Paired stimulation study of the median nerve sensory action potential in diabetic patients
Objectives – Conventional nerve conduction studies (NCS) are not sensitive to detect mild diabetic neuropathy. In order to detect subtle changes, we compared the conventional NCS with the relative refractory period (RRP) measurement of the median sensory nerve action potential by a paired stimulati...
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| Veröffentlicht in: | Acta neurologica Scandinavica 2008-08, Vol.118 (2), p.94-98 |
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| container_title | Acta neurologica Scandinavica |
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| creator | Nakatani-Enomoto, S. Bandoh, M. Kita, Y. Yamanouchi, H. Enomoto, H. Kimura, T. Hashimoto, K. Yahara, O. Ugawa, Y. |
| description | Objectives – Conventional nerve conduction studies (NCS) are not sensitive to detect mild diabetic neuropathy. In order to detect subtle changes, we compared the conventional NCS with the relative refractory period (RRP) measurement of the median sensory nerve action potential by a paired stimulation method.
Methods – Subjects were 29 diabetic patients whose conventional NCS were all normal. They were divided into two groups: neurologically symptomatic and asymptomatic groups. Twenty‐eight age‐matched control subjects were also studied.
Results – The RRP of the symptomatic diabetic patients (5.9 ± 0.5 ms) and that of the asymptomatic patients (5.6 ± 0.5 ms) was significantly longer than that of the control subjects (4.9 ± 0.6 ms). There was no significant difference in RRP between the symptomatic and asymptomatic patients. This may be due to the fact that NCS reflects mainly large myelinated fiber function and early symptoms represent mainly thin myelinated or unmyelinated fiber function.
Conclusions – The RRP measurement could reveal some mild involvement of peripheral nerves undetectable by conventional NCS, even though they caused no clinical symptoms. |
| doi_str_mv | 10.1111/j.1600-0404.2007.00989.x |
| format | Article |
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Methods – Subjects were 29 diabetic patients whose conventional NCS were all normal. They were divided into two groups: neurologically symptomatic and asymptomatic groups. Twenty‐eight age‐matched control subjects were also studied.
Results – The RRP of the symptomatic diabetic patients (5.9 ± 0.5 ms) and that of the asymptomatic patients (5.6 ± 0.5 ms) was significantly longer than that of the control subjects (4.9 ± 0.6 ms). There was no significant difference in RRP between the symptomatic and asymptomatic patients. This may be due to the fact that NCS reflects mainly large myelinated fiber function and early symptoms represent mainly thin myelinated or unmyelinated fiber function.
Conclusions – The RRP measurement could reveal some mild involvement of peripheral nerves undetectable by conventional NCS, even though they caused no clinical symptoms.</description><identifier>ISSN: 0001-6314</identifier><identifier>EISSN: 1600-0404</identifier><identifier>DOI: 10.1111/j.1600-0404.2007.00989.x</identifier><identifier>PMID: 18279481</identifier><identifier>CODEN: ANRSAS</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Action Potentials - physiology ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Diabetic Neuropathies - physiopathology ; diabetic neuropathy ; Female ; Humans ; Male ; Median Nerve - cytology ; Median Nerve - physiology ; Median Neuropathy - physiopathology ; Medical sciences ; Middle Aged ; Nerve Fibers, Myelinated - physiology ; Nerve Fibers, Unmyelinated - physiology ; Nervous system (semeiology, syndromes) ; Neural Conduction - physiology ; Neurology ; Neurons, Afferent - physiology ; Neurons, Afferent - ultrastructure ; refractory period ; Refractory Period, Electrophysiological - physiology ; sensory nerve action potential</subject><ispartof>Acta neurologica Scandinavica, 2008-08, Vol.118 (2), p.94-98</ispartof><rights>Copyright © 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5159-1be98a6027b76f210e06509c0e82ab0438d36d4b3d8e96a72ab551c2eb38fe313</citedby><cites>FETCH-LOGICAL-c5159-1be98a6027b76f210e06509c0e82ab0438d36d4b3d8e96a72ab551c2eb38fe313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-0404.2007.00989.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-0404.2007.00989.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20495275$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18279481$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakatani-Enomoto, S.</creatorcontrib><creatorcontrib>Bandoh, M.</creatorcontrib><creatorcontrib>Kita, Y.</creatorcontrib><creatorcontrib>Yamanouchi, H.</creatorcontrib><creatorcontrib>Enomoto, H.</creatorcontrib><creatorcontrib>Kimura, T.</creatorcontrib><creatorcontrib>Hashimoto, K.</creatorcontrib><creatorcontrib>Yahara, O.</creatorcontrib><creatorcontrib>Ugawa, Y.</creatorcontrib><title>Paired stimulation study of the median nerve sensory action potential in diabetic patients</title><title>Acta neurologica Scandinavica</title><addtitle>Acta Neurol Scand</addtitle><description>Objectives – Conventional nerve conduction studies (NCS) are not sensitive to detect mild diabetic neuropathy. In order to detect subtle changes, we compared the conventional NCS with the relative refractory period (RRP) measurement of the median sensory nerve action potential by a paired stimulation method.
