Vibratory thresholds correlation with systolic blood pressure in diabetic women

Comparison of vibration perception thresholds in individuals with diffuse upper limb pain and carpal tunnel syndrome

The study objective was to compare vibration perception and patterns of blood flow in outpatients with diffuse upper limb pain disorder (ULPD), carpal tunnel syndrome (CTS) and age and sex matched healthy controls. Vibration perception and discrimination thresholds were compared in subjects with ULPD (n=27), CTS (n=27) and healthy matched controls (n=54). Vibration measurements were taken bilaterally at three sites: (a) over the dorsum of the second and (b) fifth metacarpals and (c) the palmar aspect of the first and second metacarpals, corresponding to the innervation territories of the radial, ulnar and median nerves, respectively. Non-invasive assessments of peripheral blood flow were also performed in both limbs. When compared to healthy controls, subjects with ULPD had widespread elevation of vibration thresholds both ipsilateral and contralateral to the symptomatic limb. Subjects with CTS had similarly elevated vibration thresholds at sites both adjacent to and distant from the site of peripheral nerve injury. The responses to cold pressor testing of the upper limbs were physiologically normal in both the CTS and ULPD patient groups. Furthermore, there were no significant differences in the haemodynamic responses between the patient groups. The global elevation of vibration thresholds in subjects with both ULPD and CTS is consistent with altered central nervous system mechanisms, common to both conditions, which may be either adaptive to or maintaining the perception of pain.

Effect of treatment with losartan on cardiovascular autonomic and large sensory nerve fiber function in individuals with diabetes mellitus: a 1-year randomized, controlled trial

This study evaluated the effect of losartan, an angiotensin II receptor antagonist, on cardiovascular autonomic function and large sensory nerve fiber function in individuals with diabetes mellitus. In a double-blind placebo-controlled trial, individuals were randomly assigned to treatment with a daily oral dose of 50-mg losartan (n=24) or placebo (n=20) for 12 months. Tests of cardiovascular autonomic function (i.e., RR-variation during deep breathing and the Valsalva maneuver) and of large sensory nerve fiber function (i.e., vibratory thresholds) were measured at baseline and at 12 months. No significant difference at baseline was found for duration of diabetes, glycemic control, blood pressure, or body mass index (BMI) between the two groups. After 12 months, the decline in RR-variation that occurs over time appeared to be less for those taking losartan. There was, however, no statistically significant change in the results for any of the tests of cardiovascular autonomic function or vibratory thresholds between the groups. Multivariate analyses in the losartan study group revealed an independent association of duration of diabetes, change in (reduced) systolic blood pressure (SBP), and improved vibratory thresholds. This association was particularly noted for women. Pharmacologic agents may affect cardiovascular autonomic function by favorable or detrimental changes in the electrophysiology of the heart. The results of this study indicate that, although losartan may have slowed the normal decline in RR-variation, it did not result in any significant improvement in cardiovascular autonomic nerve fiber function. An association of vibratory thresholds and SBP was observed.