SynthesisEuropean journal of neurology2026
Corneal Confocal Microscopy and Skin Biopsy to Differentiate Painful From Painless Diabetic Neuropathy: A Systematic Review With Multiple Meta-Analyses.
Synthesis in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPainful diabetic neuropathy affects ~20%-40% of individuals with diabetes, driven by peripheral small nerve fiber damage and modulated by spinal cord and brain mechanisms. Corneal nerve imaging using corneal confocal microscopy (CCM) and skin biopsy to quantify intraepidermal nerve fiber density (IENFD) are objective measures of small nerve fiber damage.
objectivesCCM and IENFD were assessed for their ability to distinguish painful from painless diabetic neuropathy.
methodsFollowing PROSPERO-registered protocol and PRISMA guidelines, PubMed, Embase, and Web of Science were searched for studies on corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), and IENFD in patients with painful and painless diabetic neuropathy. Standardized mean difference (SMD) with 95% confidence intervals (CI) was pooled using random-effects meta-analyses.
resultsSeven studies (n = 683) showed lower CNFD (SMD -0.50, 95% CI -0.96 to -0.03, p = 0.03) and CNFL (SMD -0.32, 95% CI -0.59 to -0.05, p = 0.02) in painful compared to painless DPN, with no difference in CNBD. Ten studies (n = 664) demonstrated lower IENFD in painful compared to painless DPN (SMD -0.31, 95% CI -0.59 to -0.02, p = 0.03, I
conclusionBoth CCM and skin biopsy demonstrate small nerve fiber loss in painful compared to painless DPN, supporting their value in identifying alterations in small nerve fiber structure in painful DPN.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.