Quick and Simple Evaluation of Sudomotor Function for Screening of Diabetic Neuropathy

Yajnik, Chittaranjan S.; Kantikar, Vaishali; Pande, Amol J.; Deslypère, J.P.

doi:10.5402/2012/103714

Cited by 82 publications

(80 citation statements)

References 24 publications

(29 reference statements)

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“…Yajnik et al 25 evaluated different neuropathy assessments on 265 diabetes patients and found that ESC measurements between the left and right side varied by 9.5% for hands and 6.0% for feet, compared with 14.2% for the vibration perception threshold test. Lower measures of ESC were significantly associated with increasing symptoms on the Michigan Neuropathy Scoring Instrument A, which evaluates the presence of small and large fiber neuropathy symptoms; increasing physical abnormalities on the Michigan Neuropathy Scoring Instrument B, which includes feet inspection, vibration perception, ankle reflexes, and monofilament perception; and increasing scores on the vibration perception threshold test, reflecting impaired vibration perception.…”

Section: Discussionmentioning

confidence: 99%

“…Lower ESC was specifically associated with postural fall in blood pressure, a measure of sympathetic cardiac autonomic neuropathy. 25 Mayaudon et al 8 measured sensitivity, specificity, and reproducibility of Sudoscan among 133 type 2 DM patients compared with 41 HCs. ESC showed a sensitivity of 75% and a specificity of 100%, with an area under the ROC curve of 0.88, similar to our current report.…”

Section: Discussionmentioning

confidence: 99%

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Sudoscan, a Noninvasive Tool for Detecting Diabetic Small Fiber Neuropathy and Autonomic Dysfunction

Casellini

Parson²,

Richardson³

et al. 2013

Diabetes Technology & Therapeutics

251

247

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Objective: Sudomotor dysfunction may be an early detectable abnormality in diabetic small fiber neuropathy. The aim of this study was to evaluate the efficacy of SudoscanÔ (Impeto Medical, Paris, France) in detecting diabetic neuropathy (DN), in comparison with other standardized tests, in patients with diabetes mellitus (DM). Subjects and Methods: Sudoscan measures electrochemical skin conductance (ESC) of hands and feet through reverse iontophoresis. We evaluated 83 DM patients with and without DN and 210 healthy controls (HCs). Neuropathy Impairment Score-Lower Legs (NIS-LL), quantitative autonomic function testing (QAFT), and quantitative sensory testing (QST) were performed. Symptomatic pain was recorded using a visual analog scale. Receiver-operator characteristic (ROC) curves were calculated to evaluate the efficacy of Sudoscan in detecting DN compared with traditional modalities. Results: Diabetes patients with DN had significantly worse ESCs of feet and hands than DM patients without DN and HCs (respectively, 56.3 -3 vs. 75.9 -5.5 and 84.4 -0.9 [P < 0.0001] for feet and 51.9 -2.4 vs. 67.5 -4.3 and 73.1 -0.8 [P < 0.0001] for hands). Increasing NIS-LL scores were associated with decreasing ESC values. ESCs correlated significantly with clinical (NIS-LL), somatic (QST), and autonomic (QAFT) measures of neuropathy and with pain scores. ROC curve analysis showed significant results for both hands and feet ESC (area under the curve of 0.86 and 0.88, respectively; P < 0.0001) with sensitivity of 78% and specificity of 92% for feet to detect DN. Conclusions: Sudoscan is a promising, sensitive tool to detect neuropathy in patients with DM. This is a very simple, easy-toperform test that can be done in the clinical setting in 3-5 min.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sudoscan, a Noninvasive Tool for Detecting Diabetic Small Fiber Neuropathy and Autonomic Dysfunction

Casellini

Parson²,

Richardson³

et al. 2013

Diabetes Technology & Therapeutics

251

247

View full text Add to dashboard Cite

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“…As for the Sudoscan test, we used 60 μS of mean feet ESC as the cut‐off for diagnosis of DSPN according to previous studies18, 19.…”

Section: Methodsmentioning

confidence: 99%

Sudoscan is an effective screening method for asymptomatic diabetic neuropathy in Chinese type 2 diabetes mellitus patients

