TY - THES A1 - Bellinger, Daniel T1 - Zeitwahrnehmung in der Musik bei Morbus Parkinson - eine psychophysische Studie T1 - Perception of Time in Music in Patients with Parkinson's Disease – A Psychophysical Study N2 - Parkinson Patienten sind im Gegensatz zu gesunden Probanden in der kognitiven Verarbeitung zeitlicher Parameter, im Sinne einer Diskriminierungsfähigkeit für zeitliche Fehler innerhalb der Musikwahrnehmung beeinträchtigt. Dies betrifft lediglich die Zeiterkennung in höheren Intervallbereichen (> 600ms) und ist am ehesten durch Fluktuationen der Aufmerksamkeit, des Gedächtnisses, aber auch im Vergleich zu anderen Studien durch methodische Ansätze zu erklären. Durch die Koppelung des Audiostimulus an klare Rhythmusstrukturen weist diese Studie jedoch darauf hin, dass Überschneidungen zu anderen neuronalen Netzwerken existieren, die zur Kompensationsstrategie rekrutiert und nutzbar gemacht werden können. Dazu gehören etwa die Verarbeitung zeitlicher (Cerebellum) und musikperzeptiver Leistungen, wie etwa die Verarbeitung musikalischer Syntax (BA 6, 22, 44). Etwaige Wahrnehmungsdefizite können durch Mechanismen musiksyntaktischer Verarbeitung kompensiert werden, da zeitliche und syntaktische Strukturen in der Musik auf ihre Kongruenz hin abgeglichen und somit multineuronal mediiert werden (Paradigma der Zeit-Syntax-Kongruenz in der Musikwahrnehmung). Weiterhin sind vermutlich top-down-bottom-up-Prozesse als multimodale Interaktionen an diesem Kompensationsmechanismus beteiligt. Außerdem ist festzuhalten, dass das Krankheitsstadium nicht zwangsläufig mit einem stärkeren Wahrnehmungsdefizit für zeitliche Strukturen einhergehen muss, obwohl – wenn auch noch tolerabel – mit Progression der Erkrankung dieses Kompensationsmodell über Prinzipien der Gestaltwahrnehmung zusammenbricht und es hier zu schlechteren perzeptiven Leistungen kommen kann. Die Ergebnisse der OFF-Testungen und jener unter DBS-Therapie lassen weiterhin aufgrund der kleinen Stichprobe keine klare Aussage zu und machen weitere Untersuchungen notwendig. Das physiologische Alter korreliert außerdem mit der sensorischen Leistung, die allerdings starken, individuellen Unterschieden ausgesetzt ist und von multifaktoriellen Voraussetzungen abhängt. Auch zeigt die Studie, dass Menschen mit einem hohen Musikverständnis und einer musikalischen Ausbildung ein feineres Diskriminierungsvermögen in der zeitlichen Verarbeitung besitzen, welches v.a. im zeitlich niedrigen Intervallbereich (< 500ms) evident wird. N2 - Objective: Perception of time as well as rhythm in musical structures rely on complex brain mechanisms and require an extended network of multiple neural sources. They are therefore sensitive to impairment. Several psychophysical studies have shown that patients with Parkinson's disease (PD) have deficits in perceiving time and rhythms due to a malfunction of the basal ganglia (BG) network. Method: In this study we investigated the time perception of PD patients during music perception by assessing their just noticeable difference (JND) in the time perception of a complex musical Gestalt. We applied a temporal discrimination task using a short melody with a clear beat-based rhythm. Among the subjects, 26 patients under L-Dopa administration and 21 age-matched controls had to detect an artificially delayed time interval in the range between 80 and 300 ms in the middle of the musical period. We analyzed the data by (a) calculating the detection threshold directly, (b) by extrapolating the JNDs, (c) relating it to musical expertise. Results: Patients differed from controls in the detection of time-intervals between 220 and 300 ms (*p = 0.0200, n = 47). Furthermore, this deficit depended on the severity of the disease (*p = 0.0452; n = 47). Surprisingly, PD patients did not show any deficit of their JND compared to healthy controls, although the results showed a trend (*p = 0.0565, n = 40). Furthermore, no significant difference of the JND was found according to the severity of the disease. Additionally, musically trained persons seemed to have lower thresholds in detecting deviations in time and syntactic structures of music (*p = 0.0343, n = 39). Conclusion: As an explanation of these results, we would like to