{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:16:13Z","timestamp":1790172973080,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>In patients with amyotrophic lateral sclerosis (ALS), axonal spheroids in motor axons have been identified in post\u2010mortem studies. In this study, axonal spheroids and swellings on C\u2010fibers of ALS patients were investigated using corneal confocal microscopy (CCM) and skin biopsy, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010one ALS patients and 20 healthy subjects were evaluated with CCM to assess corneal nerve\u2010fiber length (CNFL), \u2010fiber density (CNFD), \u2010branch density (CNBD), dendritic cell (DC) density, and axonal spheroids originating from C\u2010fibers (&gt;100\u2009\u03bcm<jats:sup>2<\/jats:sup>). In addition, intraepidermal nerve fiber density (IENFD) and axonal swellings (&gt;1.5\u2009\u03bcm) were assessed in skin biopsies obtained from the arms and legs of 22 patients and 17 controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In ALS patients, IENFD, CNFD, CNFL, and CNBD were not different from controls. The density of DCs and the number of patients with increased DC density were higher in ALS patients than controls (<jats:italic>p<\/jats:italic>\u2009=\u2009.0005 and <jats:italic>p<\/jats:italic>\u2009=\u2009.008). The number of patients with axonal spheroids was higher than controls (<jats:italic>p<\/jats:italic>\u2009=\u2009.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Evaluation of DCs and axonal bulbs in C\u2010fibers of ALS patients could provide insights into pathophysiology or potentially serve as biomarkers in ALS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27995","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T21:51:04Z","timestamp":1700603464000},"page":"78-86","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Identification of corneal and intra\u2010epidermal axonal swellings in amyotrophic lateral sclerosis"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8322-1842","authenticated-orcid":false,"given":"Semra Akkaya","family":"Turhan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology 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