Assessment of Diabetic Polyneuropathy and Autonomic Neuropathy Using Current Perception Threshold in Korean Patients with Diabetes Mellitus

Koo, Bo Kyung; Ohn, Jung Hun; Kwak, Soo Heon; Moon, Min Kyong

doi:10.4093/dmj.2014.38.4.285

Cited by 8 publications

(5 citation statements)

References 17 publications

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“…Along with the CPT phenotypes, the proportion of patients with abnormal NCS increased significantly (χ 2 (2)=7.59, P =0.022). The hypoesthesia group was more likely to exhibit deterioration in the NCS variables compared with the normoesthesia or hyperesthesia group (Tables 3 and 4), which is consistent with many previous studies [56]. In our study, nearly half the patients with abnormal NCS ( n =62/133) remained subclinical (MNSI score ≤3), which is also in agreement with previous reports [19].…”

Section: Discussionsupporting

confidence: 93%

“…The perception threshold test (current perception threshold [CPT]) has been used to quantify sensory fiber function from the early asymptomatic to advanced severe neuropathic symptom stages by assessing the functions of all three major subgroups of sensory nerve fibers: Aβ, Aδ, and C-fibers [4]. This enables the qualification of clinical phenotypes according to an automated grading system: normoesthesia, hyperesthesia, and hypoesthesia [56]. However, it is not known how NCS measurements and clinical phenotypes differ in patients with diabetes.…”

Section: Introductionmentioning

confidence: 99%

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Patterns of Nerve Conduction Abnormalities in Patients with Type 2 Diabetes Mellitus According to the Clinical Phenotype Determined by the Current Perception Threshold

Park

Won

2018

Diabetes Metab J

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BackgroundClinical manifestations of diabetic peripheral neuropathy (DPN) vary along the course of nerve damage. Nerve conduction studies (NCS) have been suggested as a way to confirm diagnoses of DPN, but the results have limited utility for evaluating clinical phenotypes. The current perception threshold (CPT) is a complementary method for diagnosing DPN and assessing DPN symptoms. We compared NCS variables according to clinical phenotypes determined by CPT measurements.MethodsWe retrospectively enrolled patients with type 2 diabetes mellitus who underwent both NCS and CPT tests using a neurometer. CPT grades were used to determine the clinical phenotypes of DPN: normoesthesia (0 to 1.66), hyperesthesia (1.67 to 6.62), and hypoesthesia/anesthesia (6.63 to 12.0). The Michigan Neuropathy Screening Instrument (MNSI) was used to determine a subjective symptom score. DPN was diagnosed based on both patient symptoms (MNSI score ≥3) and abnormal NCS results.ResultsA total of 202 patients (117 men and 85 women) were included in the final analysis. The average age was 62.6 years, and 71 patients (35.1%) were diagnosed with DPN. The CPT variables correlated with MNSI scores and NCS variables in patients with diabetes. Linear regression analyses indicated that hypoesthesia was associated with significantly lower summed velocities and sural amplitudes and velocities, and higher summed latencies, than normoesthesia. Sural amplitude was significantly lower in patients with hyperesthesia than in patients with normoesthesia.ConclusionNCS variables differed among patients with diabetes according to clinical phenotypes based on CPT and decreased sural nerve velocities was associated with hyperesthesia.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Patterns of Nerve Conduction Abnormalities in Patients with Type 2 Diabetes Mellitus According to the Clinical Phenotype Determined by the Current Perception Threshold

Park

Won

2018

Diabetes Metab J

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“…A very recent paper published in 2014 [ 23 ] involving 241 Korean subjects with type 2 diabetes, evaluated the usefulness of CPT for diagnosing distal polyneuropathy and cardiovascular autonomic neuropathy in diabetic patients. The conclusions were that even though the subjects with DPN had significantly higher CPT at all of the frequencies than the subjects without DPN, and the CPT was significantly associated with neuropathic symptoms or signs corresponding to the nerve fiber stimulated, it provides little additional information compared with conventional evaluations.…”