propose the hypothesis of a time-syntax-congruency in music perception suggesting that processing of time and rhythm is a Gestalt process and that cortical areas involved in processing of musical syntax may compensate for impaired BG circuits that are responsible for time processing and rhythm perception. This mechanism may emerge more strongly as the deficits in time processing and rhythm perception progress. Furthermore, we presume that top-down-bottom-up-processes interfere additionally and interact in this context of compensation. KW - Parkinson KW - Parkinson disease KW - psychophysics KW - Psychophysik KW - Musikwahrnehmung KW - Zeitwahrnehmung KW - Rhythmusperzeption KW - musikalische Syntax KW - time perception KW - rhythmperception KW - musical syntax KW - just noticeable difference (JND) Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-198766 N1 - s. a. Frontiers of Neuroscience. 2017 Feb 23;11:68. doi: 10.3389/fnins.2017.00068. eCollection 2017 ER - TY - JOUR A1 - Capetian, Philipp A1 - Müller, Lorenz A1 - Volkmann, Jens A1 - Heckmann, Manfred A1 - Ergün, Süleyman A1 - Wagner, Nicole T1 - Visualizing the synaptic and cellular ultrastructure in neurons differentiated from human induced neural stem cells - an optimized protocol JF - International Journal of Molecular Sciences N2 - The size of the synaptic subcomponents falls below the limits of visible light microscopy. Despite new developments in advanced microscopy techniques, the resolution of transmission electron microscopy (TEM) remains unsurpassed. The requirements of tissue preservation are very high, and human post mortem material often does not offer adequate quality. However, new reprogramming techniques that generate human neurons in vitro provide samples that can easily fulfill these requirements. The objective of this study was to identify the culture technique with the best ultrastructural preservation in combination with the best embedding and contrasting technique for visualizing neuronal elements. Two induced neural stem cell lines derived from healthy control subjects underwent differentiation either adherent on glass coverslips, embedded in a droplet of highly concentrated Matrigel, or as a compact neurosphere. Afterward, they were fixed using a combination of glutaraldehyde (GA) and paraformaldehyde (PFA) followed by three approaches (standard stain, Ruthenium red stain, high contrast en-bloc stain) using different combinations of membrane enhancing and contrasting steps before ultrathin sectioning and imaging by TEM. The compact free-floating neurospheres exhibited the best ultrastructural preservation. High-contrast en-bloc stain offered particularly sharp staining of membrane structures and the highest quality visualization of neuronal structures. In conclusion, compact neurospheres growing under free-floating conditions in combination with a high contrast en-bloc staining protocol, offer the optimal preservation and contrast with a particular focus on visualizing membrane structures as required for analyzing synaptic structures. KW - transmission electron microscopy KW - human neurons KW - induced neural stem cells KW - synapse KW - synaptic vesicles KW - high contrast Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236053 SN - 1422-0067 VL - 21 IS - 5 ER - TY - JOUR A1 - Gabriel, Katharina M. A. A1 - Jírů-Hillmann, Steffi A1 - Kraft, Peter A1 - Selig, Udo A1 - Rücker, Victoria A1 - Mühler, Johannes A1 - Dötter, Klaus A1 - Keidel, Matthias A1 - Soda, Hassan A1 - Rascher, Alexandra A1 - Schneider, Rolf A1 - Pfau, Mathias A1 - Hoffmann, Roy A1 - Stenzel, Joachim A1 - Benghebrid, Mohamed A1 - Goebel, Tobias A1 - Doerck, Sebastian A1 - Kramer, Daniela A1 - Haeusler, Karl Georg A1 - Volkmann, Jens A1 - Heuschmann, Peter U. A1 - Fluri, Felix T1 - Two years' experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke) JF - BMC Neurology N2 - Background Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years' experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. Methods The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany). All hospitals providing acute stroke care in this region participate in TRANSIT-Stroke, including four hospitals with a supra-regional certified stroke unit (SU) care (level III), three of those providing teleconsultation to two hospitals with a regional certified SU (level II) and five hospitals without specialized SU care (level I). For a two-year-period (01/2015 to 12/2016), data of eight of these hospitals were available; 13 evidence-based quality indicators (QIs) related to processes during hospitalisation were evaluated quarterly and compared according to predefined target values between level-I- and level-II/III-hospitals. Results Overall, 7881 patients were included (mean age 74.6 years +/- 12.8; 48.4% female). In level-II/III-hospitals adherence of all QIs to predefined targets was high ab initio. In level-I-hospitals, three patterns of QI-development were observed: a) high adherence ab initio (31%), mainly in secondary stroke prevention; b) improvement over time (44%), predominantly related to stroke specific diagnosis and in-hospital organization; c) no clear time trends (25%). Overall, 10 out of 13 QIs reached predefined target values of quality of care at the end of the observation period. Conclusion The implementation of the comprehensive TRANSIT-Stroke network resulted in an improvement of quality of care in level-I-hospitals. KW - pilot project KW - care tempis KW - ischemic stroke KW - thrombolysis KW - areas KW - time KW - hospitals KW - mortality KW - outcomes KW - quality Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-229214 VL - 20 ER - TY - THES A1 - Töppner, Verena T1 - Therapie und Outcome von Patienten mit aneurysmatischer Subarachnoidalblutung am Universitätsklinikum Würzburg T1 - Therapy and outcome of patients with aneurysmal subarachnoid haemorrhage at the university hospital Würzburg N2 - Die aneurysmatische SAB ist trotz etablierter Therapieverfahren (Coiling und Clipping) weiterhin ein Krankheitsbild mit hoher Mortalität. In unserer Arbeit haben wir retrospektiv die Patientenakten der Patienten, die mit der Diagnose aneurysmatische SAB am Universitätsklinikum Würzburg zwischen dem 01.01.1999 und dem 31.12.2009 aufgenommen wurden, ausgewertet. Es konnte dargestellt werden das als Hauptrisikofaktoren für ein schlechtes Therapieergebnis ein schlechter Aufnahmestatus des Patienten und das Auftreten von Komplikationen im Verlauf verantwortlich sind. N2 - The aneurysmal SAH is still, despite well-established therapeutic methods (Coiling and Clipping), a disease with a high rate of mortality. Our study did a retrospective research on the data of patients who have been hospitalized with the diagnosis of aneurysmal subarachnoid haemorrhage between 01.01.1999 and. 31.12.2009 at the university hospital Würzburg. We could define a bad neurological status at admission and the occurrence of complications as the major risk factors for a bad neurological outcome. KW - Subarachnoidalblutung KW - Aneurysma Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-209129 ER - TY - JOUR A1 - Gómez-Fernández, Paloma A1 - Lopez de Lapuente Portilla, Aitzkoa A1 - Astobiza, Ianire A1 - Mena, Jorge A1 - Urtasun, Andoni A1 - Altmann, Vivian A1 - Matesanz, Fuencisla A1 - Otaegui, David A1 - Urcelay, Elena A1 - Antigüedad, Alfredo A1 - Malhotra, Sunny A1 - Montalban, Xavier A1 - Castillo-Triviño, Tamara A1 - Espino-Paisán, Laura A1 - Aktas, Orhan A1 - Buttmann, Mathias A1 - Chan, Andrew A1 - Fontaine, Bertrand A1 - Gourraud, Pierre-Antoine A1 - Hecker, Michael A1 - Hoffjan, Sabine A1 - Kubisch, Christian A1 - Kümpfel, Tania A1 - Luessi, Felix A1 - Zettl, Uwe K. A1 - Zipp, Frauke A1 - Alloza, Iraide A1 - Comabella, Manuel A1 - Lill, Christina M. A1 - Vandenbroeck, Koen T1 - The rare IL22RA2 signal peptide coding variant rs28385692 decreases secretion of IL-22BP isoform-1, -2 and -3 and is associated with risk for multiple sclerosis JF - Cells N2 - The IL22RA2 locus is associated with risk for multiple sclerosis (MS) but causative variants are yet to be determined. In a single nucleotide polymorphism (SNP) screen of this locus in a Basque population, rs28385692, a rare coding variant substituting Leu for Pro at position 16 emerged significantly (p = 0.02). This variant is located in the signal peptide (SP) shared by the three secreted protein isoforms produced by IL22RA2 (IL-22 binding protein-1(IL-22BPi1), IL-22BPi2 and IL-22BPi3). Genotyping