Detection of early motor involvement in diabetic polyneuropathy using a novel MUNE method – MScanFit MUNE

Kristensen, Alexander Gramm; Bostock, Hugh; Finnerup, Nanna Brix; Andersen, Henning; Jensen, Troels Staehelin; Gylfadottir, Sandra Sif; Itani, Mustapha; Krøigård, Thomas; Sindrup, Søren Hein; Tankisi, Hatice

doi:10.1016/j.clinph.2019.08.003

Cited by 28 publications

(25 citation statements)

References 16 publications

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“…The changes in axonal function demonstrated in this model were evident without accompanying deficits in nerve conduction values. This finding is in keeping with several clinical studies that have demonstrated that changes in motor nerve excitability occur prior to overt PN [18,[36][37][38]. Increased sensory nerve superexcitability has been demonstrated in human prediabetes, which correlated with glycated hemoglobin in the absence of changes in other nerve excitability parameters and NCV measures suggesting that such isolated findings in one parameter has physiological meaning [39].…”

Section: Discussionsupporting

confidence: 89%

Evidence of Altered Peripheral Nerve Function in a Rodent Model of Diet-Induced Prediabetes

et al. 2020

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Peripheral neuropathy (PN) is a debilitating complication of diabetes that affects >50% of patients. Recent evidence suggests that obesity and metabolic disease, which often precede diabetes diagnosis, may influence PN onset and severity. We examined this in a translationally relevant model of prediabetes induced by a cafeteria (CAF) diet in Sprague–Dawley rats (n = 15 CAF versus n = 15 control). Neuropathy phenotyping included nerve conduction, tactile sensitivity, intraepidermal nerve fiber density (IENFD) and nerve excitability testing, an in vivo measure of ion channel function and membrane potential. Metabolic phenotyping included body composition, blood glucose and lipids, plasma hormones and inflammatory cytokines. After 13 weeks diet, CAF-fed rats demonstrated prediabetes with significantly elevated fasting blood glucose, insulin and impaired glucose tolerance as well as obesity and dyslipidemia. Nerve conduction, tactile sensitivity and IENFD did not differ; however, superexcitability was significantly increased in CAF-fed rats. Mathematical modeling demonstrated this was consistent with a reduction in sodium–potassium pump current. Moreover, superexcitability correlated positively with insulin resistance and adiposity, and negatively with fasting high-density lipoprotein cholesterol. In conclusion, prediabetic rats over-consuming processed, palatable foods demonstrated altered nerve function that preceded overt PN. This work provides a relevant model for pathophysiological investigation of diabetic complications.

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Section: Discussionsupporting

confidence: 89%

Evidence of Altered Peripheral Nerve Function in a Rodent Model of Diet-Induced Prediabetes

et al. 2020

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“…Several techniques are available to classify and characterize peripheral neuropathy. These include clinical assessment and structural and electrophysiology tests such as skin biopsy for intraepidermal nerve fiber density calculation, 22 corneal confocal microscopy (CCM), 23 nerve conduction studies (NCS), 4,24 and the newer MScanfit motor unit number estimation (MUNE) method 25,26 …”

Section: Introductionmentioning

confidence: 99%

“…These include clinical assessment and structural and electrophysiology tests such as skin biopsy for intraepidermal nerve fiber density calculation, 22 corneal confocal microscopy (CCM), 23 nerve conduction studies (NCS), 4,24 and the newer MScanfit motor unit number estimation (MUNE) method. 25,26 There is a need for a detailed assessment of large and small nerve fiber function as well as a quantification of motor function after chemotherapy. 17 We therefore conducted a deep-profile study of patients 5 years after receiving chemotherapy with docetaxel or oxaliplatin using a wide scale of assessment tools to determine the pattern of their neuropathy and neuropathic pain and the effect of quality of life and psychological functioning.…”

mentioning

confidence: 99%

Oxaliplatin‐ and docetaxel‐induced polyneuropathy: clinical and neurophysiological characteristics

