Open AccessThermal quantitative sensory testing as a screening tool for cardiac autonomic neuropathy in patients with diabetes mellitus
Author(s) -
Potockova Veronika,
Mala Sarka,
Hoskovcova Lucie,
Capek Vaclav,
Nedelka Tomas,
Riedlbauchova Lucie,
Baumgartner Daniel,
Mensova Livie,
Mazanec Radim
Publication year - 2022
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.2506
Subject(s) - medicine , diabetes mellitus , diabetic neuropathy , peripheral neuropathy , physical examination , predictive value , autonomic neuropathy , cardiology , physical medicine and rehabilitation , endocrinology , biology , cell culture , genetics , neuroblastoma
Electrophysiological diagnosis of cardiac autonomic neuropathy (CAN) is based on the evaluation of cardiovascular autonomic reflex tests (CARTs). CARTs are relatively time consuming and must be performed under standardized conditions. This study aimed to determine whether thermal quantitative sensory testing (TQST) can be used as a screening tool to identify patients with diabetes at a higher risk of CAN. Methods Eighty‐five patients with diabetes and 49 healthy controls were included in the study. Neurological examination, CARTs, TQST, biochemical analyses, and neuropathy symptom questionnaires were performed. Results CAN was diagnosed in 46 patients with diabetes (54%). CAN‐positive patients with diabetes had significantly higher warm detection thresholds (WDT) and significantly lower cold detection thresholds (CDT) in all tested regions (thenar, tibia, and the dorsum of the foot). CDT on the dorsum < 21.8°C in combination with CDT on the tibia < 23.15°C showed the best diagnostic ability in CAN prediction, with 97.4 % specificity, 60.9% sensitivity, 96.6% positive predictive value, and 67.3% negative predictive value. Conclusion TQST can be used as a screening tool for CAN before CART.