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Objectives: Cerebral palsy (CP) is a motor impairment syndrome leading to disorders of movement and posture. Screening of electrophysiological parameters Hoffman reflex (H-reflex and nerve conduction velocities) becomes a necessary for the early detection and management of the disease. The study aimed to assess the various electrophysiological parameters of nerve conduction velocity in CP and age-matched normal children. Matrials and Methods: The present cross-sectional study was performed between children suffering from CP and healthy control. A total of 27 children of 12–24 months of age of either sex were examined. Among them, six children were normal (with age match), seven were diagnosed with spastic CP and remaining 14 children were diagnosed with hypotonic CP The electrophysiological parameters were recorded in the right lower limb (posterior tibial nerve-soleus muscle) of all children. Results: In electrophysiological parameters, H-reflex latency in secs values was significantly decreased in all CP children. The maximum amplitudes of reflexly excitable motor neurons (Hmax) (mV) and Hmax/maximum amplitude of motor response ratio in the gastrocnemius-soleus muscle were significantly increased in spastic CPas compared to control. H-reflex conduction velocity (HRCV) was significantly higher than motor nerve conduction velocity (MNCV) in hypotonic CP children. Conclusion: The electrophysiological parameters were altered in spastic CP children. The electrophysiological parameters in hypotonic CP were within range, indicating they did not suppress the neuronal motor pool. However, HRCV was significantly more than MNCV in hypotonic CP, suggesting some myelination process defect/white matter injury in motor neurons. We concluded that the electrophysiological parameters of the nerve conduction study are a reliable test for the assessment of tone of muscles in children. Thus, it may help in the early initiation of the treatment and therapies in CP children.
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Background: With the advancement in digital world, but smart phone usage has increased among all age groups but youngsters are involved in heavy gaming on smart phones which has led to increased risk of ill-effects especially on eyes and hands. Aim and Objectives: The study was designed to study the ill-effects of excessive usage if smart phones on peripheral nerves of hands especially of dominant hand among young adults. Materials and Methods: Nerve conduction study was performed on 100 young adults who were divided into three groups on the basis of mobile usage time. Nerve conduction velocities as well as distal latencies of motor and sensory nerves of the dominant hand were measured among different groups. Results: One-way ANOVA test was applied to study the results among different groups. Although no significant difference in conduction velocity or latency was observed in motor or sensory nerves among three groups, Ulnar sensory conduction velocity has been found to be slow as well as distal latency was found to be prolonged in third group with heavy usage of smart phones as compared to other groups. Conclusion: The reason for the above results could be due to less usage time in hours as well as in years due to which no significance differences were observed in conduction velocity/distal latency in our study. Hence, further studies are suggested with more sample size and more usage time in terms of years as well as in hours.
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Background: Nerve Conduction Studies were performed in asymptomatic HIV positive persons and corresponding controls to detect subclinical peripheral nervous system involvement in early stage of HIV. Aims & Objective: To perform Nerve Conduction Studies in asymptomatic HIV positive persons and corresponding controls. Material and Methods: In this study,100 participants in the age group 25-45 years were selected. In study group, 50 3 participants who were HIV positive and asymptomatic (CD4 count > 350 cells/mm ) and were not on Anti Retro Viral Treatment (ART), were included. In control group 50 healthy age matched HIV negative participants were included. We performed Nerve Conduction Studies in these participants. For motor nerves, Distal Latency (DL), Motor Nerve Conduction Velocity (MNCV), Compound Muscle Action Potential (CMAP) amplitude were measured and for sensory nerves Onset Latency (OL), Sensory Nerve Conduction Velocity (SNCV) and Sensory Nerve Action Potential (SNAP) amplitude were measured. Results: Nerve Conduction Studies in asymptomatic HIV revealed that, MNCV was significantly decreased for median motor nerve and tibial motor nerve in study group compared to control group, SNAP was significantly reduced for median sensory nerve in study group compared to control group, OL was significantly prolonged for sural nerve in study group than control group and SNCV was significantly decreased for sural nerve in study group than control group. Conclusion: Nerve Conduction Studies in asymptomatic HIV positive persons suggests subclinical peripheral nervous system involvement in early stages of HIV. Hence Nerve Conduction Studies can be important to detect subclinical peripheral nervous system involvement in the early stages of HIV.
