Peripheral Nerves In Patients Research Articles

Long-term Follow-up and Histological Correlation of Peripheral Nervous System Alterations in Neurofibromatosis Type\xa02

PurposeTo examine long-term alterations of the dorsal root ganglia (DRG) and the peripheral nerve in patients with neurofibromatosis type 2 (NF2) by in vivo high-resolution magnetic resonance neurography (MRN) and their correlation to histology.MethodsIn this prospective study the lumbosacral DRG, the right sciatic, tibial, and peroneal nerves were examined in 6 patients diagnosed with NF2 and associated polyneuropathy (PNP) by a standardized MRN protocol at 3 T. Volumes of DRG L3–S2 as well as peripheral nerve lesions were assessed and compared to follow-up examinations after 14–100 months. In one patient, imaging findings were further correlated to histology.ResultsFollow-up MRN examination showed a non-significant increase of volume for the DRG L3: +0.41% (p = 0.10), L4: +22.41% (p = 0.23), L5: +3.38% (p = 0.09), S1: +10.63% (p = 0.05) and S2: +1.17% (p = 0.57). Likewise, peripheral nerve lesions were not significantly increased regarding size (2.18 mm2 vs. 2.15 mm2, p = 0.89) and number (9.00 vs. 9.33, p = 0.36). Histological analyses identified schwannomas as the major correlate of both DRG hyperplasia and peripheral nerve lesions. For peripheral nerve microlesions additionally clusters of onion-bulb formations were identified.ConclusionPeripheral nervous system alterations seem to be constant or show only a minor increase in adult NF2. Thus, symptoms of PNP may not primarily attributed to the initial schwannoma growth but to secondary long-term processes, with symptoms only occurring if a certain threshold is exceeded. Histology identified grouped areas of Schwann cell proliferations as the correlate of DRG hyperplasia, while for peripheral nerve lesions different patterns could be found.

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit.

This mini-review aims to summarize and discuss previous and recent advances in the clinical presentation, pathophysiology, diagnosis, treatment, and outcome of SARS-CoV-2-associated peripheral neuropathies. Literature review. Altogether, 105 articles about SARS-CoV-2-associated neuropathy describing 261 patients were retrieved. Peripheral neuropathy in patients with COVID-19 is frequent and predominantly due to immune mechanisms or neurotoxic side effects of drugs used to treat the symptoms of COVID-19 and, to a lesser extent, due to the compression of peripheral nerves resulting from prolonged bedding in the Intensive Care Unit (ICU) and pre-existing risk factors such as diabetes. SARS-CoV-2 does not cause viral neuropathy. Neurotoxic drugs such as daptomycin, linezolid, lopinavir, ritonavir, hydro-chloroquine, cisatracurium, clindamycin, and glucocorticoids should be administered with caution and patients should be appropriately bedded in the ICU to prevent SARS-CoV-2-associated neuropathy. Patients with Guillain-Barré syndrome (GBS) benefit from immunoglobulins, plasma exchange, and steroids. Neuropathies of peripheral nerves in patients with COVID-19 are frequent and mostly result from immune mechanisms or neurotoxic side effects of drugs used to treat the symptoms of COVID-19 and, to a lesser extent, from the compression of peripheral nerves due to prolonged bedding on the ICU. SARS-CoV-2 does not cause infectious neuropathy.

Enhanced sensory conduction in primary fibromyalgia: a case\u2013control pilot study