Section: Using the Neurometer® For The Screening And Diagnosis Of Diamentioning

confidence: 99%

Measurement of Current Perception Thresholds Using the Neurometer® – Applicability in Diabetic Neuropathy

Inceu

Vereşiu

2015

Medicine and Pharmacy Reports

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The incidence of diabetes mellitus is continuously growing worldwide, while the specific chronic complications that it induces have a negative impact on life expectancy andquality, entailing extremely high costs of healthcare services. Diabetic peripheral neuropathy is one of the most common chronic complications of diabetes, affecting almost half of diabetic people during life.This review aims at summarizing the evidence on the advantages and the usefulness of current perception threshold measurement for peripheral diabetic neuropathy assessment. Among the different methods used for the screening and diagnosis of diabetic neuropathy, measurement of current perception threshold using the Neurometer® has the ability to assess three sub-types of nerve fiber by producing transcutaneous electrical stimuli at frequencies of 2000, 250 and 5 Hz.Current evidence shows that this method provides a useful, noninvasive evaluation technique of patients with peripheral nervous system disorders, being able to detect neuropathy in the earliest and asymptomatic stages.

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“…One of the most common diabetic complications is diabetic polyneuropathy [ 9 , 10 ] which can exist with or without neuropathic pain. Its incidence is growing with the duration of diabetes.…”

Section: Introductionmentioning

confidence: 99%

The impact of neuropathic pain and other comorbidities on the quality of life in patients with diabetes

Dobrota

Hrabač

Škegro

et al. 2014

Health Qual Life Outcomes

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BackgroundDiabetic polyneuropathy (DPN) is one of the most common complications of diabetes and can exist with or without neuropathic pain. We were interested in how neuropathic pain impairs the quality of life in diabetic patients and what is the role of comorbidities in this condition.MethodsThe study included 80 patients with painful DPN (group “P”) and 80 patients with DPN, but without neuropathic pain (group “D”). Visual analogue scale (VAS) and Leeds assessment of neuropathic symptoms and signs (LANSS) pain scale were used for assessment of neuropathic pain, SF-36 standardized questionnaire for assessment of the quality of life and BDI questionnaire for assessment of depression.ResultsSubjects in group P had statistically significantly lower values compared to group D in all 8 dimensions and both summary values of the SF-36 scale. We ascribe the extremely low results of all parameters of SF-36 scale in group P to painful diabetic polyneuropathy with its complications. The patients in group D showed higher average values in all dimension compared to group P, but also somewhat higher quality of life compared to general population of Croatia in 4 of 8 dimensions, namely vitality (VT), social functioning (SF), role-emotional (RE) and mental health (MH), which was unexpected result.Clinically, the most pronounced differences between two groups were noted in sleeping disorders and problems regarding micturition and defecation , which were significantly more expressed in group P. The similar situation was with walking distance and color-doppler sonography of carotid arteries, which were significantly worse in group P. Consequently, subjects in group P were more medicated than the patients in group D, particularly with tramadol, antiepileptics and antidepressants.ConclusionPainful DPN is a major factor that influences various aspects of quality of life in diabetic patients. Additionally, this study gives an overview of diabetic population in the Republic of Croatia, information that could prove useful in future studies.

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Assessment of Diabetic Polyneuropathy and Autonomic Neuropathy Using Current Perception Threshold in Korean Patients with Diabetes Mellitus

Cited by 8 publications

References 17 publications

Patterns of Nerve Conduction Abnormalities in Patients with Type 2 Diabetes Mellitus According to the Clinical Phenotype Determined by the Current Perception Threshold

Patterns of Nerve Conduction Abnormalities in Patients with Type 2 Diabetes Mellitus According to the Clinical Phenotype Determined by the Current Perception Threshold

Measurement of Current Perception Thresholds Using the Neurometer® – Applicability in Diabetic Neuropathy

The impact of neuropathic pain and other comorbidities on the quality of life in patients with diabetes

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