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Objective:To observe any effect of repeated transcranial magnetic stimulation (rTMS) in the treatment of diabetic peripheral neuropathic pain (DPNP).Methods:Eighty-six persons with type 2 diabetes mellitus and DPNP were randomly divided into an observation group and a control group, each of 43. Both groups were given basic treatment to control plasma glucose and blood pressure, while the observation group was additionally provided with daily 10Hz rTMS of the primary motor cortex (M1 area) of the non-dominant hand 5 days a week for 4 weeks. Before and after the treatment, pain in both groups was evaluated using a visual analog scale (VAS) and the Patient′s Global Impression Change scale (PGIC). The motor conduction velocity (MCV) and sensory conduction velocity of the median and the common peroneal nerves were also tested.Results:After treatment, the average VAS pain rating and PGIC score of the observation group were significantly lower than the control group′s averages and those before treatment. The observation group′s treatment effectiveness rate (79.07%) was then much better than that of the control group (23.26%). After the treatment, the average MCV of the median and common peroneal nerves of the observation group (47.65±1.94 m/s and 46.98±3.26 m/s, respectively) were significantly faster than before treatment, and those of the control group.Conclusions:rTMS based on routine intervention can significantly relieve DPNP and promote the recovery of injured nerves, bettering diabetics′ physical condition and life quality.
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Objective:To analyze the characteristics of nerve injury in patients with diabetic peripheral neuropathy (DPN) and explore the diagnostic value of current perception threshold (CPT) and nerve conduction velocity (NCV) for DPN.Methods:One hundred and thirty-six DPN patients admitted to Beijing Puren Hospital from June 2017 to December 2019 were selected, and 130 diabetic non-DPN patients admitted during the same period were used as controls. All the subjects were tested by CPT and NCV. Among them, the detection of NCV included sensory nerve conduction velocity (SCV) and motor nerve conduction velocity (MCV). Statistical analysis was performed on the relevant indicators of the two groups of subjects.Results:The CPT values of the upper limb median nerve and ulnar nerve at 2 000 Hz, 250 Hz, and 5 Hz, the superficial peroneal nerves at 250 Hz, and 5 Hz, and the CPT values of the sural nerve at 2 000 Hz and 250 Hz were higher than those of non-DPN patients, DPN injury mainly occurred in myelinated nerve fibers in the lower extremities [60.29%(82/136)], and the difference were statistically significant ( P<0.05). The SCV and MCV of the median nerve, ulnar nerve, and common peroneal nerve in the DPN group were lower than those in the non-DPN group, the SCV abnormal rate was higher than the MCV: 55.88%(76/136) vs. 37.50%(51/136); 58.82%(80/136) vs. 41.18% (56/136); 67.65%(92/136) vs. 50.00%(68/136), and the differences were statistically significant ( P<0.05). The area under the predictive value curve (AUC) of CPT for DPN was 0.815 (95% CI 0.735 ~ 0.895). The AUC of NCV for DPN was 0.875 (95% CI 0.813 ~ 0.944). The AUC of CPT and NCV for DPN was 0.923 (95% CI 0.876 ~ 0.970). Conclusions:DPT patients have abnormal CPT and NCV, and nerve damage occurs mostly in myelinated nerve fibers and SCV. Diagnosing DPN by combining CPT and NCV is helpful to improve the detection rate of DPN.
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OBJECTIVE@#To compare the clinical therapeutic effect on painful diabetic peripheral neuropathy (PDPN) between dragon-tiger fighting needling and pregabalin capsules.@*METHODS@#A total of 60 patients with PDPN were randomized into an observation group and a control group, 30 cases in each one. On the base of treatment with routine anti-hyperglycaemic measures and nutritional neurotherapy, the dragon-tiger fighting needling was exerted at Sanyinjiao (SP 6), Zusanli (ST 36), Yinlingquan (SP 9) and Xuehai (SP 10) in the observation group, once daily. Pregabalin capsules were prescribed for oral administration in the control group, 75 mg, twice a day. The treatment for 2 weeks was as one course and 2 courses of treatment were required in total. The score of visual analogue scale (VAS), the score of MOS item short form health survey (SF-36) and nerve conduction velocity before and after treatment were compared between the two groups. The clinical therapeutic effect was evaluated in the two groups.@*RESULTS@#After treatment, VAS score was reduced as compared with before treatment in the two groups (@*CONCLUSION@#The dragon-tiger fighting needling therapy relieves painful symptoms, improves the quality of life and increases nerve conduction velocity in the patients with diabetic peripheral neuropathy, and the therapeutic effect is better than oral administration of pregabalin capsules.
Subject(s)
Animals , Humans , Acupuncture Points , Acupuncture Therapy , Diabetes Mellitus , Diabetic Neuropathies/drug therapy , Quality of Life , Tigers , Treatment OutcomeABSTRACT
Background: Leprosy and the associated scourge have affected humanity for thousands of years. One of the most debilitating consequences of leprosy is peripheral neuropathy. Nerve Conduction Velocity study provides us with a non-invasive modality to assess peripheral nerve involvement in leprosy.Methods: With this in mind, a cross-sectional observational study was conducted including 30 leprosy patients as "Cases" and 30 age-matched healthy subjects, not suffering from any kind of neurological disorders, as "Controls". Using a digital electromyography machine, the Latency, Amplitude and Conduction Velocities of Motor and Sensory fibres of Ulnar and Median nerves were recorded. The results were compared among controls and cases using suitable statistical tests (descriptive statistics and significance testing using unpaired t-test).Results: In this study, with regard to Sensory Nerve conduction Velocity (SNCV), statistically very significant difference was noted in case of right (p 0.0011) and left (p 0.0037) ulnar nerves among controls and cases. The difference in the amplitude of Motor Action potential (MAP) with regard to right median nerve, among cases and controls, was also statistically significant (p 0.0127). Further the amplitude of Sensory Nerve Action Potential (SNAP) values were higher among cases compared to controls.Conclusions: As such, the findings of this study (and which is also corroborated by many previous studies) lead us to the conclusion that NCV studies can detect lepromatous neuropathy much before the emergence of frank clinical signs and this type of neuropathy is predominantly demyelinating in nature with occasional axonal loss.
