163510"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,2,4]],"date-time":"2018-02-04T00:00:00Z","timestamp":1517702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cold\u2010induced peripheral neuropathy has been described in individuals exposed to severe cold resulting in pain, hypersensitivity to cold, hyperhidrosis, numbness, and skin changes. Nerve conduction studies and thermal detection thresholds are abnormal in symptomatic patients, and intraepidermal nerve fiber density (<jats:styled-content style=\"fixed-case\">IENFD<\/jats:styled-content>) in skin biopsies is reduced.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 41\u2010year\u2010old male was included as a healthy subject in a study of the spontaneous variability of quantitative sensory testing (<jats:styled-content style=\"fixed-case\">QST<\/jats:styled-content>), nerve conduction studies (<jats:styled-content style=\"fixed-case\">NCS<\/jats:styled-content>), and <jats:styled-content style=\"fixed-case\">IENFD<\/jats:styled-content>. Unexpectedly, <jats:styled-content style=\"fixed-case\">IENFD<\/jats:styled-content> was significantly reduced, whereas the rest of the examination was normal except for reduced vibration detection threshold. The results were confirmed at follow\u2010up examination. The subject had been repeatedly exposed to severe cold resulting in short lasting numbness and paresthesia while living in the eastern part of Greenland and the northern part of Norway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Loss of intraepidermal nerve fibers caused by exposure to severe cold may be asymptomatic, and their function assessed by thermal detection thresholds may be preserved. This case illustrates that <jats:styled-content style=\"fixed-case\">QST<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IENFD<\/jats:styled-content> are complementary tests and that subclinical cold\u2010induced peripheral neuropathy may be prevalent in subjects living in or near polar regions which could have implications for the recruitment of healthy subjects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.917","type":"journal-article","created":{"date-parts":[[2018,2,4]],"date-time":"2018-02-04T05:09:02Z","timestamp":1517720942000},"source":"Crossref","is-referenced-by-count":3,"title":["Asymptomatic loss of intraepidermal nerve fibers with preserved thermal detection thresholds after repeated exposure to severe cold"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1565-6948","authenticated-orcid":false,"given":"Thomas","family":"Kr\u00f8ig\u00e5rd","sequence":"first","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense C Denmark"},{"name":"Department of Clinical Research Faculty of Health Science University of Southern Denmark  Odense C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wirenfeldt","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Faculty of Health Science University of Southern Denmark  Odense C Denmark"},{"name":"Department of Pathology Odense University Hospital  Odense C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toke K.","family":"Svendsen","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense C Denmark"},{"name":"Department of Clinical Research Faculty of Health Science University of Southern Denmark  Odense C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren H.","family":"Sindrup","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense C Denmark"},{"name":"Department of Clinical Research Faculty of Health Science University of Southern Denmark  Odense C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,4]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2362.1996.153309.x"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-017-1227-x"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn093"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000227"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8027.2010.00269.x"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8027.2010.00271.x"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.01.041"},{"key":"e_1_2_4_9_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1001\/archderm.1955.03730340033007","article-title":"Local cold injury. 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