Contribution of Central Neuropathy to Postural Instability in IDDM Patients With Peripheral Neuropathy

Uccioli, Luigi; Giacomini, P; Pasqualetti, Patrizio; Girolamo, Stefano Di; Ferrigno, Paola; Monticone, Giovanna; Bruno, Ernesto; Boccasena, P.; Magrini, A; Parisi, Luca; Menzinger, G.; Rossini, Paolo Maria

doi:10.2337/diacare.20.6.929

Cited by 48 publications

(43 citation statements)

References 15 publications

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“…19 Two other studies in which patients with electrophysiologically confirmed peripheral neuropathy and controls were examined showed greater body sway and greater frequency of falls among people with neuropathy. 29,40 The potential utility of interventions to improve balance in at-risk patients with peripheral neuropathy was suggested in a report showing improvement in balance in such patients following an exercise regimen designed to improve distal balance and strength. 31 The distal-toproximal pattern of diabetic neuropathy suggests that decreased peroneal motor nerve function might be most strongly associated with tests targeted to the ankle and foot, where small muscle wasting is common and where large muscles are served by the peroneal nerve.…”

Section: Discussionmentioning

confidence: 99%

Diabetes, peripheral neuropathy, and old age disability

et al. 2001

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The purpose of this study was to determine whether peripheral neuropathy explains the apparent association between diabetes and disability in old age, and to evaluate the utility of lower extremity function tests in older diabetic adults with and without neuropathy. We evaluated 39 adults, aged 70-79 years, for pressure sensation (log(10)g), vibration perception threshold (VPT; microns), and electrophysiologic function of the peroneal nerve. The subjects included patients with established diabetic neuropathy (DN; n = 14), diabetic controls without neuropathy (DC; n = 13), and nondiabetic controls (NDC; n = 12). Nonparametric statistical methods were used to relate neuropathy measures to performance in tests of walking speed, static and dynamic balance, coordination, and ankle strength (kilograms). Significant age-adjusted correlations were observed between measures of sensory neuropathy and a variety of performance measures, and electrophysiologic measures were related to static balance. DN subjects had significantly higher pressure sensation than NDC (5.17 vs 3.38g, P < 0.05), higher VPT (62.5 vs 21.7 microm, P < 0.05), and lower peroneal motor response amplitudes at multiple sites. Pressure sensation and nerve conduction measures did not differ between DC and NDC. Compared with NDC, DN subjects performed significantly worse on tests of walking speed (0.99 vs 1.34 m/s; P < 0.05), static balance (4.9 vs 20.4 s; P < 0.05), dynamic balance (9.23 vs 25.52 s; P < 0.05), and coordination (6.73 vs 4.76 s; P < 0.05). No differences were observed in these measures between DC and NDC. Observed differences in physical abilities between older diabetic and nondiabetic adults may have been due to the subset of diabetic individuals with peripheral neuropathy. Quantitative measures of sensory and motor nerve function have distinct effects on physical performance. Interventions aimed at reducing the impact of diabetes-associated disability in old age may have the greatest impact among people with peripheral neuropathy.

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Section: Discussionmentioning

confidence: 99%

Diabetes, peripheral neuropathy, and old age disability

et al. 2001

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“…During each recording, 800 artifact-free sweeps (analysis time 100 msec) were averaged with a 2.5 kHz sampling frequency (bandpass 15-1,500 Hz) and repeated at least twice to check their reproducibility. 17 …”

Section: Short Latency Sep (Sl-sep) Recording Methodsmentioning

confidence: 99%

Percutaneous tibial nerve stimulation produces effects on brain activity: Study on the modifications of the long latency somatosensory evoked potentials

Finazzi‐Agrò

Rocchi

Pachatz

et al. 2008

Neurourology and Urodynamics

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“…When both Aα and Aβ fibers were affected, as seen in CMT2 42 and DN, 19,[23][24][25][26]34,36,47,50 patients were unstable. This postural imbalance could be ascribed to the decreased function of Aβ fibers.…”

Section: 54mentioning

confidence: 99%