Bennedsgaard

Ventzel

Andersen

et al. 2020

J Peripheral Nervous Sys

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The aim of this study was to evaluate the presence and characterization of chemotherapyinduced neuropathy (CIPN) and neuropathic pain 5 years after adjuvant chemotherapy with docetaxel or oxaliplatin. Patients from an ongoing prospective study, who had received adjuvant chemotherapy with docetaxel or oxaliplatin in 2011 to 2012 were invited to participate. The patients underwent a thorough examination with interview, neurological examination, questionnaires, assessment tools, nerve conduction studies (NCS), quantitative sensory testing, MScan motor unit number estimation (MUNE), and corneal confocal microscopy (CCM). Patients were divided into no, possible, probable, and confirmed CIPN. Out of the 132 eligible patients, 63 agreed to participate: 28 had received docetaxel and 35 had received oxaliplatin. Forty-one percent had confirmed CIPN, 34% possible or probable CIPN, and 22% did not have CIPN. The CIPN was characterized mainly by sensory nerve fiber loss, with a more pronounced large fiber than small fiber loss but also some motor fiber loss identified on NCS and MUNE. In general, patients had mild neuropathy with relatively low scores on assessment tools and no association with mood and quality of life. CCM was not useful as a diagnostic tool. Of the patients with probable or confirmed CIPN, 30% experienced pain, which was most often mild, but still interfered moderately with daily life in 20% to 25% and was associated with lower quality of life. In conclusion CIPN was confirmed in 41% 5 years after chemotherapy. The neuropathy was generally mild, but in patients with neuropathic pain it was associated with lower quality of life.

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“…CMAP scan MUNE has been tested in several previous studies in both healthy control subjects and individuals with neuromuscular diseases (such as amyotrophic lateral sclerosis), and has shown excellent intra-and inter-rater reproducibility [35]- [39]. In the present study, the same CMAP scan protocol (stimulus steps, duration, frequency, etc.)…”

Section: Resultsmentioning

confidence: 85%

CMAP Scan Examination of the First Dorsal Interosseous Muscle After Spinal Cord Injury

Zong

Chen

et al. 2021

IEEE Trans. Neural Syst. Rehabil. Eng.

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The study assessed motor unit loss in muscles paralyzed by spinal cord injury (SCI) using a novel compound muscle action potential (CMAP) scan examination. The CMAP scan of the first dorsal interosseous (FDI) muscle was applied in tetraplegia (n=13) and neurologically intact (n=13) subjects. MScanFit was used for estimating motor unit numbers in each subject. The D50 value of the CMAP scan was also calculated. We observed a significant decrease in both CMAP amplitude and motor unit number estimation (MUNE) in paralyzed FDI muscles, as compared with neurologically intact muscles. Across all subjects, the CMAP (negative peak) amplitude was 8.01 ± 3.97 mV for the paralyzed muscles and 16.75 ± 3.55 mV for the neurologically intact muscles (p < 0.001). The CMAP scan resulted in a MUNE of 59 ± 37 for the paralyzed muscles, much lower than 108 ± 21 for the neurologically intact muscles (p < 0.001). No significant difference in D50 was observed between the two groups (p = 0.2). For the SCI subjects, there was no significant correlation between MUNE and CMAP amplitude, or any of the clinical assessments including pinch force, grip force, the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) score, and SCI duration (p > 0.05). The findings provide an evidence of motor unit loss in the FDI muscles of individuals with tetraplegia, which may contribute to weakness and other hand function deterioration. The CMAP scan offers several practical benefits compared with the traditional MUNE techniques because it is noninvasive, automated and can be performed within several minutes.

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Detection of early motor involvement in diabetic polyneuropathy using a novel MUNE method – MScanFit MUNE

Abstract: Highlights MScanFit MUNE yields detailed information on motor unit loss. Motor involvement in diabetic neuropathy may be present as early as sensory involvement. MScanFit MUNE provides sensitive detection of motor involvement in diabetic polyneuropathy.

Cited by 28 publications

References 16 publications

Evidence of Altered Peripheral Nerve Function in a Rodent Model of Diet-Induced Prediabetes

Evidence of Altered Peripheral Nerve Function in a Rodent Model of Diet-Induced Prediabetes

Oxaliplatin‐ and docetaxel‐induced polyneuropathy: clinical and neurophysiological characteristics

CMAP Scan Examination of the First Dorsal Interosseous Muscle After Spinal Cord Injury

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