Assessment of symptomatic diabetic patients with normal nerve conduction studies: Utility of cutaneous silent periods and autonomic tests
Established electrophysiological methods have limited clinical utility in the diagnosis of small‐fiber neuropathy (SFN). In this study, diabetic patients with clinically diagnosed SFN were evaluated with autonomic tests and cutaneous silent periods (CSPs). Thirty‐one diabetic patients with clinicall...
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| Veröffentlicht in: | Muscle & nerve 2011-03, Vol.43 (3), p.317-323 |
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| creator | Koytak, Pinar Kahraman Isak, Baris Borucu, Deniz Uluc, Kayihan Tanridag, Tulin Us, Onder |
| description | Established electrophysiological methods have limited clinical utility in the diagnosis of small‐fiber neuropathy (SFN). In this study, diabetic patients with clinically diagnosed SFN were evaluated with autonomic tests and cutaneous silent periods (CSPs). Thirty‐one diabetic patients with clinically suspected SFN and normal nerve conduction studies were compared with 30 controls. In the upper extremities (UE), the CSP parameters did not differ statistically between the patient and control groups, whereas, in the lower extremities (LE), patients had prolonged CSP latencies (P = 0.018) and shortened CSP durations (P < 0.001). The sensitivity of the CSP duration was 32.6%, and the specificity was 96.7%. The expiration‐to‐inspiration ratios and amplitudes of the sympathetic skin responses in the lower extremities were also reduced. Our findings indicate that the diagnostic utility of CSPs was higher than that of the autonomic tests to support the clinically suspected diagnosis of SFN. Muscle Nerve, 2011 |
| doi_str_mv | 10.1002/mus.21877 |
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In this study, diabetic patients with clinically diagnosed SFN were evaluated with autonomic tests and cutaneous silent periods (CSPs). Thirty‐one diabetic patients with clinically suspected SFN and normal nerve conduction studies were compared with 30 controls. In the upper extremities (UE), the CSP parameters did not differ statistically between the patient and control groups, whereas, in the lower extremities (LE), patients had prolonged CSP latencies (P = 0.018) and shortened CSP durations (P < 0.001). The sensitivity of the CSP duration was 32.6%, and the specificity was 96.7%. The expiration‐to‐inspiration ratios and amplitudes of the sympathetic skin responses in the lower extremities were also reduced. Our findings indicate that the diagnostic utility of CSPs was higher than that of the autonomic tests to support the clinically suspected diagnosis of SFN. Muscle Nerve, 2011</description><identifier>ISSN: 0148-639X</identifier><identifier>EISSN: 1097-4598</identifier><identifier>DOI: 10.1002/mus.21877</identifier><identifier>PMID: 21321948</identifier><identifier>CODEN: MUNEDE</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; autonomic tests ; Biological and medical sciences ; cutaneous silent period duration ; diabetes mellitus ; Diabetes Mellitus - diagnosis ; Diabetes Mellitus - physiopathology ; Diabetes. Impaired glucose tolerance ; Diabetic Neuropathies - diagnosis ; Diabetic Neuropathies - physiopathology ; Early Diagnosis ; Electrodiagnosis. Electric activity recording ; Electromyography - methods ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Female ; Galvanic Skin Response - physiology ; Humans ; interneuron ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Nervous system ; Neural Conduction - physiology ; Reaction Time - physiology ; Skin - physiopathology ; small-fiber neuropathy</subject><ispartof>Muscle & nerve, 2011-03, Vol.43 (3), p.317-323</ispartof><rights>Copyright © 2011 Wiley