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Differential impairment of the sudomotor and nociceptor axon‐reflex in diabetic peripheral neuropathy
Author(s) -
Berghoff Martin,
Kilo Sonja,
Hilz Max J.,
Freeman Roy
Publication year - 2006
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.20497
Subject(s) - sudomotor , axon reflex , medicine , nociceptor , endocrinology , efferent , diabetic neuropathy , diabetes mellitus , peripheral neuropathy , microneurography , reflex , axon , type 2 diabetes , nociception , anatomy , afferent , blood pressure , baroreflex , heart rate , receptor
It is not known whether C‐fiber functional subclasses are differentially affected by diabetes mellitus or whether the patterns of C‐fiber dysfunction are different between type 1 and type 2 diabetes. We therefore examined efferent sympathetic sudomotor and primary afferent nociceptor C‐fiber function in diabetic patients. Acetylcholine (10%) was used to evoke C‐fiber (axon‐reflex)–mediated responses. The nociceptor (flare) response was measured using a laser Doppler device. The sudomotor response was quantified with silastic imprints. The nociceptor C‐fiber–mediated flare response was reduced in type 2 diabetic patients ( P < 0.008) but was similar to controls in type 1 diabetic patients. The sympathetic C‐fiber–mediated responses, including sweat volume ( P < 0.05) and the number of activated sweat glands ( P = 0.003), were increased in patients with type 1 diabetes. There also was a trend toward a larger axon‐reflex sweat area in patients with type 1 diabetes ( P = 0.09). No differences in these sweat responses were found in patients with type 2 diabetes compared to controls. These findings suggest that the functional abnormalities in diabetic peripheral neuropathy are not homogeneous and that C‐fiber subclasses are differentially affected in type 1 and 2 diabetes mellitus. Muscle Nerve, 2006