Perception threshold tracking: validating a novel method for assessing function of large and small sensory nerve fibers in diabetic peripheral neuropathy with and without pain

Røikjer, Johan; Croosu, Suganthiya Santhiapillai; Frøkjær, Jens Brøndum; Hansen, Tore; Arendt‐Nielsen, Lars; Ejskjær, Niels; Mørch, Carsten Dahl

doi:10.1097/j.pain.0000000000002780

Cited by 9 publications

(19 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of many pharmacological options (TCAs, SSRIs, SNRIs Anti-arrhythmic, opioids and AEDs), the recent includes lacosamide with better results in controlling CDPN pain more than others. [2][3][4][5]12,13 The current study was conducted to evaluate the effectiveness of lacosamide in reducing the neuropathic pain and its clinical comparison with placebo in local settings. The study found that lacosamide 400 mg/ day was effective for this purpose.…”

Section: Discussionmentioning

confidence: 99%

Role of Lacosamide in Diabetic Neuropathy: An Experience at Tertiary Care Hospital in Rural Sindh

Rehman¹,

Ahmed²,

Mujtaba³

et al. 2022

PJMHS

View full text Add to dashboard Cite

Background: Lacosamide is a relatively newer drug for treatment of chronic diabetic painful neuropathy (CDPN). Objective: To analyse the effectiveness and safety of lacosamide in patients with diabetic neuropathy. Study Design: Randomized controlled clinical trial. Duration and Place of Study: This study was conducted at department of neurology, Khairpur Medical College, Khairpur Mir’s, during from the period Oct 2021 to March 2022. Methodology: Ninety-two patients of either gender, age 20-60 years, known case of diabetes mellitus for minimally 5 years having pain intensity in the range of 4-9 on 11-point (0–10) numerical rating scale & HbA1c value 6.1%-10% were included and assigned randomly (Lacosamide = 46 & Placebo = 46) after taking a valid informed/ written consent. Lacosamide 400 mg/ day was given upto 20 weeks which initially increased from baseline at rate of 100 mg per week. The primary outcome variable was changes from baseline in average pain scores. Results: The mean age of lacosamide group was 40.26±11.33 while in placebo group was 41.30±10.46 years. The mean Pretrial Pain Score measured on NRS of lacosamide group was 6.59±1.95 which decreased to 3.39±1.94 and in placebo group was 6.71±1.89 which decreased to 6.35±1.52 by the end of maintenance phase (20 weeks; p<0.0001). Adverse events (59%) of the patients experience adverse events at least for 1 time. Common side-effects included headache (11% vs. 31%), dizziness (09% vs. 11%), nausea (15% vs. 8%), and diarrhea (8% vs. 19%) with lacosamide and placebo group respectively each (p<0.0001). Conclusion: Lacosamide is a safe and effective drug and achieved in pain relief and may be prescribed as routine treatment of chronic diabetic painful neuropathy. Keywords: Diabetes mellitus, Pain, Chronic diabetic painful neuropathy, Lacosamide, Numerical rating scale

show abstract

Section: Discussionmentioning

confidence: 99%

Role of Lacosamide in Diabetic Neuropathy: An Experience at Tertiary Care Hospital in Rural Sindh

Rehman¹,

Ahmed²,

Mujtaba³

et al. 2022

PJMHS

View full text Add to dashboard Cite

show abstract

“…The study was conducted between August 2019 and February 2022 in participants from the "MEDON" (Methods for Early Detection Of diabetic peripheral Neuropathy)-cohort (clinicaltrials.gov: NCT04078516) [12][13][14]. This population is described in details elsewhere, but in short, the original cohort consisted of 80 participants equally divided into four groups: participants with T1DM and painful diabetic peripheral neuropathy (PDPN), participants with T1DM and DPN, participants with T1DM and no DPN, and healthy controls (HC) without diabetes or pain [12][13][14]. The four groups were matched 1:1:1:1 on age (+/-2 years) and sex.…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…Neuropathic pain severity (over the last 4 weeks) was derived from the PainDETECT questionnaire as average and peak pain intensity rated on a visual analog scale (VAS) ranging from 0-10, where 0 is no pain and 10 is the most intense pain imaginable [18]. Quantitative sensory testing and conventional nerve conduction studies were performed as previously described and reported [12][13][14].…”

Section: Assessment Of Peripheral Nervesmentioning

confidence: 99%

“…Perception threshold tracking of small nerve fibres was performed following our previously published protocol using the method of limits [12,19]. In short, the participants were electrically stimulated using a custom-made pin electrode (Aalborg University, Denmark) in an area 2-3 cm proximal to the second toe on the dorsum of the right foot.…”

