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Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy
This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using t...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300160/ https://www.ncbi.nlm.nih.gov/pubmed/28182728 http://dx.doi.org/10.1371/journal.pone.0171223 |
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author | Sung, Jia-Ying Tani, Jowy Chang, Tsui-San Lin, Cindy Shin-Yi |
author_facet | Sung, Jia-Ying Tani, Jowy Chang, Tsui-San Lin, Cindy Shin-Yi |
author_sort | Sung, Jia-Ying |
collection | PubMed |
description | This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (P<0.05), shortened strength-duration time constant (P<0.01), increased superexcitability (P<0.01), decreased subexcitability (P<0.05), decreased accommodation to depolarizing current (P<0.01), and a trend of decreased accommodation to hyperpolarizing current in threshold electrotonus. All the changes progressed into G1 (TNSr 1–8) and G2+3 (TNSr 9–24) groups. In contrast, motor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (P<0.01) in the G0 group. This study revealed that the development of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches. |
format | Online Article Text |
id | pubmed-5300160 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-53001602017-02-28 Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy Sung, Jia-Ying Tani, Jowy Chang, Tsui-San Lin, Cindy Shin-Yi PLoS One Research Article This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (P<0.05), shortened strength-duration time constant (P<0.01), increased superexcitability (P<0.01), decreased subexcitability (P<0.05), decreased accommodation to depolarizing current (P<0.01), and a trend of decreased accommodation to hyperpolarizing current in threshold electrotonus. All the changes progressed into G1 (TNSr 1–8) and G2+3 (TNSr 9–24) groups. In contrast, motor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (P<0.01) in the G0 group. This study revealed that the development of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches. Public Library of Science 2017-02-09 /pmc/articles/PMC5300160/ /pubmed/28182728 http://dx.doi.org/10.1371/journal.pone.0171223 Text en © 2017 Sung et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Sung, Jia-Ying Tani, Jowy Chang, Tsui-San Lin, Cindy Shin-Yi Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy |
title | Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy |
title_full | Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy |
title_fullStr | Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy |
title_full_unstemmed | Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy |
title_short | Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy |
title_sort | uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300160/ https://www.ncbi.nlm.nih.gov/pubmed/28182728 http://dx.doi.org/10.1371/journal.pone.0171223 |
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