{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:02:33Z","timestamp":1790071353908,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004243","name":"Prinses Beatrix Spierfonds","doi-asserted-by":"publisher","award":["W.TR22\u201001"],"award-info":[{"award-number":["W.TR22\u201001"]}],"id":[{"id":"10.13039\/501100004243","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Peripheral Nervous Sys"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>\n                      Small fiber neuropathy (\n                      <jats:styled-content style=\"fixed-case\">SFN<\/jats:styled-content>\n                      ) is a peripheral neuropathy causing neuropathic pain, reduced quality of life (\n                      <jats:styled-content style=\"fixed-case\">QoL<\/jats:styled-content>\n                      ), and high societal costs. Previous studies assessed these societal costs before a definitive diagnosis was established, leaving it unclear whether diagnostic confirmation affects costs, pain intensity, or\n                      <jats:styled-content style=\"fixed-case\">QoL<\/jats:styled-content>\n                      . This study assessed changes in these outcomes before and after diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients referred to the tertiary SFN expertise center in the Netherlands completed questionnaires before diagnosis (at placement on the waiting list, approximately 7\u2009months before consultation) and at 3 and\/or 6\u2009months after confirmation. Healthcare utilization, patient and family costs, and productivity losses were assessed using the iMTA Medical Consumption and Productivity Cost Questionnaires. QoL was measured with the EQ\u20105D\u20105L and pain intensity with a numeric rating scale. Missing data were handled using multiple imputation, and changes over time were analyzed using within\u2010subject comparisons and generalized linear mixed models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty\u2010four patients completed both pre\u2010 and postdiagnosis questionnaires. After follow\u2010up, total healthcare costs, patient and family costs, productivity losses, pain intensity, and QoL remained unchanged. However, diagnostic confirmation of SFN was associated with fewer medical specialist visits, lower related costs, and improved health perception.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>These findings suggest that diagnostic clarification alone is insufficient to reduce the overall burden of SFN, highlighting the need for more effective symptom management and supportive care strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jns.70153","type":"journal-article","created":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T23:52:20Z","timestamp":1785714740000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Burden of Small Fiber Neuropathy: Changes in Pain, Costs, and Quality of Life Before and After Diagnosis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5385-7575","authenticated-orcid":false,"given":"Dennis","family":"Kool","sequence":"first","affiliation":[{"name":"Mental Health and Neuroscience Research Institute, Maastricht University  Maastricht the Netherlands"},{"name":"Department of Neurology Maastricht University Medical Center+  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot","family":"Geerts","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute, Maastricht University  Maastricht the Netherlands"},{"name":"Department of Neurology Maastricht University Medical Center+  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Brandts","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) Maastricht University Medical Center (MUMC+)  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5717-5704","authenticated-orcid":false,"given":"Merel","family":"Kimman","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) Maastricht University Medical Center (MUMC+)  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M. L.","family":"Gorissen\u2010Brouwers","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute, Maastricht University  Maastricht the Netherlands"},{"name":"Department of Neurology Maastricht University Medical Center+  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2467-067X","authenticated-orcid":false,"given":"Catharina G.","family":"Faber","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute, Maastricht University  Maastricht the Netherlands"},{"name":"Department of Neurology Maastricht University Medical Center+  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingemar S. 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J.","family":"Hoeijmakers","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute, Maastricht University  Maastricht the Netherlands"},{"name":"Department of Neurology Maastricht University Medical Center+  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/bs.irn.2024.10.001"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a8236e"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awz333"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/wco.0000000000001103"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13508"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474\u20104422(14)70251\u20100"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23910"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12514"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000012894"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000003008"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23265"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17155556"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2015.05.009"},{"key":"e_1_2_12_15_1","volume-title":"Manual iMTA Medical Cost Questionnaire (iMCQ)","author":"iMTA Productivity and Health Research Group","year":"2018"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0304\u20103959(01)00349\u20109"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010011\u20109903\u2010x"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.01.003"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291796004382"},{"key":"e_1_2_12_20_1","unstructured":"Centraal Bureau Voor de Statistiek \u201c3. 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