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Role of Electrophysiological Studies in Diabetic Neuropathy

Published online by Cambridge University Press:  18 September 2015

Vera Bril
Vera Bril*
Affiliation:
Division of Neurology, The Toronto Hospital, University of Toronto, Toronto
*
Division of Neurology, EN11-209, Toronto Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4
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Abstract:

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Electrophysiological studies are a reproducible and noninvasive method of assessing peripheral nerve function. The sensitivity of these methods has been validated in population-based and clinical studies, and the variability of test results is typically lower than with other noninvasive tests of nerve function. It has been recommended that standardized procedures including temperature control and equipment calibration be utilized with electrophysiological testing. The failure to detect significant changes in nerve conduction studies from clinical studies may be due to poor standardization of technique and inadequate sample size to detect differences. Baseline results from a multicenter, randomized trial indicate that different electrophysiological measures are highly correlated and reproducible. This and future studies that incorporate standardized techniques and an adequate sample size should be able to detect significant differences between treatments and identify effective therapeutic interventions for diabetic neuropathy.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 21 , Issue S4 , November 1994 , pp. S8 - S12
Copyright
Copyright © Canadian Neurological Sciences Federation 1994

References

1.Vinik, AI, Holland, MT, Le Beau, JM, et al. Diabetic neuropathies. Diabetes Care 1992; 15: 1926–1975.CrossRefGoogle ScholarPubMed
2.Diabetes Data. U.S. Department of Health, Education, and Welfare. National Institutes of Health. DHEW Publication No. (NIH) 78–1468. Washington, DC: U.S. Government Printing Office, 1978.Google Scholar
3.Brown, MR, Dyck, PJ, McClearn, GE, et al. Central and peripheral nervous system complications. Diabetes 1982; 31 (Suppl I, part 2): 65–70.CrossRefGoogle Scholar
4.Lamontagne, A, Buchthal, F.Electrophysiological studies in diabetic neuropathy. J Neurol Neurosurg Psychiatry 1970; 33: 442–452.CrossRefGoogle ScholarPubMed
5.Young, RJ, Ewing, DJ, Clarke, BF.Nerve function and metabolic control in teenage diabetics. Diabetes 1983; 32: 142–147.CrossRefGoogle ScholarPubMed
6.Boulton, AJ, Knight, G, Drury, J, Ward, JD.The prevalence of symptomatic, diabetic neuropathy in an insulin-treated population. Diabetes Care 1985; 8: 125–128.CrossRefGoogle Scholar
7.Consensus Statement of the American Diabetes Association and the American Academy of Neurology: Report and Recommendations of the San Antonio Conference on Diabetic Neuropathy. Diabetes 1988; 37: 1000–1004.CrossRefGoogle Scholar
8.Macleod, AF, Till, S, Sonksen, PH.Discussion of the clinical trials of the aldose reductase inhibitor tolrestat. Int Proc J 1991; 4: 17–24.Google Scholar
9.Dyck, PJ, Kratz, KM, Lehman, KA, et al. The Rochester Diabetic Neuropathy Study: design, criteria for types of neuropathy, selection bias, and reproducibility of neuropathic tests. Neurology 1991; 41: 799–807.CrossRefGoogle ScholarPubMed
10.Dyck, PJ, Karnes, JL, O’Brien, PC, et al. The Rochester Diabetic Neuropathy Study: reassessment of tests and criteria for diagnosis and staged severity. Neurology 1992; 42: 1164–1170.CrossRefGoogle ScholarPubMed
11.Sundkvist, G, Armstrong, F, Bradbury, J, et al. for the United Kingdom/Scandinavian Ponalrestat Trial. Peripheral and autonomic nerve function in 259 diabetic patients with peripheral neuropathy treated with ponalrestat (an aldose reductase inhibitor) or placebo for 18 months. J Diab Complications 1992; 6: 123–130.CrossRefGoogle ScholarPubMed
12.Santiago, JV, Sonksen, PH, Boulton, AJM, et al. Withdrawal of the ARI, tolrestat in patients with diabetic neuropathy: effect on nerve function. J Diab Complications 1993; 7: 170–179.CrossRefGoogle Scholar
13.Consensus Statement. Proceedings of a Consensus Development Conference on Standardized Measures in Diabetic Neuropathy. Neurology 1992; 42: 1823–1829.CrossRefGoogle Scholar
14.Sima, AAF, Brown, MR, Prashar, A, et al. The reproducibility and sensitivity of sural nerve morphometry in the assessment of diabetic peripheral polyneuropathy. Diabetologia 1992; 35: 560–569.CrossRefGoogle ScholarPubMed
15.Sima, AAF, Bril, V, Nathaniel, V, et al. Regeneration and repair of myelinated fibers in sural-nerve biopsy specimens from patients with diabetic neuropathy treated with sorbinil. N Engl J Med 1988; 319: 548–555.CrossRefGoogle ScholarPubMed
16.Agardh, CD, Rosen, I, Schersten, B.Improvement of peripheral nerve function after institution of insulin treatment in diabetes mellitus. A case-control study. Acta Med Scand 1983; 213: 283–287.CrossRefGoogle ScholarPubMed
17.Boulton, AJM, Levin, S, Comstock, JA.A multicentre trial of the aldose-reductase inhibitor, tolrestat, in patients with symptomatic diabetic neuropathy. Diabetologia 1990; 33: 431–437.CrossRefGoogle ScholarPubMed
18.Judzewitsch, RG, Jaspan, JB, Polonsky, KS, et al. Aldose reductase inhibition improves nerve conduction velocity in diabetic patients. N Engl J Med 1983; 308: 119–125.CrossRefGoogle ScholarPubMed
19.Reichard, P, Nilsson, B-Y, Rosenqvist, U.The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med 1993; 329: 304–309.CrossRefGoogle ScholarPubMed
20.Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–986.CrossRefGoogle Scholar
21.Boulton, AJM, Armstrong, WD, Scarpello, JHB, Ward, JD.The natural history of painful diabetic neuropathy. Postgrad Med J 1983; 59: 556–559.CrossRefGoogle ScholarPubMed
22.Dorfman, LJ, Bosley, TM.Age-related changes in peripheral and central nerve conduction in man. Neurology 1979; 29: 38–44.CrossRefGoogle ScholarPubMed
23.Pfeifer, MA, Weinberg, CR, Cook, DL, et al. Correlations among autonomic, sensory, and motor neural function tests in untreated non-insulin dependent diabetic individuals. Diabetes Care 1985; 8: 576–584.CrossRefGoogle ScholarPubMed
24.Macleod, AF, Boulton, AJM, Owens, DR, et al. A multicentre trial of the aldose-reductase inhibitor tolrestat, in patients with symptomatic diabetic peripheral neuropathy. Diabetes Metab 1992; 18: 14–20.Google ScholarPubMed