BackgroundThis study aimed to test the changes in the conduction properties of peripheral nerves in patients with primary fibromyalgia (FM). Thirty patients with FM and sixteen healthy controls participated in this study. Visual analogue scale (VAS) for pain severity, pain duration, Widespread Pain Index (WPI), Symptom Severity (SS) scale, Hamilton depression rating scale, Taylor’s manifest anxiety scale, and Fibromyalgia Impact Questionnaire (FIQR) were used for measurement of psychiatric comorbidities and quality of life for each patient. Routine motor and sensory nerve conduction studies of both median, ulnar, common peroneal, posterior tibial, and sural nerves were measured for all study participants.ResultsWe found statistically significant increase in Sensory Conduction Velocity (SCV), Sensory Nerve Action Potential (SNAP) amplitude, and decrease in Sensory Latency (SL) in patients with FM compared to controls. There were no significant changes in motor nerve conduction between patients and controls. Regression analysis showed a significant relation between WPI and both SCV and SL especially in nerves of upper limbs. However, no significant relation between SCV and SL and other presumed predictors including VAS for pain severity, pain duration, SS scale, FIQR, and psychiatric comorbidities. Patients with FM suffered more depression and anxiety than controls.ConclusionsWe found enhanced conductivity of the sensory rather than the motor nerves in patients with FM. To our knowledge, this is the first study to describe these sensory changes which may add further evidence of peripheral sensitization in patients with FM.

Особливості клінічно-діагностичних параметрів дистальної симетричної полінейропатії у хворих на цукровий діабет типу 2 в динаміці лікування залежно від поліморфізму G894Т гена ендотеліальної NO-синтази

Мета. Встановлення динаміки клінічно-лабораторних характеристик і функціонального стану периферичних нервів у хворих на цукровий діабет типу 2 (ЦД-2), ускладнений дистальною симетричною полінейропатією (ДСПН) залежно від розподілу частот генотипів G894Т поліморфізму гена ендотеліальної NO-синтази на тлі рекомендованого лікування. Матеріали та методи. Обстежено 110 хворих із ДСПН на тлі ЦД-2, що становили основну групу, та 80 практично здорових осіб. Розподіл хворих здійснювався за ступенем тяжкості ДСПН: із початковими проявами полінейропатії — 32 (29,1 %), з помірним ступенем — 58 (52,7 %) та з вираженим ступенем — 20 (18,2 %) осіб. Пацієнти отримували препарат L-аргінін на тлі базисного лікування. Проводилося неврологічне обстеження за шкалами нейропатичного симптоматичного підрахунку, модифікованого нейропатичного дисфункціонального підрахунку, електронейроміографічне тестування периферичних нервів нижніх кінцівок, визначалися показники вуглеводного обміну, про- та антиоксидантного захисту, функціонального стану ендотелію. Результати. Гомозиготність за мінорною алеллю Т підвищує ймовірність розвитку ДСПН на тлі ЦД-2: відношення шансів становило 2,91 (95% довірчий інтервал 1,19–7,14; р < 0,05). У пацієнтів із генотипами GT і GG поліморфізму G894T гена ендотеліальної NO-синтази визначається найбільш висока ефективність рекомендованої терапії на противагу носіям ТТ-генотипу, у яких динаміка клінічно-лабораторних і функціональних параметрів була найнижчою. Висновки. Гомозиготність за мінорною алеллю Т поліморфізму G894Т гена ендотеліальної NO-синтази підвищує частоту розвитку, тяжкість перебігу ДСПН на тлі ЦД-2, а також пов’язана з менш стійким ефектом від лікування цього ускладнення.

Effect of omalizumab treatment on peripheral nerves in patients with chronic spontaneous urticaria

Aim: Chronic spontaneous urticaria (CSU) is characterised by itchy, red and raised lesions that appear as an attack without any cause and last for six weeks or longer. Omalizumab is a humanised monoclonal antibody that selectively binds to the Ce3 moiety of circulating IgE and is indicated for the treatment of resistant CSU. In this study, we aimed to investigate whether there was peripheral nervous system involvement in patients with chronic urticaria receiving omalizumab treatment. Methods: Forty-seven patients who were treated with omalizumab for CSU were included in the study. Electrophysiological measurements were performed following a neurological examination before treatment and at three months after omalizumab treatment. In nerve conduction tests, eight different nerves were studied in four extremities (total 16 nerves). During these studies, two motor and two sensory nerves (median and ulnar) in the upper extremities, and two motor (tibial and common peroneal) and two sensory nerves (sural and superficial peroneal) in the lower extremities were analysed. Results: No pathological electrophysiological findings supporting neuropathy were detected in any of the measurements performed before and after treatment. When the nerve conduction velocity, amplitude and latency values ​​of all examined nerves were compared, no significant difference was found between the pre- and post-treatment values. Conclusions: It can be considered that omalizumab has no effect on peripheral nerves, and it is a safe and well tolerated agent in terms of both peripheral nerves and neurological structure.