Methods – Subjects were 29 diabetic patients whose conventional NCS were all normal. They were divided into two groups: neurologically symptomatic and asymptomatic groups. Twenty‐eight age‐matched control subjects were also studied.
Results – The RRP of the symptomatic diabetic patients (5.9 ± 0.5 ms) and that of the asymptomatic patients (5.6 ± 0.5 ms) was significantly longer than that of the control subjects (4.9 ± 0.6 ms). There was no significant difference in RRP between the symptomatic and asymptomatic patients. This may be due to the fact that NCS reflects mainly large myelinated fiber function and early symptoms represent mainly thin myelinated or unmyelinated fiber function.
Conclusions – The RRP measurement could reveal some mild involvement of peripheral nerves undetectable by conventional NCS, even though they caused no clinical symptoms.</description><subject>Action Potentials - physiology</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</subject><subject>Diabetic Neuropathies - physiopathology</subject><subject>diabetic neuropathy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Median Nerve - cytology</subject><subject>Median Nerve - physiology</subject><subject>Median Neuropathy - physiopathology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nerve Fibers, Myelinated - physiology</subject><subject>Nerve Fibers, Unmyelinated - physiology</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neural Conduction - physiology</subject><subject>Neurology</subject><subject>Neurons, Afferent - physiology</subject><subject>Neurons, Afferent - ultrastructure</subject><subject>refractory period</subject><subject>Refractory Period, Electrophysiological - physiology</subject><subject>sensory nerve action potential</subject><issn>0001-6314</issn><issn>1600-0404</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkV9v0zAUxS3ExLrBV0B-gbeEazvxH4mXqRobWjX6MITEi-UkN8IlTYqdsPbbz12r8sj84uvr37m2ziGEMshZWp9WOZMAGRRQ5BxA5QBGm3z7isxOF6_JDABYJgUrzslFjKt04qoo3pBzprkyhWYz8nPpfMCGxtGvp86NfuhTPTU7OrR0_IV0jY13Pe0x_EUasY9D2FFXP4ObYcR-9K6jvqcJq3D0Nd2kKakd35Kz1nUR3x33S_L9y_XD_DZbfLv5Or9aZHXJSpOxCo12EriqlGw5AwRZgqkBNXcVFEI3QjZFJRqNRjqVmmXJao6V0C0KJi7Jx8PcTRj-TBhHu_axxq5zPQ5TtNKUTBhj_gty0NJopRKoD2AdhhgDtnYT_NqFnWVg9wHYld37bPc-230A9jkAu03S98c3pipZ9094dDwBH46Ai7Xr2uD62scTx6EwJVdl4j4fuEff4e7FH7BX99epSPLsIPdxxO1J7sJvK5VQpf1xf2MXsFzeyYe5vRNPPXGwOQ</recordid><startdate>200808</startdate><enddate>200808</enddate><creator>Nakatani-Enomoto, S.</creator><creator>Bandoh, M.</creator><creator>Kita, Y.</creator><creator>Yamanouchi, H.</creator><creator>Enomoto, H.</creator><creator>Kimura, T.</creator><creator>Hashimoto, K.</creator><creator>Yahara, O.</creator><creator>Ugawa, Y.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>200808</creationdate><title>Paired stimulation study of the median nerve sensory action potential in diabetic patients</title><author>Nakatani-Enomoto, S. ; Bandoh, M. ; Kita, Y. ; Yamanouchi, H. ; Enomoto, H. ; Kimura, T. ; Hashimoto, K. ; Yahara, O. ; Ugawa, Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5159-1be98a6027b76f210e06509c0e82ab0438d36d4b3d8e96a72ab551c2eb38fe313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Action Potentials - physiology</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</topic><topic>Diabetic Neuropathies - physiopathology</topic><topic>diabetic neuropathy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Median Nerve - cytology</topic><topic>Median Nerve - physiology</topic><topic>Median Neuropathy - physiopathology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nerve Fibers, Myelinated - physiology</topic><topic>Nerve Fibers, Unmyelinated - physiology</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neural Conduction - physiology</topic><topic>Neurology</topic><topic>Neurons, Afferent - physiology</topic><topic>Neurons, Afferent - ultrastructure</topic><topic>refractory period</topic><topic>Refractory Period, Electrophysiological - physiology</topic><topic>sensory nerve action potential</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakatani-Enomoto, S.