Date of Award

2024

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Pathology

First Advisor

Douglas Taatjes

Abstract

Peripheral neuropathies (PNPs) have an estimated prevalence of 1 in 200 individuals and can have numerous causes including metabolic, vascular, and degenerative, among others. Nerve morphometry is a laboratory technique used to analyze nerve structures in quantitative terms, allowing clinicians to observe morphological differences in nerve structure. Such procedures can provide valuable information concerning the progression of peripheral neuropathies, which are characterized by both axonal loss and demyelination.To appropriately assess the presence of disease and future prognoses, the sural nerve is biopsied and used for nerve morphometry analysis. To quantify the myelin and axon pathology, the nerve must be prepared for observation using both light microscopy (LM) and transmission electron microscopy (TEM). Standardized morphometry must be conducted to ascertain key metrics such as axon diameter and axon density. This process remains laborious and complex. This study aimed to investigate a consolidated approach to conducting nerve morphometry solely using TEM, thus, reducing the complexity and time requirements to conduct the procedure. Using twenty sural nerve clinical cases collected from the University of Vermont Medical Center and analyzed at the University of Vermont Larner College of Medicine Microscopy Imaging Center, cases were re-imaged and analyzed utilizing standard LM, whole-slide imaging, and TEM. The resulting data obtained from these modes of imaging were compared to the data previously obtained for clinical diagnosis by standard LM, assessing both axon diameter measurements and myelinated fiber density profiles. Results indicated no statistical difference between the whole-slide LM and TEM morphometric analyses and the standard LM morphometric analyses. The results of this study indicate that both whole-slide imaging and TEM may be effective alternatives to conducting standard light microscopy myelinated fiber morphometry and reduce the time needed to complete the procedure. Additional benefits regarding the time reduction of the procedure could have positive implications for the clinician and patient such as shorter time-to-report that impact both diagnostics and treatment. Further studies with additional samples are necessary to confirm these results.

Language

en

Number of Pages

60 p.

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