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Abstract Objective: The effects of vitamin D on the central and peripheral nervous system continue to be investigated today. In the present study, we aimed to evaluate pain and electrophysiologic response in patients with carpal tunnel syndrome (CTS) who have undergone replacement therapy due to vitamin D deficiency. Methods: Fifty female patients diagnosed with mild and moderate CTS and accompanied by vitamin D deficiency were included in this study. Nerve conduction study (NCS) was performed before and after vitamin D replacement, and the patient's pain was evaluated with Visual Analogue Scale (VAS). Results: When NCS were compared before and after treatment, there was a statistically significant improvement in the median distal sensory onset latency (DSOL) and sensory conduction velocity (CV) and motor distal latencies (DML) values (p=0.001; p<0.001; p=0.001, respectively). At the same time, there was a decrease in the VAS values in patients (p<0.001). When the two groups were compared there was an improvement in DSOL and sensory CV in both groups, but in DML only in moderate CTS group. Conclusion: In this study, it was shown that mild and moderate CTS patients had an improvement in pain and electrophysiological parameters after vitamin D replacement. Replacing vitamin D in early stages of CTS may be beneficial.
Resumo Objetivo: Os efeitos da vitamina D no sistema nervoso central e periférico continuam sendo investigados atualmente. Neste estudo, objetivamos avaliar a dor e a resposta eletrofisiológica em pacientes com síndrome do túnel do carpo (STC) submetidos a terapia de reposição devido à deficiência de vitamina D. Métodos: Cinquenta pacientes do sexo feminino diagnosticadas com STC leve e moderada e acompanhadas de deficiência de vitamina D foram incluídas neste estudo. O estudo da condução nervosa (ECN) foi realizado antes e após a reposição da vitamina D, e a dor do paciente foi avaliada com a Escala Visual Analógica (EVA). Resultados: Quando a ECN foi comparada antes e após o tratamento, houve uma melhora estatisticamente significativa na latência mediana do início sensorial distal (DSOL) e nos valores de velocidade de condução sensorial (VC) e latência distal motora (LDM) (p=0,001; p<0,001; p=0,001, respectivamente). Ao mesmo tempo, houve uma diminuição dos valores da EVA nos pacientes (p<0,001). Quando os dois grupos foram comparados, houve uma melhora no DSOL e no VC sensorial em ambos, mas no LDM apenas no grupo STC moderado. Conclusão: Neste estudo, foi demonstrado que pacientes com STC leve e moderada apresentaram melhora da dor e parâmetros eletrofisiológicos após a reposição de vitamina D. A substituição da vitamina D nos estágios iniciais da STC pode ser benéfica.
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Humans , Female , Vitamin D Deficiency , Carpal Tunnel Syndrome , Pain , Vitamin D , Vitamins , Median Nerve , Neural ConductionABSTRACT
Introduction: Normative data of Nerve conduction study(NCS) are used to evaluate Nerve conduction study ofpatients presenting with signs and symptoms of peripheralnerve disease. The Nerve conduction velocity depends onage, gender, temperature and nerve diameter. The study wasdone to observe the effect of the cerebral dominance if anyon the motor nerve conduction velocity by recording nerveconduction velocity of both right and left sides in upper limb.Material and Methods: The nerve conduction study was doneon 100 medical students (50 male and 50 female) studying inAdesh Institute of Medical Science sand Research, Bathinda.Motor nerve conduction for Median nerve was done usingcomputerized software Octopus EMG/NCV/EP. Amplitude,duration and conduction velocity of Median Nerve weremeasured for both the upper limbs.Results: Motor nerve conduction velocity of Median Nervewas found to be greater in right limb (56.87 ± 3.6 m/s and57.5 ± 3.35 m/s) as compared to left limb (56.33 ± 3.53 m/sand 56.97 ± 3.48 m/s) in both male and female students but theresults were statistically non-significant (p>0.05). The latencyof median nerve conduction was less in females (2.65± 0.24ms and 2.75± 0.32 m/s) than in males (2.71± 0.27ms and2.78± 0.32 m/s) on both sides.Conclusion: Motor nerve conduction velocity was found tobe greater in right limb as compared to left limb in both malesand females Motor nerve conduction velocity was found to bemore in female students as compared to male students.
