Peripheral Nerve Conduction Velocity Research Articles

416 The Impact of Pancreas Transplantation on Secondary Diabetic Complications: A Systematic Review

Abstract Aim Pancreas transplantation (PT) provides diabetic cure for patients with complicated Type 1 Diabetes Mellitus (T1DM). We aimed to examine the impact of PT on secondary diabetic complications, including retinopathy, neuropathy, and cardiovascular disease. Method A database search using MedLINE for publications up to April 2023 was conducted employing MeSH terms ‘Pancreas Transplantation’ AND ‘Diabetes Mellitus, Type 1’ AND ‘Diabetic Retinopathy’ OR ‘Heart Disease’ OR ‘Cardiovascular Diseases’ OR ‘Peripheral Vascular Disease’ OR “Amputation’ OR ‘Neuropathy.” Results 223 articles were screened, with 172 excluded as per study design (total included 51). 64.7% (n=33) of studies were retrospective case control studies, 35.3% (n=18) of studies were retrospective cohort studies. A total of 5616 patients with a mean of 99.1 (SD± 262.4) simultaneous kidney transplant (SPK) patients and 48.2 (SD± 262.4) pancreas transplant alone (PTA) patients per article were studied. All articles examining diabetic retinopathy concluded that retinopathy improved or stabilized. 69% (n=11) of papers demonstrated no significant change to visual acuity. An equal number of articles (n=4) demonstrated increased peripheral nerve conduction velocity after SPK and PTA. 40% (n=2) of articles examining vibration perception studies demonstrated an increase post-transplantation. Improvements in cardiac events incidence, metabolic factors, and heart structure were seen in 79% (n=15) of cardiovascular articles. Conclusions Despite significant heterogeneity in outcome measures observed, PT provides benefits in mitigating the complication profile of T1DM. Standardised outcome measurement should be adopted to allow assessment of the impact of beta-cell replacement with the potential for objective evidence reversibility of secondary complications.

The Relationship Between UA/HDL and Diabetic Peripheral Neuropathy: A Cross-Sectional Analysis.

This study was designed to analyze correlations between the uric acid to high-density lipoprotein cholesterol ratio (UHR) and peripheral nerve conduction velocity (NCV) among type 2 diabetes mellitus (T2DM) patients. This was a single-center cross-sectional analysis of 324 T2DM patients. All patients were separated into a group with normal NCV (NCVN) and a group with abnormal NCV (NCVA). Patients were also classified into groups with low and high UHR values based on the median UHR in this study cohort. Neurophysiological data including motor and sensory conduction velocity (MCV and SCV, respectively) were measured for all patients. Relative to patients with low UHR values, those in the high UHR group presented with greater NCVA prevalence (P = 0.002). UHR remained negatively correlated with bilateral superficial peroneal nerve SCV, bilateral common peroneal nerve MCV, bilateral ulnar nerve SCV, and bilateral right median nerve MCV even after adjustment for confounding factors. UHR was identified as an NCVA-related risk factor, with a 1.370-fold increase in NCVA prevalence for every unit rise in UHR(P < 0.001). These results identify UHR as a risk factor associated with NCVA that was independently negatively associated with NCV among T2DM patients.

Mitofusin 2 Variant Presenting With a Phenotype of Multiple System Atrophy of Cerebellar Subtype.

To investigate the etiology of cerebellar ataxia in an adult male patient. We performed standard neurologic assessment and genome sequencing of a 62-year-old man with rapidly progressive balance and gait abnormalities. The propositus exhibited cognitive dysfunction, mild appendicular bradykinesia, prominent appendicular ataxia, dysarthria, and hypomimia with minimal dysautonomic symptoms. Nerve conduction studies showed mild peripheral sensory neuropathy and normal motor nerve conduction velocities. Brain imaging showed progressive cerebellar atrophy and gliosis of the olivopontocerebellar fibers, characterized by T2 hyperintensity within the pons. Genetic testing revealed a likely pathogenic germline variant in MFN2 (NM_014874: c.[838C>T];[=], p.(R280C)) in the GTPase domain (G) interface; pathogenic variants of MFN2 typically cause hereditary sensory and motor neuropathy VI or Charcot-Marie-Tooth disease 2A. The presence of progressive ataxia, "hot cross bun" sign, and dysautonomia has been associated with multiple system atrophy, cerebellar type (MSA-C). We describe progressive cerebellar ataxia in an individual with a deleterious variant in MFN2. Our findings suggest that pathogenic variants in MFN2 can result in a spectrum of phenotypes including cerebellar ataxia with cerebellar-pontine atrophy in the absence of significant neuropathy and in a manner closely resembling MSA-C.