Nerve ultrasound studies in POEMS syndrome.

The aim of our study was to assess the ultrasonographic features of peripheral nerves in patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome. 34 POEMS syndrome patients and 26 healthy control (HC) participants were recruited prospectively. Cross-sectional area (CSA) was measured in nerves of limbs, trunks of brachial plexus, and cervical nerve roots RESULTS: The CSAs were mildly enlarged at the arm segment of median nerve, elbow segment of ulnar nerve and upper trunk, moderately enlarged at the forearm segment of both median and ulnar nerve, upper trunk of brachial plexus, and C6, C7 cervical nerve roots, and markedly enlarged at the arm segment of ulnar nerve, middle and lower trunk of brachial plexus, as well as C5 cervical root. The CSAs of upper limb nerves were larger in POEMS syndrome patients than in HCs, and the enlargements were most prominent proximally.

Individual mechanisms underlying peripheral nerve damage when exposed to metallic mercury

Introduction. There is a lack of knowledge of the pathophysiological mechanisms that form peripheral nerve disorders in mercury lesions of professional origin. The study aims to reveal the mechanisms underlying peripheral nerve damage in the long-term post-contact period of chronic mercury intoxication (CMI). Materials and methods. Fifty-one people had the diagnosis of a long-term period of CMI. The post-contact period was 8.5±2.6 years. The authors compared the results with a control group of 26 healthy men who had no contact with toxic substances. Stimulating electroneuromyography was performed. We studied the body systems that could contribute to the formation of disorders in the peripheral nerves. Changes in peripheral hemodynamics were studied using reovasography. The content of autoantibodies, neuron-specific enolase, serotonin, histamine, catecholamines (epinephrine, dopamine), metanephrine, and neurotrophin-3 was reviewed. The content of ceruloplasmin, secondary products of lipid peroxidation processes, reduced glutathione, the activity of superoxide dismutase and the content of nitric oxide levels were determined. Results. The study established pathogenetic structural links of peripheral nerve disorders. The autoimmune process's role was to increase the range of antibodies to the MAG protein and increase the level of antibodies to DNA. Violations of elastic-tonic properties of peripheral vessels could be associated with the functional state of motor axons. The increased content of neurotransmitters is related to the state of peripheral blood circulation; the most pronounced changes were on the legs, which could contribute to the occurrence and maintenance of vasoconstriction. The role of oxidative stress in the formation of demyelinating disorders in patients' peripheral nerves in the long-term period of CRI is possible. Conclusion. Neuroimmunological processes has an essential role in the development of peripheral nerve demyelination was shown, which consists in an increase in the content of antibodies to the MAG protein expressed on Schwann cells of peripheral nerves and in an increase in the level of antibodies to DNA involved in the formation of demyelinating changes when exposed to metallic mercury. The revealed pathological changes in the state of the peripheral blood circulation, characterized by a violation of the vessels' elastic-tonic properties, leading to demyelination of motor axons in patients in the long-term period of CMI. The increased content of neurotransmitters in the examined is of great importance in the state of peripheral circulation. Pronounced changes in blood circulation are established on the lower extremities, which may be associated with the predominance of α-adrenergic receptors in the arterial bed and may contribute to the occurrence and maintenance of vasoconstriction in the legs. The relationship between changes in indicators of oxidative stress, consisting of a decrease in the value of superoxide dismutase and reduced glutathione, and the formation of demyelinating disorders of peripheral nerves in patients in the long-term period of CMI has been proved.

Imaging Review of Peripheral Nerve Injuries in Patients with COVID-19

With surging numbers of coronavirus disease 2019 (COVID-19) patients throughout the world, neuromuscular complications and rehabilitation concerns are becoming more apparent. Peripheral nerve injury can occur in COVID-19 patients secondary to post-infectious inflammatory neuropathy, prone positioning-related stretch/compression injury, systemic neuropathy, or nerve entrapment from hematoma. Imaging of peripheral nerves in COVID-19 patients may help characterize nerve pathology, identify site and severity of nerve damage, and potentially elucidate mechanisms of injury thereby aiding the medical diagnosis and decisionmaking process. This review article aims to provide a first comprehensive summary of the current knowledge of COVID-19 and peripheral nerve imaging.

