Abstract

Sir, We read with great interest the article by Shun et al . (2004) recently published in your journal. The authors report on a significant skin denervation and its correlations with diabetes duration and functional impairments. On nerve conduction studies, they observed abnormal findings in only ∼50% of diabetic patients. It is well known that conventional nerve conduction tests fail to detect function of the most distal part of sensory nerve fibres or receptors. Recently we reported on a neurophysiological pattern providing data on the most extreme segments of peripheral sensory nerves (Aprile et al ., 2003). During conventional orthodromic sensory conduction studies using submaximal stimulus intensity, a sensory response characterized by a morphology with two peaks (double peak potential) is observed; …

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