Common Peroneal Nerve Conduction Velocity Research Articles

Clinical research of modified Danggui-Sini decoction combined with Mecobalamin in treatment of diabetic peripheral neuropathy

Objective To investigate the clinical effect of modified Danggui-Sini decoction combined with Mecobalamin on diabetic peripheral neuropathy. Methods A total of 104 patients with diabetic peripheral neuropathy from January 2015 -2016 year in December in our hospital patients were randomly divided into study group and control group, each of 52 patients. The control group was given Mecobalamin 0.5 mg/times. The study group was given modified Danggui-Sini decoction plus the intervention of the observation group. Four weeks were a course of treatment. The clinical effect rates, the incidence of adverse events, change of common peroneal nerve conduction velocity, hemorheological indexes and advanced glycation end products (AGEs) were compared between the two groups before and after treatment. Results The total effective rate of the study group was 96.2%, which was significantly higher than 82.7% of the control group (χ2=4.981, P<0.05). During treatment, the incidence of adverse events was 5.8% in the study group, and the incidence of adverse events in the control group was 3.9%. There was no significant difference in the incidence of adverse reactions between two groups (P<0.05). After treatment, the motor nerve conduction velocity (49.1 ± 4.5 m/s vs. 42.8 ± 4.3 m/s) and sensory nerve conduction velocity (40.1 ± 3.7 m/s vs. 36.5 ± 3.9 m/s) in the study group were significantly higher than those in the control group (t=2.732, 2.723, P<0.05). The whole blood viscosity [(3.72 ± 0.58) mPa•s vs. (4.55 ± 0.47) mPa•s], plasma viscosity [(1.03 ± 0.12) mPa•s vs. (1.78 ± 0.09 ) mPa•s], erythrocyte blood pressure (31.23% ± 3.19% vs. 37.33% ± 4.12% ), AGEs (58.44 ± 4.87 ng/L vs. 68.03 ± 4.98 ng/L) in the observation group were significantly lower than those in the control group (t=2.704, -2.682, -2.737, -2.856, P<0.05). Conclusions The modified Danggui-Sini decoction combined with Mecobalamin on diabetic peripheral neuropathy can improve peripheral nerve conduction velocity, improve curative effect, showed fewer adverse events. Key words: Diabetic neuropathies; Dang Gui Si Ni Tang; Mecobalamin; Clinical study

Quantitative measures of sympathetic skin response in diabetes: relation to sudomotor and neurological function.

The sympathetic skin response (SSR) at the foot to a deep inspiration was measured in 68 randomly selected diabetic patients and 46 age matched normal subjects and compared with other quantitative measures of neurological and sudomotor function. SSR was obtained in all but three diabetic patients. The upper limit of normal for the onset latency was 2202 ms and the lower limit for the amplitude of the first wave 92 microV. Ten diabetic patients had measurable but prolonged latencies, and 11 had measurable but low amplitudes. There were no significant associations between latency, height, and age, but in insulin dependent patients there was a significant diminution of response amplitude with increasing duration of diabetes. Latency was weakly associated with Marstock thermal thresholds, respiratory RR variation, and common peroneal nerve conduction velocity. SSR amplitude was associated with the density of pilocarpine activatable sweatspots in the same region of the foot. Patients with abnormal latencies were significantly older and had reduced thermal sensation than those with normal latencies. Median coefficients of variation for repeat testing in diabetic patients were 9% for latency and 13% for amplitude. The test is objective and reproducible, but latency measurements reflect conduction in a long multineuronal pathway and are not purely a measure of peripheral C fibre function; amplitude measurements reflect the density of spontaneously activable sweat glands and are therefore a valid measure of peripheral sympathetic activity, though they depend more on temperature than do latencies (mean change over the range 32-34 degrees C; 8.5% degrees C for amplitude, -2.5%/degrees C for latency).

Absence of the sensory action potential of the medial plantar nerve: a sensitive indicator of diabetic neuropathy.

The sensory action potential of the medial plantar nerve (MPSAP), using needle recording electrodes subcutaneously, was measured in 119 patients with diabetes ((75 insulin-dependent, mean age 43.7 +/- 1.2 SEM years (range 15-73) and in 75 age-matched normal subjects (mean age 44.0 +/- 1.5 years (range 19-75)). The MPSAP was not detectable in 56 out of 119 diabetics; there was only one absent MPSAP response in the normal group, in a patient aged 71 years. Diabetics with absent MPSAP responses were significantly older, heavier and taller and had diabetes of longer duration. The amplitudes and conduction velocities in the sural, common peroneal, and tibial nerves were also significantly smaller. The amplitudes of the MPSAP, when present, correlated with height (r = -0.47(43), p less than 0.001), weight (r = -0.44(43), p less than 0.001), the distal tibial compound motor action potential (r = 0.37(43), p less than 0.01), and the common peroneal nerve conduction velocity (r = 0.32(43), p less than 0.02). The MPSAP was always absent if the sural SAP was less than 5uV but also in 14/59 patients whose sural SAP amplitudes were within 1 sd of the normal mean (greater than 10.7 uV). The MPSAP was absent at a younger age and with diabetes of shorter duration than is seen with unrecordable sural SAPs. It may therefore represent an early manifestation of neuropathy in diabetes.