A phase 2 study of trametinib for patients with pediatric glioma or plexiform neurofibroma with refractory tumor and activation of the MAPK/ERK pathway: TRAM-01

BackgroundPediatric low-grade gliomas (PLGG) are the most frequent brain tumors in children. Up to 50% will be refractory to conventional chemotherapy. It is now known that the majority of PLGG have activation of the MAPK/ERK pathway. The same pathway is also activated in plexiform neurofibromas (PNs) which are low-grade tumors involving peripheral nerves in patients with neurofibromatosis type 1 (NF1). These lesions are known to be refractory to chemotherapy. Specific MEK inhibitors such as trametinib are now available and have been approved for other cancers harboring mutations in the MAPK/ERK pathway such as melanoma. We have observed significant responses to trametinib in patients with refractory PLGG in our institutions and results from the phase I study are promising. The treatment appears not only efficacious but is also usually well tolerated. We hypothesize that we will observe responses in the majority of refractory PLGG and PN treated with trametinib in this phase 2 study.MethodsThe primary objective is to determine the objective response rate of trametinib as a single agent for treatment of progressing/refractory tumors with MAPK/ERK pathway activation. The TRAM-01 study is a phase II multicentric open-label basket trial including four groups. Group 1 includes NF1 patients with progressing/refractory glioma. Group 2 includes NF1 patients with plexiform neurofibroma. Group 3 includes patients with progressing/refractory glioma with KIAA1549-BRAF fusion. Group 4 includes other patients with progressing/refractory glioma with activation of the MAPK/ERK pathway. Eligible patients for a given study group will receive daily oral trametinib at full dose for a total of 18 cycles of 28 days. A total of 150 patients will be enrolled in seven Canadian centers. Secondary objectives include the assessment of progression-free survival, overall survival, safety and tolerability of trametinib, serum levels of trametinib and evaluation of quality of life during treatment.DiscussionTrametinib will allow us to target directly and specifically the MAPK/ERK pathway. We expect to observe a significant response in most patients. Following our study, trametinib could be integrated into standard treatment of PLGG and PN.Trial registrationClinicalTrials.gov Identifier: NCT03363217 December 6, 2017.

THE STATE OF THE CENTRAL AND PERIPHERAL CONDUCTIVE STRUCTURES IN PATIENTS WITH VIBRATION DISEASE

Introduction. The defeat of motor and sensory conductive structures, which ultimately leads to the development of demyelination processes and, as a consequence, the formation of polyneuropathic syndrome is natural under the influence of industrial vibrations. Exposure to vibration, along with other harmful working conditions, can potentiate the development of metabolic syndrome, which can lead to the development of diabetes, which is one of the most common causes of damage to the peripheral nervous system. Based on the above, it seems relevant to give a comprehensive assessment of the state of peripheral nerves and afferent conductive structures in workers exposed in their professional activities combined effect of local and general vibration, and patients with vibration disease, burdened with diabetes. Material and methods. 114 people were examined in clinical conditions. The observed cases included 50 with vibration disease (WB) associated with exposure to local and General vibration (group 1), the second group - 29 people with WB, burdened with type 2 diabetes. The control group (group 3) consisted of 35 conditionally healthy men, representative age (52.0±6.4 years) without contact with harmful factors of production. Results. In patients of group 1, changes were observed in increasing the time of postsynaptic activation of the posterior horns of the spinal cord and activation of neurons of the somatosensory zone of the cerebral cortex. In patients of group 2, changes in the state of the central afferent pathways were more pronounced, shown in increasing the time of the excitation wave from the cervical thickening to the thalamic nuclei, as well as violations in the state of the conductive structures in the thalamic region. Analysis of the peripheral nerves in group 1 patients revealed changes in demyelinating lesions of the motor and sensory components of the tibial nerve and changes in the speed indices of the nerves of the upper extremities. The examined 2 groups had similar disorders, there was a statistically significant decrease in the speed of sensory axons of the lower extremities. conclusion. It was found that the combined effect of vibration and diabetes mellitus leads to aggravation of the demyelination processes of both sensory and motor axons of peripheral nerves in patients. There is a statistically significant decrease in the amplitude of the M-response on the lower extremities.