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Background: The prevalence of type 2 diabetes mellitus(T2DM) is growing worldwide, and these patients may beasymptomatic and present with complications at the time ofdiagnosis. Diabetic neuropathy is the most commoncomplication affecting the patients who may present with distalpolyneuropathy at the time of diagnosis and also poorglycaemic control. The Diabetic peripheral polyneuropathyaffects approximately 1 in every 10 newly diagnosed patients,whereas two third of patients with diabetes mellitus haveclinical or subclinical neuropathy.Objective: This study is designed to find prevalence of diabeticperipheral neuropathy in Newly Diagnosed Patients of T2DM ina tertiary care hospital.Materials and Methods: This observational study was carriedout in patients diagnosed with T2DM as per ADA criteria. Athorough clinical examination; Nerve conduction velocitytesting; evaluation of plasma glucose and glycosylatedhemoglobin and assessment of neuropathy by using theDiabetic neuropathy index and diabetic neuropathy score wasperformed on all patients.Results: 18% of patients had signs of peripheral neuropathyas shown by NCV testing at the time of diagnosis. Thesepatients had elevated levels of glycosylated hemoglobin,fasting plasma glucose and 2-hour plasma glucose and lowerscores of DNI and DNS which were statistically significant. Themost common type of neuropathy seen in these patients wassensorimotor involvement with demyelinating type ofneuropathy with more involvement of lower limbs. The NCVstudies showed reduced distal latency and prolongedamplitude as well as conduction velocity in patients withdiabetic neuropathy.Conclusion: Our study showed that approximately 1 in 5newly diagnosed patients with type 2 diabetes mellitus are atrisk of developing diabetic peripheral neuropathy.
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Objective@#To investigate the effect of red light combined with hot compress on diabetic peripheral neuropathy (DPN).@*Methods@#From June 2017 to June 2018, 110 patients with DPN admitted to the Department of Endocrinology, Hangzhou Hospital of Traditional Chinese Medicine were selected in the study.The patients were divided into study group (55 cases) and control group (55 cases) according to the random number table method.All patients were given DPN basic care and treatment, with red light in the control group, and red light combined with hot compress in the study group.The motor nerve conduction velocity (MCV) and the sensory nerve conduction velocity (SCV) of the ulnar nerve, median nerve and common peroneal nerve were compared between the two groups before and after treatment.The total scores of the Toronto clinical scoring system (TCSS) were compared between the two groups before and after treatment.The efficacy of the two groups was compared.@*Results@#Before treatment, there were no statistically significant differences in MCV [(40.45±5.33)m/s vs.(40.14±5.08)m/s, t=0.312, P=0.755; (41.15±5.51)m/s vs.(40.86±5.23)m/s, t=0.283, P=0.778; (42.27±5.84)m/s vs.(41.94±5.75)m/s, t=0.299, P=0.766] and SCV [(39.38±4.82)m/s vs.(39.08±4.60)m/s, t=0.334, P=0.739; (40.13±5.45)m/s vs.(39.86±5.15)m/s, t=0.267, P=0.790; (41.18±5.78)m/s vs.(40.89±5.46)m/s, t=0.278, P=0.782] between the ulnar nerve, median nerve and common peroneal nerve in the two groups.After treatment, the ulnar nerve, median nerve and common peroneal nerve of the two groups were treated.The MCV[(48.77±7.25)m/s vs.(44.62±6.30)m/s, t=3.204, P=0.002; (49.35±7.46)m/s vs.(45.36±6.45)m/s, t=3.001, P=0.003; (49.26±7.13)m/s vs.(46.35±6.22)m/s, t=2.281, P=0.025] and SCV[(47.67±6.52)m/s vs.(43.57±5.61)m/s, t=3.535, P=0.001; (47.77±6.63)m/s vs.(44.31±5.14)m/s, t=3.059, P=0.003; (48.33±7.17)m/s vs.(45.12±6.41)m/s, t=2.475, P=0.015] of the two groups were increased, while which of the study group increased more significantly.Before treatment, there was no statistically significant difference in the total scores of TCSS between the two groups [(10.15±1.23)points vs.(10.45±1.51)points, t=1.142, P=0.256]. After treatment, the total scores of TCSS decreased in the two groups, while which of the study group decreased more significantly[(7.22±0.85)points vs.(8.15±0.96)points, t=5.379, P=0.000]. After treatment, the effective rate of the study group was 87.27%, which of the control group was 63.64%, the difference was statistically significant(χ2=8.295, P=0.004).@*Conclusion@#The combination of red light and hot compress on DPN has a more prominent clinical effect, which is worthy of wide application.
