| 1. |
- Løseth, Sissel, et al.
(författare)
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Small and large fiber neuropathy in those with type 1 and type 2 diabetes : a 5-year follow-up study
- 2016
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Ingår i: Journal of the peripheral nervous system. - : Wiley. - 1085-9489 .- 1529-8027. ; 21:1, s. 15-21
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to evaluate progression of diabetic polyneuropathy and differences in the spectrum and evolution of large- and small-fiber involvement in patients with diabetes type 1 and 2 over 5 years. Fifty-nine patients (35 type 1 and 24 type 2) were included. Nerve conduction studies (NCS), quantitative sensory testing, skin biopsy for quantification of intraepidermal nerve fiber density (IENFD), symptom scoring and clinical evaluations were performed. Z-scores were calculated to adjust for the physiologic effects of age and height/gender. Neuropathic symptoms were not significantly more frequent in type 2 than in type 1 diabetic patients at follow-up (54% vs. 37%). The overall mean NCS Z-score remained within the normal range, but there was a small significant decline after 5 years in both groups: type 1 (p = 0.004) and type 2 (p = 0.02). Mean IENFD Z-scores changed from normal to abnormal in both groups, but only significantly in those with type 2 diabetes (reduction from 7.9 +/- 4.8 to 4.3 +/- 2.8 fibers/mm, p = 0.006). Cold perception threshold became more abnormal only in those with type 2 diabetes (p = 0.049). There was a minimal progression of large fiber neuropathy in both groups. Reduction of small fibers predominated and progressed more rapidly in those with type 2 diabetes.
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| 2. |
- Marrero, Humberto Gonzalez, et al.
(författare)
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Optimizing testing methods and collection of reference data for differentiating critical illness polyneuropathy from critical illness myopathy.
- 2016
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Ingår i: Muscle and Nerve. - : Wiley. - 0148-639X .- 1097-4598. ; 53:4, s. 555-563
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: In severe acute quadriplegic myopathy in intensive care unit (ICU) patients, muscle fibers are electrically inexcitable; in critical illness polyneuropathy the excitability remains normal. Conventional electrodiagnostic methods do not provide the means to adequately differentiate between them.OBJECTIVE: To further optimize methodology for the study of critically ill ICU patients and to create a reference database in healthy controls.METHODS: Different electrophysiologic protocols were tested to find sufficiently robust and reproducible techniques for clinical diagnostic applications.RESULTS: Many parameters show large test-retest variability within the same healthy subject. Reference values have been collected and described as a basis for studies of weakness in critical illness.DISCUSSION: Using the ratio of neCMAP/dmCMAP (response from nerve and direct muscle stimulation), refractory period, and stimulus-response curves may optimize the electrodiagnostic differentiation of patients with critical illness myopathy from those with critical illness polyneuropathy.
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| 3. |
- Nandedkar, Sanjeev D., et al.
(författare)
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Cumulative Motor Index : An Index to Study Progression of Amyotrophic Lateral Sclerosis
- 2015
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Ingår i: Journal of clinical neurophysiology. - 0736-0258 .- 1537-1603. ; 32:1, s. 79-85
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:To study disease progression in patients with amyotrophic lateral sclerosis (ALS), we have developed the cumulative motor index (CMI) using the compound muscle action potential amplitude recorded in multiple upper and lower limb muscles.Methods:To study its reproducibility, CMI was measured by 2 operators in 10 healthy subjects on 2 occasions. In 15 patients with ALS, CMI and ALS functional rating score (revised) were measured at 3- to 6-month interval for 12 months or longer.Results:The CMI had good reproducibility in healthy subjects. In one patient with ALS, CMI and ALS functional rating score (revised) remained relatively unchanged. In all remaining 14 patients with disease progression, CMI decreased in a relatively monotonic manner. At 1 year after baseline study, CMI was reduced more than ALS functional rating score (revised) in 10 patients. CMI measurements were possible for longer time period, than analysis from a single distal muscle recording.Conclusions:The CMI can be measured using standard equipment and software available in most electrodiagnostic laboratories. This may be a simple measurement that can be used for clinical studies of ALS progression over longer time periods.
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