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Tanaka Y, Sasaki T, Kawabata S, Hashimoto J, Higashikawa H, Hoshino Y, Sekihara K, Adachi Y, Fujita K, Nimura A, Watanabe T, Miyano Y, Kaminaka S, Yamamoto Y, Yoshii T. Assessing ulnar neuropathy at the elbow using magnetoneurography. Clin Neurophysiol 2024; 161:180-187. [PMID: 38520798 DOI: 10.1016/j.clinph.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/09/2024] [Accepted: 02/23/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE To measure neuromagnetic fields of ulnar neuropathy patients at the elbow after electrical stimulation and evaluate ulnar nerve function at the elbow with high spatial resolution. METHODS A superconducting quantum interference device magnetometer system recorded neuromagnetic fields of the ulnar nerve at the elbow after electrical stimulation at the wrist in 16 limbs of 16 healthy volunteers and 21 limbs of 20 patients with ulnar neuropathy at the elbow. After artifact removal, neuromagnetic field signals were processed into current distributions, which were superimposed onto X-ray images for visualization. RESULTS Based on the results in healthy volunteers, conduction velocity of 30 m/s or 50% attenuation in current amplitude was set as the reference value for conduction disturbance. Of the 21 patient limbs, 15 were measurable and lesion sites were detected, whereas 6 limbs were unmeasurable due to weak neuromagnetic field signals. Seven limbs were deemed normal by nerve conduction study, but 5 showed conduction disturbances on magnetoneurography. CONCLUSIONS Measuring the magnetic field after nerve stimulation enabled visualization of neurophysiological activity in patients with ulnar neuropathy at the elbow and evaluation of conduction disturbances. SIGNIFICANCE Magnetoneurography may be useful for assessing lesion sites in patients with ulnar neuropathy at the elbow.
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Affiliation(s)
- Yuta Tanaka
- Department of Orthopedic Surgery, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Toru Sasaki
- Department of Orthopedic Surgery, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Shigenori Kawabata
- Department of Orthopedic Surgery, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; Department of Advanced Technology in Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Jun Hashimoto
- Department of Orthopedic Surgery, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; Department of Advanced Technology in Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Hisato Higashikawa
- Department of Orthopedic Surgery, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Yuko Hoshino
- Department of Advanced Technology in Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Kensuke Sekihara
- Department of Advanced Technology in Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Yoshiaki Adachi
- Applied Electronics Laboratory, Kanazawa Institute of Technology, 7-1 Ogigaoka, Nonoichi, Kanazawa-shi, Ishikawa 920-1331, Japan
| | - Koji Fujita
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Akimoto Nimura
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Taishi Watanabe
- Ricoh Institute of Future Technology, RICOH Company, Ltd., 2-3-10 Kandasurugadai, Chiyoda-ku, Tokyo 101-0062, Japan.
| | - Yuki Miyano
- Ricoh Institute of Future Technology, RICOH Company, Ltd., 2-3-10 Kandasurugadai, Chiyoda-ku, Tokyo 101-0062, Japan.
| | - Saeri Kaminaka
- Ricoh Institute of Future Technology, RICOH Company, Ltd., 2-3-10 Kandasurugadai, Chiyoda-ku, Tokyo 101-0062, Japan.
| | - Yusuke Yamamoto
- Ricoh Institute of Future Technology, RICOH Company, Ltd., 2-3-10 Kandasurugadai, Chiyoda-ku, Tokyo 101-0062, Japan.
| | - Toshitaka Yoshii
- Department of Orthopedic Surgery, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
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Tyszkiewicz C, Hwang SK, DaSilva JK, Kovi RC, Fader KA, Sirivelu MP, Liu J, Somps C, Cook J, Liu CN, Wang H. Absence of functional deficits in rats following systemic administration of an AAV9 vector despite moderate peripheral nerve and dorsal root ganglia findings: A clinically silent peripheral neuropathy. Neurotoxicology 2024; 101:46-53. [PMID: 38316190 DOI: 10.1016/j.neuro.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/16/2024] [Accepted: 02/01/2024] [Indexed: 02/07/2024]
Abstract
Adeno-associated virus (AAV)-based vectors are commonly used for delivering transgenes in gene therapy studies, but they are also known to cause dorsal root ganglia (DRG) and peripheral nerve toxicities in animals. However, the functional implications of these pathologic findings and their time course remain unclear. At 2, 4, 6, and 8 weeks following a single dose of an AAV9 vector carrying human frataxin transgene in rats, non-standard functional assessments, including von Frey filament, electrophysiology, and Rotarod tests, were conducted longitudinally to measure allodynia, nerve conduction velocity, and coordination, respectively. Additionally, DRGs, peripheral nerves, brain and spinal cord were evaluated histologically and circulating neurofilament light chain (NfL) was quantified at 1, 2, 4, and 8 weeks, respectively. At 2 and 4 weeks after dosing, minimal-to-moderate nerve fiber degeneration and neuronal degeneration were observed in the DRGs in some of the AAV9 vector-dosed animals. At 8 weeks, nerve fiber degeneration was observed in DRGs, with or without neuronal degeneration, and in sciatic nerves of all AAV9 vector-dosed animals. NfL values were higher in AAV9 vector-treated animals at weeks 4 and 8 compared with controls. However, there were no significant differences in the three functional endpoints evaluated between the AAV9 vector- and vehicle-dosed animals, or in a longitudinal comparison between baseline (predose), 4, and 8 week values in the AAV9 vector-dose animals. These findings demonstrate that there is no detectable functional consequence to the minimal-to-moderate neurodegeneration observed with our AAV9 vector treatment in rats, suggesting a functional tolerance or reserve for loss of DRG neurons after systemic administration of AAV9 vector.
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Affiliation(s)
- Cheryl Tyszkiewicz
- Drug Safety Research and Development, Pfizer Inc., Groton, CT 06340, USA
| | - Seo-Kyoung Hwang
- Drug Safety Research and Development, Pfizer Inc., Groton, CT 06340, USA
| | - Jamie K DaSilva
- Drug Safety Research and Development, Pfizer Inc., Groton, CT 06340, USA
| | - Ramesh C Kovi
- Drug Safety Research and Development, Pfizer Inc., Cambridge, MA 02139, USA
| | - Kelly A Fader
- Drug Safety Research and Development, Pfizer Inc., Groton, CT 06340, USA
| | - Madhu P Sirivelu
- Drug Safety Research and Development, Pfizer Inc., Cambridge, MA 02139, USA
| | - June Liu
- Drug Safety Research and Development, Pfizer Inc., Groton, CT 06340, USA
| | - Chris Somps
- Drug Safety Research and Development, Pfizer Inc., Groton, CT 06340, USA
| | - Jon Cook
- Drug Safety Research and Development, Pfizer Inc., Groton, CT 06340, USA
| | - Chang-Ning Liu
- Drug Safety Research and Development, Pfizer Inc., Groton, CT 06340, USA.
| | - Helen Wang
- Drug Safety Research and Development, Pfizer Inc., Cambridge, MA 02139, USA
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Thakur K, Goyal M. Effectiveness of neuromuscular taping on balance, proprioception, pain, and nerve conduction parameters in patients with diabetic peripheral neuropathy: a two-group pretest-posttest randomized sham-controlled trial study protocol. J Diabetes Metab Disord 2023; 22:1793-1800. [PMID: 37975124 PMCID: PMC10638368 DOI: 10.1007/s40200-023-01275-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/30/2023] [Indexed: 11/19/2023]
Abstract
Background The management of diabetic peripheral neuropathy (DPN) comprises a multidimensional approach. Along with pharmacological treatment, physiotherapy has gained applaudable popularity in improving the symptoms of DPN. Neuromuscular taping (NMT) is effective in improving motor, sensory, and balance impairments in many neuromuscular and musculoskeletal conditions but no research has conducted to evaluate the effect of NMT on balance, proprioception, pain, and nerve conduction parameters in patients with DPN. Purpose To evaluate the effectiveness of NMT on balance, proprioception, pain, and nerve conduction parameters in patients with DPN. Methods 50 DPN patients aged 40-60 years, scored ≥ 2/13 on physical appearance and ≥ 1/10 on physical examination of Michigan Neuropathy Screening Instrument (MNSI), > 12 on Leeds Assessment of Neuropathic Symptom and Sign (LANSS) scale and < 45 on Berg Balance Scale (BBS) will be included. The experimental group (EG) will receive NMT at the tibialis anterior, tibialis posterior, and peroneus longus muscle and transverse arch of the foot and TENS at the tibial and peroneal nerves (80 Hz, 50 Amp, 0.2 ms square pulses, 2 to 3 times sensory threshold) and the control group (CG) will receive sham taping at the ankle joint and TENS with the same parameters as EG. Outcome measures will be taken at baseline, at 4 weeks, and at 8 weeks of intervention, respectively. Conclusion The results obtained upon completion of this study may provide a cost-effective non-invasive treatment option to improve the outcomes that will be measured in the present study in patients with DPN. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01275-5.
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Affiliation(s)
- Kanika Thakur
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana- Ambala, Haryana 133207 India
| | - Manu Goyal
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana- Ambala, Haryana 133207 India
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Zhang H, Chen Y, Zhu W, Niu T, Song B, Wang H, Wang W, Zhang H. The mediating role of HbA1c in the association between elevated low-density lipoprotein cholesterol levels and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus. Lipids Health Dis 2023; 22:102. [PMID: 37443036 DOI: 10.1186/s12944-023-01865-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Increased levels of low-density lipoprotein cholesterol (LDL-C) have been identified as one potential risk factor for diabetic peripheral neuropathy (DPN) in patients. The current study seeks to clarify the link between LDL-C, hyperglycemia, and DPN in patients with type 2 diabetes mellitus (T2DM). METHODS Here, a total of 120 T2DM individuals were recruited. These volunteers with T2DM were divided into 2 groups, based on the presence or absence of peripheral neuropathy. Additionally, their baseline characteristics were compared. Association among LDL-C and glycosylated hemoglobin (HbA1c) levels and DPN, particularly with respect to specific nerve conduction velocity were analyzed. To identify factors influencing DPN, regression was performed. Furthermore, mediation analysis was employed to evaluate the indirect, direct and total effects of LDL-C on specific nerve conduction velocity, with HbA1c serving as a mediator. RESULTS Compared to 55 patients without DPN, 65 patients with DPN demonstrated elevated levels of LDL-C and HbA1c. Both LDL-C and HbA1c have been found to be associated with reduced the motor fiber conduction velocities of Ulnar (or the Common peroneal) nerve in diabetic patients. HbA1c is one of the known risk factors for DPN in individuals with T2DM. Further mediation analysis revealed that the effect of LDL-C on the Ulnar (or the Common peroneal) nerve motor fiber conduction velocities are fully mediated by HbA1c in patients with T2DM. CONCLUSIONS The impact of elevated LDL-C levels upon the Ulnar (or the Common peroneal) nerve motor fiber conduction velocities in patients with T2DM was found to be entirely mediated by increased HbA1c levels.