The phenomenon of focal peripheral nerve constriction: review of the literature

Today the description of phenomenon of the focal “hourglass-like constriction” of the peripheral nerves in patients with acute pain mononeuropathy is often found in literature. The use of additional imaging techniques of peripheral nerves such as high-resolution ultrasound and magnetic resonance imaging allowed to detect this pathology more often. The purpose of the review is to summarize information about the phenomenon of the focal “hourglass-like constriction”. We analyzed 30 publications in PubMed database by key words: “Hourglass like construction of peripheral nerve” with the description of 158 patients with the focal “hourglass-like constriction”.

Ultrasound elastography in the evaluation of peripheral neuropathies: a systematic review of the literature.

Peripheral neuropathy is associated with an increase in intraneural pressure, and hence ultrasound elastography seems to be an ideal method to detect early stages of this condition based on changes in the affected nerve stiffness. The aim of this systematic review was to analyse the applicability of strain elastography (SE) and shear wave elastography (SWE) in the evaluation of peripheral nerves in patients with neuropathy of various aetiologies. Published evidence shows clearly that ultrasound elastography can accurately diagnose many types of peripheral neuropathies (carpal tunnel syndrome and other entrapment neuropathies, diabetic peripheral neuropathy and peripheral neuropathy associated with other systemic diseases), sometimes at the stages at which the condition is still asymptomatic. However, it is still unclear whether elastographic changes within the nerves precede functional anomalies detectable on nerve conduction studies. Also, relatively little is known about the relationship between the stiffness of peripheral nerves and the severity of peripheral neuropathy and its underlying condition. Based on the reproducibility data, SWE seems to be superior to SE. Nevertheless, the sources of heterogeneity in the peripheral nerve stiffness in healthy persons need to be identified, and the sets of reference values for specific peripheral nerves need to be determined. Finally, the potential confounding effect of hardening artefacts, such as bones, on the stiffness of peripheral nerves needs to be verified. After addressing all these issues, elastographic evaluation of peripheral nerve stiffness might become a reliable, easily accessible, and convenient diagnostic test performed routinely in patients with various peripheral neuropathies.

Diffusion Tensor Imaging of Tibial and Common Peroneal Nerves in Patients With Guillain-Barre Syndrome: A Feasibility Study.

The development of a noninvasive, objective, and accurate method to assess peripheral nerve disorders in Guillain-Barre syndrome (GBS) is of clinical significance. Diffusion tensor imaging (DTI) has been used to evaluate some peripheral nerve disorders. To investigate the feasibility of DTI in evaluating the peripheral nerve disorders in patients with GBS. Case control. Twenty GBS patients and 16 healthy volunteers. 3.0T, T1 WI-SE, T2 WI-SPAIR, DTI; electrophysiology. MRI data were analyzed by two radiologists blindly and independently. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusion coefficient (AD), and radial diffusion coefficient (RD) values of tibial nerve (TN) and common peroneal nerve (CPN) were recorded. Motor nerve conduction velocity (MCV) and motor nerve conduction amplitude of TN and CPN were recorded. Intraclass correlation coefficient (ICC), t-test, receiver-operating characteristic (ROC), and area under the curve (AUC) analysis, Pearson correlation coefficient. The FA and AD values of TN and CPN in the GBS group were significantly lower and the ADC and RD values were higher than those in the controls (P <0.05). The AUC of the FA values (0.970 for TN and 0.927 for CPN) were higher than that of the ADC, AD, and RD values. FA and AD values were positively correlated and ADC, RD values were negatively correlated with MCV and motor nerve conduction amplitude, respectively (P <0.05). The correlations between FA value and electrophysiology parameters were the highest. DTI quantitative parameters could evaluate the disorders of peripheral nerves in patients with GBS. A moderate correlation was observed between DTI and electrophysiology parameters. 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1356-1364.

