Raffaele Galiero1, Dario Ricciardi2, Pia Clara Pafundi3, Vincenzo Todisco2, Gioacchino Tedeschi4, Giovanni Cirillo5, Ferdinando Carlo Sasso6. 1. Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, I-80138 Naples, Italy. Electronic address: raffaele.galiero@unicampania.it. 2. Division of Neurology and Neurophysiopathology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, I-80138 Naples, Italy. 3. Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, I-80138 Naples, Italy. Electronic address: piaclara.pafundi@unicampania.it. 4. Division of Neurology and Neurophysiopathology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, I-80138 Naples, Italy. Electronic address: gioacchino.tedeschi@unicampania.it. 5. Division of Neurology and Neurophysiopathology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, I-80138 Naples, Italy; Division of Human Anatomy - Neuronal Networks Morphology Lab, University of Campania "Luigi Vanvitelli", Naples, Italy. Electronic address: giovanni.cirillo@unicampania.it. 6. Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, I-80138 Naples, Italy. Electronic address: ferdinando.sasso@unicampania.it.
Abstract
AIMS: Peripheral neuropathy (PN) affects two-thirds of type 2 diabetes patients (T2DM). According to diabetic PN length-dependent pattern, neurophysiological evaluation of foot-sole nerves might increase NCS diagnostic sensitivity, hence allowing early diagnosis of PN. Thus, we aim to assess the ability of whole plantar nerve (WPN) conduction in diabetic PN early diagnosis. METHODS: This is a single center prospective observational cohort study on 70 T2DM patients referred to Internal Medicine Unit of A.O.U. "Luigi Vanvitelli" between October 2019/October 2020. Primary endpoint was WPN efficacy assessment in PN early detection. As secondary, we evaluated (i) a potential cut-off of SNAPs amplitude by WPN and (ii) WPN diagnostic accuracy vs. gold-standard distal sural nerve conduction. RESULTS: ROC curve analysis allowed to establish two potential cut-offs for people aged ≤60 years (AUROC: 0.83, 95%CI: 0.69-0.96, p < 0.001) and ≤60 years (AUROC: 0.76, 95%CI: 0.59-0.93, p = 0.017). In depth, we fixed a cut-off of WPN-SNAP amplitude of 4.55 μV and 2.65 μV, respectively, with subsequent 48 patients classified as PN-T2DM. CONCLUSIONS: Our data support WPN conduction study reliability in characterizing the most distal sensory nerve fibers at lower limbs. Thus, WPN may represent an extremely useful diagnostic tool for diabetic PN early detection.
AIMS: Peripheral neuropathy (PN) affects two-thirds of type 2 diabetespatients (T2DM). According to diabetic PN length-dependent pattern, neurophysiological evaluation of foot-sole nerves might increase NCS diagnostic sensitivity, hence allowing early diagnosis of PN. Thus, we aim to assess the ability of whole plantar nerve (WPN) conduction in diabetic PN early diagnosis. METHODS: This is a single center prospective observational cohort study on 70 T2DM patients referred to Internal Medicine Unit of A.O.U. "Luigi Vanvitelli" between October 2019/October 2020. Primary endpoint was WPN efficacy assessment in PN early detection. As secondary, we evaluated (i) a potential cut-off of SNAPs amplitude by WPN and (ii) WPN diagnostic accuracy vs. gold-standard distal sural nerve conduction. RESULTS: ROC curve analysis allowed to establish two potential cut-offs for people aged ≤60 years (AUROC: 0.83, 95%CI: 0.69-0.96, p < 0.001) and ≤60 years (AUROC: 0.76, 95%CI: 0.59-0.93, p = 0.017). In depth, we fixed a cut-off of WPN-SNAP amplitude of 4.55 μV and 2.65 μV, respectively, with subsequent 48 patients classified as PN-T2DM. CONCLUSIONS: Our data support WPN conduction study reliability in characterizing the most distal sensory nerve fibers at lower limbs. Thus, WPN may represent an extremely useful diagnostic tool for diabetic PN early detection.
Authors: Marcelo Amaral Coelho; Madhan Jeyaraman; Naveen Jeyaraman; Ramya Lakshmi Rajendran; André Atsushi Sugano; Tomas Mosaner; Gabriel Silva Santos; João Vitor Bizinotto Lana; Anna Vitória Santos Duarte Lana; Lucas Furtado da Fonseca; Rafael Barnabé Domingues; Prakash Gangadaran; Byeong-Cheol Ahn; José Fábio Santos Duarte Lana Journal: Bioengineering (Basel) Date: 2022-05-18
Authors: Byron M Perrin; Jessica Southon; Jane McCaig; Isabelle Skinner; Timothy C Skinner; Michael I C Kingsley Journal: Medicina (Kaunas) Date: 2021-12-30 Impact factor: 2.430