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Affiliation(s)
- Hui Zhang
- Henan Key Laboratory of Rare Diseases, Endocrinology and Metabolism Center, The First Affiliated Hospital and College of Clinical Medicine of Henan of Science and Technology, Luoyang, China
| | - Yang Chen
- Department of Endocrinology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wenwen Zhu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Tong Niu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Bing Song
- Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Hongxiao Wang
- Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Wei Wang
- Department of Endocrinology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
| | - Haoqiang Zhang
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
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Mentese B, Kutlu N. Menstrual cycle phases, sex hormones and hand preference modulate nerve conduction velocity in healthy subjects. Physiol Behav 2023; 258:114003. [PMID: 36273497 DOI: 10.1016/j.physbeh.2022.114003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 10/10/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022]
Abstract
The aim of the present study was to investigate the relationship between hand preference and electrophysiological parameters in women menstrual cycle phases and men. Our study was conducted on 25 healthy, naturally cycling females and 30 healthy males between the ages of 18 and 25 who participated voluntarily. The female participants completed three test sessions (early follicular phase, the late follicular phase, and the luteal phase). We measured sex hormone concentrations in blood samples collected. Nerve conduction velocity was calculated using electromyography by stimulating the median nerves of the left and right hands of both the male and female participants. The median nerve conduction velocities of the dominant hands of both the males and females were higher than those of the non-dominant hands. The median nerve conduction velocity during the follicular phase of both the right-handed and left-handed females was higher than in the right-handed and left-handed males, while the latency was shorter. When we evaluated the nerve conduction velocities of the participants, we observed the effects of sexual dimorphism and lateralization. The findings suggested that nerve conduction velocity was found to be affected during the phases of the menstrual cycle in healthy female volunteers.
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Affiliation(s)
- Beste Mentese
- University of Manisa Celal Bayar, Faculty of Medicine, Department of Physiology, Manisa, Turkey.
| | - Necip Kutlu
- University of Manisa Celal Bayar, Faculty of Medicine, Department of Physiology, Manisa, Turkey.
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Dong D, Liu H. Prevalence of carpal tunnel syndrome in patients with long-term type 2 diabetes mellitus. Heliyon 2022; 8:e12615. [PMID: 36593820 PMCID: PMC9803777 DOI: 10.1016/j.heliyon.2022.e12615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/11/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Generally, Carpal tunnel syndrome (CTS) is more common in diabetes mellitus (DM), especially in subjects with coexisting diabetic polyneuropathy (DPN) and/or long-term DM. Based on the analysis of nerve conduction velocity (NCV), the prevalence of CTS and the features of nerve injury were retrospectively explored in type 2 diabetes mellitus (T2DM) patients. In this cohort, there were 353 T2DM patients who were hospitalized in Taiyuan Central Hospitalbetween January 2018 and January 2019. The pathological rates of NCVs between the left and right median nerves were compared, including the gender effect. The examinations were mainly directed to analyze the median nerve injury features. Among 353 patients, 139 patients (39.3%) presented with CTS. These 139 T2DM patients with CTS were then divided into groups based on the nerve injury location and injured nerve type. The prevalence of sensory nerve injury (SNI) was higher than that of motor nerve injury (MNI). The CTS patients had a significantly higher occurrence rate of SNI than MNI (P < 0.05). The abnormal rate of sensory nerve conduction velocity (SCV, P = 0.01) and motor nerve conduction velocity (MCV, P < 0.05) were higher in the right median nerve. No significant differences were detected for other nerves on either side. Significant differences in abnormal rates of SCV of the left (P = 0.04) and the right (P = 0.03) median nerves between the two genders were found. There were no significant abnormalities for other nerves on either side and either gender. Early screening of NCV is needed for T2DM patients to detect CTS with a high prevalence rate. This study suggests that early detection of NCV can identify CTS in the absence of clinical conditions and SNI may occur earlier in long-term T2DM patients with CTS.
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Affiliation(s)
- Defu Dong
- Department of General Surgery, Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030000, China
| | - Hongwei Liu
- Department of General Surgery, Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030000, China,Department of Neurology, Tai yuan Central Hospital, Shanxi Medical University, Taiyuan, China,Corresponding author.
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Lee CW, Jin JS, Kwon S, Jin C, Cho SY, Park SU, Jung WS, Moon SK, Park JM, Ko CN, Cho KH. Are herbal medicines alone or in combination for diabetic peripheral neuropathy more effective than methylcobalamin alone? A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 49:101657. [PMID: 36007447 DOI: 10.1016/j.ctcp.2022.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE In Asian countries, herbal medicines have been used to treat diabetic peripheral neuropathy (DPN) as an adjunctive therapy. This review aims to assess the effectiveness and safety of herbal medicines for the treatment of DPN. METHODS A literature search was conducted on PubMed, Embase, CENTRAL, Scopus, CINAHL, CNKI, DBPIA, and OASIS for randomized controlled trials that evaluated the effects of herbal medicines on DPN. The oral methylcobalamin administered group was selected as the control. The primary outcome measure was nerve conduction velocity (NCV), and the secondary outcome measure was the total efficacy rate (TER). The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. A meta-analysis was conducted using Review Manager 5.4.1 software. RESULTS Seventy-two RCTs with a total of 6260 patients were included. The meta-analysis showed that herbal medicine and co-administration of herbal medicine and methylcobalamin (CHM) treatment for DPN significantly increased the sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of the median and common peroneal nerves than methylcobalamin treatment alone. Herbal medicine and CHM treatment for DPN also significantly improved the TER compared to the control group. Herbal medicine and CHM treatment was found to be relatively safe. CONCLUSION Our study suggests that herbal medicine and CHM might be more effective than methylcobalamin alone in the management of DPN. Further rigorous studies should be conducted to make more definite conclusions.
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Affiliation(s)
- Chang-Woo Lee
- Department of Korean Medicine Cardiology and Neurology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Joon-Soo Jin
- Department of Korean Medicine Cardiology and Neurology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seungwon Kwon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Chul Jin
- Department of Korean Medicine Cardiology and Neurology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seung-Yeon Cho
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seong-Uk Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Woo-Sang Jung
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang-Kwan Moon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jung-Mi Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Chang-Nam Ko
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ki-Ho Cho
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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Ebrahimi HA, Jafari M, Khanjani N, Moradi N. Evaluation of Date Extract on Nerve Conduction Velocity in Male Rats. Basic Clin Neurosci 2022; 13:385-391. [PMID: 36457882 PMCID: PMC9706299 DOI: 10.32598/bcn.2021.878.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/15/2020] [Accepted: 08/25/2020] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Neuropathy is a condition in which the Peripheral Nervous System (PNS) is disordered. Studying the effects of antioxidants on the performance improvement of this system is vital. This study aimed to investigate the effects of date extract on Nerve Conduction Velocity (NCV), Distal Motor Latency (DML), and wave height of the sciatic nerve in male rats. METHODS This laboratory study used 24 male Wistar rats weighing 250-300 g, divided into the test and control groups. The test group received 10% date extract daily, at 4 mL/kg of body weight, for three weeks. In the beginning, nerve Conduction Velocity (NCV), Distal Motor Latency (DML), and wave height of the sciatic nerve were examined in all animals and reexamined for NCV three weeks later. P-values lower than 0.05 were considered significant. RESULTS Sciatic NCV and wave height were significantly increased; however, compared to the control group, DML of the knee significantly declined in the test group. CONCLUSION The compositions of date extract accelerate electrical signal transmission. HIGHLIGHTS Irreparable damages to the Peripheral Nervous System (PNS) are major problems in societies.Different therapeutic methods have been adopted for peripheral nerve repair.According to FAO, the production and use of dates are rising.Dates are used in traditional medicine for curing hoarseness, paralysis, backache, and rheumatic pains. PLAIN LANGUAGE SUMMARY Dates are highly important in our nutrition. There have been studies on the positive antioxidative effects of date extract in preventing diabetic neuropathy. Dates are used in traditional medicine for curing hoarseness, paralysis, backache, and rheumatic pains, among others. The importance of dates is derived from their rich compositions of carbohydrates, salts and minerals, dietary fiber, vitamins, fatty acids, amino acids, and proteins. Different therapeutic methods have been adopted for PNS, still, 50% of these damages become permanent and cause disability. Date palms are in the palm family native to Iran, and found in relatively tropical regions.Dates are used in traditional medicine for curing hoarseness, paralysis, backache, and rheumatic pains, among others. In short, the compositions of date extract accelerate electrical signal transmission.
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Affiliation(s)
| | - Mandana Jafari
- Pharmaceutics Research Institute of Neuropharmacology, Kerman University Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Najmeh Moradi
- Afzalipour Medical Faculty Kerman, University of Medical Sciences, Kerman, Iran
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Yildirim C, Cevik S, Yamaner H, Orkmez M, Eronat O, Bozdayı MA, Erdem M. Boric acid improves the behavioral, electrophysiological and histological parameters of cisplatin-induced peripheral neuropathy in rats. J Trace Elem Med Biol 2022; 70:126917. [PMID: 34963081 DOI: 10.1016/j.jtemb.2021.126917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/24/2021] [Accepted: 12/20/2021] [Indexed: 11/22/2022]
Abstract
Boric acid (BA) has been used in many diseases because it increases the amount of reduced glutathione in the body and reduces oxidative damage. This study aims to investigate the effects of boric acid in cisplatin-induced neuropathy, in which oxidative stress is also effective in its pathophysiology. In this study, 8-10 weeks old, 170-190 g Wistar Albino rats were used. Each group contained seven rats (n = 35). Experimental groups consist of control, sham, neuropathy, treatment, and boric acid groups. For the neuropathy model, a single dose of cisplatin (3 mg/kg, i.p) was administered once a week for five weeks, and for the treatment group, boric acid was administered daily (100 mg/kg, intragastric) for five weeks. After drug administration, the rotarod test to evaluate motor performance, the tail-flick and hot/cold plate tests to evaluate sensory conduction states, the von Frey filament test to evaluate the mechanical allodynia, and the adhesive removal test to assess sensorimotor function were performed. The sciatic nerve's motoric conduction velocity was also assessed electrophysiologically. Oxidative stress parameters were also assessed biochemically in sciatic nerve tissue and serum. Hematoxylin and eosin staining was used to evaluate the sciatic nerve tissue histopathologically. The motor conduction velocity of the sciatic nerve, impaired by cisplatin, was increased considerably by boric acid (p < 0.05). It also reduced the latency time of the compound muscle action potential (CMAP), which was increased by cisplatin. (p < 0.05). The von Frey filament test results demonstrated increased pain sensitivity of the cisplatin group increased, and mechanical allodynia was observed. Boric acid significantly alleviated this condition (p < 0.05). In the cold plate, adhesive removal, and rotarod tests, boric acid attenuated the adverse effects of cisplatin (p < 0.05). Biochemically, BA reduced the level of MDA, which was raised by cisplatin, and significantly increased the level of SOD, which was lowered by cisplatin (p < 0.05). Histopathologically; BA reduced neuronal degeneration and vacuolization caused by cisplatin. As a consequence, it has been determined that boric acid alleviates the adverse effects of cisplatin. BA reduced the destructive effect of cisplatin by reducing oxidative stress, and this effect was verified electrophysiologically, behaviorally, and histopathologically.