Mao

Liu

Qiao

et al. 2016

J of Diabetes Invest

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Aims/IntroductionThe aim of the present study was to use the sudomotor function test, Sudoscan, as a screening method for the evaluation of asymptomatic diabetic distal symmetric polyneuropathy in Chinese type 2 diabetes patients. As a result, more attention could be paid to those asymptomatic patients who could be easily neglected and underdiagnosed in everyday clinic.Materials and MethodsA total of 394 Chinese type 2 diabetes patients were enrolled and tested for symptoms and clinical signs of neuropathy using the Neurological Symptom Score, Neuropathy Disability Score, and vibration perception threshold. Sudoscan was carried out, and the results were collected as the measurement of the electrochemical skin conductance of both hands and feet.ResultsIn the present study, we found that the abnormal rate of Sudoscan results in patients with asymptomatic neuropathy was higher than those without neuropathy and those with symptomatic neuropathy. This study also showed that lower electrochemical skin conductance at the feet was significantly associated with increasing symptoms, Neurological Symptom Score (r = −0.124, P < 0.05), Neuropathy Disability Score (r = −0.3, P < 0.01) and vibration perception threshold value (r = −0.18, P < 0.05). Logistic analysis showed that age (odds ratio 1.042, 95% confidence interval 1.014−1.071, P < 0.05) and feet electrochemical skin conductance levels (odds ratio 0.98, 95% confidence interval 0.962–0.993, P < 0.01) were independently associated with diabetic distal symmetric polyneuropathy.ConclusionsSudoscan might be a promising tool to screen asymptomatic diabetic distal symmetric polyneuropathy in Chinese patients with type 2 diabetes mellitus.

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“…In addition, an algorithm that integrates ESC with age and BMI has been developed to produce a score estimating the individual's current risk of cardiac autonomic neuropathy (cardiac risk score). This risk score has been validated in several clinical studies10, 11, 12, 13, 14.…”

Section: Methodsmentioning

confidence: 99%

Study on autonomic dysfunction and metabolic syndrome in Chinese patients

Zhu

Zhao

Zeng

et al. 2016

J of Diabetes Invest

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Aims/IntroductionThere is still a lack of simple methods and instruments for the early assessment of autonomic dysfunction in metabolic syndrome patients. Assessment of sudomotor function has been proposed to explore autonomic function, and could be used as an early biomarker for metabolic syndrome. In the present study, we use a quick and non‐invasive method to measure sudomotor function, and aimed to evaluate its efficacy to identify metabolic syndrome in a Chinese population.Materials and MethodsInformation on the 1,160 Chinese participants involved in the study, such as age, sex, blood pressure, waist circumference, body mass index, fasting plasma glucose and lipid profile, and SUDOSCAN, was recorded. During the sudomotor test, patients were asked to place their bare hands and feet on large electrodes. The test took 2 min to carry out, was painless and no participant preparation was required.ResultsA total of 567 participants were diagnosed with metabolic syndrome. The prevalence of metabolic syndrome correlated significantly with increasing SUDOSCAN cardiac risk score (P for trend <0.0001). Furthermore, an increase in cardiac risk score value was associated with an increase in the number of metabolic syndrome components (P for trend <0.0001). Compared with the no‐risk group (cardiac risk score <20), participants in the high‐risk group (cardiac risk score ≥30) had a 2.83‐fold increased risk of prevalent metabolic syndrome (P < 0.0001), and 1.51‐fold increased risk (P = 0.01) after adjustments.ConclusionsAutonomic dysfunction is correlated to components of metabolic syndrome. The role of SUDOSCAN in the screening of at‐risk populations for metabolic syndrome has to be confirmed by further studies.

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Quick and Simple Evaluation of Sudomotor Function for Screening of Diabetic Neuropathy

Cited by 82 publications

References 24 publications

Sudoscan, a Noninvasive Tool for Detecting Diabetic Small Fiber Neuropathy and Autonomic Dysfunction

Sudoscan, a Noninvasive Tool for Detecting Diabetic Small Fiber Neuropathy and Autonomic Dysfunction

Sudoscan is an effective screening method for asymptomatic diabetic neuropathy in Chinese type 2 diabetes mellitus patients

Study on autonomic dysfunction and metabolic syndrome in Chinese patients

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