Slowing of Peripheral Nerve Conduction Velocity in Children and Adolescents With Type 1 Diabetes Is Predicted by Glucose Fluctuations.

There is a strong need for the better identification of early subclinical manifestations of microvascular complications, such as diabetic peripheral neuropathy, in young individuals with diabetes. To identify peripheral neuropathy and contributing factors at an asymptomatic disease stage, and to exclude height as a known modifying factor, we performed association studies of height-adjusted nerve conduction velocity. We identified high glucose variability, especially the SD of mean glucose, as an unexpectedly strong predictor of slowed nerve conduction velocity. More attention should be paid to the goal of low glucose variability in the care of individuals with diabetes.

Assessment of peripheral nerve conduction in iron deficiency anemia patients in Indian rural adult population attending a tertiary care hospital

Background: Iron deficiency anemia (IDA) is the most common nutritional deficiency anemia in India. Peripheral neuropathy can result due to iron deficiency as it disrupts myelination and neuronal energetics in neuronal functioning. Nerve conduction studies (NCS) can quantitatively detect peripheral nerve dysfunction. This study was conducted to observe effect of IDA on peripheral nerve conduction velocity in adults using neuroelectrophysiological techniques with the aim to recommend Complete Blood Count for serologic evaluation of patients with peripheral neuropathy in Indian population. Objectives: This study aims to compare motor and sensory nerve conduction study parameters between controls and IDA patients and evaluate the effect of various grades of IDA on motor and sensory nerves. Methodology: 30 newly diagnosed patients of IDA in age group of 20-45 yrs and 30 healthy controls in same age group were recruited in this study. NCS was conducted on bilateral motor and sensory median and ulnar nerves in Neurophysiology laboratory using Neurosoft machine. Neuroelectrophysiological data of both the groups was evaluated and analysed using Student’s unpaired t test. Also, patients were categorised as mild, moderate and severe anemia cases and one way ANOVA was used for comparison among patients with various grades of anemia. Results: CMAP (compound muscle action potential), SNAP (sensory nerve action potential) and nerve conduction velocity (NCV) of bilateral median and ulnar nerves was reduced and DL (distal latency) was increased in bilateral median and ulnar nerves in patients with IDA compared to controls. The results were statistically significant (p=0.001). A highly significant difference between motor and sensory nerve conduction values between mild, moderate and severe IDA patients was also observed (p=0.001). Conclusion: The results of the study confirmed peripheral nerves involvement in IDA patients. As severity of anemia increases, peripheral neuropathy worsens. These results can be extrapolated for screening patients with peripheral neuropathy for iron deficiency as a routine part of diagnostic approach for peripheral neuropathy.

P17-067-23 Peripheral Nerve Conduction Velocities in Malnourished Bangladeshi Children Before and After Nutrition-Specific Intervention

P17-067-23 Peripheral Nerve Conduction Velocities in Malnourished Bangladeshi Children Before and After Nutrition-Specific Intervention

The Retinal Nerve Fiber Layer Thickness Is Associated with Systemic Neurodegeneration in Long-Term Type 1 Diabetes.

To determine whether the retinal nerve fiber layer thickness can be used as an indicator for systemic neurodegeneration in diabetes. We used existing data from 38 adults with type 1 diabetes and established polyneuropathy. Retinal nerve fiber layer thickness values of four scanned quadrants (superior, inferior, temporal, and nasal) and the central foveal thickness were extracted directly from optical coherence tomography. Nerve conduction velocities were recorded using standardized neurophysiologic testing of the tibial and peroneal motor nerves and the radial and median sensory nerves, 24-hour electrocardiographic recordings were used to retrieve time- and frequency-derived measures of heart rate variability, and a pain catastrophizing scale was used to assess cognitive distortion. When adjusted for hemoglobin A1c, the regional thickness of the retinal nerve fiber layers was (1) positively associated with peripheral nerve conduction velocities of the sensory and motor nerves (all P < 0.036), (2) negatively associated with time and frequency domains of heart rate variability (all P < 0.033), and (3) negatively associated to catastrophic thinking (all P < 0.038). Thickness of the retinal nerve fiber layer was a robust indicator for clinically meaningful measures of peripheral and autonomic neuropathy and even for cognitive comorbidity. The findings indicate that the thickness of the retinal nerve fiber layer should be studied in adolescents and people with prediabetes to determine whether it is useful to predict the presence and severity of systemic neurodegeneration.