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Affiliation(s)
- Caner Yildirim
- Gaziantep University, Faculty of Medicine, Department of Physiology, Gaziantep, Turkey.
| | - Sena Cevik
- Gaziantep University, Faculty of Medicine, Department of Physiology, Gaziantep, Turkey.
| | - Hatice Yamaner
- Gaziantep University, Faculty of Medicine, Department of Physiology, Gaziantep, Turkey.
| | - Mustafa Orkmez
- Gaziantep University, Faculty of Medicine, Department of Medical Biochemistry, Gaziantep, Turkey.
| | - Omer Eronat
- Gaziantep University, Faculty of Medicine, Department of Pathology, Gaziantep, Turkey.
| | - Mehmet Akif Bozdayı
- Gaziantep University, Faculty of Medicine, Department of Medical Biochemistry, Gaziantep, Turkey.
| | - Mehmet Erdem
- Gaziantep University, Vocational School of Health Services, Gaziantep, Turkey.
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Lin L, Chen Y, Li Y, Cheng K, Deng H, Lu J, Zhao L, Shen X. 10.6-μm infrared laser as adjuvant therapy for diabetic peripheral neuropathy: study protocol for a double-blind, randomized controlled trial. Trials 2022; 23:53. [PMID: 35042552 DOI: 10.1186/s13063-021-05901-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background Diabetic peripheral neuropathy (DPN) is the most common chronic neurological complication. It is the main cause of disability in diabetes mellitus (DM) patients and seriously affects the quality of life of patients. Pharmacological treatments always associate with limited efficacy and adverse effects. Moxibustion has been recommended to treat DPN as an adjuvant therapy to conventional medical treatment to accelerate alleviation of the symptoms of DPN. 10.6-μm laser moxibustion (LM), whose wavelength is close to the peak of infrared radiation spectrum of the traditional moxibustion as well as human acupoints, produces the thermal effect similar with moxibustion but with no smoke or smell. The purpose of this sham controlled clinical trial is to determine the effect and safety of 10.6-μm LM as adjuvant therapy in patients with DPN. Methods This is a protocol for a randomized, double-blind, sham-controlled trial. One hundred fourteen patients meeting the inclusion and exclusion criteria will be recruited and randomly assigned to the LM group or the sham LM group with a 1:1 allocation ratio. Patients in both groups will receive a basic integrated treatment of Chinese and Western medicine and a total of 12 sessions of true or sham LM treatments over 4 weeks with 3 sessions a week. The primary outcome is nerve conduction velocity (NCV), and the secondary outcomes include Michigan Neuropathy Screening Instrument (MNSI) scores, Diabetes-Specific Quality of Life (DSQL) scores, blood rheology parameters, and assessments of safety and blinding. Outcome measures will be collected at baseline, 2 weeks after treatment, the end of LM treatments (4 weeks), and 4, 8 weeks after the end of LM treatment (8, 12weeks). Discussion This study will be conducted to compare the efficacy of LM versus sham LM combined with medical treatment. 10.6-μm LM may alleviate symptoms, improve quality of life, and reduce the dosage of drugs as well as avoid causing serious side effects. Trial registration Chinese Clinical Trial Registry ChiCTR2000029329. Registered on 25 January 2020.
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Podnar S. Length of affected nerve segment in ulnar neuropathies at the elbow. Clin Neurophysiol 2021; 133:104-110. [PMID: 34826645 DOI: 10.1016/j.clinph.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To establish length of the affected nerve segment (LANS) in ulnar neuropathy at the elbow (UNE). METHODS In a group of our previously reported UNE patients we identified 2-cm segments with reduced motor nerve conduction velocity (MNCV) on electrodiagnostic (EDx) studies and increased nerve cross-sectional areas (CSA) on ultrasonographic (US) studies. LANS was obtained by summation of these abnormal 2-cm segments separately for each approach. We also studied effect of selected independent parameters on LANS. RESULTS Altogether we studied 189 patients (194 arms). Mean (SD) LANS determined in 171 arms with reduced ulnar MNCV was 4.15 (1.89) cm, and was similar (p = 0. 21) to LANS obtained in 147 arms with increased CSA 4.46 (2.29) cm. Longer LANS were found in right arms, clinically severe UNE, axonal UNE and UNE due to entrapment. The most commonly affected 6 cm segment included 89% of abnormal 2-cm segments, with 50% of included 2-cm segments being normal. By contrast, the whole 10 cm segment included all abnormal 2-cm segments, with 66% of included segments being normal. CONCLUSIONS In UNE both EDx and US studies revealed average LANS of around 4 cm. LANS was longer in more severe UNE. SIGNIFICANCE LANS needs to be taken into account in discussion of the mechanisms of UNE and approach to EDx diagnosis of UNE, particularly length of the segment used in nerve conduction studies across the elbow.
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Affiliation(s)
- Simon Podnar
- Institute of Clinical Neurophysiology, Division of Neurology, University Medical Centre Ljubljana, Slovenia.
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Adki KM, Kulkarni YA. Neuroprotective effect of paeonol in streptozotocin-induced diabetes in rats. Life Sci 2021; 271:119202. [PMID: 33577853 DOI: 10.1016/j.lfs.2021.119202] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Diabetic neuropathy is one of the most common microvascular complication of diabetes. It is associated with neuronal dysfunction and pain. Paeonol is an important natural product reported for its antioxidant, anti-inflammatory and antidiabetic activities. AIM The present research was planned to study effect of paeonol in diabetic peripheral neuropathy in rats. METHODS Diabetes was induced in Sprague Dawley rats by using Streptozotocin (55 mg/kg, i.p.). After six weeks, diabetic animals were treated daily with paeonol at a dose of 50, 100 and 200 mg/kg for four weeks. At the end of the treatment, plasma glucose, mechanical allodynia, mechanical hyperalgesia, thermal hyperalgesia and nerve conduction velocities were recorded. Oxidative stress parameters were studied in sciatic nerve. Histopathology study of sciatic nerve, NF-κB and MCP-1 expression were also studied at the end of study. KEY FINDINGS Paeonol treatment significantly lowered the plasma glucose levels, mechanical allodynia, mechanical hyperalgesia and thermal hyperalgesia as compared to diabetic control group. Paeonol treatment also enhanced the motor and sensory nerve conduction velocity. Paeonol treated diabetic animals showed significant changes in oxidative stress parameters. Histopathology study indicated that paeonol treatment prevented the neuronal damage, lowered demyelination and leukocyte infiltration. NF-κB and MCP-1 expression was significantly decreased in sciatic nerve of diabetic animals treated with paeonol. SIGNIFICANCE Results of the present study indicate that paeonol may be considered as effective option for management of diabetic neuropathy.
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Affiliation(s)
- Kaveri M Adki
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (West), Mumbai 400 056, India
| | - Yogesh A Kulkarni
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (West), Mumbai 400 056, India.
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Saadati H, Noroozzadeh S, Esmaeili H, Amirshahrokhi K, Shadman J, Niapour A. The Neuroprotective Effect of Mesna on Cisplatin-Induced Neurotoxicity: Behavioral, Electrophysiological, and Molecular Studies. Neurotox Res 2021; 39:826-40. [PMID: 33216283 DOI: 10.1007/s12640-020-00315-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/07/2020] [Accepted: 11/15/2020] [Indexed: 02/07/2023]
Abstract
Peripheral neuropathy and cognitive impairments following cisplatin administration may interfere with the clinical usage of the drug. Mesna is a chemoprotective agent with anti-inflammatory and anti-oxidant effects. Our study aimed to investigate the protective effects of mesna against cisplatin-induced neurotoxicity. Neurotoxicity was induced by the administration of 2.5 mg/kg cisplatin twice a week for four consecutive weeks in male Wistar rats. The neuroprotective effect of mesna (150 mg/kg/day) was evaluated through behavioral, electrophysiological, and molecular studies. Cisplatin treatment caused passive avoidance memory impairment, increased anxiety-like behaviors, altered thermal sensitivity, and decreased muscle strength in a grip strength test. Our electrophysiological studies indicated that administration of cisplatin induced peripheral sensory neuropathy and decreased the amplitudes of the compound action potential of sensory nerves. Cisplatin administration increased MDA and 4-HNE levels and decreased anti-oxidant (SOD and GPx) enzymes. Proinflammatory cytokines (IL-1β and TNF-α) and metalloproteinase-2 and 9 (MMP-2/9) were increased by cisplatin treatment. Morphological alterations were observed in the dorsal root ganglion (DRG) of cisplatin-treated rats. Cognitive impairments, anxiety, muscle strength, and thermal sensitivity changes induced by cisplatin were improved with mesna treatment. The reduced conduction velocity in sensory nerves was recovered in the cisplatin + mesna group. Mesna partially alleviated redox imbalance, reduced the proinflammatory cytokines, and MMP-2/9 levels. Mesna administration also relieved the morphological changes in DRG of cisplatin-treated rats. In conclusion, our results revealed that mesna can alleviate cisplatin-induced central and peripheral nervous system toxicity. These results support the concept that chemotherapy-induced neuropathy can be partially inhibited via mesna.
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Jenny C, Lütschg J, Broser PJ. Change in cross-sectional area of the median nerve with age in neonates, infants and children analyzed by high-resolution ultrasound imaging. Eur J Paediatr Neurol 2020; 29:137-143. [PMID: 32826155 DOI: 10.1016/j.ejpn.2020.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/23/2020] [Accepted: 07/31/2020] [Indexed: 11/29/2022]
Abstract
AIM To analyze age dependencies in the cross-sectional area (CSA) of the median nerve during early childhood. METHOD A total of 43 participants (32 of whom were children younger than 2 years) were included in this cross-sectional study to analyze the age dependency of the CSA of the median nerve at three locations (wrist, forearm and upper arm) using high-resolution ultrasound images. RESULTS A strong and highly significant correlation was found between age and CSA (p < 0.001). When plotted, the relationship followed a logarithmic curve (p < 0.001) with a growth rate that decreases with age. Based on the regression analysis, a temporally similar increase in CSA for all three locations was found. The nerve reaches 70% of its final CSA by 2 years of age at all three locations. INTERPRETATION Similar to the nerve conduction speed, the increase in CSA is greatest during the first 2 years of life. Then, the rate gradually and synchronously slows at the proximal and distal locations. Measurement of the CSA in the clinical setting might offer a new method to assess the maturation of the nervous system in infants with minimal interference.
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Affiliation(s)
- Carole Jenny
- Medical Faculty, University of Basel, Switzerland
| | - Jürg Lütschg
- Medical Faculty, University of Basel, Switzerland; Children's Hospital of Eastern Switzerland, Sankt Gallen, Switzerland
| | - Philip J Broser
- Medical Faculty, University of Basel, Switzerland; Children's Hospital of Eastern Switzerland, Sankt Gallen, Switzerland.
