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Sural sensory action potential identifies diabetic peripheral neuropathy responders to therapy
Author(s) -
Vinik Aaron I.,
Bril Vera,
Litchy William J.,
Price Karen L.,
Bastyr Edward J.
Publication year - 2005
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.20423
Subject(s) - sural nerve , medicine , snap , peripheral neuropathy , nerve conduction velocity , compound muscle action potential , peripheral , diabetic neuropathy , surgery , diabetes mellitus , electrophysiology , endocrinology , computer graphics (images) , computer science
Identifying patients with diabetic peripheral neuropathy (DPN) amenable to therapy is a challenge. To determine whether the amplitude of the sural sensory nerve action potential (sural SNAP) reflects the severity of DPN, an analysis was performed on 205 patients with DPN, identified by an abnormal vibration detection threshold (VDT), who were enrolled in a multinational clinical trial investigating ruboxistaurin (RBX) mesylate. Nerve conduction velocity and response amplitude and latency were measured and compared. VDT was significantly lower in those with preserved sural SNAPs ( n = 128) than in those in whom they were absent ( n = 77; 21.5 vs. 22.7 JND units, P = 0.002). Thus, preserved sural SNAP denoted less severe DPN. Logistic regression analyses evaluating baseline characteristics, HbA 1c , and baseline symptom scores identified only DPN duration as a factor that might contribute to the presence of sural SNAP ( P = 0.004; OR = 0.896). For patients with abnormal VDT, preserved sural SNAP identifies a patient population with less severe DPN who may respond to therapeutic intervention in clinical trials. Muscle Nerve, 2005