OBJECTIVE: To investigate whether glycemic control is associated with reversible changes in axonal excitability in human diabetic nerves. It is known that voluntary contraction or compression ischemia alters nerve Na+/K+ pump activity, and axonal excitability changes due to the pump activity can be estimated by threshold tracking. METHODS: Threshold, the current required to produce a compound muscle action potential 50% of maximum, was determined from the stimulus-response curve, and threshold changes produced by maximal voluntary contraction or ischemia were measured before and after insulin treatment in 10 diabetic patients. RESULTS: Within 3 weeks of the start of treatment, the threshold changes became greater following voluntary contractions (+13+/-4% versus +23+/-5%; mean+/-SEM; p=0.04) and during ischemia (-5+/-2% versus -11+/-2%; p=0.04). CONCLUSIONS: The extent of threshold fluctuation depends on multiple metabolic factors associated with diabetes such as decreased Na+/K+ ATPase activity, increased anaerobic glycolysis, and tissue acidosis, and nerve excitability can respond quickly to glycemic control in diabetic patients.
OBJECTIVE: To investigate whether glycemic control is associated with reversible changes in axonal excitability in humandiabetic nerves. It is known that voluntary contraction or compression ischemia alters nerve Na+/K+ pump activity, and axonal excitability changes due to the pump activity can be estimated by threshold tracking. METHODS: Threshold, the current required to produce a compound muscle action potential 50% of maximum, was determined from the stimulus-response curve, and threshold changes produced by maximal voluntary contraction or ischemia were measured before and after insulin treatment in 10 diabeticpatients. RESULTS: Within 3 weeks of the start of treatment, the threshold changes became greater following voluntary contractions (+13+/-4% versus +23+/-5%; mean+/-SEM; p=0.04) and during ischemia (-5+/-2% versus -11+/-2%; p=0.04). CONCLUSIONS: The extent of threshold fluctuation depends on multiple metabolic factors associated with diabetes such as decreased Na+/K+ ATPase activity, increased anaerobic glycolysis, and tissue acidosis, and nerve excitability can respond quickly to glycemic control in diabeticpatients.
Authors: Andreas C Themistocleous; Alexander G Kristensen; Roma Sola; Sandra S Gylfadottir; Kristine Bennedsgaard; Mustapha Itani; Thomas Krøigård; Lise Ventzel; Søren H Sindrup; Troels S Jensen; Hugh Bostock; Jordi Serra; Nanna B Finnerup; Hatice Tankisi; David L H Bennett Journal: Ann Neurol Date: 2022-03-07 Impact factor: 11.274
Authors: Caroline B Prudencio; Marilza V C Rudge; Fabiane A Pinheiro; Carlos I Sartorão Filho; Sthefanie K Nunes; Cristiane R Pedroni; Baerbel Junginger; Angélica M P Barbosa Journal: PLoS One Date: 2019-11-07 Impact factor: 3.240