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Zhou X, Zhang B, Qiao K, Lu J, Chen X, Wang Y, Zhu D, Wang Y. Central nervous system impairment detected by somatosensory evoked potentials in patients with Charcot-Marie-Tooth disease type 1A. J Clin Neurosci 2020; 79:191-196. [PMID: 33070894 DOI: 10.1016/j.jocn.2020.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 07/06/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
Diseases related to peripheral myelin protein 22 (PMP22) have been implicated to involve the central nervous system (CNS). This study aimed to detect central nerve impairment using somatosensory evoked potentials (SSEPs) in patients with Charcot-Marie-Tooth disease (CMT) 1A. A total of 30 CMT1A patients and 26 healthy volunteers were included. Baseline characteristics, brain MRI and segmental SSEPs were collected from the participants. The peak latencies of N9, N13 and N20 were recorded, and central conduction velocity (CCT) was calculated and compared between groups. Significant differences were found in the peak latencies and amplitudes of N9, N13 and N20 between the two groups. CCT was significantly prolonged in the CMT group (7.05 ± 2.09 ms) compared to the control group (5.40 ± 1.79 ms) (p = 0.003). Six of 30 CMT patients had abnormal MRI signals, but no correlation with CCT was found. The central somatosensory pathway that carries SSEPs was impaired in CMT1A patients, which implies an important underlying role of PMP22 in the CNS.
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Affiliation(s)
- Xiajun Zhou
- Department of Neurology, Renji Hospital Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Beidi Zhang
- Department of Neurology, Huashan Hospital Fudan University, Shanghai 200040, China
| | - Kai Qiao
- Department of Neurology, Huashan Hospital Fudan University, Shanghai 200040, China
| | - Jiahong Lu
- Department of Neurology, Huashan Hospital Fudan University, Shanghai 200040, China
| | - Xiangjun Chen
- Department of Neurology, Huashan Hospital Fudan University, Shanghai 200040, China
| | - Yin Wang
- Department of Pathology, Huashan Hospital Fudan University, Shanghai 200040, China
| | - Desheng Zhu
- Department of Neurology, Renji Hospital Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Yi Wang
- Department of Neurology, Huashan Hospital Fudan University, Shanghai 200040, China.
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Abstract
PURPOSE Non-invasive estimation of the conduction velocity distribution (CVD) of a peripheral nerve has the potential to both improve clinical diagnoses of pathology and to observe the progress of the disease or the efficacy of treatments. Comparisons were made of the performance of three non-invasive CVD estimation methods proposed by independent research groups on peripheral nerve bundles under different conditions. METHODS The first method (Cummins) uses a nerve compound action potential (CAP) with temporal dispersion and a mathematical single fiber action potential (SFAP). The second method (Barker) uses two CAPs and a non-mathematical SFAP waveform. The third method (Hirose) uses two CAPs recorded from distal and proximal sites. The Cummins and Barker methods have iterative solutions in the time domain while the Hirose method is a deconvolution estimator in the frequency domain. In order to compare these methods, we used cold exposure to affect primarily motor fibers and ischemia to affect primarily sensory fibers on rat caudal nerve bundles. RESULTS The Cummins method is sensitive to changes in motor and sensory fiber percentages in CVD if it is used with the volume conductor model. The Barker and Hirose methods are sensitive to motor fiber percentages in CVD but they cannot detect changes in sensory fiber percentages accurately. CONCLUSIONS Estimation of the CVD using a priori SFAP created with a volume conductor model can non-invasively supply accurate and precise information about fiber groups in a peripheral nerve bundle.
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Affiliation(s)
- Kamil Savaş
- Medical Faculty, Department of Biophysics, Akdeniz University, Antalya, Turkey
| | - Hilmi Uysal
- Medical Faculty, Department of Neurology, Akdeniz University, Antalya, Turkey
| | - Nazmi Yaraş
- Medical Faculty, Department of Biophysics, Akdeniz University, Antalya, Turkey
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Khandare AL, B K, Validandi V, Ssyh Q, Harishankar N, Singh SS, Kodali V. Neurolathyrism in goat (Capra hircus) kid: Model development. Res Vet Sci 2020; 132:49-53. [PMID: 32480188 DOI: 10.1016/j.rvsc.2020.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 11/22/2022]
Abstract
The present study was undertaken to develop an animal model to study neurolathyrism. For this purpose 24 goat (Capra hircus) kids (new born, 15 days old) were divided into four groups. Group I Control, Group II Low toxin (0.17 g% β-ODAP containing grass pea), Group III high toxin (0.96 g% β-ODAP containing grass pea) and Group IV high toxin (0.96 g% β-ODAP containing grass pea flour (powder) fortified with 5 mg% pure β-ODAP). The experiment was continued for 3 months. Clinical examination was carried out weekly. Muscle conduction velocity (MCV), nerve conduction velocity (NCV), blood and urinary β-ODAP, nitrite in blood and cerebrospinal fluid (CSF) examination were performed by standard methods. Clinical examination showed neurolathyrism symptoms in three kids. The abnormal MCV and NCV were observed in all the experimental animals. Blood nitrite, blood and urine β-ODAP levels were significantly increased in experimental groups. Three kids were affected with neurolathyrism due to consumption of grass pea irrespective of its β-ODAP content and kid may serve as a neurolathyrism model.
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Zhang Y, Shen X, He L, Zhao F, Yan S. Association of sarcopenia and muscle mass with both peripheral neuropathy and nerve function in patients with type 2 diabetes. Diabetes Res Clin Pract 2020; 162:108096. [PMID: 32109517 DOI: 10.1016/j.diabres.2020.108096] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/14/2020] [Accepted: 02/24/2020] [Indexed: 01/06/2023]
Abstract
AIM This study aimed to investigate the association of sarcopenia and muscle mass with both peripheral neuropathy and nerve function in type 2 diabetes mellitus. METHODS A total of 1794 patients (937 men and 857 women) with type 2 diabetes, with a mean age of 60.22 years, were enrolled for a cross-sectional study; of these, 183 patients were enrolled for a follow-up study with a median follow-up of 2.7 years. All participants underwent nerve conduction studies and muscle mass index (ASM/HT2) measurements. The composite Z scores for the sensory nerve conduction velocity (SCV) and the motor nerve conduction velocity (MCV) were calculated. The changes in ASM/HT2, SCV, and MCV were calculated from the measurements nearly 2 years apart and classified into three groups: a decrease in ASM/HT2 of >3%, a minor change within ±3%, and an increase in ASM/HT2 of >3%. RESULTS The ASM/HT2 of men was positively associated with the composite Z scores of MCV and SCV, and sarcopenia highly correlated with DPN after adjusting for confounding factors. The optimal cutoff point for ASM/HT2 that indicated DPN was 7.09 kg/m2. Furthermore, increases in ASM/HT2 independently predicted a greater benefit of MCV and SCV increment outcomes, whereas a minor change in ASM/HT2 only significantly associated with lower benefit in terms of SCV increment. However, this phenomenon was not observed in women. CONCLUSIONS Sarcopenia and DPN exhibited a close association. The increased muscle mass improved the partial MCVs and SCVs. However, a sex-related discrepancy was observed in this phenomenon.
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Affiliation(s)
- Yongze Zhang
- Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Diabetes Research Institute of Fujian Province, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China
| | - Ximei Shen
- Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Diabetes Research Institute of Fujian Province, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China
| | - Lanlan He
- Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Diabetes Research Institute of Fujian Province, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Graduate Student of Department of Endocrinology, The First Affiliated Hospital of Fujian Medical University, Diabetes Research Institute of Fujian Province, Fuzhou 350005, Fujian, China
| | - Fengying Zhao
- Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Diabetes Research Institute of Fujian Province, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China
| | - Sunjie Yan
- Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Diabetes Research Institute of Fujian Province, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China.
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Jafari Nejad Bajestani M, Yousefi M, Hadjzadeh MA, Hosseini M, Taghipour A, Yousefvand S, Ghorbanzadeh HR. The effects of lettuce extract on the level of T4, memory and nerve conduction velocity in male rats. Avicenna J Phytomed 2020; 10:472-80. [PMID: 32995325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE According to the traditional medicine, lettuce can affect nerve conduction velocity and memory. So, to investigate the effect of lettuce seeds extract on body activities, lettuce seeds were used. MATERIALS AND METHODS In the present study, the effects of lettuce (Lactuca sativa) seeds extract consumption (in drinking water) on T4 level, animals' weight, water and food consumption, nerve conduction velocity (NCV), and memory in Wistar rats, were investigated. In this study, 24 Wistar rats were used, and divided into three groups: control, L 200 mg/kg, and L 400 mg/kg. RESULTS The results showed that, the T4 level, food and water intake, time spent and distance travelled in Q1, delay time to enter and the number of entrance into the dark room in both treated groups were not significantly different from the control group. Animal weight and NCV, in 400 mg/kg group were not significantly different from the control group, but in 200 mg/kg group, they were significantly decreased (p<0.05). The duration spent in the dark room (48 hr after shock) in L 400 mg/kg increased compared to the control group (p<0.05), but in L 200 mg/kg group at all time points, and in L 400 mg/kg treated group 3 and 24 hr after shock, it was not significantly different from the control group. CONCLUSION Based on these findings, the T4 level, memory, food and water intake were not changed by lettuce extract, while NCV and animal weight were decreased following treatment with lettuce extract.
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Sekiguchi K, Kohara N, Baba M, Komori T, Naito Y, Imai T, Satoh J, Yamaguchi Y, Hamatani T. Aldose reductase inhibitor ranirestat significantly improves nerve conduction velocity in diabetic polyneuropathy: A randomized double-blind placebo-controlled study in Japan. J Diabetes Investig 2019; 10:466-474. [PMID: 29975462 PMCID: PMC6400176 DOI: 10.1111/jdi.12890] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/20/2018] [Accepted: 07/02/2018] [Indexed: 01/01/2023] Open
Abstract
AIMS/INTRODUCTION Diabetic polyneuropathy is one of the most frequent diabetic complications, and impairs patients' quality of life. We evaluated the efficacy and safety of ranirestat (40 mg/day) in patients with diabetic polyneuropathy. MATERIALS AND METHODS This was a multicenter, placebo-controlled, randomized double-blind, parallel-group, phase III study in which 557 patients were randomly assigned to either the ranirestat or placebo group and assessed for 52 weeks. The co-primary end-points were the changes in tibial motor nerve conduction velocity and total modified Toronto Clinical Neuropathy Score as a measure of clinical symptoms. RESULTS There was a significant increase in tibial motor nerve conduction velocity in the ranirestat group compared with the placebo group. The difference between groups in the change at last observation was 0.52 m/s (P = 0.021). Increases in nerve conduction velocity in the ranirestat group were found not only in the tibial motor nerves, but also in the median motor nerves, proximal median sensory nerves and distal median sensory nerves. No significant differences in modified Toronto Clinical Neuropathy Score or safety parameters were found between the two groups. CONCLUSIONS Ranirestat (40 mg/day) was well tolerated and improved nerve conduction velocity. Regarding symptoms and signs, no detectable benefits over the placebo were observed in the ranirestat group during the 52 weeks of treatment.