Positioning the Nerve Cuff Distally on the Sciatic Nerve Improves the Classification of Ankle-Movement Proprioceptive ENG Signals.

Recording of neural signals from intact peripheral nerves in patients with spinal cord injury or stroke survivors offers the possibility for the development of closed-loop sensorimotor prostheses. However, questions remain over the positioning of neural interfaces such that the separability of neural data recorded from the peripheral nerves is improved. Afferent electroneurographic signals were recorded with nerve cuffs placed on the sciatic nerve of rats in response to various mechanical stimuli to the hindpaw. The mean absolute value of the signal was extracted and fed into classifiers. The performance of the classifier was evaluated when information was available from a single cuff placed either distally or proximally on the sciatic nerve. Results confirmed earlier findings that proprioceptive ENG signals, elicited by the movement of the ankle, can be identified and separated in neural recordings made with a cuff electrode. In addition, classification scores improved when the nerve cuff was placed distally on the nerve rather than proximally, taking advantage of the nerve's underlying anatomy.

Influence of nerve cuff channel count and implantation site on the separability of afferent ENG

Objective. Recording of neural signals from intact peripheral nerves in patients with spinal cord injury or stroke survivors offers the possibility for the development of closed-loop sensorimotor prostheses. Nerve cuffs have been found to provide stable recordings from peripheral nerves for prolonged periods of time. However, questions remain over the design and positioning of nerve cuffs such that the separability of neural data recorded from the peripheral nerves is improved. Approach. Afferent electroneurographic (ENG) signals were recorded with nerve cuffs placed on the sciatic nerve of rats in response to various mechanical stimuli to the hindpaw. The mean absolute value of the signal was extracted and input to a classifier. The performance of the classifier was evaluated under two conditions: (1) when information from either a 3- or 16-channel cuff was used; (2) when information was available from a cuff placed either distally or proximally along the nerve. Main results. We show that both 3- and 16-channel cuffs were able to separate afferent ENG signals with an accuracy greater than chance. The highest classification scores were achieved when the classifier was fed with information obtained from a 16-channel cuff placed distally. While the 16-channel cuff always outperformed the 3-channel cuff, the difference in performance was increased when the 16-channel cuff was placed distally rather than proximally on the nerve. Significance. The results indicate that increasing the complexity of a nerve cuff may only be advantageous if the nerve cuff is to be implanted distally, where the nerve has begun to divide into individual fascicles.

CRT-500.07 The Role of Small Nerve Fibers in the Development of Atrial Fibrillation

Atrial fibrillation is (AF) the most common sustained cardiac rhythm disorder. Small nerve fibres carry autonomic modalities, somatic pain and temperature sensations. The aim of our study was to assess the role of small A-delta nerve fibres in the peripheral nerves of patients with AF. The function

Nerve ultrasound in polyneuropathies.

Ultrasound can be used to visualize pathology in the peripheral nerves of patients with polyneuropathy. Nerve enlargement is the most frequent pathology, but other abnormalities, including abnormal nerve echogenicity and vascularity, are also encountered. This monograph presents an overview of the role of nerve ultrasound in the evaluation and management of both inherited and acquired polyneuropathies. A description of the sonographic techniques and common abnormalities is provided, followed by a presentation of typical findings in different neuropathies. Scoring systems for characterizing the presence and pattern of nerve abnormalities as they relate to different polyneuropathies are presented. Muscle Nerve 57: 716-728, 2018.

Effect of statins on oxidative DNA damage in diabetic polyneuropathy.

