Assessment of symptomatic diabetic patients with normal nerve conduction studies: Utility of cutaneous silent periods and autonomic tests

Koytak, Pınar Kahraman; İşak, Barış; Borucu, Deniz; Uluç, Kayıhan; Tanridag, Tulin; Us, Önder

doi:10.1002/mus.21877

Cited by 14 publications

(7 citation statements)

References 40 publications

(71 reference statements)

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“…Pinar et al (19) conducted a study to verify the parameters of the cutaneous silent period (latency and duration) in symptomatic diabetics, with clinically defined thin-fiber neuropathy and normal nerve conduction. The study included 31 diabetics and 30 healthy control subjects.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus Type Has Impact on Cutaneous Silent Period

Drnda

Suljić

2019

Med Arch

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Introduction:Neurophysiological tests allow accurate assessment of the function of the peripheral nervous system. Detection of neurophysiological changes allows us to understand the neurological clinical symptoms and signs of patients with type 1 and type 2 diabetes and the possibility for their symptomatic treatment.Aim:Evaluate the effect of diabetes mellitus on the “cutaneous silent period” in detecting diabetic polyneuropathy.Material and Methods:The study included 150 subjects, 90 suffering from diabetes, divided into three groups of 30, depending on the disease duration, and a control group of 60 respondents not suffering from diabetes or other polyneuropathies. The control group are referred for EMG analysis on another basis (cervical radiculopathy, brachialgia, etc.). Group 1 consisted of 30 subjects with diabetes mellitus type 2 and duration of illness up to 5 years. Group 2 consisted of 30 subjects with type 2 diabetes mellitus 2 and illness duration from 5 to 10 years. Group 3 consisted of 30 patients with type 1 diabetes mellitus. The study groups consisted of patients referred for EMNG analysis to the EMG office of the Clinical Center of Sarajevo University, Neurology Clinic and the Neurophysiology Laboratory in Ljubljana, from July 1, 2011 to May 1, 2016. All patients were examined neurologically and electroneurographic analysis was performed.Results:A statistically significant difference was found in the incidence of pathologic CSP with respect to the study groups, χ2 = 26.153; p=0.001. Pathologic CSP was more common in group 1 and group 2 of subjects (56.17%) compared to group 3 and control subjects, where it occurred in 13.3% of the cases.Conclusion:The pathological cutaneous period of silence was more frequent in subjects of group 1 and group 2, that is, in subjects with DM type 2, compared to subjects with DM type 1.

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Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus Type Has Impact on Cutaneous Silent Period

Drnda

Suljić

2019

Med Arch

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“…Any defect in this inhibition process prolongs CSP latency by delaying motor neuron inhibition. Furthermore, during the inhibition of interneurons, more motor neurons are involved in the process as a result of any stimulation and, eventually, CSP duration shortens . It has been shown that technical and demographic factors and/or neuropathies may prolong CSP latency .…”

Section: Discussionmentioning

confidence: 99%

Cutaneous silent period in myofascial pain syndrome

et al. 2017

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Introduction: An increased response to painful stimuli without spontaneous pain suggests a role of central hyperexcitability of pain pathways in the pathogenesis of myofascial pain syndrome (MPS). In this study we aimed to test the hypothesis that spinal pain pathways are affected in MPS. We used cutaneous silent period (CSP) parameters to demonstrate the hyperexcitability of spinal pain pathways in MPS. Methods: Twenty-nine patients diagnosed with MPS and 30 healthy volunteers were included in the study. The CSP recordings were performed in the right upper and left lower extremities. Results: In both upper and lower extremities, patients had prolonged CSP latencies (P 5 0.034 and P 5 0.049 respectively) and shortened CSP durations (P 5 0.009 and P 5 0.008, respectively). Discussion: Delayed and shortened CSP in MPS patients implies dysfunction in the inhibitory mechanism of the spinal/supraspinal pain pathways, suggesting central sensitization in the pathogenesis of MPS and supporting our research hypothesis.

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“…Его можно получить с помощью любого устройства для ЭМГ и использовать для изучения А-дельта-волокон при периферической нейропатии [45,46]. Это может быть полезным методом ранней диагностики диабетической нейропатии тонких волокон [43,47,48].…”

Section: диагностика ранней дпнunclassified

“…Симпатические кожные реакции используются для ранней диагностики автономной нейропатии [47]. В некоторых исследованиях были обнаружены следующие отклонения при ранних стадиях диабета и при нарушении толерантности к глюкозе: отсутствие симпатических кожных реакций, увеличение латентного периода и понижение амплитуды [49,50].…”

Section: диагностика ранней дпнunclassified

Diagnosis and treatment of the early stages of diabetic polyneuropathy

2020

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Diabetic polyneuropathy (DPN) is the most common and earliest complication of diabetes mellitus and it may occur much earlier in patients with type-2 diabetes than in patients with type-1. Distal polyneuropathy can develop not only in diabetes mellitus, but also at the stage of prediabetes and even in patients with metabolic syndrome without impaired glycemic state. Hyperglycemia viewed as a major, but not the sole factor, responsible for development and progression DPN. The control of blood glucose as an obligatory step of therapy to delay or reverse DPN is no longer an arguable issue. Damage of peripheral nervous system in prediabetes and in the initial stages of diabetes mainly affects small nerve fibers, which also leads to disorders of the autonomic nervous system. Cardiac autonomic neuropathy diagnosed in 5-7.7% of patients at the time of diagnosis of type 1 and type 2 diabetes mellitus. For the early diagnosis of DPN, both routine assessment of peripheral sensation can be used, as well as specialized methods (sympathetic skin reactions, skin biopsy, confocal corneal microscopy, quantitative sensory tests) and validated questionnaires (Utah Early Neuropathy Scale) focused on assessing the function of small nerve fibers. Non-electrophysiological studies also were tested for early diagnosis of DPN: peripheral nerve sonoelastography, optical coherence tomography, MRI neurography, spiral positron emission CT (SPECT) with 123I-MIBG. DPN diagnosis in the pre-clinical stage very important, because treatment with diet and lifestyle intervention may be successful. The correlation between the severity of oxidative stress and the activity of antioxidant defense is considered as a potential mechanism for early nerves damage with hyperglycemia and as a possible target for therapeutic intervention. In this work, we will review prevalence, diagnostic approaches and potential treatment options for early diabetic polyneuropathy.

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Assessment of symptomatic diabetic patients with normal nerve conduction studies: Utility of cutaneous silent periods and autonomic tests

Cited by 14 publications

References 40 publications

Diabetes Mellitus Type Has Impact on Cutaneous Silent Period

Diabetes Mellitus Type Has Impact on Cutaneous Silent Period

Cutaneous silent period in myofascial pain syndrome

Diagnosis and treatment of the early stages of diabetic polyneuropathy

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