{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:05:17Z","timestamp":1792209917013,"version":"4.4.0"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Transthyretin amyloidosis (ATTR) is a systemic disorder characterized by the extracellular accumulation of amyloid fibrils, classified as either mutant (ATTRv, v for variant) or wild\u2010type (ATTRwt), based on the genetic sequence of the transthyretin (TTR) protein. ATTRwt primarily manifests with cardiac and osteo\u2010articular involvement. Nevertheless, evidence of peripheral neuropathy, besides carpal tunnel syndrome (CTS), can be found in ATTRwt patients. Although neurological complications of ATTRv have been extensively studied, to date information on peripheral nervous system (PNS) involvement in ATTRwt remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with a confirmed diagnosis of ATTRwt underwent neurological examination and nerve conduction studies (NCS). In patients with confirmed polyneuropathy, we suggested a sural nerve biopsy to detect amyloid deposits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We examined 30 patients with a mean age of 81.1\u2009years (range 60\u201396). The absence of lower\u2010limb distal tendon reflexes was shown in 53% of cases. CTS was present in 70% of cases. NCS revealed a sensory polyneuropathy in 18 patients (60%). Among the patients with neuropathy, four agreed to undergo sural nerve biopsy: in two patients, histological examination showed the presence of Congo red\u2010positive amyloid deposits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We observed a sensory neuropathy in more than half of the enrolled ATTRwt patients, supporting the systemic nature of the disease. However, the unclear pathogenesis of sensory polyneuropathy, considering the various comorbidities in the elderly population, highlights the need for further investigation. Histological confirmation of amyloid deposition in nerve tissue may provide a causal link between amyloidosis and PNS involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70374","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T11:22:03Z","timestamp":1762341723000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Polyneuropathy in Wild\u2010Type Transthyretin Amyloidosis"],"prefix":"10.1111","volume":"32","author":[{"given":"Maria Ausilia","family":"Sciarrone","sequence":"first","affiliation":[{"name":"Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3177-1575","authenticated-orcid":false,"given":"Francesca","family":"Vitali","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Guglielmino","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Romano","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS UOC Neurologia  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8070-3586","authenticated-orcid":false,"given":"Giovanni","family":"Siconolfi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ceccanti","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Inghilleri","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Chimenti","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences Sapienza University  Rome Italy"},{"name":"Cellular and Molecular Cardiology Lab IRCCS Lazzaro Spallanzani  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Graziani","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli\u2010IRCCS UOC Cardiologia  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Lillo","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli\u2010IRCCS UOC Cardiologia  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Libonati","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Cambieri","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Moret","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Stifano","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli\u2010IRCCS UOC Neurochirurgia  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7539-505X","authenticated-orcid":false,"given":"Marco","family":"Luigetti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Fondazione Policlinico Universitario A. 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