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- Title
The Relationship Between Sural Nerve Morphometric Findings and Measures of Peripheral Nerve Function in Mild Diabetic Neuropathy.
- Authors
Veves, A.; Malik, R. A.; Lye, R. H.; Masson, E. A.; Sharma, A. K.; Schady, W.; Boulton, A. J. M.; Thomas, P. K.
- Abstract
Objective. To correlate the morphometric findings in sural nerve biopsies from patients with early diabetic neuropathy and electrophysiological measures and quantitative sensory testing. Conventional electrophysiological tests were found to be effective surrogates for structural abnormalities in the detection of diabetic neuropathy. Design. Nonparametric control study. Subjects. Fifteen patients (12 men, 3 womenl with diabetic neuropathy were studied. Eight patients had insulin-dependent diabetes mellitus (IDDM). The age range was 18-65 years with a mean of 46 5,ears. No indication of variance was given. All patients were graded as having stage 1 (asymptomatic) or stage 2 (symptomatic) neuropathy according to the Dyck criteria. Nerve biopsies from the study subjects were compared with nerve biopsies from 8 age-matched (mean age 48 years, range or variance not given) non-neuropathic, nondiabetic subjects (mostly organ-donor subjects). Measurements. Fascicular nerve biopsies from patients with diabetes were compared with control nerve specimens from non-neuropathic, nondiabetic subjects. Standardized electrophysiological observations and quantitative sensory testing were undertaken on all patients with diabetes and compared with data from control subjects examined in the same laboratory. Comparisons were made by nonparametric statistics. Nerve condition studies were made of peroneal and median motor as well as median and sural sensory conduction velocity. Sural and median sensory action potential amplitude were also measured. For assessment of sensation, vibration perception threshold measurements were made on a hallux nerve. Medial malleolus warm thermal discriminatory thresholds and current perception thresholds were measured in sural nerve territory. Measurements were made of myelinated fiber density on both the nerve biopsy specimens and control nerves. Unmyelinated axons were not examined. Results. Myelinated fiber density was reduced in the nerves of patients with diabetes and the control subjects. The degree of reduction was strongly correlated with sural nerve conduction velocity and amplitude, median sensory amplitude, and peroneal motor conduction velocity. No correlation was detected between myelinated fiber density and any of the three quantitative sensory tests. Conclusion. Conventional lower limb electrophysiological tests are reliable surrogates for structural abnormalities in the detection of early diabetic neuropathy.
- Publication
Diabetes Spectrum, 1993, Vol 6, Issue 4, p244
- ISSN
1040-9165
- Publication type
Journal Article