A Case Series of Patients With MYBPC1 Gene Variants Featuring Undulating Tongue Movements as Myogenic Tremor

Myosin-binding protein C1 (MYBPC1) encodes myosin-binding protein C, slow type (sMyBP-C), an accessory protein that regulates actomyosin cross-linking, stabilizes thick filaments, and modulates contractility in muscle sarcomeres and has recently been linked to myopathy with tremor. The clinical features of MYBPC1 mutations manifesting in early childhood bear some similarities to those of spinal muscular atrophy (SMA), such as hypotonia, involuntary movement of the tongue and limbs, and delayed motor development. The development of novel therapies for SMA has necessitated the importance of differentiating SMA from other diseases in the early infancy period. We report the characteristic tongue movements of MYBPC1 mutations, along with other clinical findings, such as positive deep tendon reflexes and normal peripheral nerve conduction velocity testing, which could help in considering other diseases as differential diagnoses.

Randomized double-blind, placebo-controlled study of oral gabapentin for prevention of neuropathy in patients receiving paclitaxel

BackgroundPeripheral neuropathy is a common dose-limiting side effect of paclitaxel. To date, there is no effective strategy to prevent paclitaxel-induced peripheral neuropathy. A recent small phase II study demonstrated the potential role of oral gabapentin in this setting. This phase III study is aimed to assess the efficacy of oral gabapentin in preventing paclitaxel-induced neuropathy.ObjectiveTo compare the efficacy of oral gabapentin with placebo in preventing clinically significant peripheral neuropathy (NCI CTCAEv5.0 grade 2 or higher) in patients receiving paclitaxel.MethodsThis is a randomized, placebo-controlled, double-blind, parallel-group superiority trial. The primary outcome is the development of grade 2 or higher chemotherapy-induced peripheral neuropathy. Secondary outcomes include any grade neuropathy, the percentage change in sensory nerve conduction velocities in peripheral nerves, time to development of any grade neuropathy, paclitaxel dose reductions and delays due to peripheral neuropathy, patient-reported outcomes, adverse events, and adherence to oral therapy. A total of 136 patients receiving paclitaxel will be randomly allocated (stratified by weekly vs. non-weekly administration) to receive either oral gabapentin or placebo till three weeks after the last dose of chemotherapy or occurrence of the primary outcome.ConclusionThis study aims to find if oral gabapentin reduces the incidence of grade 2 or higher chemotherapy-induced peripheral neuropathy in patients receiving paclitaxel.Trial registrationThe trial is registered prospectively with the Clinical Trials Registry of India (CTRI/2022/02/040030) on April 4, 2022.

Enzyme replacement therapy for children with acid sphingomyelinase deficiency in the real world: A single center experience in Taiwan

BackgroundAcid sphingomyelinase deficiency (ASMD) is a lysosomal storage disease with multi-systemic involvement, with no disease-modifying treatment available. Olipudase alfa is an investigational enzyme product developed to replace the deficient acid sphingomyelinase in ASMD patients. Several clinical trials have reported promising safety and efficacy results in adult and pediatric patients. However, no data have been reported outside of the clinical trial setting yet. This study aimed to evaluate major outcomes in pediatric chronic ASMD patients receiving olipudase alfa in the real-world setting. Materials and methodsTwo children with type A/B (chronic neuropathic) ASMD have received olipudase alfa treatment since May 2021. Clinical parameters, including height, weight, complete blood count, liver function tests, lipid profiles, biomarkers, abdominal ultrasonography with shear wave elastography, chest computed tomography, nerve conduction studies, neurodevelopmental evaluations, and six-minute walk tests, were checked at baseline and every three to six months in the first year of enzyme replacement therapy (ERT) to assess its efficacy and safety. ResultsThe two patients in our study started olipudase alfa treatment at the age of 5 years and 8 months and 2 years and 6 months. During the first year of treatment, both patients saw a reduction in their hepatic and splenic volumes as well as liver stiffness. Height z-score, weight z-score, lipid profiles, biomarker levels, interstitial lung disease scores, and bone mineral densities also improved over time. The six-minute walk test showed a gradual increase in walking distance in both patients. There were no obvious improvements or deterioration in neurocognitive function and peripheral nerve conduction velocities after treatment. No severe infusion-associated reactions were noted during the first year of treatment. One patient had two episodes of transient but significantly elevated liver enzymes during the dose-escalation phase. The patient was asymptomatic, and the impaired liver function resolved spontaneously within two weeks. ConclusionOur results provide real-world experience that olipudase alfa is safe and effective in improving major systemic clinical outcomes for pediatric chronic ASMD patients. Monitoring of liver stiffness by shear wave elastography is a noninvasive procedure that can monitor treatment efficacy during ERT.

