Features of damage to the conductive structures of the nervous system in patients with vibration disease, burdened with diabetes mellitus and metabolic syndrome

Abstract

Introduction. Of interest are the processes developing in vibration disease (VD) in combination with metabolic syndrome (MS) or diabetes mellitus (DM), combined forms of diseases worsen their course and prognosis.
 The study aims to assess the features of the state of central afferent conductive structures and peripheral nerves in patients with vibration disease, burdened with diabetes mellitus or metabolic syndrome.
 Materials and methods. The scientists have examined 155 workers with VD — group one with an established diagnosis of VD (86 people); group two — with VD combined with DM (30 people); group three — with VD burdened with MS (39 people). The authors have conducted the electroneuromyographic examination and registration of somatosensory evoked potentials, with stimulation of the median nerve in the wrist. Abduction points — Erb point, cervical spinal cord, from the scalp of the projection area of the precentral gyrus. The researchers have applied multivariate discriminant analysis from the STATISTICA — version 6 application software package of StatSoft Inc (USA).
 Results. With VD complicated by MS, changes were in the distal part of the motor axons, with VD burdened with DM, the amplitude of the motor component of the median and tibial nerves decreased, the speed of the pulse in the proximal part of the median nerve. Somatosensory evoked potentials in VD in combination with MS revealed an increase in latency of N13 and N20. The duration of N13-N18, N13-N20, latency N18, N20, N30 increased in the case of WB, burdened with DM.
 Limitations. The limitation of the study is the use of unrelated samples for statistical analysis. The study of the state of central and peripheral conductive structures in connected samples should be considered evidence-based: metabolic syndrome and further — diabetes mellitus.
 Conclusion. The patterns of peripheral nerve damage in VD associated with exposure to general and local vibration, burdened with DM or MS, were disorders of afferent axons of the upper and lower extremities, as well as changes in the distal parts of the motor component of the tibial and median nerves. The features of the peripheral nerve states in VD, burdened with DM, were the complex involvement of the motor component in the pathological process, characterized by changes in the amplitude, pulse transit time at the level of the terminal unmyelinated fibers of the median and tibial nerves and changes in the proximal part of the median nerve. In VD complicated by MS, pathological changes were characteristic of the distal part of the motor axons. The patterns of afferent conductive structures lesion in VD, burdened with DM or MS, consisted in a violation of the activity of neurons of the cervical spinal cord and the somatosensory cortex. The peculiarity of the state of the central afferent conducting structures in VD, burdened with DM, was the slowing down of the afferent excitation wave in the area of thalamic structures to the somatosensory zone of the cortex, a violation of the conduction from the trunk to the cortical projections of the somatosensory zone. In case of VD, complicated by MS — the time of the afferent excitation wave at the level of the cervical spine and the somatosensory cortex.
 Ethics. Conclusion of the MEC of the Federal State Budgetary Scientific Institution "East Siberian Institute of Medical and Environmental Research" No. 32 dated 09.10.2019.