Section: Perception Threshold Trackingmentioning

confidence: 99%

“…We have recently developed a novel perception threshold tracking technique, which utilizes weak electrical currents to selectively stimulate peripheral large (Aβ) and small nerve fibres (Aδ) [12]. It differed between people with and without diabetes and correlated with thermal thresholds obtained from quantitative sensory testing [12]. However, the limited accuracy and reproducibility of thermal thresholds compared to CCM or skin biopsies, limits the strength of this comparison.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic Accuracy of Perception Threshold Tracking in the Detection of Small Fiber Damage in Type 1 Diabetes

Røikjer

Croosu

Sejergaard

et al. 2023

J Diabetes Sci Technol

View full text Add to dashboard Cite

Aim: An objective assessment of small nerve fibers is key to the early detection of diabetic peripheral neuropathy (DPN). This study investigates the diagnostic accuracy of a novel perception threshold tracking technique in detecting small nerve fiber damage. Methods: Participants with type 1 diabetes (T1DM) without DPN (n = 20), with DPN (n = 20), with painful DPN (n = 20) and 20 healthy controls (HCs) underwent perception threshold tracking on the foot and corneal confocal microscopy. Diagnostic accuracy of perception threshold tracking compared to corneal confocal microscopy was analyzed using logistic regression. Results: The rheobase, corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), and corneal nerve fiber length (CNFL) (all P < .001) differed between groups. The diagnostic accuracy of perception threshold tracking (rheobase) was excellent for identifying small nerve fiber damage, especially for CNFL with a sensitivity of 94%, specificity 94%, positive predictive value 97%, and negative predictive value 89%. There was a significant correlation between rheobase with CNFD, CNBD, CNFL, and Michigan Neuropathy Screening Instrument (all P < .001). Conclusion: Perception threshold tracking had a very high diagnostic agreement with corneal confocal microscopy for detecting small nerve fiber loss and may have clinical utility for assessing small nerve fiber damage and hence early DPN. Clinical Trials: NCT04078516

show abstract

Cognitive function in individuals with and without painful and painless diabetic polyneuropathy—A cross‐sectional study in type 1 diabetes

Croosu

Gjela

Røikjer

et al. 2023

Endocrino Diabet & Metabol

Self Cite

View full text Add to dashboard Cite

Introduction Previous studies suggest that cognitive impairment is more prevalent in individuals with painful and painless diabetic peripheral neuropathy (DPN). However, the current evidence is not well described. This study investigated cognitive function in adults with type 1 diabetes mellitus (T1DM) and the association to painful/painless DPN and clinical parameters. Methods This cross‐sectional, observational, case–control study included 58 participants with T1DM, sub‐grouped into 20 participants with T1DM and painful DPN, 19 participants with T1DM and painless DPN, 19 participants with T1DM without DPN, and 20 healthy controls were included. The groups were matched for sex and age. The participants performed Addenbrooke's examination III (ACE‐III), which assesses attention, memory, verbal fluency, language and visuospatial skills. Working memory was evaluated using an N‐back task. Cognitive scores were compared between the groups and correlated to age, diabetes duration, HbA1c and nerve conduction measurements. Results Compared to healthy controls, T1DM participants showed lower total ACE‐III (p = .028), memory (p = .013) and language scores (p = .028), together with longer reaction times in the N‐back task (p = .041). Subgroup analyses demonstrated lower memory scores in those with painless DPN compared with healthy controls (p = .013). No differences were observed between the three T1DM subgroups. Cognitive scores and clinical parameters were not associated. Conclusions This study supports the notion of cognitive alterations in T1DM and indicates that cognitive function is altered in T1DM regardless of underlying neuropathic complications. The memory domain appears altered in T1DM, particularly in those with painless DPN. Further studies are needed to verify the findings.

show abstract

Perception threshold tracking: validating a novel method for assessing function of large and small sensory nerve fibers in diabetic peripheral neuropathy with and without pain

Abstract: Supplemental Digital Content is Available in the Text.Perception threshold tracking is a novel method suitable for differentiating diabetic polyneuropathies from controls and some painful diabetic polyneuropathies from nonpainful ones.

Cited by 9 publications

References 42 publications

Role of Lacosamide in Diabetic Neuropathy: An Experience at Tertiary Care Hospital in Rural Sindh

Role of Lacosamide in Diabetic Neuropathy: An Experience at Tertiary Care Hospital in Rural Sindh

Diagnostic Accuracy of Perception Threshold Tracking in the Detection of Small Fiber Damage in Type 1 Diabetes

Cognitive function in individuals with and without painful and painless diabetic polyneuropathy—A cross‐sectional study in type 1 diabetes

Contact Info

Product

Resources

About