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Affiliation(s)
- Kenji Sekiguchi
- Division of NeurologyKobe University Graduate School of MedicineKobeHyogoJapan
| | - Nobuo Kohara
- Department of NeurologyKobe City Medical Center General HospitalKobeHyogoJapan
| | - Masayuki Baba
- Department of NeurologyAomori Prefectural Central HospitalAomoriJapan
| | - Tetsuo Komori
- Department of NeurologyNational Hakone HospitalKanagawaJapan
| | - Yutaka Naito
- Department of NeurologyJapanese Red Cross Ise HospitalIseMieJapan
| | - Tomihiro Imai
- Department of Occupational TherapySapporo Medical University School of Health SciencesSapporoJapan
| | - Jo Satoh
- Tohoku Medical and Pharmaceutical University Wakabayashi HospitalSendaiMiyagiJapan
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Lin ZX, Ling H, Lin X, Xie D. [A meta-analysis of the effect of occupational exposure to 1-bromopropane on workers' nerve conduction velocity]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2018; 36:343-346. [PMID: 29996378 DOI: 10.3760/cma.j.issn.1001-9391.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analysis the occupational exposure to 1-bromopropane on the worker's nerve conduc-tion velocity. Methods: To PubMed, Wanfang, VIP, Chinese Journal Full-text Database (CNKI) and other databases as a data source, searched and screened database to October 2017 on occupational exposure to 1-bromopropane workers on the role of nerve conduction in the paper. According to inclusion and exclusion criteria, we screened literatures, extracted data and evaluated the quality of the included studies, using RevMan5.3 software to test the heterogeneity of the results and us-ing the corresponding mathematical model for data combination analysis. Results: A total of 5 articles were included in the literature. The results showed that the tibial nerve MCV of workers in the 1-bromopropane exposure group was slower than that in the control group (SMD=-0.47,95%CI=-0.70~-0.24) , the difference was statistically significant (Z=4.06, P<0.01). The tibial nerve DL of the exposure group was more prolonged than that of the control group (SMD=0.35,95%CI=0.00~0.69) , with a statistically significant difference (Z=1.99, P=0.05). The sural nerve SCV of the exposure group was slower than that of the control group (SMD=-0.47, 95%CI=-0.78~-0.15), with a statistically significant difference (Z=2.88,P<0.01). Conclusion: Occupational exposure to 1-bromopropane may have an effect on the worker's nerve conduction ve-locity.It's necessary to do broader and deeper neurotoxicity studies about 1-bromopropane.
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Affiliation(s)
- Z X Lin
- Shantou Institute of Occupational Disease Prevention and Control, Shantou 515000, China
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Mazzia C, Munir K, Wellby M, Rault M, Capowiez Y, Gooneratne R. Nerve conduction velocity as a non-destructive biomarker in the earthworm Aporrectodea caliginosa exposed to insecticides. Environ Sci Pollut Res Int 2018; 25:24362-24367. [PMID: 29948719 DOI: 10.1007/s11356-018-2469-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
Earthworms are important and useful soil organisms, but in agricultural soils, they are potentially exposed to a wide variety of pesticides. Insecticides represent the highest threat to earthworms and many are neurotoxic. There is a need for a reliable, relevant, simple biomarker to assess the sub-lethal effects of neurotoxic insecticides on earthworms under laboratory or field conditions. The Aporrectodea caliginosa earthworms were exposed to 0 (control), 0.5×, 1× (normal field application rate), and 5× concentrations of a carbamate (Pirimor®) and an organophosphate (Lorsban®) insecticides. The nerve conduction velocity (NCV) of the medial giant fibers of A. caliginosa earthworm was recorded on days 0, 1, 2, 3, 4, and 7 to quantify sub-lethal neurotoxic effects. Acetylcholinesterase (AChE) enzyme activity of A. caliginosa homogenates was measured at the conclusion of the experiment. Pirimor® but not Lorsban® induced a significant decrease in NCV on days 3, 4, and 7 at 1× and 5× doses. A significant dose-dependent decrease was observed on AChE activity to Pirimor® at the doses used but not Lorsban®. A clear relationship is observed between AChE activity and NCV in the case of Pirimor®. This study showed that NCV is a sensitive biomarker that correlates well with classical biomarker measurements such as AChE enzyme activity. This technique could be used to study the impact of insecticides on earthworms and also their recovery.
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Affiliation(s)
- Christophe Mazzia
- Univ Avignon Aix Marseille Univ, CNRS, IRD, IMBE, Pôle Agrosciences, 301 rue Baruch de Spinoza, BP 21239, 84916, Avignon, France.
| | - Kiran Munir
- INRA, UMR 1114 'EMMAH', Domaine Saint Paul, 84914, Avignon CEDEX 09, France
| | - Martin Wellby
- INRA, UMR 1114 'EMMAH', Domaine Saint Paul, 84914, Avignon CEDEX 09, France
| | - Magali Rault
- Univ Avignon Aix Marseille Univ, CNRS, IRD, IMBE, Pôle Agrosciences, 301 rue Baruch de Spinoza, BP 21239, 84916, Avignon, France
| | - Yvan Capowiez
- Faculty of Agriculture and Life Sciences, Lincoln University, P O Box 85084, Lincoln, Christchurch, 7647, New Zealand
| | - Ravi Gooneratne
- INRA, UMR 1114 'EMMAH', Domaine Saint Paul, 84914, Avignon CEDEX 09, France
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Wong YS, Ong CT, Hsieh YY, Hung TW, Guo HR. Carpal tunnel syndrome after an electrical injury: a case report and review of literature. J Occup Health 2018; 60:320-323. [PMID: 29899196 PMCID: PMC6078841 DOI: 10.1539/joh.2017-0247-cs] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 03/22/2018] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Carpal tunnel syndrome (CTS) is prevalent in workers who utilize hand-held vibration tools, engage in tasks involving repetitive wrist movements, and suffer from wrist overuse. Although electrical injuries involving the median nerve are a relatively rare but plausible cause of CTS, the related literature is limited. Here, we report a case of CTS in which the symptoms developed after an electrical injury, and review the related literature. CASE SUMMARY The patient was a right-handed male electrician who often used hand tools but had no symptoms of CTS before the injury, with the left hand as the point of entry. Typical symptoms of CTS manifested after the electrical injury, and a nerve conduction velocity test confirmed the presence of severe CTS in the left hand. Therefore, we believe that the symptoms can be largely attributed to the electrical injury. CONCLUSIONS The available literature supports the occurrence of delayed compressive neuropathy caused by scarring from substantial cutaneous burns in patients with electrical injuries. This case shows that electrical injuries may cause CTS in the absence of severe scarring through other mechanisms such as direct injuries to the nerve. Therefore, patients with electrical burns should be routinely examined for peripheral nerve compression symptoms in follow-ups, even when there are minimal cutaneous burns.
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Affiliation(s)
- Yi-Sin Wong
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital
- Department of Environmental and Occupational Health, National Cheng Kung University
| | - Cheung-Ter Ong
- Department of Neurology, Ditmanson Medical Foundation Chia-Yi Christian Hospital
- Department of Nursing, Chung Jen Junior College of Nursing, Health Science and Management
| | - Yi-Ying Hsieh
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital
| | - Tuey-Wen Hung
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital
| | - How-Ran Guo
- Department of Environmental and Occupational Health, National Cheng Kung University
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital
- Occupational Safety, Health, and Medicine Research Center, National Cheng Kung University
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Tehrani KHN. A Study of Nerve Conduction Velocity in Diabetic Patients and its Relationship with Tendon Reflexes (T-Reflex). Open Access Maced J Med Sci 2018; 6:1072-1076. [PMID: 29983804 PMCID: PMC6026439 DOI: 10.3889/oamjms.2018.262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 05/21/2018] [Accepted: 05/25/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Neuropathy is one of the most common complications of diabetes mellitus. Neuropathy can cause the sensory deficit, neurological disorder, limb ulcers, osteomyelitis, and amputation. Therefore, neurological examinations, determining the nerve conduction velocity and performing sensory and motor tests are important for timely diagnosis and treatment. AIM The present study aimed to investigate the nerve conduction velocity in diabetic patients and its relationship with tendon reflexes. MATERIAL AND METHODS The present study was observational-cross sectional research carried out on 77 diabetic patients who were admitted into the EMG/NCV Department of Shariati Hospital in the academic year 1996-1997. In all patients, the medical history of the patient (age, duration of diabetes, gender and age of onset of diabetes), neurological examination, nerve conduction velocity, heat test, vibration test, tendon reflexes, D.L and Amplitude were examined and recorded. Finally, the raw data obtained were entered into the IBM SPSS Statistics software, and the important relationships between these variables were analysed. Moreover, in the present study, the statistical significance level (P-value) was considered less than 0.05. RESULTS The present study was conducted on a population consisting of 48 women and 29 men with diabetes. The age range of participants was 14-70 years old with an average age of 50.506 ± 7.50. The results of present study showed that the participants with clinical neuropathy (11.2 ± 7.2) had a significantly longer duration of diabetes than the normal group and those participants with sub-clinical neuropathy (P-value = 0.12). Statistical analyses indicated that increase in age, increase in the duration of diabetes and the gender of male significantly made the nerve conduction velocity abnormal. The analysis of the response to neural reflexes indicated that the ratio of neurological disorders in the five nerves of the ankle and knee was generally higher in the abnormal group (the patients with nerve conduction disorder) compared to the normal (the patients with normal nerve conduction) and in some cases, such as the ulnar motor nerve of ankle (P-value = 0.010), and the ulnar motor nerve of knee motor (P-value = 0.002) and also in the peroneal motor nerve of knee (P-value = 0.003) and the sural sensory nerve of knee (P-value = 0.003), increase in neurological disorders was significant. CONCLUSION Increase in age, increase in the duration of diabetes, and the male gender can significantly increase the risk of abnormal nerve conduction velocity.
