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Peer-reviewedCC BY 4.0Frontiers in Aging Neuroscience

Small-fiber degeneration, sensory dysfunction, and nociception comorbidity in central neurodegenerative disease

  1. 1Department of Anesthesiology, The University of Kansas Medical Center, Kansas City, KS, United States
  2. 2Department of Neurology, The University of Kansas Medical Center, Kansas City, KS, United States

Abstract

Progressive neurodegenerative disease typically calls for clinical effort to improve cognitive and motor deficits. It is also focused on improving patients' quality of life. However, across these dementias and other diseases, the underlying causes and potential mechanisms remain unclear. Most experimental and clinical research focuses on the central nervous system, examining pathogenic proteins such as tau and amyloid beta, as well as the potential cascade following mitochondrial damage and neuroinflammation. Although peripheral involvement, including gut microbiome influences and other visceral organs, is well-documented, the peripheral nervous system remains an understudied component of these progressive diseases. As peripheral terminals of primary afferent neurons are exposed to inflammatory or toxic mediators, these neurons respond to these threats via neuron-specific phenotypic changes, including the generation of pain. Although normal peripheral sensitization is protective, exposure to damage in a chronic disease state can have long-term detrimental effects. Diseases that lead to central neurodegeneration often also feature peripheral neuropathy and chronic pain. We provide an overview of the incidence of peripheral neuropathy within these diseases, the contribution of changes in sensation to disease, and secondary neuropathic phenotypes resulting from disease. Woven in are discussions of the intersection of degeneration and toxic protein aggregation, briefly touching on resulting inflammatory signaling. Altogether, this review aims to synthesize current understanding of sensory peripheral nerve involvement across these neurodegenerative diseases.

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BibTeX
@article{hauser2026smallfiber,
  title = {{Small-fiber degeneration, sensory dysfunction, and nociception comorbidity in central neurodegenerative disease}},
  author = {Will Hauser and Jessica E. Keller and Mamatha Pasnoor and Douglas E. Wright},
  journal = {Frontiers in Aging Neuroscience},
  year = {2026},
  month = oct,
  doi = {10.3389/fnagi.2026.1854989},
  url = {https://doi.org/10.3389/fnagi.2026.1854989},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Small-fiber degeneration, sensory dysfunction, and nociception comorbidity in central neurodegenerative disease
AU  - Will Hauser
AU  - Jessica E. Keller
AU  - Mamatha Pasnoor
AU  - Douglas E. Wright
PY  - 2026
DA  - 2026/10/21
JO  - Frontiers in Aging Neuroscience
DO  - 10.3389/fnagi.2026.1854989
UR  - https://doi.org/10.3389/fnagi.2026.1854989
AB  - Progressive neurodegenerative disease typically calls for clinical effort to improve cognitive and motor deficits. It is also focused on improving patients' quality of life. However, across these dementias and other diseases, the underlying causes and potential mechanisms remain unclear. Most experimental and clinical research focuses on the central nervous system, examining pathogenic proteins such as tau and amyloid beta, as well as the potential cascade following mitochondrial damage and neuroinflammation. Although peripheral involvement, including gut microbiome influences and other visceral organs, is well-documented, the peripheral nervous system remains an understudied component of these progressive diseases. As peripheral terminals of primary afferent neurons are exposed to inflammatory or toxic mediators, these neurons respond to these threats via neuron-specific phenotypic changes, including the generation of pain. Although normal peripheral sensitization is protective, exposure to damage in a chronic disease state can have long-term detrimental effects. Diseases that lead to central neurodegeneration often also feature peripheral neuropathy and chronic pain. We provide an overview of the incidence of peripheral neuropathy within these diseases, the contribution of changes in sensation to disease, and secondary neuropathic phenotypes resulting from disease. Woven in are discussions of the intersection of degeneration and toxic protein aggregation, briefly touching on resulting inflammatory signaling. Altogether, this review aims to synthesize current understanding of sensory peripheral nerve involvement across these neurodegenerative diseases.
SN  - 1663-4365
ER  -