O-27 Sensory and motor nerve excitability testing in type 2 diabetics. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Kristensen, Alexander Gramm; Finnerup, Nanna; Andersen, Henning; Jensen, Troels; Gylfadottir, Sif; Itani, Mustapha; Krøigård, Thomas; Sindrup, Søren; Tankisi, Hatice
• Is Part Of: Clinical neurophysiology. Volume 130:Issue 7(2019:Jul.)
• Page Start: e30
• Publication Date: 2019-07
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2019.04.343
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Background: Previous studies have proposed the utility of nerve excitability testing (NET) with threshold tracking for understanding disease pathophysiology and early diagnosis of diabetic polyneuropathy (DPN). We aimed in this study to elucidate sensory and motor NET changes in DPN. Materials and methods: We included 128 diabetics and 31 healthy controls (HC). All participants were examined with Nerve Conduction Studies (NCS) on three motor (tibial, peroneal and median) and three sensory (sural (bilateral) and median) nerves. Patients were divided into two groups, patients with neuropathy (DPN+) and patients without neuropathy (DPN-) using NCS in lower extremities. Motor and sensory NET and NCS on the median nerve were compared between the groups using 3-way ANOVA. Results: Out of 27 NET parameters, 7 motor (including TEd(peak), S2 accommodation, TEd40(Accom)) and 2 sensory parameters(accommodation half-time and TEh(slope 101–140 ms)) were significantly different between groups ( p < 0.05). The differences between the groups for NCS were more pronounced for median motor (distal motor latency, conduction velocity (CV) amplitude and minimum F-wave latency) ( p < 0.01) and sensory (CV and amplitude, p = 0.000035 and p = 0.00054, respectively). Conclusions: Overall, the changes in NET were not as prominent as changes in NCS and not in concord with previously reported excitability changes. This may be because NET measures the function of the surviving axons rather than non-functioning axons. We are therefore uncertain of the utility of NET in diagnostics or understanding the mechanisms of DPN. Part of the International Diabetic Neuropathy Consortium research programme, supported byNovo Nordisk Foundation Challenge Programme (Grant No.NNF14OC0011633 ).