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Zhang X, Fang C, Li X, Cao YJ, Zhang QL, Zhang HH, Huang Y, Hu J, Liu CF. Clinical characteristics and risk factors of diabetic peripheral neuropathy of type 1 diabetes mellitus patients. Diabetes Res Clin Pract 2017; 129:97-104. [PMID: 28521198 DOI: 10.1016/j.diabres.2017.04.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/25/2017] [Accepted: 04/19/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Small nerve fibers are more easily injured than large ones for diabetic peripheral neuropathy (DPN). The study investigated the characteristics and related risk factors of DPN of T1DM patients using nerve conduction velocity and CPT values, which provided evidences for its early diagnosis. METHODS 70 T1DM patients and 48 healthy volunteers were included. All subjects accepted nerve conduction velocity and CPT examinations for four limbs. Detailed clinical indicators were recorded. CPT values were compared between TIDM group and control group. The risk factors affecting DPN were further explored. RESULTS Compared with the control group, CPT values under three frequencies were decreased in T1DM group. The abnormality rate of sural nerves was higher than that of median nerves (P<0.001). Median nerve dysfunction mainly presented as hypoesthesia under 250Hz and 5Hz current stimulus. And sural nerve dysfunction mainly presented as hyperesthesia under three frequencies. Compared with left median nerve, abnormal rate of right median nerve was higher under 2000Hz current stimulus (P=0.035). However, abnormal rate of left sural nerve was higher than that of right side under 250Hz and 5Hz current stimulus (P=0.001, <0.001). Duration, NDS scores and CPT values of right median nerve under 2000Hz current stimulus were independent risk factors of abnormal nerve conduction velocity. CONCLUSIONS The study proved that DPN of T1DM are mainly lower limb-injured., amyelinated and thin myelinated nerve fiber-involved. CPT can be combined with traditional nerve conduction velocity examination, which will help the diagnosis of DPN of T1DM earlier and more comprehensively.
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Affiliation(s)
- Xia Zhang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Chen Fang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Xiang Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Yong-Jun Cao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Qi-Lin Zhang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Hong-Hong Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Yun Huang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Ji Hu
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
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Ma JJ, Hao SL, Cheng XT, Yuan Y. [The clinical value of SUDOSCAN in diagnosis of diabetic distal symmetrical peripheral neuropathy]. Zhonghua Yi Xue Za Zhi 2017; 97:1170-1174. [PMID: 28427125 DOI: 10.3760/cma.j.issn.0376-2491.2017.15.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To evaluate the clinical value of SUDOSCAN in diagnosis of diabetic distal symmetrical peripheral neuropathy. Methods: According to the diagnostic criteria for multiple diabetic distal symmetrical peripheral neuropathy, a total of 130 patients with type 2 diabetes mellitus (T2DM) in Department of Endocrinology, the Affiliated Hospital of Qingdao University between August 2015 and July 2016 were divided into two groups, diabetic peripheral neuropathy group (DPN group, 50 cases) and non-diabetic peripheral neuropathy group (NDPN group, 80 cases). Additional 80 healthy volunteers were selected as healthy control group (NC group). SUDOSCAN was employed to detect electrochemical skin conductance (ESC, the unit was μS) of subjects' hands and feet, and the correlation between sensory nerve conduction velocity (SCV) and ESC was analyzed as well. Results: The average hands ESC in NC and T2DM group were (79.1±10.4) μS and (59.7±18.1) μS, respectively; the average feet ESC were (82.0±8.2) μS and (62.1±21.8) μS, respectively (both P<0.01). The average hands ESC in DPN and NDPN group were (53.2±18.9) μS and (63.7±16.5) μS; the average feet ESC were (53.5±24.4) μS and (67.4±18.2) μS, respectively (both P<0.05). The hands and feet ESC were positively correlated with SCV, and the correlation coefficient were 0.425 and 0.445, respectively (both P<0.01). The area under the receiver operating characteristic curve (ROC) of hands and feet ESC to evaluate diabetic symmetrical peripheral polyneuropathy were 0.785 and 0.768 (both P<0.01). Conclusion: SUDOSCAN is a promising tool for the diagnosis of diabetic symmetrical peripheral polyneuropathy.
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Affiliation(s)
- J J Ma
- Department of Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
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Kamel DM, Hamed NS, Abdel Raoof NA, Tantawy SA. Pulsed magnetic field versus ultrasound in the treatment of postnatal carpal tunnel syndrome: A randomized controlled trial in the women of an Egyptian population. J Adv Res 2017; 8:45-53. [PMID: 27980864 PMCID: PMC5144749 DOI: 10.1016/j.jare.2016.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 11/04/2016] [Accepted: 11/14/2016] [Indexed: 01/16/2023] Open
Abstract
The aim of this study was to compare the effects of pulsed electromagnetic field versus pulsed ultrasound in treating patients with postnatal carpal tunnel syndrome. The study was a randomized, double-blinded trial. Forty postnatal female patients with idiopathic carpal tunnel syndrome were divided randomly into two equal groups. One group received pulsed electromagnetic field, with nerve and tendon gliding exercises for the wrist, three times per week for four weeks. The other group received pulsed ultrasound and the same wrist exercises. Pain level, sensory and motor distal latencies and conduction velocities of the median nerve, functional status scale and hand grip strength were assessed pre- and post-treatment. There was a significant decrease (P < 0.05) in pain level, sensory and motor distal latencies of the median nerve, and significant increase (P < 0.05) in sensory and motor conduction velocities of the median nerve and hand grip strength in both groups, with a significant difference between the two groups in favour of pulsed electromagnetic field treatment. However, the functional status scale showed intergroup no significant difference (P > 0.05). In conclusion, while the symptoms were alleviated in both groups, pulsed electromagnetic field was more effective than pulsed ultrasound in treating postnatal carpal tunnel syndrome.
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Key Words
- CTS, carpal tunnel syndrome
- CTSQ, carpal tunnel syndrome questionnaire
- Carpal tunnel syndrome
- EMG, electromyography
- Electromagnetic field
- MMCV, median motor conduction velocity
- MMDL, median motor distal latency
- MSCV, median sensory conduction velocity
- MSDL, median segmental sensory distal latency
- MSDL, median sensory distal latency
- NCSs, nerve conduction studies
- NCV, nerve conduction velocity
- Nerve conduction velocity
- PEMF, pulsed electromagnetic magnetic field
- Pain
- Postnatal
- Pregnancy
- Pulsed ultrasound
- US, ultrasound
- VAS, visual analogue scale
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Affiliation(s)
- Dalia M. Kamel
- Department of Physical Therapy for Obstetrics and Gynecology, Faculty of Physical Therapy, Cairo University, P.O. Box 12612, Giza, Egypt
- Department of Physical Therapy, Faculty of Medical and Health Sciences. Ahlia University, P.O. Box 10878, Manama, Bahrain
| | - Nashwa S. Hamed
- Department of Physical Therapy for Neuromuscular Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, P.O. Box 12612, Giza, Egypt
| | - Neveen A. Abdel Raoof
- Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Cairo University, P.O. Box 12612, Giza, Egypt
| | - Sayed A. Tantawy
- Department of Physical Therapy, Faculty of Medical and Health Sciences. Ahlia University, P.O. Box 10878, Manama, Bahrain
- Center of Radiation, Oncology and Nuclear Medicine, Cairo University, Giza, Egypt
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Abstract
Presentation of scrub typhus associated with brachial neuritis is extremely rare with only a few cases reported so far. Here, we report a case of a 45-year-old female who presented with fever and right shoulder pain. Laboratory parameters showed leucocytosis with ELISA and PCR for scrub typhus positive. Electromyography (EMG) and Nerve Conduction Velocity (NCV) study was suggestive of brachial neuritis. She was given doxycycline therapy for 10 days following which her shoulder pain resolved.
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Affiliation(s)
- Giridhar Reddy Banda
- Postgraduate Student, Department of Medicine, Kasturba Medical College , Manipal, Karnataka, India
| | | | - Priyanka Ballal
- Intern, Department of Medicine, Kasturba Medical College , Manipal, Karnataka, India
| | - Jayaprakash Belle
- Associate Professor, Department of Medicine, Kasturba Medical College , Manipal, Karnataka, India
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Xie C, Zhou X, Zhu D, Liu W, Wang X, Yang H, Li Z, Hao Y, Zhang GX, Guan Y. CNS involvement in CMTX1 caused by a novel connexin 32 mutation: a 6-year follow-up in neuroimaging and nerve conduction. Neurol Sci 2016; 37:1063-70. [PMID: 27098243 DOI: 10.1007/s10072-016-2537-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 02/24/2016] [Indexed: 12/29/2022]
Abstract
X-linked Charcot-Marie-Tooth disease, type 1 (CMTX1) is one of the most common inherited neurological disorders. Obvious CNS involvement is relatively rare in CMTX1 patients. A 24-year-old male with CMTX1 presented with three transient stroke-like attacks, and was followed up regularly for 6 years with brain MRI and electrophysiological examination. Transient symmetrical high signals on T2 imaging and restricted diffusion were found in bilateral deep white matter. Electrophysiological measurement revealed a sensorimotor peripheral neuropathy with slightly reduced nerve conduction velocities. A novel thymine to cytosine mutation at nucleotide position 445 in the connexin 32 allele of the GJB1 gene was identified. During the 6-year longitudinal study, patient's motor and sensory function did not worsen; radiological abnormalities correlated with episodes of CNS dysfunction and resolved after clinical recovery; electrophysiological records showed no obvious change. Little change in the patient's clinical, radiological and electrophysiological results over the follow-up reflected a slow disease progression.
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Affiliation(s)
- Chong Xie
- Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China
| | - Xiajun Zhou
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, China
| | - Desheng Zhu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei Liu
- Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China
| | - Xiaoqing Wang
- Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China
| | - Hong Yang
- Department of Neurology, Shanghai Yangpu Geriatric Hospital, Shanghai, China
| | - Zezhi Li
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, China
| | - Yong Hao
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, China
| | - Guang-Xian Zhang
- Department of Neurology, Thomas Jefferson University, 900 Walnut Street, Suite 300, Philadelphia, PA, 19107, USA.
| | - Yangtai Guan
- Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, China
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30
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Lee EB, Lee YY, Lee JM, Son SM, Hwang SK, Kwon S, Kim SY. Clinical importance of F-waves as a prognostic factor in Guillain-Barré syndrome in children. Korean J Pediatr 2016; 59:271-5. [PMID: 27462356 PMCID: PMC4958705 DOI: 10.3345/kjp.2016.59.6.271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/22/2015] [Accepted: 11/09/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. METHODS The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. RESULTS Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). CONCLUSION This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.
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Affiliation(s)
- Eung-Bin Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Yun Young Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Jae Min Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Su Min Son
- Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea
| | - Su-Kyeong Hwang
- Department of Pediatrics, Kyungpook National University Children's Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Soonhak Kwon
- Department of Pediatrics, Kyungpook National University Children's Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sae Yoon Kim
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
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Muthuraman A, Ramesh M. Ischemic-reperfusion of unilateral external iliac artery in rat: A new model for vasculitic femoral neuropathy. Neurosci Lett 2016; 628:10-6. [PMID: 27288016 DOI: 10.1016/j.neulet.2016.06.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 05/14/2016] [Accepted: 06/07/2016] [Indexed: 01/14/2023]
Abstract
Clinically, ischemic environment during gynecological surgery at lithotomy position is most common causative factor for the development of vasculitic femoral neuropathy (VFN). The present study was designed to induce the clinically relevant rat model of VFN by ischemic-reperfusion (I/R) injury of unilateral external iliac artery (uEIA). The VFN was induced by 3, 4 and 5h occlusion of uEIA followed by reperfusion. The I/R of uEIA induced VFN was evaluated by (i) behavioral parameters i.e., hind limb temperature; weight bearing capacity; (ii) kinematic analysis i.e., paw posture, splay angle, static sciatic index (SSI), and ankle-angle tests; (iii) evaluation of pain perception i.e., plantar and pin prick; (iv) serum biochemical estimation i.e., nitrate, lipid peroxidation, TNF-α and calcium level; (v) evaluation of motor and sensory nerve conduction velocity; and (vi) measurement of nerve fiber density. The 4 and 5h occlusion of uEIA has produced the potential changes in behavioral, functional, electrophysiological, biochemical and histopathological assessment. The 5h occlusion of uEIA has shown to produce the mortality. Whereas, 3h occlusion does not produce the significant changes in the development of VFN. The 4h ischemic occlusion of uEIA has shown potential rat model of VFN due to its close mimicking capacity of VFN in human. Therefore, it can be useful to explore the newer anti-neuralgic medicine and with their pharmacodynamic action in the field of various neurovascular disorders.