Oxidative stress induces nerve damage in type 2 diabetes mellitus and leads to diabetic polyneuropathy (DPN) and can affect the DNA and antioxidant status. Statins have pleiotropic, protective effects on the peripheral nerves of patients with diabetes. The aim of this study was to determine the effects of ezetimibe/simvastatin and rosuvastatin on DNA damage in patients with DPN. This randomized, double-blind, placebo-controlled, clinical trial comprised outpatients from Guadalajara, Mexico. The inclusion criteria were either gender, age 35–80 years, type 2 diabetes, glycated hemoglobin ≤10%, diabetic polyneuropathy stage 1/2, and signed informed consent. Patients who were taking antioxidant therapy or statins, had hypersensitivity to drugs, experienced organ failure, were pregnant or breastfeeding, or had other types of neuropathy were excluded. We assigned patients to placebo, ezetimibe/simvastatin 10/20 mg, or rosuvastatin 20 mg, and the primary outcomes were 8-hydroxy-2′-deoxyguanosine (8-OHdG) for DNA damage, 8-oxoguanine-DNA-N-glycosilase (hOGG1) for DNA repair, and superoxide dismutase (SOD). Seventy-four patients were recruited. Nine patients were included as negative controls. There were no differences in 8-OHdG between the healthy subjects (4.68 [3.53–6.38] ng/mL) and the DPN patients (4.51 [1.22–9.84] ng/mL), whereas the hOGG1 level was 0.39 (0.37–0.42) ng/mL in the healthy subjects and 0.41 (0.38–0.54) ng/mL in patients with DPN at baseline (p = 0.01). SOD decreased significantly in patients with DPN (5.35 [0.01–17.90] U/mL) compared with the healthy subjects (9.81 [8.66–12.61] U/mL) at baseline (p < 0.001). No significant changes in DNA biomarkers were observed in any group between baseline and final levels. We noted a rise in hOGG1 in patients with DPN, without modifications after treatment. There was a slight, albeit insignificant, increase in SOD in patients who were on statins.

Ultrasonographic evaluation of cervical nerve roots and peripheral nerves in patients with spinal and bulbar muscular atrophy

Ultrasonographic evaluation of cervical nerve roots and peripheral nerves in patients with spinal and bulbar muscular atrophy

Electrophysiological evaluation of peripheral nerve in patients with impaired glucose tolerance

This study retrospectively reviewed 75 patients with impaired glucose tolerance(IGT)admitted in our hospital from March 2015 to October 2015. All patients underwent Toronto clinical scoring system(TCSS) evaluation. Patients with IGT were further divided into normal score group(TCSS-N, n=50)and abnormal score group(TCSS-A, n=25)according to their scoring results, and 30 healthy volunteers were served as control group. All patients and controls underwent motor and sensory nerve conduction studies, as well as sympathetic skin response(SSR)test using the Keypoint.Net(Medoc Ltd)electromyogram device. The results showed that the SSR amplitude of lower limbs was reduced [(0.61±0.44 vs 1.00±0.33)mv, P<0.05] and latency of lower limbs was extended [(1 880±282 vs 1 642±256)ms, P<0.05]in IGT group compared with control group. But median, ulnar, tibial, and peroneal nerve sensory and motor conduction revealed no difference between two groups. In TCSS-A group, the SSR amplitude of lower limbs was reduced [(0.47±0.39)mv, P<0.05], latency of lower limbs was extended [(2 062±291)ms, P<0.05]and the sensory nerve action potential(SNAP)amplitude of the tibial nerve was significantly lower compared with control group [(1.83±0.37 vs 2.07±0.30)μv, P<0.05]. Compared to TCSS-N group, latency of lower limbs was extended [(2 062±291 vs 1 808±246)ms, P<0.05]in TCSS-A group. The SSR amplitude of lower limbs were reduced[(0.66±0.44)mv, P<0.05]and latency were prolonged(P<0.05)in TCSS-N group compared with control group. Pearson correlation analysis showed that the SSR amplitude and latency of the lower limbs were correlated with the postprandial blood glucose, blood glucose fluctuation, body weight, as well as body mass index. These results suggest that there exists peripheral nerve damage in the patients with IGT, mainly involving the small fiber nerve of the lower limbs. Large fibers may also be mildly affected as the disease progresses. (Chin J Endocrinol Metab, 2017, 33: 574-577) Key words: Peripheral nerve; Impaired glucose tolerance; Nerve conduction; Sympathetic skin response