was extended to a Europe-wide case-control dataset and yielded high significance in the full dataset (p = 3.17 × 10\(^{-4}\)). Importantly, logistic regression analyses conditioning on the main known MS-associated SNP at this locus, rs17066096, revealed that this association was independent from the primary association signal in the full case-control dataset. In silico analysis predicted both disruption of the alpha helix of the H-region of the SP and decreased hydrophobicity of this region, ultimately affecting the SP cleavage site. We tested the effect of the p.Leu16Pro variant on the secretion of IL-22BPi1, IL-22BPi2 and IL-22BPi3 and observed that the Pro16 risk allele significantly lowers secretion levels of each of the isoforms to around 50%–60% in comparison to the Leu16 reference allele. Thus, our study suggests that genetically coded decreased levels of IL-22BP isoforms are associated with augmented risk for MS. KW - IL22RA2 KW - IL-22 binding protein isoform KW - mutation KW - signal peptide KW - multiple sclerosis KW - autoimmune Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-200769 SN - 2073-4409 VL - 9 IS - 1 ER - TY - JOUR A1 - Rickert, V. A1 - Wagenhäuser, L. A1 - Nordbeck, P. A1 - Wanner, C. A1 - Sommer, C. A1 - Rost, S. A1 - Üçeyler, N. T1 - Stratification of Fabry mutations in clinical practice: a closer look at α‐galactosidase A‐3D structure JF - Journal of Internal Medicine N2 - Background Fabry disease (FD) is an X‐linked lysosomal storage and multi‐system disorder due to mutations in the α‐galactosidase A (α‐GalA) gene. We investigated the impact of individual amino acid exchanges in the α‐GalA 3D‐structure on the clinical phenotype of FD patients. Patients and methods We enrolled 80 adult FD patients with α‐GalA missense mutations and stratified them into three groups based on the amino acid exchange location in the α‐GalA 3D‐structure: patients with active site mutations, buried mutations and other mutations. Patient subgroups were deep phenotyped for clinical and laboratory parameters and FD‐specific treatment. Results Patients with active site or buried mutations showed a severe phenotype with multi‐organ involvement and early disease manifestation. Patients with other mutations had a milder phenotype with less organ impairment and later disease onset. α‐GalA activity was lower in patients with active site or buried mutations than in those with other mutations (P < 0.01 in men; P < 0.05 in women) whilst lyso‐Gb3 levels were higher (P < 0.01 in men; <0.05 in women). Conclusions The type of amino acid exchange location in the α‐GalA 3D‐structure determines disease severity and temporal course of symptom onset. Patient stratification using this parameter may become a useful tool in the management of FD patients. KW - Fabry disease KW - Fabry genotype KW - Fabry phenotype KW - lyso‐Gb3 KW - α‐GalA 3D‐structure Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-218125 VL - 288 IS - 5 SP - 593 EP - 604 ER - TY - JOUR A1 - Berve, Kristina A1 - West, Brian L. A1 - Martini, Rudolf A1 - Groh, Janos T1 - Sex- and region-biased depletion of microglia/macrophages attenuates CLN1 disease in mice JF - Journal of Neuroinflammation N2 - Background The neuronal ceroid lipofuscinoses (CLN diseases) are fatal lysosomal storage diseases causing neurodegeneration in the CNS. We have previously shown that neuroinflammation comprising innate and adaptive immune reactions drives axonal damage and neuron loss in the CNS of palmitoyl protein thioesterase 1-deficient (Ppt1\(^{-/-}\)) mice, a model of the infantile form of the diseases (CLN1). Therefore, we here explore whether pharmacological targeting of innate immune cells modifies disease outcome in CLN1 mice. Methods We applied treatment with PLX3397 (150 ppm in the chow), a potent inhibitor of the colony stimulating factor-1 receptor (CSF-1R) to target innate immune cells in CLN1 mice. Experimental long-term treatment was non-invasively monitored by longitudinal optical coherence tomography and rotarod analysis, as well as analysis of visual acuity, myoclonic jerks, and survival. Treatment effects regarding neuroinflammation, neural damage, and neurodegeneration were subsequently analyzed by histology and