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Affiliation(s)
- Arunachalam Muthuraman
- Department of Pharmacology, Neuropharmacology Division, Akal Toxicology Research Centre, A Unit of Akal College of Pharmacy & Technical Education, Mastuana Sahib, Sangrur 148001, Punjab, India.
| | - Muthusamy Ramesh
- Department of Pharmacology, Neuropharmacology Division, Akal Toxicology Research Centre, A Unit of Akal College of Pharmacy & Technical Education, Mastuana Sahib, Sangrur 148001, Punjab, India; School of Health Sciences, University of KwaZulu-Natal (UKZN), Durban 4001 South Africa.
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Conzen C, Conzen M, Rübsamen N, Mikolajczyk R. Predictors of the patient-centered outcomes of surgical carpal tunnel release - a prospective cohort study. BMC Musculoskelet Disord 2016; 17:190. [PMID: 27121725 PMCID: PMC4848854 DOI: 10.1186/s12891-016-1046-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/22/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) causes a substantial burden of disease in society. While CTS can be resolved by surgical carpal tunnel release, it still remains unclear as to what degree outcomes depend on patients' characteristics. This study assesses patient-centered outcomes after surgical carpal tunnel release in a large outpatient clinic in Germany. METHODS Patients with CTS were recruited prospectively between August 1st and December 31st, 2013. We assessed socio-demographic and psychological factors as well as nerve conduction velocities at baseline (before the surgery) and at three and six months after surgery. We analyzed the improvement of patient-centered outcomes (symptoms and function of the affected hand as well as measures of well-being and subjective quality of life) at the two follow-up time points and investigated if socio-demographic characteristics and CTS-related variables predict the success of the surgery with respect to nerve conduction velocities and patient-centered outcomes by means of analysis of covariance (ANCOVA). Factors influencing the duration of sick leave were investigated by means of Cox regression. RESULTS The study sample consisted of 71 CTS cases. Surgical carpal tunnel release generally improved nerve conduction velocity and patient-centered outcomes. Regarding the former, the improvement was proportional to the severity score at baseline. The presence of muscular atrophy in the thenar area at baseline displayed medium size effects for the patient-centered outcomes. Other socio-demographic characteristics and CTS-related variables did not have a strong predictive effect on the improvement of nerve conduction velocity and patient-centered outcomes. CONCLUSIONS There is a significant improvement of clinical and subjective outcomes after CTS surgery in the outpatient sector. The improvement is largely independent of socio-demographic and clinical characteristics of the patients.
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Affiliation(s)
- Catharina Conzen
- Neurosurgical outpatients' clinic Dr. med. Dr. PH Michael A. Conzen and partners, Bielefeld, Germany
| | - Michael Conzen
- Neurosurgical outpatients' clinic Dr. med. Dr. PH Michael A. Conzen and partners, Bielefeld, Germany
| | - Nicole Rübsamen
- ESME - Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany
| | - Rafael Mikolajczyk
- ESME - Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany. .,Hannover Medical School, Hannover, Germany.
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Abstract
The study of diabetic neuropathy has relied primarily on the use of streptozotocin-treated rat and mouse models of type 1 diabetes. This chapter will review the creation and use of other rodent models that have been developed in order to investigate the contribution of factors besides insulin deficiency to the development and progression of diabetic neuropathy as it occurs in obesity, type 1 or type 2 diabetes. Diabetic peripheral neuropathy is a complex disorder with multiple mechanisms contributing to its development and progression. Even though many animal models have been developed and investigated, no single model can mimic diabetic peripheral neuropathy as it occurs in humans. Nonetheless, animal models can play an important role in improving our understanding of the etiology of diabetic peripheral neuropathy and in performing preclinical screening of potential new treatments. To date treatments found to be effective for diabetic peripheral neuropathy in rodent models have failed in clinical trials. However, with the identification of new endpoints for the early detection of diabetic peripheral neuropathy and the understanding that a successful treatment may require a combination therapeutic approach there is hope that an effective treatment will be found.
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Affiliation(s)
- M A Yorek
- Iowa City Health Care System, Iowa City, IA, United States; University of Iowa, Iowa City, IA, United States; Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, IA, United States.
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Hussain G, Rizvi SAA, Singhal S, Zubair M, Ahmad J. Serum levels of TGF-β1 in patients of diabetic peripheral neuropathy and its correlation with nerve conduction velocity in type 2 diabetes mellitus. Diabetes Metab Syndr 2016; 10:S135-S139. [PMID: 26559756 DOI: 10.1016/j.dsx.2015.10.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS To correlate serum levels of TGF-β1 with motor and sensory nerve conduction velocities in patients of type 2 diabetes mellitus MATERIALS AND METHODS The study was conducted in diagnosed type 2 diabetes mellitus patients which were divided in patients with clinically detectable peripheral neuropathy of shorter duration (n=37) and longer duration (n=27). They were compared with patients without clinical neuropathy (n=22). Clinical diagnosis was based on neuropathy symptom score (NSS) and Neuropathy disability score (NDS) for signs. Blood samples were collected for baseline investigations and estimation of serum TGF-β1. Nerve conduction velocity was measured in both upper and lower limbs. Median, Ulnar, Common Peroneal and Posterior Tibial nerves were selected for motor nerve conduction study and Median and Sural nerves were selected for sensory nerve conduction study RESULTS In patients of type 2 diabetes mellitus with clinically detectable and serum TGF-β1 showed positive correlation with nerve conduction velocities CONCLUSION High level of TGF-β1 in serum of T2DM patients with neuropathy show possible contribution in development of neuropathy. Due to its independent association this cytokine might be used as biomarker for diabetic peripheral neuropathy.
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Affiliation(s)
- Gauhar Hussain
- Department of Physiology, Teerthankar Mahaveer Medical College & Research Centre, Teerthankar Mahaveer University, Moradabad, U.P., India
| | - S Aijaz Abbas Rizvi
- Department of Physiology, J.N. Medical College & Hospital, Aligarh Muslim University, Aligarh, U.P., India
| | - Sangeeta Singhal
- Department of Physiology, J.N. Medical College & Hospital, Aligarh Muslim University, Aligarh, U.P., India
| | - Mohammad Zubair
- Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N. Medical College & Hospital, Aligarh Muslim University, Aligarh 202002, U.P., India
| | - Jamal Ahmad
- Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N. Medical College & Hospital, Aligarh Muslim University, Aligarh 202002, U.P., India.
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Jiang DQ, Li MX, Wang Y, Wang Y. Effects of prostaglandin E1 plus methylcobalamin alone and in combination with lipoic acid on nerve conduction velocity in patients with diabetic peripheral neuropathy: A meta-analysis. Neurosci Lett 2015; 594:23-9. [PMID: 25800109 DOI: 10.1016/j.neulet.2015.03.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 03/19/2015] [Indexed: 12/22/2022]
Abstract
This report was to evaluate the efficacy of lipoic acid, prostaglandin E1 and methylcobalamin (L+P+M) for the treatment of diabetic peripheral neuropathy (DPN) in comparison with that of prostaglandin E1 plus methylcobalamin (P+M), in order to provide the basis and reference for clinical rational drug use. Randomized controlled trials (RCTs) of L+P+M for DPN published up to 3rd August, 2014 were searched. A random or fixed effect model was used to analyze outcomes which were expressed as risk ratios (RRs) or mean difference (MD) with a 95% confidence interval (CI). Eighteen RCTs with 1410 participants were included. Clinical efficacy of L+P+M therapy was significantly better than P+M therapy (fifteen trials; RR 1.32, 95% CI 1.24-1.41, P<0.00001, I(2)=32%). As compared with P+M therapy, the pooled effects of L+P+M therapy on nerve conduction velocities (NCVs) were (fifteen trials; MD 4.70, 95% CI 3.77-5.63, P<0.00001, I(2)=79%) for median MNCV, (thirteen trials; MD 4.73, 95% CI 3.69-5.77, P<0.00001, I(2)=85%) for median SNCV, (sixteen trials; MD 4.22, 95% CI 3.32-5.12, P<0.00001, I(2)=83%) for peroneal MNCV, (fourteen trials; MD 3.09, 95% CI 2.04-4.14, P<0.00001, I(2)=82%) for peroneal SNCV. There was no serious adverse events associated with drugs intervention. L+P+M therapy was superior to P+M therapy for improvement of clinical efficacy and NCVs in DPN patients. These findings should be further verified by high-quality RCTs.
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Affiliation(s)
- De-Qi Jiang
- Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China; Department of Biopharmaceutical, Yulin Normal University, Yulin 537000, China
| | - Ming-Xing Li
- Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China
| | - Yan Wang
- Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China
| | - Yong Wang
- Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China.
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Mondelli M, Aretini A. Low sensitivity of F-wave in the electrodiagnosis of carpal tunnel syndrome. J Electromyogr Kinesiol 2014; 25:247-52. [PMID: 25561074 DOI: 10.1016/j.jelekin.2014.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 11/26/2014] [Accepted: 12/05/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Previous studies showed "F-wave inversion" (F-INV) as a sensitive method in the electrodiagnosis of early stage of carpal tunnel syndrome (CTS). This study aimed at evaluating the sensitivity and specificity of F-wave and nerve conduction velocity (NCV) testing in CTS. METHODS We consecutively enrolled 244 cases and 108 controls. F-waves analysis included: Fwave minimum and mean latencies, F-wave persistence and chronodispersion, mean-F/CMAP amplitude ratio, F-INV. Specificity and sensitivity of F-waves parameters were calculated in the whole sample of CTS patients and by grouping the patients according to CTS severity. Multivariate logistic regression was also performed using F-INV as a dependent variable. RESULTS In the whole sample the sensitivity of F-mean-INV and of median-ulnar NCV comparative testing was 50.8% and 93.7%, respectively. F-INV sensitivity dropped to 8% in CTS early stage. F-INV could be predicted only by distal motor latency of the median nerve. The sensitivity of all F-wave parameters increased only in the most severe stages of CTS. CONCLUSIONS This study does not confirm the electrodiagnostic usefulness of F-INV in early stage of CTS. All F-wave parameters, including F-INV, are much less sensitive than conventional NCV in CTS electrodiagnosis. F-wave does not add further useful information specifically related to CTS.
