Significance of Nueroelectrophysiological Tests in the Early Diagnosis of Sub-clinical Neuropathay with Diabetes Mellitus / 华中科技大学学报（医学）（英德文版）

To evaluate the application of nueroelectrophysiological tests in early diagnosis of sub-clinical neuropathy in diabetes mellitus (DM), The routine nerve conductive velocity (NCV),F-wave and sympathetic skin response (SSR) were detected in 27 patients with diabetes mellitus but without symptoms and signs of lesions of nerve system. Our results showed that 48.1%, 44.4 %, 51.9 % of the patients were found to have abnormal NCV, F-wave and SSR respectively. The abnormalities were mainly characterized by prolonged latency, reduced velocity and absence of wave-form.There were significant differences between the controls and the DM group (P＜0.05). Both the distal and proximal segments of nerves were affected and the distal lesions took place earlier than proximal ones and the changes in low extremities were more severe than those of upper extremities. F-wave can be used as a sensitive indicator for the early diagnosis of peripheral neuropathy and it can help to detect the subclincial lesions. SSR can be used for the evaluation of functional status of autonomic nerves in DM patients.

Detection of subclinical diabetic neuropathy: Potential factors affecting electrodiagnostic parameters

OBJECTIVES: To identify the factors that can potentially affect the ability of electrodiagnostic tests such as sural/radial amplitude ratio or SRAR and the presence of carpal tunnel syndrome or CTS to detect early subclinical neuropathy in diabetes mellitus (DM). Likewise, to investigate the likelihood of developing subclinical neuropathy that can be detected by a positive CTS or SRAR abnormalities, because of the presence of anthropometric factors and sugar levels, in addition to DM duration METHODOLOGY: A retrospective cohort study was undertaken among 144 DM type 2 patients with confirmed subclinical neuropathy. Demographic data such as age, height and age, body mass index (BMI) and blood glucose profiles were obtained. Nerve conduction findings (SRAR and CTS protocols) were statistically analyzed using two sample t-test and multiple logistic regression ratios RESULTS: Patients who were positive in the CTS protocols were taller and had lower BMI. They had shorter duration of DM but with extreme elevations in blood glucose. Variables that are independently associated with a (+) CTS are duration of DM, FBS, BMI, height and weight. Patients with SRAR abnormalities were older and obese, with longer duration of DM and less marked elevations in blood glucose. Variables that are independently associated with SRAR abnormalities are age, duration of DM, weight and BMI CONCLUSION: Factors such as age, duration of DM, weight and height, BMI as well as glucose control can potentially affect the ability of various electrodiagnostic tests (SRAR and the presence of CTS) to detect early subclinical neuropathy. Since confounding factors was different between CTS and SRAR, the pathogenesis of these conditions may be different. The likelihood of developing subclinical neuropathy that can be detected by a (+) CTS or SRAR abnormalities because of the presence of certain factors, were documented.

T-reflex Changes in Asymptomatic Diabetics

BACKGROUND: The loss or depression of ankle jerk has been considered one of the earliest physical findings of diabetic polyneuropathy, even in asymptomatic cases. Therefore, the electronic ankle T-reflex test (ATR) could be a sensitive, objective test for the early detection of polyneuropathy among diabetics. METHOD: In order to verify the sensitivity and usefulness of the ATR, the ankle jerk and ATR were studied in 99 legs of 50 patients with diabetes who did not have any symptoms related to neuropathy or peripheral vascular disease at the time of the study. A sensory nerve conduction study (SNCS) of sural and superficial peroneal nerves was also performed and the results were compared with the ATR. RESULTS: The ATR response was abnormal in 42.4% of the legs tested and was more sensitive than the sural SNCS (18.2%) or superficial peroneal SNCS (30.3%) in revealing subclinical abnormalities. Our results confirm that ATR abnormalities in asymptomatic diabetics are more frequent than conventional SNCS abnormalities and are a reliable indicator of peripheral nerve dysfunction in diabetic patients. CONCLUSIONS: The ATR seems to be a sensitive test in detecting subclinical abnormalities in diabetics and would be useful especially in early or equivocal cases of

Diagnostic value of F wave in diabetic peripheral neuropathy / 临床神经病学杂志

Objective To investigate the diagnostic value of F wave in diabetic peripheral neuropathy (DPN).Methods F and M wave parameters were measured in 106 patients with diabetes mellitus and 75 normal persons, including the minimum latency, duration, amplitude and area of F wave, and the amplitude and the area of M wave.Results (1) In the 30 patients with diabetes mellitus without peripheral neuropathy, there were 8 cases with prolonged the duration of F wave, 4 cases with prolonged the minimum latency of F wave, 2 cases with increased in the ratio of the area of F/M wave. (2) The minimum latency prolonged of F wave, the ratio of the amplitude of F/M wave and the ratio of the area of F/M wave significantly increased in the 76 patients with DPN, the duration of F wave prolonged in the mild DPN but no one revealed remarkable abnormal. (3) In the controls, the function of upper limit of the minimum latency of F wave (Y) and leg length (X) was Y=12.3+48.8X 2. Conclusion (1) F wave could be served as sensitive index to the early diagnosis of DPN, and might detect subclinical DPN. (2) The proximal nerve segment could be affected without the lesions of the distal nerve segment in patients with DPN, and it suggested that vascular factor plays an important role in the mechanism of DPN.