immunohistochemistry. Results We show that PLX3397 treatment attenuates neuroinflammation in CLN1 mice by depleting pro-inflammatory microglia/macrophages. This leads to a reduction of T lymphocyte recruitment, an amelioration of axon damage and neuron loss in the retinotectal system, as well as reduced thinning of the inner retina and total brain atrophy. Accordingly, long-term treatment with the inhibitor also ameliorates clinical outcomes in CLN1 mice, such as impaired motor coordination, visual acuity, and myoclonic jerks. However, we detected a sex- and region-biased efficacy of CSF-1R inhibition, with male microglia/macrophages showing higher responsiveness toward depletion, especially in the gray matter of the CNS. This results in a better treatment outcome in male Ppt1\(^{-/-}\) mice regarding some histopathological and clinical readouts and reflects heterogeneity of innate immune reactions in the diseased CNS. Conclusions Our results demonstrate a detrimental impact of innate immune reactions in the CNS of CLN1 mice. These findings provide insights into CLN pathogenesis and may guide in the design of immunomodulatory treatment strategies. KW - Neuronal ceroid lipofuscinosis KW - Microglia KW - Macrophages KW - T lymphocytes KW - Neurodegeneration KW - Axon degeneration Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-230234 VL - 17 ER - TY - JOUR A1 - Samper Agrelo, Iria A1 - Schira-Heinen, Jessica A1 - Beyer, Felix A1 - Groh, Janos A1 - Bütermann, Christine A1 - Estrada, Veronica A1 - Poschmann, Gereon A1 - Bribian, Ana A1 - Jadasz, Janusz J. A1 - Lopez-Mascaraque, Laura A1 - Kremer, David A1 - Martini, Rudolf A1 - Müller, Hans Werner A1 - Hartung, Hans Peter A1 - Adjaye, James A1 - Stühler, Kai A1 - Küry, Patrick T1 - Secretome analysis of mesenchymal stem cell factors fostering oligodendroglial differentiation of neural stem cells in vivo JF - International Journal of Molecular Sciences N2 - Mesenchymal stem cell (MSC)-secreted factors have been shown to significantly promote oligodendrogenesis from cultured primary adult neural stem cells (aNSCs) and oligodendroglial precursor cells (OPCs). Revealing underlying mechanisms of how aNSCs can be fostered to differentiate into a specific cell lineage could provide important insights for the establishment of novel neuroregenerative treatment approaches aiming at myelin repair. However, the nature of MSC-derived differentiation and maturation factors acting on the oligodendroglial lineage has not been identified thus far. In addition to missing information on active ingredients, the degree to which MSC-dependent lineage instruction is functional in vivo also remains to be established. We here demonstrate that MSC-derived factors can indeed stimulate oligodendrogenesis and myelin sheath generation of aNSCs transplanted into different rodent central nervous system (CNS) regions, and furthermore, we provide insights into the underlying mechanism on the basis of a comparative mass spectrometry secretome analysis. We identified a number of secreted proteins known to act on oligodendroglia lineage differentiation. Among them, the tissue inhibitor of metalloproteinase type 1 (TIMP-1) was revealed to be an active component of the MSC-conditioned medium, thus validating our chosen secretome approach. KW - neural stem cells KW - mesenchymal stem cells KW - transplantation KW - oligodendroglia KW - glial fate modulation KW - myelin KW - spinal cord KW - secretome KW - TIMP-1 Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-285465 SN - 1422-0067 VL - 21 IS - 12 ER - TY - JOUR A1 - Elhfnawy, Ahmed Mohamed A1 - Abd El‐Raouf, Mervat A1 - Volkmann, Jens A1 - Fluri, Felix A1 - Elsalamawy, Doaa T1 - Relation of infarction location and volume to vertigo in vertebrobasilar stroke JF - Brain and Behavior N2 - Objective Vertigo is a common presentation of vertebrobasilar stroke. Anecdotal reports have shown that vertigo occurs more often in multiple than in single brainstem or cerebellar infarctions. We examined the relation between the location and volume of infarction and vertigo in patients with vertebrobasilar stroke. Methods Consecutive patients with vertebrobasilar stroke were prospectively recruited. The infarction location and