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Objective: To study the therapeutic effect of point injection of Salvia Miltiorrhiza and Ligustrazine Hydrochloride Injection (SMLHI) on diabetic peripheral neuropathy (DPN) patients and its effect on oxidative stress response. Methods: A total of 100 DPN patients were selected from the Neurology Department of the Fifth Affiliated Hospital of Zhengzhou University from March 2016 to February 2018. According to the random number table method, the patients were divided into observation group and control group with 50 cases in each group. Each group was treated with routine hypoglycemic drugs, diet control and exercise control, while the control group was treated with Mecobalamin Tablets. The observation group was treated with Mecobalamin Tablets combined with SMLHI at acupoints for 4 weeks as a course of treatment for two consecutive courses of treatment. The clinical symptom score, serum superoxide dismutase (SOD), gamma-glutamyltransferase (GGT), ferritin (SF), total anti-oxidant capacity (T-AOC), and malondialdehyde (MDA) levels, median nerve and peroneal nerve conduction velocity (MNCV), median nerve, peroneal nerve conduction velocity (SNCV), and curative effect were observed and compared before and after treatment. Results: After treatment, the clinical symptom score of the observation group was significantly lower, and the total effective rate of the observation group was 84.00%, which was higher than that of the control group 64.00% (P < 0.05). The SOD level in the observation group was higher, while the GGT, SF, T-AOC, and MDA levels were lower (P < 0.05). The MNCV and SNCV in the observation group were higher (P < 0.05). Conclusion: Acupoint injection of SMLHI for DPN patients can significantly reduce oxidative stress reaction in vivo, promote the recovery of nerve function, improve clinical symptoms of patients with high safety, which is worthy of clinical promotion.
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Objective To investigate the effect of red light combined with hot compress on diabetic peripheral neuropathy (DPN).Methods From June 2017 to June 2018,110 patients with DPN admitted to the Department of Endocrinology,Hangzhou Hospital of Traditional Chinese Medicine were selected in the study. The patients were divided into study group (55 cases) and control group (55 cases) according to the random number table method.All patients were given DPN basic care and treatment,with red light in the control group,and red light combined with hot compress in the study group.The motor nerve conduction velocity ( MCV) and the sensory nerve conduction velocity (SCV) of the ulnar nerve,median nerve and common peroneal nerve were compared between the two groups before and after treatment.The total scores of the Toronto clinical scoring system ( TCSS) were compared between the two groups before and after treatment.The efficacy of the two groups was compared.Results Before treatment,there were no statistically significant differences in MCV [(40.45 ± 5.33)m/s vs.(40.14 ± 5.08)m/s,t=0.312,P=0.755;(41.15 ± 5.51)m/s vs.(40.86 ± 5.23)m/s,t=0.283,P=0.778;(42.27 ± 5.84)m/s vs.(41.94 ± 5.75)m/s, t=0.299,P=0.766] and SCV [(39.38 ± 4.82) m/s vs.(39.08 ± 4.60) m/s,t=0.334,P=0.739;(40.13 ± 5.45)m/s vs.(39.86 ± 5.15)m/s,t=0.267,P=0.790;(41.18 ± 5.78)m/s vs.(40.89 ± 5.46) m/s,t=0.278, P=0.782] between the ulnar nerve,median nerve and common peroneal nerve in the two groups.After treatment,the ulnar nerve,median nerve and common peroneal nerve of the two groups were treated.The MCV[(48.77 ± 7.25)m/s vs.(44.62 ± 6.30)m/s,t=3.204,P=0.002;(49.35 ± 7.46)m/s vs.(45.36 ± 6.45)m/s,t=3.001,P=0.003;(49.26 ± 7.13)m/s vs.(46.35 ± 6.22)m/s,t=2.281,P=0.025] and SCV[(47.67 ± 6.52)m/s vs.(43.57 ± 5.61)m/s,t=3.535,P=0.001;(47.77 ± 6.63)m/s vs.(44.31 ± 5.14) m/s,t=3.059,P=0.003;(48.33 ± 7.17)m/s vs.(45.12 ± 6.41)m/s,t=2.475,P=0.015] of the two groups were increased,while which of the study group increased more significantly.Before treatment,there was no statistically significant difference in the total scores of TCSS between the two groups [(10.15 ± 1.23) points vs.(10.45 ± 1.51) points,t=1.142,P=0.256].After treatment,the total scores of TCSS decreased in the two groups, while which of the study group decreased more significantly[(7.22 ± 0.85)points vs.(8.15 ± 0.96)points,t=5.379,P=0.000].After treatment,the effective rate of the study group was 87.27%,which of the control group was 63.64%,the difference was statistically significant (χ2 =8.295,P=0.004).Conclusion The combination of red light and hot compress on DPN has a more prominent clinical effect,which is worthy of wide application.
