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

Abstract

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.

The diagnostic usefulness of the combined COMPASS 31 questionnaire and electrochemical skin conductance for diabetic cardiovascular autonomic neuropathy and diabetic polyneuropathy

“…With regard to sudomotor assessment, we found that hands and feet ESC were lower in participants with CAN and DPN and were significantly related to all cardiovascular tests (in particular with deep breathing test: P < .0001) and the autonomic score, to the scores of neuropathic symptoms and signs, and to VPT, but not to thermal thresholds. These findings confirm previous observations of correlations of hands and feet ESC with clinical neuropathy scores (ie, NIS‐LL, UENS and MNSI, NDS and NSS, TCNS), deep breathing, Valsalva test, CARTs‐based autonomic score, VPT, and thermal thresholds, with the lowest significance for the latter . In the current study, feet ESC showed a fair diagnostic accuracy for CAN, in particular for confirmed CAN with an AUC of 0.92, while the abnormality of hands or feet ESC had the best sensitivity for confirmed CAN (83%) and the best specificity for DPN (67%).…”

“…The only relationship between ESC and clinical variables was that of mean ESC feet with triglycerides (rho = −0.273, P = .0065). In the analysis of covariance after adjustment for triglycerides, the significant differences in mean ESC feet between the groups with and without CAN and with and without 13,14 Valsalva test, 13 CARTs-based autonomic score, 14 VPT, 14,20,21,41 and thermal thresholds, with the lowest significance for the latter. 13 In the current study, feet ESC showed a fair diagnostic accuracy for CAN, in particular for confirmed CAN with an AUC of 0.92, while the abnormality of hands or feet ESC had the best sensitivity for confirmed CAN (83%) and the best specificity for DPN (67%).…”

Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention

“…Significant progress has been made to develop point-of-care devices (POCD) that are capable of diagnosing early, subclinical neuropathy. Papanas [39,40] and Sudoscan [41,42].…”

“…Sudomotor function has been proposed as a surrogate marker for the small fibre involvement in DPN [41,42,59]. Sudoscan, provides a quantitative measurement of sudomotor function within 3-minutes.…”

Electrochemical Skin Conductance and Quantitative Sensory Testing on Fibromyalgia

“…11 Autonomic dysfunction could even be the common clustering of FM, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis, and underlie their pathogenesis. 12 Adelta and C nerve fibers, involved in painful and thermal perception, also innervate sweat glands that are linked to the autonomic nervous system, [13][14][15][16] and sweat gland innervation could be dysfunctional because of an alteration of these nerve fibers. Such a dysautonomia may be a detectable abnormality in diabetic SFN, 17 familial amyloid polyneuropathy, or Fabry's disease, 15,[18][19][20][21][22] and has been studied using an electrophysiological noninvasive tool (Sudoscan; Impeto Medical, Paris, France) that measures electrochemical skin conductance (ESC).…”