COMPARATIVE NEUROPHYSIOLOGICAL STUDY FOR THE DIAGNOSIS OF MILD POLYNEUROPATHY IN PATIENTS WITH DIABETES MELLITUS AND GLUCOSE INTOLERANCE

• Published in: International journal of neuroscience 2006-06, Vol.116 (6), p.745-759
• Main Authors: TURGUT, N LDA, GÜLD KEN, S BEL, BALCI, KEMAL, TUGRUL, ARMAGAN, BERBEROGLU, UFUK, ALTUN, BETÜL UGUR
• Format: Article
• Language: English
• Subjects: Adult; autonomic neuropathy; Biological and medical sciences; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Diabetes mellitus; Diabetes Mellitus - physiopathology; Diabetes. Impaired glucose tolerance; Electric Stimulation - methods; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; F-wave; Female; Galvanic Skin Response - physiology; glucose intolerance; Glucose Intolerance - physiopathology; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neural Conduction - physiology; Neurology; Neurophysiology - methods; Polyneuropathies - diagnosis; Polyneuropathies - etiology; Polyneuropathies - physiopathology; polyneuropathy; Reaction Time - physiology; Reaction Time - radiation effects; sural nerve
• ISSN: 0020-7454; 1563-5279; 1543-5245
• DOI: 10.1080/00207450600675340

This article evaluates diagnostic sensitivity of minimal F-wave latency, sural/radial amplitude ratio (SRAR), dorsal sural/radial amplitude ratio (DSRAR), sympathetic skin response (SSR), and R-R interval variability (RRIV) for detecting early polyneuropathy in patients with glucose intolerance and diabetic patients. F-wave latencies were more prolonged in diabetic patients with normal and abnormal nerve conduction studies than control subjects (p < .001). SRAR was lower, SSR latency was more prolonged, and RRIV was lower in diabetic patients with abnormal nerve conduction studies than healty controls (p < .001). SSR latency was more prolonged and RRIV was lower in diabetic patients with normal nerve conduction studies than healty controls (p < .01, p < .05, respectively). DSRAR was lower in diabetic patients with normal and abnormal nerve conduction studies than control subjects (p < .001). DSRAR was also lower in patients with glucose intolerance than control subjects (p < .01). DSRAR was the most sensitive and specific test in either of diabetic patients with normal nerve conduction studies (sensitivity 66%, specificity 90%) and diabetic patients with abnormal nerve conduction studies (sensitivity 100%, specificity 90%). DSRAR is the most reliable method for detection of early nerve pathology. Patients with glucose intolerance might have subclinical neuropathy that can be demonstrated with DSRAR analysis.