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Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes

Background: Diabetic neuropathy is characterized by the paradoxical co-existence of hypo- and hyperalgesia to sensory stimuli. The literature shows consistently sensory differences between healthy and participants with diabetes. We hypothesized that due to differences in pathophysiology, advanced qu...

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Autores principales: Hansen, Line Elise Møller, Fjelsted, Camilla Ann, Olesen, Søren Schou, Phillips, Anna Evans, Faghih, Mahya, Wegeberg, Anne-Marie, Drewes, Asbjørn Mohr, Brock, Christina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8915693/
https://www.ncbi.nlm.nih.gov/pubmed/35295514
http://dx.doi.org/10.3389/fpain.2021.701172
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author Hansen, Line Elise Møller
Fjelsted, Camilla Ann
Olesen, Søren Schou
Phillips, Anna Evans
Faghih, Mahya
Wegeberg, Anne-Marie
Drewes, Asbjørn Mohr
Brock, Christina
author_facet Hansen, Line Elise Møller
Fjelsted, Camilla Ann
Olesen, Søren Schou
Phillips, Anna Evans
Faghih, Mahya
Wegeberg, Anne-Marie
Drewes, Asbjørn Mohr
Brock, Christina
author_sort Hansen, Line Elise Møller
collection PubMed
description Background: Diabetic neuropathy is characterized by the paradoxical co-existence of hypo- and hyperalgesia to sensory stimuli. The literature shows consistently sensory differences between healthy and participants with diabetes. We hypothesized that due to differences in pathophysiology, advanced quantitative sensory testing (QST) might reveal sensory discrepancies between type 1 (T1D) and type 2 diabetes (T2D). Furthermore, we investigated whether vibration detection thresholds (VDT) were associated with sensory response. Method: Fifty-six adults with T1D [43 years (28–58)], 99 adults with T2D [65 years (57–71)], and 122 healthy individuals [51 years (34–64)] were included. VDT, pressure pain detection thresholds (pPDT) and tolerance (pPTT), tonic cold pain (hand-immersion in iced water), and central pain mechanisms (temporal summation and conditioned pain modulation) were tested and compared between T1D and T2D. VDT was categorized into normal (< 18 V), intermediary (18–25 V), or high (> 25 V). Results: In comparison to healthy, analysis adjusted for age, BMI, and gender revealed hypoalgesia to tibial (pPDT): p = 0.01, hyperalgesia to tonic cold pain: p < 0.01, and diminished temporal summation (arm: p < 0.01; abdomen: p < 0.01). In comparison to participants with T2D, participants with T1D were hypoalgesic to tibial pPDT: p < 0.01 and pPTT: p < 0.01, and lower VDT: p = 0.02. VDT was not associated with QST responses. Conclusion: Participants with T1D were more hypoalgesic to bone pPDT and pPTT independent of lower VDT, indicating neuronal health toward normalization. Improved understanding of differentiated sensory profiles in T1D and T2D may identify improved clinical endpoints in future trials.
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spelling pubmed-89156932022-03-15 Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes Hansen, Line Elise Møller Fjelsted, Camilla Ann Olesen, Søren Schou Phillips, Anna Evans Faghih, Mahya Wegeberg, Anne-Marie Drewes, Asbjørn Mohr Brock, Christina Front Pain Res (Lausanne) Pain Research Background: Diabetic neuropathy is characterized by the paradoxical co-existence of hypo- and hyperalgesia to sensory stimuli. The literature shows consistently sensory differences between healthy and participants with diabetes. We hypothesized that due to differences in pathophysiology, advanced quantitative sensory testing (QST) might reveal sensory discrepancies between type 1 (T1D) and type 2 diabetes (T2D). Furthermore, we investigated whether vibration detection thresholds (VDT) were associated with sensory response. Method: Fifty-six adults with T1D [43 years (28–58)], 99 adults with T2D [65 years (57–71)], and 122 healthy individuals [51 years (34–64)] were included. VDT, pressure pain detection thresholds (pPDT) and tolerance (pPTT), tonic cold pain (hand-immersion in iced water), and central pain mechanisms (temporal summation and conditioned pain modulation) were tested and compared between T1D and T2D. VDT was categorized into normal (< 18 V), intermediary (18–25 V), or high (> 25 V). Results: In comparison to healthy, analysis adjusted for age, BMI, and gender revealed hypoalgesia to tibial (pPDT): p = 0.01, hyperalgesia to tonic cold pain: p < 0.01, and diminished temporal summation (arm: p < 0.01; abdomen: p < 0.01). In comparison to participants with T2D, participants with T1D were hypoalgesic to tibial pPDT: p < 0.01 and pPTT: p < 0.01, and lower VDT: p = 0.02. VDT was not associated with QST responses. Conclusion: Participants with T1D were more hypoalgesic to bone pPDT and pPTT independent of lower VDT, indicating neuronal health toward normalization. Improved understanding of differentiated sensory profiles in T1D and T2D may identify improved clinical endpoints in future trials. Frontiers Media S.A. 2021-06-28 /pmc/articles/PMC8915693/ /pubmed/35295514 http://dx.doi.org/10.3389/fpain.2021.701172 Text en Copyright © 2021 Hansen, Fjelsted, Olesen, Phillips, Faghih, Wegeberg, Drewes and Brock. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pain Research
Hansen, Line Elise Møller
Fjelsted, Camilla Ann
Olesen, Søren Schou
Phillips, Anna Evans
Faghih, Mahya
Wegeberg, Anne-Marie
Drewes, Asbjørn Mohr
Brock, Christina
Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes
title Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes
title_full Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes
title_fullStr Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes
title_full_unstemmed Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes
title_short Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes
title_sort simple quantitative sensory testing reveals paradoxical co-existence of hypoesthesia and hyperalgesia in diabetes
topic Pain Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8915693/
https://www.ncbi.nlm.nih.gov/pubmed/35295514
http://dx.doi.org/10.3389/fpain.2021.701172
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