{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T20:24:28Z","timestamp":1762374268980,"version":"3.40.5"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T00:00:00Z","timestamp":1568246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain Pathology"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Schwannomatosis and neurofibromatosis type 2 (NF2) are two distinct neuro\u2010genetic tumor predisposition disorders, which, however, share some clinical and genetic features. While germline mutations in the <jats:italic>NF2<\/jats:italic> gene are only found in NF2, a majority of schwannomatosis patients have germline mutations in the <jats:italic>SMARCB1<\/jats:italic> or <jats:italic>LZTR1<\/jats:italic> genes. The overlapping clinical phenotypes pose a serious challenge in differential diagnosis and in risk stratification of these two entities which is further complicated by frequent mosaicism in both disorders. Chronic neuropathic pain which is a typical consequence of small fiber neuropathy, is characteristic for schwannomatosis. By contrast, NF2 patients do not have chronic pain but may have moderate to severe sensory deficits and paresis which are not characteristic for schwannomatosis. In the present study, we determined intraepidermal nerve fiber density (IEND) in skin biopsies of 34 clinically ascertained schwannomatosis and 25 NF2 patients. In the NF2 group, 11\/25 (44%) presented with IEND below the age\u2010 and gender\u2010matched bottom 5% normative reference IEND. In contrast, nearly all (33\/34\u00a0=\u00a097%) schwannomatosis patients showed IEND below or on the bottom 5% normative reference. The reduction of IEND in schwannomatosis patients was age\u2010independent. Paired <jats:italic>t<\/jats:italic>\u2010test revealed no difference between the NF2\u2010IEND and the corresponding bottom 5% normative reference (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.98). By contrast, IEND in the schwannomatosis patients were highly significantly lower than the corresponding 5% normative reference IEND (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). In addition, the difference between the IEND of our patients and the 5% lowest normative reference IEND was highly significantly larger in schwannomatosis patients than in NF2 patients (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). IEND of our patients did not correlate with neither the presence nor types of germline mutations in neither the NF2 nor the LZTR1 gene. In conclusion, schwannomatosis patients have marked low IEND which provides a major parameter for diagnosis and differential diagnosis.<\/jats:p>","DOI":"10.1111\/bpa.12780","type":"journal-article","created":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T12:58:06Z","timestamp":1566219486000},"page":"386-391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Distinctive low epidermal nerve fiber density in schwannomatosis patients provides a major parameter for diagnosis and differential diagnosis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3596-5932","authenticated-orcid":false,"given":"Said C.","family":"Farschtschi","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan","family":"Kluwe","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Maxillofacial Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard","family":"Sch\u00f6n","sequence":"additional","affiliation":[{"name":"Institute of Medical Biometry and Epidemiology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhard E.","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg 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