Spinal somatosensory evoked potentials in juvenile diabetes

Cracco, Joan B.; Castells, Saladore; Mark, Erna

doi:10.1002/ana.410150110

Cited by 50 publications

(14 citation statements)

References 17 publications

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“…While some authors observed slower central nerve conduction times only in diabetic patients with neuropathy [24,25], others reported alterations in central conduction times in diabetic patients without neuropathy [17,19,20,22,23,26,27].…”

Section: Discussionmentioning

confidence: 98%

“…Reports on functional assessment of the CNS in patients with diabetes have produced controversial results. With the use of somatosensory evoked potentials (SEPs), several authors have detected a significant increase in spinal tract conduction time [17][18][19], while others have observed a delayed conduction time in the supraspinal tract [20,21]. In addition to alterations of somatosensory pathways in diabetes, reports have also documented slower central conduction times of acoustic and visual pathways [22,23].…”

Section: Discussionmentioning

confidence: 98%

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Central motor conduction after magnetic stimulation in diabetes

et al. 1998

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Central motor conduction times (CMCTs), obtained by means of magnetic stimulation of the motor cortex and spinal roots, were studied in 138 patients affected by diabetes mellitus but with no signs or symptoms of central nervous system (CNS) involvement. CMCTs were significantly increased in diabetic patients (p < 0.001, t-test) with respect to normal controls, with values exceeding upper confidence limits (mean +/- 2.5 SD of controls) in about 30% of patients. There was no correlation between CMCT delay and type of diabetes (insulin-dependent or non-insulin-dependent), patient age, disease duration, degree of metabolic control compensation, presence or absence of retinopathy or nephropathy, and presence or absence of peripheral or autonomic neuropathy. CNS involvement in diabetes mellitus is discussed. Particular emphasis is given to the sensitivity and reliability of CMCTs obtained by means of magnetic stimulation as a tool in the early diagnosis of CNS functional alterations in diabetes mellitus.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Central motor conduction after magnetic stimulation in diabetes

et al. 1998

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“…Neurobehavioral studies have reported cognitive decline in patients with diabetes (1)(2)(3)(4)(5), and neurophysiological studies have revealed conduction delays in the central auditory (6)(7)(8)(9), somatosensory (7,8,10), and visual (7,11) pathways in diabetic patients. Moreover, other recent studies have reported alterations in P300 eventrelated potentials (ERPs) in diabetic patients (2,12,13).…”

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confidence: 99%

Neurophysiological Evidence for Altered Higher Brain Functions in NIDDM

1996

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OBJECTIVE To investigate neurophysiological alterations of higher brain function in patients with NIDDM. RESEARCH DESIGN AND METHODS Auditory P300 event-related potentials were recorded in 60 NIDDM patients who had no evidence of stroke, dementia, or any other neurological illnesses. The P300 wave latencies in diabetic patients were compared with those in neurologically healthy control subjects, with consideration of clinical parameters and diabetic complications. RESULTS Diabetic patients had significantly longer P300 latencies than control subjects. Seven diabetic patients had pathologically prolonged P300 values. There was a trend toward longer P300 latencies in diabetic patients with retinopathy and in those with HbA1 of ≥10%; the differences between these diabetic subgroups and control subjects were both statistically significant. However, three of seven diabetic patients with abnormal P300 latencies had no retinal lesions, and no significant correlation was observed among diabetic patients between P300 latencies and HbA1 levels. Peripheral neuropathy, nephropathy, blood glucose levels, and disease duration appeared not to correlate with P300 alterations. CONCLUSIONS These findings suggest the presence of central nervous pathological processes in NIDDM that affect higher brain functions, as assessed by P300 latencies. Our findings also suggest that microangiopathy and metabolic derangement during the preceding 4- to 8-week period may contribute in small part to the pathophysiology of this central nervous involvement.

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“…SEPs allow propagation analysis along the spinal and supraspinal sensory pathways and relays, while MEPs permit (via electrical potentials transcranially induced by strong and transient magnetic pulses) a noninvasive and nearly painless investigation of propagation along corticospinal tracts controlling limb and axial musculature (8)(9)(10). Previous studies have assessed static posturography (SP), SEPs, MEPs, and electroneurography in diabetic patients as independent measurements (11)(12)(13), but they have never been combined in a unitary protocol to be tested in particular against SP The aim of the present study is to evaluate young diabetic subjects by employing a multidisciplinary approach combining an objective measurement of posture (posturography) with a comprehensive neurophysiological protocol evaluating the propagation of nervous sen- sory and motor impulses along the peripheral nerves and central (brain and spinal) cord fibers.…”

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confidence: 99%