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Objective To analyze the characteristics of nerve damage in diabetic peripheral neuropathy by ultrasound and neuroelectrophysiological techniques and provide a basis for early diagnosis and treatment of diabetic peripheral neuropathy. Methods From January 2016 to May 2018, 225 patients with type 2 diabetes admitted to the hospital were divided into DPN group (110 cases) and non-diabetic peripheral neuropathy (NDPN) group (115 cases),and 120 healthy volunteers were as controls. Ultrasound and nerve conduction velocity(NCV) were used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy(DPN). Results Among the three study groups, the sensory nerves conduction velocity and motor nerves conduction velocity of the ulnar nerve, median nerve, and common peroneal nerve were significantly reduced in the DPN group. But in the same group,the ulnar nerve, median nerve, and common peroneal nerve cross-sectional area (CSA) was significantly increased [(8.68 ± 1.89) mm2 vs. (6.79 ± 1.69) and (5.82 ± 1.57) mm2, (10.59 ± 1.82) mm2 vs. (7.98 ± 1.97) and (7.25 ± 1.71) mm2, (21.24 ± 2.53 )mm2 vs. (16.54 ± 2.49) and (15.40 ± 2.20) mm2]. In the measurement of sensory nerve conduction velocity, the abnormalities of ulnar nerve, median nerve and common peroneal nerve were significantly higher than thoseof motor nerve [34.54%(38/110) vs. 18.18%(20/110), 36.36% (40/110)vs. 20.90% (23/110), 52.72% (58/110) vs. 20.00% (22/110)]. In ultrasound and SCV, the proportion of ulnar nerve and median nerve injury was higher in patients aged 45 years or older or patients over 10 years of course (P<0.05). The proportion of median nerve injury was higher in patients with larger MAGE (P < 0.05). In the abnormal performance of ultrasound: the proportion of abnormal ulnar nerve, median nerve and common peroneal nerve in patients with large MAGE was significantly higher than that in patients with small MAGE (P<0.05); the results of ultrasound measurement of CSA showed that the ulnar nerve, median nerve and common peroneal nerve thickening were more obvious in patients with MAGE>4 mmol/L. Conclusions DPN affects sensory nerves first, and the proportion of injury is significantly higher than that of motor nerves; lower limb nerves are more susceptible to damage, compared with upper limb nerves; patients aged 45 years or older or patients with course over 10 years have a higher proportion of ulnar nerve and median nerve damage; patients with larger MAGE (>4 mmol/L) have a higher proportion of median nerve damage. The characteristics above can provide an effective basis for the prevention, diagnosis and treatment of DPN.
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<p><b>OBJECTIVE</b>To compare the clinical efficacy differences between warming acupuncture and conventional acupuncture for diabetic peripheral neuropathy (DPN) with syndrome of deficiency and cold coagulation, obstruction of collaterals and blood stasis.</p><p><b>METHODS</b>A total of 64 patients were randomly divided into a warming acupuncture group and a conventional acupuncture group, 32 cases in each one. Based on basic treatment of blood glucose regulation, warming acupuncture was applied at Pishu (BL 20), Shenshu (BL 23), Guanyuanshu (BL 26), Zusanli (ST 36), Chongyang (ST 42), Quchi (LI 11) and Hegu (LI 4) in the warming acupuncture group, while acupuncture was applied at the identical acupoints in the conventional acupuncture group. Both the treatments were given once a day with an interval of one day every six days; totally the treatment was given for 4 weeks. The TCM symptom score, Toronto clinical scoring system (TCSS) and nerve conduction velocity (NCV) before and after treatment were compared in the two groups.</p><p><b>RESULTS</b>After treatment, the TCM symptom scores in the two groups were significantly reduced (both <0.01); the improvement of TCM symptom in the warming acupuncture group was superior to that in the conventional acupuncture group (<0.05). After treatment, the TCSS scores in the two groups were significantly reduced (both <0.01); the TCSS score in the warming acupuncture group was significantly lower than that in the conventional acupuncture group (<0.05). After treatment, the NCV of motor nerve of tibial nerve and nervus peroneus communis, as well as sensory nerve of tibial nerve and sural nerve was improved in the warming acupuncture group (all <0.05), while only the NCV of motor nerve and sensory nerve of tibial nerve was improved in the conventional acupuncture group (both <0.05); there were no significant difference between the two groups (all >0.05).</p><p><b>CONCLUSION</b>Warming acupuncture and conventional acupuncture could both increase TCM symptom score, improve NCV in patients of DPN with syndrome of deficiency and cold coagulation, obstruction of collaterals and blood stasis; warming acupuncture has advantage in symptom improvement.</p>
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Humans , Acupuncture Points , Acupuncture Therapy , Methods , Diabetic Neuropathies , Therapeutics , Yang DeficiencyABSTRACT
<p><b>OBJECTIVE</b>To observe the efficacy difference among medication, medication plus rehabilitation training and medication plus rehabilitation training plus acupuncture on injury of nervus peroneus communis.</p><p><b>METHODS</b>A total of 81 patients were randomly divided into a control group, an observation 1 group and an observation 2 group; three patients dropped out and 78 patients were included into statistical analysis, 26 patients in each group. The patients in the control group were treated with oral administration of mecobalamin, 500 μg per time, 3 times a day for 60 days. Based on the treatment of control group, the patients in the observation 1 group were treated with rehabilitation training by computer-aided movable and measurable ankle-foot orthosis (CMM-AFO). Based on the treatment of observation 1 group, the patients in the observation 2 group were treated with acupuncture at Jiexi (ST 41), Fenglong (ST 40), Yanglingquan (GB 34) and Zusanli (ST 36), etc, 30 min per treatment, once a day for 60 days. After 60-day treatment, the clinical efficacy was evaluated; the muscle strengths of foot dorsal stretch and digital flexion were evaluated; the motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) were recorded.</p><p><b>RESULTS</b>After treatment, 20 patients were cured in the observation 2 group, which was significantly higher than 8 patients in the control group and 15 patients in the observation 1 group (both <0.05). The muscle strengths, SCV and MCV in the observation 2 group were significantly higher than those in the control group and the observation 1 group (all <0.05).</p><p><b>CONCLUSION</b>Acupuncture combined with CMM-AFO have significant efficacy on injury of nervus peroneus communis, and improve muscle strengths, SCV and MCV, which are superior to medication alone and medication plus rehabilitation training.</p>