Efficacy of electroacupuncture with different frequencies in the treatment of chemotherapy-induced peripheral neuropathy: A study protocol for a randomized controlled trial.

IntroductionChemotherapy-induced peripheral neuropathy (CIPN) is a common complication in patients with cancer during chemotherapy. It mainly leads to severe numbness of the hands and feet and causes great pain in patients. Electroacupuncture (EA) is considered to be beneficial in improving peripheral neuropathy and relieving numbness of the hands and feet. This trial aims to evaluate the therapeutic effect of different frequencies of EA on CIPN in patients with cancer.Methods and analysisThis study is a randomized controlled trial. In total, 160 eligible CIPN patients are randomly assigned to the 2 Hz EA group, 100 Hz EA group, 2/100 Hz EA group, and control group in the ratio of 1:1:1:1. All patients in the EA treatment groups receive treatment with EA three times a week for 4 weeks and following up for 4 weeks. The patients in the control group are given Mecobalamin (MeCbl) tablets orally, one tablet at a time, three times a day, for 4 weeks, and following up for 4 weeks. The primary outcome measures are the participant neurotoxicity questionnaire (PNQ) and the peripheral neurotoxicity assessment rating (NCI CTCAE V5.0). Secondary outcomes are the quality of life scale (EORTC QLQ-C30) and the measurement of peripheral nerve conduction velocity (NCV). The results are evaluated at baseline, post-treatment phase, and following up for 4 weeks. All major analyses are based on the intention to treat principle.Ethics/disseminationThis protocol was approved by the Medical Ethics Committee of the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) on 7 December 2021. The license number is IRB-2021-458. This study provides clinical efficacy data of different frequencies of EA in the treatment of CIPN. The results help to prove whether EA is an effective therapy for CIPN and optimize the frequency of EA for CIPN. The results of this study are shared with health care professionals, the public, and relevant organizations through the publication of manuscripts and conference reports.Trial registration numberChiCTR2100054458.

Identification of Male-Specific Molecular Markers by Recombination of RhoGEF10 Gene in Spotted Knifejaw (Oplegnathus punctatus).

The spotted knifejaw (Oplegnathus punctatus) is a marine economic fish with high ecological value, food value, and fishing value, and its growth has obvious sex dimorphism. The rapid identification of its sex is beneficial to the development of sex determination and breeding. In this study, the method of comparative genomics and PCR amplification was used to further establish a rapid detection method for the recombinant RhoGEF10 gene in O. punctatus, which can quickly, accurately, and efficiently identify the sex of the O. punctatus to be tested. The homologous comparison results of male and female individuals showed that the DNA fragment length of the RhoGEF10 gene on the X1 chromosome was 326 bp, and the DNA fragment length on the Y chromosome was 879 bp. Therefore, it can be concluded that there is an insert fragment of 553 bp on the Y chromosome. PCR amplification results showed that the two DNA fragments of 879 bp and 326 bp were amplified in the Y chromosome and X1 chromosome of the male O. punctatus (X1X2Y), respectively, and the 879 bp fragment was a unique marker fragment of the recombinant RhoGEF10 gene; The female O. punctatus (X1X1X2X2) only a single DNA fragment of 326 bp was amplified. At the same time, the inserted fragment of the male individual resulted in partial inactivation of the RhoGEF10 protein, which in turn resulted in a slowing of peripheral nerve conduction velocity and thinning of the myelin sheath in male O. punctatus. The method shortens the time for accurate identification of the O. punctatus RhoGEF10 gene recombination and improves the detection efficiency. It is of great significance and application value in the research of nerve conduction and myelin development, male and female sex identification, the preparation of high male seedlings, and family selection based on the RhoGEF10 gene in the O. punctatus.