volume were assessed in the diffusion‐weighted magnetic resonance imaging. Results Fifty‐nine patients were included, 32 (54.2%) with vertigo and 27 (45.8%) without vertigo. The infarction volume did not correlate with National Institute of Health Stroke Scale (NIHSS) score on admission (Spearman ρ = .077, p = .56) but correlated with modified Rankin Scale (ρ = .37, p = .004) on discharge. In the vertigo group, the proportion of men was lower (53.1% vs. 77.8%, p = .049), fewer patients had focal neurological deficits (65.6% vs. 96.3%, p = .004), patients tended to present later (median [IQR] was 7.5 [4–46] vs. 4 [2–12] hours, p = .052), numerically fewer patients received intravenous thrombolysis (15.6% vs. 37%, p = .06), and the total infarction volume was larger (5.6 vs. 0.42 cm3, p = .008) than in nonvertigo group. In multivariate logistic regression, infarction location either in the cerebellum or in the dorsal brainstem (odds ratio [OR] 16.97, 95% CI 3.1–92.95, p = .001) and a total infarction volume of >0.48 cm3 (OR 4.4, 95% CI 1.05–18.58, p = .043) were related to vertigo. In another multivariate logistic regression, after adjusting for age, sex, intravenous thrombolysis, serum level of white blood cells, and atrial fibrillation, vertigo independently predicted a total infarction volume of >0.48 cm3 (OR 5.75, 95% CI 1.43–23.08, p = .01). Conclusion Infarction location in the cerebellum and/or dorsal brainstem is an independent predictor of vertigo. Furthermore, larger infarction volume in these structures is associated with vertigo. A considerable proportion of patients with vascular vertigo present without focal neurological deficits posing a diagnostic challenge. National Institute of Health Stroke Scale is not sensitive for vertebrobasilar stroke. KW - brain stem KW - cerebellum KW - infarction volume KW - stroke KW - vertebrobasilar insufficiency KW - vertigo Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-218047 VL - 10 IS - 3 ER - TY - JOUR A1 - Klitsch, Alexander A1 - Evdokimov, Dimitar A1 - Frank, Johanna A1 - Thomas, Dominique A1 - Saffer, Nadine A1 - Meyer zu Altenschildesche, Caren A1 - Sisignano, Marco A1 - Kampik, Daniel A1 - Malik, Rayaz A. A1 - Sommer, Claudia A1 - Üçeyler, Nurcan T1 - Reduced association between dendritic cells and corneal sub‐basal nerve fibers in patients with fibromyalgia syndrome JF - Journal of the Peripheral Nervous System N2 - In our study, we aimed at investigating corneal langerhans cells (LC) in patients with fibromyalgia syndrome (FMS) and small fiber neuropathy (SFN) as potential contributors to corneal small fiber pathology. We enrolled women with FMS (n = 134) and SFN (n = 41) who underwent neurological examination, neurophysiology, prostaglandin analysis in tear fluid, and corneal confocal microscopy (CCM). Data were compared with those of 60 age‐matched female controls. After screening for dry eye disease, corneal LC were counted and sub‐classified as dendritic (dLC) and non‐dendritic (ndLC) cells with or without nerve fiber association. We further analyzed corneal nerve fiber density (CNFD), length (CNFL), and branch density (CNBD). Neurological examination indicated deficits of small fiber function in patients with SFN. Nerve conduction studies were normal in all participants. Dry eye disease was more prevalent in FMS (17%) and SFN (28%) patients than in controls (5%). Tear fluid prostaglandin levels did not differ between FMS patients and controls. While corneal LC density in FMS and SFN patients was not different from controls, there were fewer dLC in association with nerve fibers in FMS and SFN patients than in controls (P < .01 each). Compared to controls, CNFL was lower in FMS and SFN patients (P < .05 each), CNFD was lower only in FMS patients (P < .05), and CNBD was lower only in SFN patients (P < .001). There was no difference in any CCM parameter between patients with and without dry eyes. Our data indicate changes in corneal innervation and LC distribution in FMS and SFN, potentially based on altered LC signaling. KW - corneal confocal microscopy KW - fibromyalgia syndrome KW - Langerhans cells KW - pain KW - small fiber neuropathy Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-214150 VL - 25 IS - 1 ER -