Small fiber involvement is independent from clinical pain in late-onset Pompe disease.

The HADS-A and the HADS-D scores showed a highly significant correlation with each other (r = 0.84, p < 0.001), and both correlated significantly (p < 0.001) with the current (r = 0.56 and r = 0.57, respectively), average (r = 0.59 and r = 0.52, respectively), and maximal pain intensity (r = 0.70 and r = 0.61, respectively) (Fig. 2 A, B).

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Although the degree of fiber reduction did not correlate with the durations and the main effects of MANOVA did not reach significance, patients in the group of reduced IENFD showed a trend towards higher pain scores associated with a higher nerve fiber loss (Fig. 5 ).

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