Reduced Peripheral Nerve Conduction Velocity is Associated with Alzheimer's Disease: A Cross-Sectional Study from China.

PurposeElderly individuals with degenerative diseases of the central nervous system are more likely to develop peripheral neuropathy; however, research is limited as to whether the decline in peripheral nerve conduction can be used as a biomarker of Alzheimer’s disease (AD).Patients and MethodsThis study enrolled 74 patients with mild cognitive impairment (MCI), 21 with AD, and 82 healthy elderly individuals. All participants underwent a peripheral nerve conduction and neuropsychological evaluation. Nicolet EDX was used to assess peripheral nerve conduction in the limbs and comparisons were made between the three cognitive groups. Furthermore, the relationship between peripheral nerve conduction and cognitive function was investigated.ResultsA ladder-shaped difference was found in the median (p < 0.001) and common peroneal (p < 0.001) motor nerve velocity, with the control group > MCI group > AD group, even after controlling for variables. The median motor nerve amplitude in the AD group was lower than that in the control group (P = 0.017). After controlling for age, sex, education, and height, the median motor nerve velocity was positively correlated with the Montreal Cognitive Assessment (r = 0.196, p = 0.015), and the common peroneal motor nerve velocity was positively correlated with verbal fluency task-idioms (r = 0.184, p = 0.026). The median (AUC: 0.777, p < 0.001) and common peroneal motor nerve velocities (AUC: 0.862; p < 0.001) were significantly associated with the diagnosis of AD. The accuracy rate of these two motor nerve velocities to predict AD was 51.5%.ConclusionOur study found that peripheral motor nerve velocity may correlate with early cognitive impairment in AD. However, the accuracy of different cognitive classifications and the value of early diagnosis are not ideal when peripheral motor nerve velocity is used alone. Whether peripheral nerve function can be used as a marker for early diagnosis of AD needs further clarification but provides a new possibility for the future of biomarker research.

Electroneurography abnormality in Parkinson’s disease: a potential biomarker to help diagnosis

Parkinson’s disease (PD) is a common neurodegenerative disease, pathologically characterized by the progressive degeneration of dopaminergic neurons in the substantia nigra. Although various biomarkers and imaging criteria for PD have been established, objective and reliable evaluation methods are still lacking. Electroneurography, as an objective measurement of evoked compound muscle action potentials, is used to assess the integrity of the peripheral nerve and is important in the diagnosis and differential diagnosis of PD with neuromuscular injury. Moreover, it provides references for the evaluation and quantification of the motor function in PD. Here, we summarize recent advances in clinical research of electroneurography in PD, including the peripheral nerve conduction velocity, needle electromyography, surface electromyography, and motion unit number estimation. The potential values of electroneurography in PD diagnosis are also involved.

Correlation Between Hemoglobin Glycosylation Index and Nerve Conduction Velocity in Patients with Type 2 Diabetes Mellitus.

ObjectiveThis study aimed to investigate the relationship between hemoglobin glycation variation index (HGI) and peripheral nerve conduction velocity (NCV) in patients with type 2 diabetes mellitus (T2DM).Materials and MethodsThis is a cross-sectional study, including 324 patients with T2DM were included in this study. Basic information and blood indicators were collected. The motor conduction velocities (MCV) of the bilateral ulnar nerve, median nerve, and common peroneal nerve, and the sensory conduction velocities (SCV) of the ulnar nerve, median nerve, and superficial peroneal nerve were measured. The patients were divided into two groups according to the NCV: normal nerve conduction group (NCVN group) and abnormal nerve conduction group (NCVA group). When the NCV is less than the specific normal value, the patients were divided into the NCVA group. HGI was calculated as the difference between the measured and predicted values of glycosylated hemoglobin (HbA1c) using the linear relationship between HbA1c level and fasting plasma glucose levels. At last, all study participants were divided into High HGI and Low HGI groups using the median of HGI as the boundary. The study also analyzed the correlation between HGI and NCV.ResultsCompared to the NCVN group, the HGI levels of the NCVA group were higher (P < 0.001). The prevalence of NCVA in the high HGI group was higher than that in the low HGI group (P = 0.004). HGI was negatively correlated with bilateral ulnar nerve MCV, bilateral median nerve MCV, bilateral common peroneal nerve MCV, bilateral median nerve SCV and left superficial peroneal nerve SCV, and the correlation still existed after adjusting for confounding factors.ConclusionThis study found that HGI is inversely associated with NCV in patients with T2DM, and this correlation is higher between HGI and MCV of peripheral nerve.

