Peripheral Nerve Conduction And Sympathetic Skin Response Are Reliable Methods to Detect Diabetic Cardiac Autonomic Neuropathy

Abstract

AimThis study aimed to investigate the role of nerve conduction studies (NCS) and sympathetic skin response (SSR) in evaluating diabetic cardiac autonomic neuropathy (DCAN).MethodsDCAN was diagnosed using the Ewing test combined with heart rate variability analysis. NCS and SSR were assessed by electrophysiological methods. The association between NCS/SSR and DCAN was assessed via multivariate regression and receiver-operating characteristic analyses.ResultsThe amplitude and conduction velocity of the motor/sensory nerve were found to be significantly lower in the DCAN+ group (all P < 0.05). A lower amplitude of peroneal nerve motor fiber was found to be associated with increased odds for DCAN (OR 2.77, P < 0.05). The SSR amplitude was lower while the SSR latency was longer in the DCAN+ group than in the DCAN– group. The receiver-operating characteristic analysis revealed that the optimal cutoff points of upper/lower limb amplitude of SSR to indicate DCAN were 1.40 mV (sensitivity, 61.9%; specificity, 66.3%, P < 0.001) and 0.85 mV (sensitivity, 66.7%; specificity, 68.5%, P < 0.001), respectively. The optimal cutoff points of upper/lower limb latency to indicate DCAN were 1.40 s (sensitivity, 61.9%; specificity, 62%, P < 0.05) and 1.81 s (sensitivity, 69.0%; specificity, 52.2%, P < 0.05), respectively.ConclusionsNCS and SSR are reliable methods to detect DCAN. Abnormality in the peroneal nerve (motor nerve) is crucial in predicting DCAN. SSR may help predict DCAN.

Assessment of intraepidermal nerve fiber density and neurophysiological studies in patients with idiopathic polyneuropathy

“…There are significant differences between prolonged latency SSR (< 0.001) and diminished amplitude SSR (< 0.001) in both hand and foot between patients with idiopathic axonal polyneuropathy and control groups. Consequently, subclinical involvement of small nerve fiber can appear early even in the absence of autonomic symptoms in polyneuropathy [24], which aligns with lin et al [25], who found significant differences in SSR latency of upper extremity (< 0.05) and amplitude of upper and lower extremity (P < 0.05) between patients with idiopathic axonal neuropathy and control groups.…”

Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic Patients

“…The sympathetic skin response (SSR) measures electrodermal activity evoked by sympathetic stimulation such as electrical stimulation [ 26 ]. It has been shown recently that SSR may be used as an indicator for diabetic cardiac autonomic neuropathy [ 27 , 28 ].…”

Prediction of the Efficacy of Lumbar Sympathetic Block in Patients with Lower Extremity Complex Regional Pain Syndrome Type 1 Based on the Sympathetic Skin Response

“…Due to the large variation in SSR, it should be considered in combination with amplitude and latency when determining whether a single test is abnormal. SSR has recently been used to evaluate patients suffering somatic and autonomic neuropathies [6][7][8], with abnormal SSR results such as prolonged SSR latency or decreased SSR amplitude described in both central and peripheral nervous system illnesses. However, until now, there has been little debate and practical application of SSR in CRPS.…”