Periodicals, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3927-8c1af33e85a7f1e664287b1e9740ca7933d27b70b23079ffeddda298a8d70f553</citedby><cites>FETCH-LOGICAL-c3927-8c1af33e85a7f1e664287b1e9740ca7933d27b70b23079ffeddda298a8d70f553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmus.21877$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmus.21877$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23917787$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21321948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koytak, Pinar Kahraman</creatorcontrib><creatorcontrib>Isak, Baris</creatorcontrib><creatorcontrib>Borucu, Deniz</creatorcontrib><creatorcontrib>Uluc, Kayihan</creatorcontrib><creatorcontrib>Tanridag, Tulin</creatorcontrib><creatorcontrib>Us, Onder</creatorcontrib><title>Assessment of symptomatic diabetic patients with normal nerve conduction studies: Utility of cutaneous silent periods and autonomic tests</title><title>Muscle & nerve</title><addtitle>Muscle Nerve</addtitle><description>Established electrophysiological methods have limited clinical utility in the diagnosis of small‐fiber neuropathy (SFN). In this study, diabetic patients with clinically diagnosed SFN were evaluated with autonomic tests and cutaneous silent periods (CSPs). Thirty‐one diabetic patients with clinically suspected SFN and normal nerve conduction studies were compared with 30 controls. In the upper extremities (UE), the CSP parameters did not differ statistically between the patient and control groups, whereas, in the lower extremities (LE), patients had prolonged CSP latencies (P = 0.018) and shortened CSP durations (P < 0.001). The sensitivity of the CSP duration was 32.6%, and the specificity was 96.7%. The expiration‐to‐inspiration ratios and amplitudes of the sympathetic skin responses in the lower extremities were also reduced. Our findings indicate that the diagnostic utility of CSPs was higher than that of the autonomic tests to support the clinically suspected diagnosis of SFN. Muscle Nerve, 2011</description><subject>Adult</subject><subject>autonomic tests</subject><subject>Biological and medical sciences</subject><subject>cutaneous silent period duration</subject><subject>diabetes mellitus</subject><subject>Diabetes Mellitus - diagnosis</subject><subject>Diabetes Mellitus - physiopathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Neuropathies - diagnosis</subject><subject>Diabetic Neuropathies - physiopathology</subject><subject>Early Diagnosis</subject><subject>Electrodiagnosis. Electric activity recording</subject><subject>Electromyography - methods</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Galvanic Skin Response - physiology</subject><subject>Humans</subject><subject>interneuron</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system</subject><subject>Neural Conduction - physiology</subject><subject>Reaction Time - physiology</subject><subject>Skin - physiopathology</subject><subject>small-fiber neuropathy</subject><issn>0148-639X</issn><issn>1097-4598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFy1SAUhhlHx16rC1_AYeM4LtJCSAK469RanVZd1Du6YwiQEU0g5ZDW-wi-tYm5rStXwPCd_zvzI_SckiNKSHk8THBUUsH5A7ShRPKiqqV4iDaEVqJomPx2gJ4A_CCEUNHwx-igpKykshIb9PsEwAEMLmQcOwy7Ycxx0NkbbL1u3XIZ5-f8D_jW5-84xDToHgeXbhw2MdjJZB8DhjxZ7-AN3mbf-7xb4syUdXBxAgy-XxSjSz5awDpYrKccQxxmQXaQ4Sl61Oke3LP9eYi2786-nL4vLj-ffzg9uSwMkyUvhKG6Y8yJWvOOuqapSsFb6iSviNFcMmZL3nLSloxw2XXOWqtLKbSwnHR1zQ7RqzV3TPF6ms1q8GBc36-bKlFTyRpZ05l8vZImRYDkOjUmP-i0U5SopXg1F6_-Fj-zL_apUzs4e0_eNT0DL_eABqP7LulgPPzjmKSciyXoeOVu58Z2_zeqj9urO3WxTnjI7tf9hE4_VcMZr9XXT-fqbX1xccUIU5z9AU-SrNo</recordid><startdate>201103</startdate><enddate>201103</enddate><creator>Koytak, Pinar Kahraman</creator><creator>Isak, Baris</creator><creator>Borucu, Deniz</creator><creator>Uluc, Kayihan</creator><creator>Tanridag, Tulin</creator><creator>Us, Onder</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</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>7X8</scope></search><sort><creationdate>201103</creationdate><title>Assessment of symptomatic diabetic patients with normal nerve conduction studies: Utility of cutaneous silent periods and autonomic tests</title><author>Koytak, Pinar Kahraman ; Isak, Baris ; Borucu, Deniz ; Uluc, Kayihan ; Tanridag, Tulin ; Us, Onder</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3927-8c1af33e85a7f1e664287b1e9740ca7933d27b70b23079ffeddda298a8d70f553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>autonomic tests</topic><topic>Biological and medical sciences</topic><topic>cutaneous silent period duration</topic><topic>diabetes mellitus</topic><topic>Diabetes Mellitus - diagnosis</topic><topic>Diabetes Mellitus - physiopathology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Neuropathies - diagnosis</topic><topic>Diabetic Neuropathies - physiopathology</topic><topic>Early Diagnosis</topic><topic>Electrodiagnosis. Electric activity recording</topic><topic>Electromyography - methods</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Galvanic Skin Response - physiology</topic><topic>Humans</topic><topic>interneuron</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system</topic><topic>Neural Conduction - physiology</topic><topic>Reaction Time - physiology</topic><topic>Skin - physiopathology</topic><topic>small-fiber neuropathy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koytak, Pinar Kahraman</creatorcontrib><creatorcontrib>Isak, Baris</creatorcontrib><creatorcontrib>Borucu, Deniz</creatorcontrib><creatorcontrib>Uluc, Kayihan</creatorcontrib><creatorcontrib>Tanridag, Tulin</creatorcontrib><creatorcontrib>Us, Onder</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>MEDLINE - Academic</collection><jtitle>Muscle & nerve</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koytak, Pinar Kahraman</au><au>Isak, Baris</au><au>Borucu, Deniz</au><au>Uluc, Kayihan</au><au>Tanridag, Tulin</au><au>Us, Onder</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of symptomatic diabetic patients with normal nerve conduction studies: Utility of cutaneous silent periods and autonomic tests</atitle><jtitle>Muscle & nerve</jtitle><addtitle>Muscle Nerve</addtitle><date>2011-03</date><risdate>2011</risdate><volume>43</volume><issue>3</issue><spage>317</spage><epage>323</epage><pages>317-323</pages><issn>0148-639X</issn><eissn>1097-4598</eissn><coden>MUNEDE</coden><abstract>Established electrophysiological methods have limited clinical utility in the diagnosis of small‐fiber neuropathy (SFN). In this study, diabetic patients with clinically diagnosed SFN were evaluated with autonomic tests and cutaneous silent periods (CSPs). Thirty‐one diabetic patients with clinically suspected SFN and normal nerve conduction studies were compared with 30 controls. In the upper extremities (UE), the CSP parameters did not differ statistically between the patient and control groups, whereas, in the lower extremities (LE), patients had prolonged CSP latencies (P = 0.018) and shortened CSP durations (P < 0.001). The sensitivity of the CSP duration was 32.6%, and the specificity was 96.7%. The expiration‐to‐inspiration ratios and amplitudes of the sympathetic skin responses in the lower extremities were also reduced. Our findings indicate that the diagnostic utility of CSPs was higher than that of the autonomic tests to support the clinically suspected diagnosis of SFN. 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| subjects | Adult autonomic tests Biological and medical sciences cutaneous silent period duration diabetes mellitus Diabetes Mellitus - diagnosis Diabetes Mellitus - physiopathology Diabetes. Impaired glucose tolerance Diabetic Neuropathies - diagnosis Diabetic Neuropathies - physiopathology Early Diagnosis Electrodiagnosis. Electric activity recording Electromyography - methods Endocrine pancreas. Apud cells (diseases) Endocrinopathies Female Galvanic Skin Response - physiology Humans interneuron Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Nervous system Neural Conduction - physiology Reaction Time - physiology Skin - physiopathology small-fiber neuropathy |
| title | Assessment of symptomatic diabetic patients with normal nerve conduction studies: Utility of cutaneous silent periods and autonomic tests |
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