Association of peripheral neuropathy with retinopathy in diabetic patients

Introduction: Diabetes mellitus one of the major cause of avoidable blindness where patients with diabetic retinopathy are 25 times more likely to become blind than the non diabetic. Diabetic retinopathy and neuropathy being the major microvascular complications of diabetes, the aim of this study is to determine the association of retinopathy with peripheral neuropathy in diabetic patients in a tertiary care hospital. Materials and Methods: Study included diabetic patients with age more than 35years of age with a total number of 150 patients attending ophthalmology outpatient department of Saveetha medical college and Hospital. They underwent a detailed ocular examination and fundus examination to know the prevalence and severity of diabetic retinopathy. Peripheral neuropathy was assessed by doing a nerve conduction velocity of peripheral nerves in all patients. The results were evaluated to ascertain the prevalence of diabetic retinopathy and to establish an association with diabetic peripheral neuropathy. Results: Among the study population the mean age of the patients was 58+/-8.5 and males were affected more than females. The occurrence of complications increased with an increase in HbA 1c values. The prevalence of diabetic neruropathy was 72% and diabetic retinopathy was 44%. The prevalence of diabetic retinopathy in individuals with diabetic peripheral neuropathy was 51% which was 1.75 times more than without diabetic neuropathy (29%). This helps us to know the magnitude of problem of diabetic retinopathy and to timely treat it. Keywords: Diabetic retinopathy, Diabetic neuropathy, Correlation, Risk factors.

Changes of Peripheral Nerve Function and Vitamin B12 Level in People With Parkinson's Disease.

Background and Purpose: Peripheral nerve function plays an important role in balance control. Impairment of peripheral sensory information appears in people with Parkinson's disease (PD). Furthermore, there is a link between peripheral nerve disorders and vitamin B12 level. Here, we studied whether there were deficits of peripheral nerve function and vitamin B12 level, which may lead to decreased postural stability in PD.Methods: Fifty PD and 50 age-matched healthy subjects were enrolled in the study. This study evaluated folic acid and vitamin B12 levels in serum. Postural balance was studied according to the clinical Tinetti scale. Some comprehensive physiological assessments of peripheral nerve functions, including peripheral sensation, the perception of temperature, pain, and touch sensations, were also undertaken in this study.Results: Compared with the control group, vitamin B12 and folic acid were decreased in PD (P < 0.05). Furthermore, the PD group exhibited declines in peripheral nerve functions, including touch, temperature, pain, and nerve conduction velocity (P < 0.05). Statistical tests identified a significant association between decreased peripheral nerve function and poor balance according to the Tinetti scale (P < 0.05). Low vitamin B12 levels were also associated with deficits of peripheral nerve function, cumulative levodopa dose, and poor balance in PD (P < 0.05).Conclusions: Data suggested that peripheral nerve function was impaired in people with PD. Deficits of sensory input and low vitamin B12 level may contribute to balance deficits in PD.

Correlation Between Thioredoxin-Interacting Protein and Nerve Conduction Velocity in Patients With Type 2 Diabetes Mellitus