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Amin SB, Vogler-Elias D, Orlando M, Wang H. Auditory neural myelination is associated with early childhood language development in premature infants. Early Hum Dev 2014; 90:673-8. [PMID: 25194836 PMCID: PMC4301398 DOI: 10.1016/j.earlhumdev.2014.07.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 07/23/2014] [Accepted: 07/30/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Auditory neural myelination (ANM) as evaluated by auditory brainstem evoked response (ABR) during the neonatal period has been used as a surrogate outcome for long-term neurodevelopment. The validity of ANM as a surrogate outcome for long-term neurodevelopment has not been well studied. AIM Evaluate the association of ABR I-V interpeak latency (IPL), an index of ANM, at 35 week postmenstrual age (PMA) with language outcome at 3 years of age. DESIGN Prospective study. SUBJECTS 24-33 week gestational age (GA) infants were eligible if they did not meet exclusion criteria: craniofacial malformation, chromosomal disorders, deafness, auditory dys-synchrony, TORCH infection, or non-English speaking parents. Infants with malignancy, head injury, encephalopathy, meningitis, blindness, or who died or relocated were also excluded. OUTCOME MEASURES ABRs were performed at 35 week PMA using 80 dB nHL and I-V IPL (ms) measured. Auditory Comprehension (AC) and Expressive Communication (EC) were evaluated by a speech-language pathologist at 3 years of age using Preschool Language Scale. RESULTS Eighty infants were studied. The mean GA and birth weight of infants were 29.2 weeks and 1336 g, respectively. There was association of worse ear I-V IPL and better ear I-V IPL with AC (Coefficient-5.4, 95% CI: -9.8 to -0.9 and Coefficient-5.5, 95% CI: -10 to-0.9, respectively) and EC (Coefficient-5.6, 95% CI: -9.5 to-1.8 and Coefficient-6.7, 95% CI: -10.6 to-2.7, respectively) after controlling for confounders. CONCLUSION The neonatal I-V IPL is a predictor of language development at 3 years of age in preterms.
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Affiliation(s)
- Sanjiv B. Amin
- Department of Pediatrics, Division of Neonatology, The University of Rochester School of Medicine and Dentistry and Nazarath College
| | - Dawn Vogler-Elias
- Department of Otolaryngology and Department of Audiology, The University of Rochester School of Medicine and Dentistry and Nazarath College
| | - Mark Orlando
- Department of Otolaryngology and Department of Audiology, The University of Rochester School of Medicine and Dentistry and Nazarath College
| | - Hongyue Wang
- Department of Biostatistics, The University of Rochester School of Medicine and Dentistry and Nazarath College
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Allison DJ, Green LA, Gabriel DA, Roy BD, Inglis JG, Ditor DS. Elevated concentrations of circulating cytokines and correlations with nerve conduction velocity in human peripheral nerves. J Neuroimmunol 2014; 277:134-9. [PMID: 25266142 DOI: 10.1016/j.jneuroim.2014.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 07/02/2014] [Accepted: 09/13/2014] [Indexed: 12/21/2022]
Abstract
The purpose of the current study was to quantify the potential relationship between various cytokines and peripheral nerve function in humans, in-vivo. Measures of nerve conduction velocity (NCV) were examined prior to and following the induction of a cytokine spike. A significant negative correlation was found between the change in IL-1ra and the change in NCV at 24h post-exercise (r=-0.65, p=0.02) while a significant positive correlation was found between the change in IL-6 and the change in NCV at 2h post-exercise (r=0.61, p=0.048). It may be possible that different cytokines induce a unique neural influence at elevated concentrations.
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Affiliation(s)
- David J Allison
- Department of Kinesiology, Brock University, St. Catharines, Ontario L2S 3A1, Canada.
| | - Lara A Green
- Department of Kinesiology, Brock University, St. Catharines, Ontario L2S 3A1, Canada.
| | - David A Gabriel
- Department of Kinesiology, Brock University, St. Catharines, Ontario L2S 3A1, Canada.
| | - Brian D Roy
- Department of Kinesiology, Brock University, St. Catharines, Ontario L2S 3A1, Canada.
| | - J Greig Inglis
- Department of Kinesiology, Brock University, St. Catharines, Ontario L2S 3A1, Canada.
| | - David S Ditor
- Department of Kinesiology, Brock University, St. Catharines, Ontario L2S 3A1, Canada.
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Hussain G, Rizvi SAA, Singhal S, Zubair M, Ahmad J. Cross sectional study to evaluate the effect of duration of type 2 diabetes mellitus on the nerve conduction velocity in diabetic peripheral neuropathy. Diabetes Metab Syndr 2014; 8:48-52. [PMID: 24661759 DOI: 10.1016/j.dsx.2013.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To study the nerve conduction velocity in clinically undetectable and detectable peripheral neuropathy in type 2 diabetes mellitus with variable duration. MATERIAL AND METHODS This cross sectional study was conducted in diagnosed type 2 diabetes mellitus patients. They were divided in groups: Group I (n=37) with clinically detectable diabetic peripheral neuropathy of shorter duration and Group II (n=27) with clinically detectable diabetic peripheral neuropathy of longer duration. They were compared with T2DM patients (n=22) without clinical neuropathy. Clinical diagnosis was based on neuropathy symptom score (NSS) and neuropathy disability score (NDS) for signs. Nerve conduction velocity was measured in both upper and lower limbs. Median, ulnar, common peroneal and posterior tibial nerves were selected for motor nerve conduction study and median and sural nerves were selected for sensory nerve conduction study. RESULTS The comparisons were done between nerve conduction velocities of motor and sensory nerves in patients of clinically detectable neuropathy and patients without neuropathy in type 2 diabetes mellitus population. This study showed significant electrophysiological changes with duration of disease. Nerve conduction velocities in lower limbs were significantly reduced even in patients of shorter duration with normal upper limb nerve conduction velocities. CONCLUSION Diabetic neuropathy symptom score (NSS) and neuropathy disability score (NDS) can help in evaluation of diabetic sensorimotor polyneuropathy though nerve conduction study is more powerful test and can help in diagnosing cases of neuropathy.
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Affiliation(s)
- Gauhar Hussain
- Department of Physiology, J. N. Medical College Hospital, Aligarh Muslim University, Aligarh 202002, India
| | - S Aijaz Abbas Rizvi
- Department of Physiology, J. N. Medical College Hospital, Aligarh Muslim University, Aligarh 202002, India
| | - Sangeeta Singhal
- Department of Physiology, J. N. Medical College Hospital, Aligarh Muslim University, Aligarh 202002, India
| | - Mohammad Zubair
- Rajiv Gandhi Centre for Diabetes and Endocrinology, J. N. Medical College Hospital, Aligarh Muslim University, Aligarh 202002, India
| | - Jamal Ahmad
- Rajiv Gandhi Centre for Diabetes and Endocrinology, J. N. Medical College Hospital, Aligarh Muslim University, Aligarh 202002, India.
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Hussain G, Rizvi SAA, Singhal S, Zubair M, Ahmad J. Serum levels of TNF-α in peripheral neuropathy patients and its correlation with nerve conduction velocity in type 2 diabetes mellitus. Diabetes Metab Syndr 2013; 7:238-242. [PMID: 24290092 DOI: 10.1016/j.dsx.2013.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To compare serum levels of TNF-α in patients of peripheral neuropathy and patients without neuropathy in type 2 diabetes mellitus. MATERIAL AND METHODS This cross sectional study was conducted in diagnosed type 2 diabetes mellitus patients. They were divided in groups, Group I (n=37) with clinically detectable diabetic peripheral neuropathy of shorter duration and Group II (n=27) with clinically detectable diabetic peripheral neuropathy of longer duration. They were compared with patients without clinical neuropathy (n=22), clinical diagnosis was based on neuropathy symptom score (NSS) and neuropathy disability score (NDS) for signs. Blood samples were collected for baseline investigations and estimation of serum TNF-α. Nerve conduction velocity was measured in both upper and lower limbs. Median, Ulnar, Common Peroneal and Posterior Tibial nerves were selected for motor nerve conduction study and Median and Sural nerves were selected for sensory nerve conduction study. RESULTS The comparisons were done between various clinical and biochemical parameters in clinically detectable and undetectable peripheral neuropathy groups of type 2 diabetes mellitus. The study showed raised serum levels of TNF-α in peripheral neuropathy patients and significant correlation with nerve conduction velocity. CONCLUSION High level of TNF-α in serum of T2DM patients with neuropathy shows possible contribution in development of neuropathy. Due to its independent association this cytokine might be used as biomarker for diabetic peripheral neuropathy.
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Affiliation(s)
- Gauhar Hussain
- Department of Physiology, J.N. Medical College Hospital, Aligarh Muslim University, Aligarh, 202002, India
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Watson J, Zhao M, Ring D. Predictors of normal electrodiagnostic testing in the evaluation of suspected carpal tunnel syndrome. J Hand Microsurg 2010; 2:47-50. [PMID: 22282667 DOI: 10.1007/s12593-010-0012-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Accepted: 08/15/2010] [Indexed: 11/25/2022] Open
Abstract
Electrodiagnostic studies (electromyography and nerve conduction velocity; EMG/NCV) are used to confirm the diagnosis of carpal tunnel syndrome (CTS) and to evaluate its severity. We investigated the hypothesis that normal electrodiagnostic median nerve testing is predicted by 1) Physician pre-test confidence in the diagnosis of CTS, and 2) Puzzling patient factors. One hundred and forty consecutive patients who underwent electrodiagnostic testing to evaluate for possible CTS were reviewed retrospectively. Both physician confidence in the diagnosis of CTS and puzzling patient factors (heightened illness concern, disproportionate complaints, and vague/nonanatomical/noncharacteristic symptoms) were recorded. Electrodiagnostic testing was used as the reference standard for diagnosis of CTS. Electrodiagnostic testing confirmed CTS in 115 patients and was within normal limits in 25 patients. Low physician confidence in the diagnosis of CTS was highly predictive of a normal electrodiagnostic test (p < 0.001), with high sensitivity (97%), moderate specificity (40%), and high overall accuracy (87%). Puzzling patient factors were moderately predictive of normal electrodiagnostic testing (p < 0.001), with low sensitivity (16%), high specificity (96%), and high overall accuracy (81%). The best multivariable model retained younger age, negative Phalen's test, and low physician confidence as the best predictors of normal electrodiagnostic testing and explained 35% of the variation in test results. A model with low confidence alone explained 19% of the variation in test results. Physician intuition as recorded in the medical record in terms of puzzlement and low confidence are very specific and accurate predictors of normal electrodiagnostic testing in the setting of suspected carpal tunnel syndrome.
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Affiliation(s)
- Jeffrey Watson
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA
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