Idiopathic distal sensory polyneuropathy: ACTTION diagnostic criteria

Roy Freeman, Jennifer S. Gewandter, Catharina G. Faber, Christopher Gibbons, Simon Haroutounian, Giuseppe Lauria, Todd Levine, Rayaz A. Malik, J. Robinson Singleton, A. Gordon Smith, Josh Bell, Robert H. Dworkin, Eva Feldman, David N. Herrmann, Ahmet Hoke, Noah Kolb, Heikki Mansikka, Anne Louise Oaklander, Amanda Peltier, Michael PolydefkisElissa Ritt, James W. Russell, Stephen Sainati, Deborah Steiner, Roi Treister, Nurcan Üçeyler

Research output: Contribution to journalArticlepeer-review


ObjectiveTo present standardized diagnostic criteria for idiopathic distal sensory polyneuropathy (iDSP) and its subtypes: idiopathic mixed fiber sensory neuropathy (iMFN), idiopathic small fiber sensory neuropathy (iSFN), and idiopathic large fiber sensory neuropathy (iLFN) for use in research.MethodsThe Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities and Networks (ACTTION) public-private partnership with the Food and Drug Administration convened a meeting to develop consensus diagnostic criteria for iMFN, iSFN, and iLFN. After background presentations, a collaborative, iterative approach was used to develop expert consensus for new criteria.ResultsAn iDSP diagnosis requires at least 1 small fiber (SF) or large fiber (LF) symptom, at least 1 SF or LF sign, abnormalities in sensory nerve conduction studies (NCS) or distal intraepidermal nerve fiber density (IENFD), and exclusion of known etiologies. An iMFN diagnosis requires that at least 1 of the above clinical features is SF and 1 clinical feature is LF with abnormalities in sensory NCS or IENFD. Diagnostic criteria for iSFN require at least 1 SF symptom and at least 1 SF sign with abnormal IENFD, normal sensory NCS, and the absence of LF symptoms and signs. Diagnostic criteria for iLFN require at least 1 LF symptom and at least 1 LF sign with normal IENFD, abnormal sensory NCS, and absence of SF symptoms and signs.ConclusionAdoption of these standardized diagnostic criteria will advance research and clinical trials and spur development of novel therapies for iDSPs.

Original languageEnglish
Pages (from-to)1005-1014
Number of pages10
Issue number22
StatePublished - 1 Dec 2020

Bibliographical note

Funding Information:
This article was reviewed and approved by the Executive Committee of the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration (FDA). Financial support for this project was provided by the ACTTION public-private partnership, which has received research contracts, grants, or other revenue from the FDA, multiple pharmaceutical and device companies, philanthropy, and other sources. The views expressed in this article are those of the authors, and no official endorsement by the FDA or the pharmaceutical and device companies that provided unrestricted grants to support the activities of the ACTTION public-private partnership should be inferred.

Publisher Copyright:
© American Academy of Neurology.

ASJC Scopus subject areas

  • Clinical Neurology


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