Aims: To investigate the correlation between thioredoxin-interacting protein (TXNIP) and peripheral nerve conduction velocity (NCV) in patients with type 2 diabetes mellitus.Methods: In total, 338 patients with type 2 diabetes mellitus (T2DM) were included in this study. We collected the clinical data and measured the motor conduction velocities of the bilateral ulnar nerve, median nerve, tibial nerve, and common peroneal nerve, and the sensory conduction velocities of the ulnar nerve, median nerve, sural nerve, and superficial peroneal nerve. According to the results, the patients were divided into two groups: normal peripheral nerve conduction group (NCVN group) and abnormal peripheral nerve conduction group (NCVA group). The two groups were then compared in terms of the conventional biochemical index and the sugar metabolic index as well as the serum levels of TXNIP, reduced glutathione (GSH), total superoxide dismutase (SOD), malondialdehyde (MDA), and tumor necrosis factor alpha (TNF-α). The correlation between TXNIP and NCV was also analyzed.Results: Compared with the NCVN group, the TXNIP and MDA values were significantly increased in the NCVA group (P < 0.05). Among the patients with T2DM, age, fasting glucose, SDBG, and TXNIP were risk factors for NCV abnormality, while vitamin D3 was a protective factor. After adjusting for related confounding factors, TXNIP was significantly correlated with NCV (P < 0.05). Among the patients with T2DM, TXNIP was an independent risk factor for left ulnar motor conduction velocity (MCV), right ulnar MCV, left median MCV, and right median MCV. TNF-α was identified as a positive influencing factor for serum TXNIP, while serum TXNIP was a positive factor for TNF-α and MDA (both P < 0.05).Conclusion: Serum TXNIP is related to NCV in T2DM patients. In combination with oxidative stress and inflammation, TXNIP may affect diabetic peripheral neuropathy (DPN).

Decrease of peripheral resistance after intraoperative administration of iloprost in patients with and without type 2 diabetes mellitus and with peripheral arterial occlusive disease.

Background:In many cases, Ilomedin® infusions are applied as part of a perioperative measure in patients with peripheral arterial occlusive disease because it makes a relevant vasodilatatory effect in patients with type 2 diabetes mellitus and with/without peripheral neuropathy.Aims:A prospective case–control study was performed to investigate the effect of prostanoids on peripheral resistance in patients with type 2 diabetes mellitus and patients without type 2 diabetes mellitus, as well as the role of peripheral neuropathy in patients undergoing arterial reconstruction.Methods:Sixty patients undergoing arterial reconstruction were enrolled. Sufficient data were collected on 38 patients. Prior to surgery, peripheral nerve conduction velocity was measured. Blood flow volume at the common femoral artery was assessed intraoperatively using a Doppler flowmeter at four time points: at baseline before arterial reconstruction (T0), after reconstruction (T1), after 5 (T2) and 10 min (T3) after intra-arterial application of 3000 ng of Ilomedin. Peripheral resistance units were calculated as a function of mean arterial pressure and flow volume using the following formula: peripheral resistance unit = mean arterial pressure (mm Hg) / flow volume (mL/min).Results:Ilomedin produced an immediate and significant drop of peripheral resistance in patients without type 2 diabetes mellitus as well as in patients with type 2 diabetes mellitus. Patients with peripheral neuropathy showed a less pronounced effect to Ilomedin compared to individuals with normal nerve conduction velocity.

Correlation Between Forearm Positions Across Elbow Joint and Ulnar Nerve Conduction Velocity Among Mobile Hand-Held Users

Abstract: Background: Extensive use of mobile hand-held devices with prolonged forearm pronation and elbow flexion could result in pain and weakness with decreased nerve conduction velocities (NCV) of peripheral nerves. Purpose: To identify the ulnar nerve conduction velocity at different forearm positions across elbow joint in mobile-hand held devices users. Design of the study: One shot case study Subjects: Fifty healthy subjects from both genders, Their age ranged from 20 to 40 years old. All subjects had body mass index BMI between 18.5 and 24.9 Kg/m2. Method: Electromyography (EMG) was used for measuring ulnar NCV across elbow joint at different angles (0, 45, and 90,120) degrees of elbow flexion with different forearm positions (supination and pronation). Result: Multivariate Analysis of Variance (MANOVA) revealed that there was a statistical significant difference in mean values of ulnar nerve conduction velocities at different angles of elbow flexion with forearm supination and pronation (P=0.001). There was a statistical significant difference in mean values of ulnar nerve conduction velocities between forearm pronation and supination at the different angles of elbow flexion (P=0.001). Conclusion: forearm supination with full extension elbow position showed the most significant increase in ulnar nerve conduction velocity than other positions. As well as the best position for elbow joint during using mobile hand held devices is 0°-45° elbow flexion with elbow supinated.