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Objective@#To analysis the occupational exposure to 1-bromopropane on the worker’s nerve conduc-tion velocity.@*Methods@#To PubMed, Wanfang, VIP, Chinese Journal Full-text Database (CNKI) and other databases as a data source, searched and screened database to October 2017 on occupational exposure to 1-bromopropane workers on the role of nerve conduction in the paper. According to inclusion and exclusion criteria, we screened literatures, extracted data and evaluated the quality of the included studies, using RevMan5.3 software to test the heterogeneity of the results and us-ing the corresponding mathematical model for data combination analysis.@*Results@#A total of 5 articles were included in the literature. The results showed that the tibial nerve MCV of workers in the 1-bromopropane exposure group was slower than that in the control group (SMD=-0.47,95%CI=-0.70~-0.24) , the difference was statistically significant (Z=4.06, P<0.01). The tibial nerve DL of the exposure group was more prolonged than that of the control group (SMD=0.35,95%CI=0.00~0.69) , with a statistically significant difference (Z=1.99, P=0.05). The sural nerve SCV of the exposure group was slower than that of the control group (SMD=-0.47, 95%CI=-0.78~-0.15), with a statistically significant difference (Z=2.88,P<0.01).@*Conclusion@#Occupational exposure to 1-bromopropane may have an effect on the worker's nerve conduction ve-locity.It’s necessary to do broader and deeper neurotoxicity studies about 1-bromopropane.
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OBJECTIVE:To observe clinical efficacy and safety of Compound xiongshao capsules in the treatment of diabetic peripheral neuropathy (DPN).METHODS:A total of 97 DPN patients selected from our hospital during Jun.2015-Apr.2016 were divided into group A (compound xiongshao treatment group,46 cases) and control group (51 cases) according to random number table.The latter was divided into group B (epalrestat+beraprost sodium group,12 cases),group C (fursultiamine+mecobalamin group,12 cases) and group D (epalrestat group,27 cases) according to clinical symptoms and economic situation of patients.Four groups were given antidiabetic drugs for blood glucose control.Based on it,group A was additionally given Compound xiongshao capsules 0.9 g,tid;group B was additionally given Epalrestat tablets 50 mg,tid+Beraprost sodium tablets 40 μg,tid;group C was additionally given Fursultiamine tablets 50 mg,tid+Mecobalamin tablets 0.5 mg,rid;group D was additionally given Epalrestat tablets 50 mg,tid.All groups were treated for 6 months.Clinical efficacies were observed.TCSS scores,motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),incubation period and amplitude of median nerve and common peroneal nerve,the levels of hemorheology indexes,blood glucose,glycosylated hemoglobin,blood lipid,serum creatinine were compared before and after treatment.The occurrence of ADR was recorded.RESULTS:Total response rates of group A and B (82.61％,83.33％)were significantly higher than those of group C and D (33.33％,66.67％),total response rate of group D was significantly higher than that of group C,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in TCSS scores,MCV,SCV,incubation period and amplitude of median nerve,MCV and amplitude of common peroneal never,SCV,incubation period and amplitude of common peroneal never or whole blood high-shear viscosity among 4 groups (P＞0.05).After treatment,TCSS scores of group A,B and D were decreased significantly compared to before treatment,and those of group A and B were lower than those of group C and D,with statistical significance (P＜0.05).MCV,incubation period and amplitude of median nerve in group A and B,amplitude of median nerve in group C,MCV and amplitude of median nerve in group D were significantly better than before treatment;MCV,incubation period and amplitude of median nerve in group A and B were significantly better than group C and D,with statistical significance (P＜0.05).MCV,incubation period and amplitude of common peroneal never in group A,B,C were significantly better than before treatment,MCV and amplitude of common peroneal never in group A,B were significantly better than group C,D;the improvement of incubation period of common peroneal never in group A,B,D were significantly better than group C,with statistical significance (P＜0.05).SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,B and D were significantly better than before treatment;SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,SCV,incubation period and amplitude of median nerve and amplitude of common peroneal nerve in group B were significantly better than group C and D;SCV of median nerve in group D was significantly better than group C,with statistical significance (P＜0.05).Whole blood high-shear viscosity of group A was decreased significantly compared to before treatment,and significantly lower than those of group B,C and D,with statistical significance (P＜0.05).There was no statistical significance in total response rate and TCSS score between group A and B,and in the levels of blood glucose,glycosylated hemoglobin,blood lipid or serum creatinine among 4 groups (P＞0.05).No obvious ADR was found in 4 groups.CONCLUSIONS:Compound xiongshao capsules shows significant therapeutic efficacy for DPN,and improves nerve conduction velocity,incubation period and amplitude of median nerve and common peroneal nerve,whole blood high-shear viscosity.Its effect is similar to that of epalrestat combined with beraprost sodium,and better than those of fursultiamine combined with mecobalamin,epalrestat alone.It does not affect the blood glucose,blood lipid and serum creatinine levels with good safety.
