Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct 7:7:191.
doi: 10.3389/fnagi.2015.00191. eCollection 2015.

Association of Statins with Sensory and Autonomic Ganglionopathy

Peter Novak  1 , Daniela A Pimentel  2 , Banu Sundar  1 , Majaz Moonis  1 , Lan Qin  1 , Vera Novak  3
Affiliations

Association of Statins with Sensory and Autonomic Ganglionopathy

Peter Novak et al. Front Aging Neurosci. .

Abstract

Objective: To examine if statins have an effect on small nerve fibers.

Methods: This retrospective study evaluated the effect of statins in pure small-fiber neuropathy (SFN). Outcome measures were symptom scales (numbness, tingling, and autonomic symptoms), skin biopsies assessing epidermal nerve fiber density (ENFD), sweat gland nerve fiber density (SGNFD), and quantitative autonomic testing.

Results: One hundred and sixty participants with pure SFN were identified. Eighty participants (women/men, age ± SD 33/47, 68.1 ± 11.6 years old) were on statins for 53.5 ± 28.7 months to treat dyslipidemia and they were age and gender matched with 80 participants (33/47, 68.1 ± 9.5) that were off statins. ANOVA showed reduced ENFD/SGNFD at the proximal leg in the statin group [(count/mm) 8.3 ± 3.6/51.3 ± 14.2] compared to the off statin group (10.4 ± 3.8, p = 0.0008/56.4 ± 12.7, p = 0.018). There was no difference in ENFD/SGNFD at the distal leg in the statin group (4.9 ± 3.2/39.8 ± 15.7) compared to the off statin group (5.9 ± 3.4, p = 0.067/41.8 ± 15.9, p = 0.426). Statins did not affect symptom scales and the outcome of autonomic testing.

Conclusion: Statin use is associated with degeneration of sensory and autonomic fibers. The pattern of abnormalities, e.g., degeneration of proximal while sparing of distal fibers, is consistent with a non-length-dependent process with lesions in the dorsal root and the autonomic ganglia. The statin-associated sensory and autonomic ganglionopathy is mild.

Keywords: ganglionopathy; neuronopathy; small-fiber neuropathy; statin toxicity; statins.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Participants’ flow diagram.
Figure 2
Figure 2
Effect of statins. ENFD, epidermal nerve fiber density; SGNFD, sweat gland nerve fiber density; ns, non-significant. *Significant, p = 0.018 and **significant, p = 0.0008.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Anderson J. L., Muhlestein J. B., Bair T. L., Morris S., Weaver A. N., Lappé D. L. (2005). Do statins increase the risk of idiopathic polyneuropathy? Am. J. Cardiol. 95, 1097–1099.10.1016/j.amjcard.2004.12.068 - DOI - PubMed
    1. Argov Z. (2015). Statins and the neuromuscular system: a neurologist’s perspective. Eur. J. Neurol. 22, 31–36.10.1111/ene.12604 - DOI - PubMed
    1. Birnbaum J., Bingham C. O., III (2014). Non-length-dependent and length-dependent small-fiber neuropathies associated with tumor necrosis factor (TNF)-inhibitor therapy in patients with rheumatoid arthritis: expanding the spectrum of neurological disease associated with TNF-inhibitors. Semin. Arthritis Rheum. 43, 638–647.10.1016/j.semarthrit.2013.10.007 - DOI - PMC - PubMed
    1. Boger M. S., Hulgan T., Donofrio P., Peltier A. C. (2011). QSART for diagnosis of statin-associated polyneuropathy. Muscle Nerve 43, 295–296.10.1002/mus.21906 - DOI - PubMed
    1. Chai J., Logigian E. L. (2010). Neurological manifestations of primary Sjogren’s syndrome. Curr. Opin. Neurol. 23, 509–513.10.1097/WCO.0b013e32833de6ab - DOI - PubMed