Beyond neuropathy in hereditary sensory and autonomic neuropathy type V: cognitive evaluation


Daniel Ciampi de Andrade, Department of Neurology, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil, Av. Dr. Enéas de Carvalho Aguiar 255/5131, São Paulo 05403000, Brazil (tel.: +55 11 3069 6000; fax: +55 11 3742 5134; e-mail:


Background and purpose:  Hereditary sensory and autonomic neuropathy (HSAN) type V is a very rare disorder. It is characterized by the absence of thermal and mechanical pain perception caused by decreased number of small diameter neurons in peripheral nerves. Recent genetic studies have pointed out the aetiological role of nerve growth factor beta, which is also involved in the development of the autonomic nervous system and cholinergic pathways in the brain. HSAN type V is usually reported not to cause mental retardation or cognitive decline. However, a structured assessment of the cognitive profile of these patients has never been made.

Methods and results:  We performed a throughout evaluation of four HSAN type V patients and compared their performance with 37 normal individuals. Our patients showed no cognitive deficits, not even mild ones.

Discussion and Conclusions:  Although newer mutations on this and related disorders are continuously described, their clinical characterization has been restricted to the peripheral aspects of these conditions. A broader characterization of this rare disorder may contribute to better understand the mechanisms of the nociceptive and cognitive aspects of pain.