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Objective To evaluate the diagnostic value of current perception threshold (CPT)diabetic peripheral neuropathy (DPN).Methods A total of 437 patients with type 2 diabetes (T2DM) were enrolled.The subjects were divided into DPN group and non-DPN group according to'the criteria of diagnosis and treatment of diabetic peripheral neuropathy in China'.The diagnostic value of CPT,10 g monofilament test,Toronto clinical scoring system (TCSS) and nerve conduction velocity (NCV) were evaluated.Results Compared with non-DPN group,the patients in DPN group were significantly older [(61.31±9.63) vs (58.09±10.38) year],with longer duration of diabetes [(8.81±6.04) vs (6.93±5.65) year],higher HbA1c [(8.60±2.05)％ vs (8.09±2.01) ％] and fasting plasma glucose (FPG) [(9.67± 3.92) vs (8.95 ± 3.45) mmol/L],more smokers (30.0％ vs 15.8％) and more likely complicated with retinopathy (36.4％ vs 22.2％).The proportion of hypoesthesia and hyperesthesia detected by CPT at all frequencies in DPN group were much higher than non-DPN group (P＜0.05).The correlation analysis showed that CPT values at each frequency were negatively correlated with NCV (r=-0.260,r=-0.155 and r=-0.168,respectively,P＜0.01).CPT 2000 Hz and 250 Hz were positively correlated with TCSS scores (r=0.105 and 0.142,respectively,P＜0.05).ROC analysis showed that CPT 2000 Hz had the largest areas under the curve (AUC=0.840),with the highest sensitivity (77.14％)and NCV test had the highest specificity (98.32％) in diagnosing DPN.Conclusion CPT can selectively and quantitatively determine different types of sensory nerve damage,which providing a useful method for early-screening of DPN.
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To investigate the influence of Angelica Four Inverse Decoction on diabetic peripheral neuropathy (DPN) nerve conduction velocity and advanced glycation end products (AEGs), Cystatin C (Cys-C) and homocysteine (Hcy) levels, 78 cases of DPN patients admitted in our hospital from March 2015 to January 2017 were selected and divided into two groups by random number table method. The two groups adopted the same basic treatment, on the basis of which, the control group was added mecobalamin tablets treatment, while the observation group was given Angelica Four Inverse Decoction. The curative effect of Chinese medicine syndrome, the scores of toronto clinical scoring system (TCSS), nerve conduction velocity and the change of serum AEGs, Cys-C and Hcy levels before and after treatment were recorded and compared between the two groups and then the safety of medicine were evaluated between the two groups. 4 weeks after the treatment, the total effective rate of the observation group was 89.7％, significantly higher than 71.8％ of the control group (P ＜ 0.05) . Compared with those before receiving treatment, the SNCV and MNCV values of the common peroneal nerve and median nerve both significantly increased in the two groups 4 weeks after the treatment (P ＜ 0.01); the improvement of nerve conduction velocity of the observation group was significantly better than that of the control group (P ＜ 0.01) . 4 weeks after the treatment, TCSS score and serum AEGs, Cys-C, Hcy levels were all significantly lower than those before receiving the treatment in the two groups (P ＜ 0.01); compared with that of the control group in the same time period, the improvement effect of TCSS score and serum AEGs, Cys-C, Hcy levels were more significant in the observation group 4 weeks after the treatment (P ＜ 0.01) . There were no obvious adverse reactions in the two groups. As a result, Angelica Four Inverse Decoction applied to DPN patients can more effectively relieve clinical symptoms and signs, improve nerve conduction velocity, reduce the level of AEGs, and improve microcirculation with remarkable curative effect and high safety.