Novel strategy: Identifying new markers for demyelination in diabetic distal symmetrical polyneuropathy

• Published in: Heliyon 2024-05, Vol.10 (9), p.e30419-e30419, Article e30419
• Main Authors: Souayah, Nizar, Chen, Hongxin, Chong, Zhao Zhong, Patel, Tejas, Pahwa, Ankit, Menkes, Daniel L., Cunningham, Timothy
• Format: Article
• Language: English
• Subjects: Conduction velocity slowing; Demyelination; Diabetic neuropathy; Distal symmetric polyneuropathy; Regression analysis
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2024.e30419

To develop a novel strategy for identifying acquired demyelination in diabetic distal symmetrical polyneuropathy (DSP). Motor nerve conduction velocity (CV) slowing in diabetic DSP exceeds expectations for pure axonal loss thus implicating superimposed acquired demyelination. After establishing demyelination confidence intervals by regression analysis of nerve conduction data from chronic inflammatory demyelinating polyneuropathy (CIDP), we prospectively studied CV slowing in 90 diabetic DSP patients with and without at least one motor nerve exhibiting CV slowing (groups A and B) into the demyelination range by American Academy of Neurology (AAN) criteria respectively and 95 amyotrophic lateral sclerosis (ALS) patients. Simultaneously, secretory phospholipase A2 (sPLA2) activity was assessed in both diabetic groups and 46 healthy controls. No ALS patient exhibited CV slowing in more than two motor nerves based on AAN criteria or the confidence intervals. Group A demonstrated a significantly higher percentage of patients as compared to group B fulfilling the above criteria, with an additional criterion of at least one motor nerve exhibiting CV slowing in the demyelinating range and a corresponding F response in the demyelinating range by AAN criteria (70.3 % vs. 1.9 %; p