</creatorcontrib><creatorcontrib>Bandoh, M.</creatorcontrib><creatorcontrib>Kita, Y.</creatorcontrib><creatorcontrib>Yamanouchi, H.</creatorcontrib><creatorcontrib>Enomoto, H.</creatorcontrib><creatorcontrib>Kimura, T.</creatorcontrib><creatorcontrib>Hashimoto, K.</creatorcontrib><creatorcontrib>Yahara, O.</creatorcontrib><creatorcontrib>Ugawa, Y.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Acta neurologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakatani-Enomoto, S.</au><au>Bandoh, M.</au><au>Kita, Y.</au><au>Yamanouchi, H.</au><au>Enomoto, H.</au><au>Kimura, T.</au><au>Hashimoto, K.</au><au>Yahara, O.</au><au>Ugawa, Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Paired stimulation study of the median nerve sensory action potential in diabetic patients</atitle><jtitle>Acta neurologica Scandinavica</jtitle><addtitle>Acta Neurol Scand</addtitle><date>2008-08</date><risdate>2008</risdate><volume>118</volume><issue>2</issue><spage>94</spage><epage>98</epage><pages>94-98</pages><issn>0001-6314</issn><eissn>1600-0404</eissn><coden>ANRSAS</coden><abstract>Objectives – Conventional nerve conduction studies (NCS) are not sensitive to detect mild diabetic neuropathy. In order to detect subtle changes, we compared the conventional NCS with the relative refractory period (RRP) measurement of the median sensory nerve action potential by a paired stimulation method.
Methods – Subjects were 29 diabetic patients whose conventional NCS were all normal. They were divided into two groups: neurologically symptomatic and asymptomatic groups. Twenty‐eight age‐matched control subjects were also studied.
Results – The RRP of the symptomatic diabetic patients (5.9 ± 0.5 ms) and that of the asymptomatic patients (5.6 ± 0.5 ms) was significantly longer than that of the control subjects (4.9 ± 0.6 ms). There was no significant difference in RRP between the symptomatic and asymptomatic patients. This may be due to the fact that NCS reflects mainly large myelinated fiber function and early symptoms represent mainly thin myelinated or unmyelinated fiber function.
Conclusions – The RRP measurement could reveal some mild involvement of peripheral nerves undetectable by conventional NCS, even though they caused no clinical symptoms.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18279481</pmid><doi>10.1111/j.1600-0404.2007.00989.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Action Potentials - physiology Aged Aged, 80 and over Biological and medical sciences Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction Diabetic Neuropathies - physiopathology diabetic neuropathy Female Humans Male Median Nerve - cytology Median Nerve - physiology Median Neuropathy - physiopathology Medical sciences Middle Aged Nerve Fibers, Myelinated - physiology Nerve Fibers, Unmyelinated - physiology Nervous system (semeiology, syndromes) Neural Conduction - physiology Neurology Neurons, Afferent - physiology Neurons, Afferent - ultrastructure refractory period Refractory Period, Electrophysiological - physiology sensory nerve action potential |
| title | Paired stimulation study of the median nerve sensory action potential in diabetic patients |
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