Prevalence Of Peripheral Neuropathy Research Articles

Peripheral neuropathy and associated factors among children living with HIV on antiretroviral therapy in Gamo zone, Southern Ethiopia: an institution-based cross-sectional study

BackgroundPeripheral neuropathy (PN) is a common neurological complication of HIV (Human Immunodeficiency Virus) that can significantly affect patients’ quality of life. In Ethiopia, children living with HIV are at an increased risk of developing peripheral neuropathy due to comorbidities such as anemia, tuberculosis, malnutrition, and poor socio-economic status. Our study aims to evaluate the prevalence of peripheral neuropathy among children living with HIV in Ethiopia using a simple clinical screening tool.MethodsA health institution-based cross-sectional study was conducted among 148 children aged 5 to 18 years living with HIV who are receiving treatment at the antiretroviral therapy (ART) clinic of the randomly selected public health institutions in the Gamo zone. An interview and neurologic examination were conducted. A binary logistic regression model was used to identify factors associated with the outcome variable. Variables with p-value < 0.25 in the bi-variable logistic regression analysis were entered and checked for association in a multivariable logistic regression model. The level of statistical significance was declared at the p-value < 0.05.ResultIn this study, 148 children participated, making a response rate of 97.5%. The mean ± standard deviation (SD) age of the respondents was 15.03 ± 2.99 years, and 81(54.7%) were male. The magnitude of PN was 20.9% (31/148). Children in the age category of 15–18 (adjusted odds ratio (AOR) = 1.88, 95%CI; 1.24–4.60), low BMI for age (AOR = 1.66, 95%CI; 1.12–4.15), last exposure to isoniazid within 1 year (AOR = 2.31, 95%CI; 1.12–8.53). Longer duration of HIV illness (AOR = 2.17, 95%CI; 1.54–4.64), and past tuberculosis (TB) treatment (AOR = 2.11, 95%CI; 1.08–7.48) were significantly associated factors with peripheral neuropathy.ConclusionOur analysis revealed that being in the age category of 15–18 years, low BMI for age, Isoniazid exposure, longer Duration of HIV illness, and past TB treatment were significantly associated with peripheral neuropathy in children living with HIV. These disease-related factors may contribute to the development and progression of peripheral neuropathy in this population.Clinical trial numberNot applicable.

Peripheral neuropathy prevalence and effect on mobility 12 months after prosthesis prescription among individuals with dysvascular lower extremity amputation.

To determine the prevalence of peripheral neuropathy (PN) and its effect on mobility in patients who were prescribed a lower limb prosthesis (LLP) after an incident dysvascular transtibial (TT) or transfemoral (TF) lower extremity amputation (LEA). We also sought to determine if the effect of PN on mobility was modified by amputation level or depression. Participants were identified retrospectively through the Veterans Affairs (VA) Corporate Data Warehouse (CDW) from March 1, 2018, to November 30, 2020, then were contacted prospectively to obtain their self-reported mobility. Multiple logistic regression was used to control for potential confounders and identify potential effect modifiers. The VA CDW, the National Prosthetics Patient Database, participant mailings and phone calls. Three hundred fifty-seven individuals who underwent a TT or TF amputation due to diabetes and/or peripheral arterial disease and were fitted with a qualifying LLP. Not applicable. The Locomotor Capabilities Index basic and advanced mobility subscale scores. Two-hundred thirty seven participants (66%) had a diagnosis of PN prior to prosthesis prescription. The detrimental effect of PN on achieving basic and advanced mobility was significant after adjusting for potential confounding factors (adjusted odds ratio [aOR], 0.53; 95% confidence interval [CI], 0.30-0.94; p = .03 and aOR, 0.43; 95% CI, 0.24-0.77; p = .005, respectively). The detrimental effect of PN was more pronounced in patients with depression, especially for advanced mobility (aOR, 0.36; 95% CI, 0.14-0.95; p = .04) versus no depression (aOR, 0.53; 95% CI, 0.27-1.0; p = .07). PN is common in patients who have undergone an LEA due to diabetes and/or vascular disease and patients with this diagnosis should be carefully evaluated. Targeted rehabilitation programs to mitigate its potential detrimental effects on mobility are important and should specifically include mental health assessment and treatment.

Prevalence and incidence of peripheral neuropathy, peripheral artery disease, foot disease, and lower extremity amputation in people with diabetes in Ireland; a systematic review protocol.

Introduction Internationally, the prevalence of diabetes is increasing, and with this comes an increase in diabetes related complications. Diabetic foot disease is the most common lower extremity complication in people with diabetes causing 2% of the global disease burden. It, is associated with major morbidity, mortality, and costs to health services. Despite this burden, the incidence and prevalence of diabetic foot disease is unknown in Ireland. This paper presents a protocol for a systematic review to examine the incidence and prevalence of diabetic foot disease in the Irish population. Methods A systematic review will be performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Pubmed, EMBASE, and Lenus, the Irish Health Research repository, will be searched for publications in any language and without restrictions to date. Title, abstract, and full text screening will be carried out independently by two investigators. Publications reporting on the incidence or prevalence of peripheral neuropathy, peripheral artery disease, ulceration, or amputation in people with diabetes in Ireland, from a defined geographical catchment area of Ireland, will be included. Joanna Briggs Institute (JBI) Critical Appraisal tool will be used to assess included studies methodological quality. Results will be reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Conclusion The results of this systematic review can be used to inform appropriate stakeholders on the incidence and prevalence of diabetic foot disease in Irish populations, enabling decision making around appropriate use of resources to help prevent, and improve management of this disease. Systematic review registration CRD42023472904

Peripheral Neuropathy (Numbness): Role of Neurologists as Primary Gatekeepers

The prevalence of peripheral neuropathies has increased over the years, and novel treatments for management of several neuropathies have emerged over the past decade. Following a literature search of the ICHUSHI database, we observed that recent literature on peripheral neuropathy most frequently includes reports from the orthopedic specialty, followed by studies reported by the neurology service. Notably, the number of studies reported by the neurology departments has increased over the past decade. However, most patients with common peripheral neuropathies do not visit the neurology department. Therefore, it is necessary to highlight the role of neurologists for comprehensive evaluation and management of neuromuscular disorders. This may result in acknowledgement of neurology as the primary gatekeeper of peripheral neurological diseases.

Prevalence of peripheral neuropathy, amputation, and quality of life in patients with diabetes mellitus

Peripheral neuropathy and amputation are common complications of diabetes mellitus (DM) that significantly impact the quality of life of the affected individuals. This study aims to investigate the prevalence of peripheral neuropathy, the level of amputation, and the quality of life in patients with DM. This cross-sectional study was conducted after approval of the synopsis involving 225 diagnosed patients with DM on pre-defined eligibility criteria, selected from public sector OPDs, specialized diabetes centres, and centres manufacturing orthotics and prosthetics. Data were collected through interviews, observations, and the administration of the Michigan Neuropathy Screening Instrument and the Asian Diabetes Quality of Life Questionnaire. The level of amputation was recorded for each participant. Data was entered into SPSS, and results were synthesized. Pearson correlation is applied to find an association between gender and the quality of life of the participants, while P ≤ 0.05 will be considered significant. The prevalence of peripheral neuropathy in a sample of 225, based on a self-administered questionnaire, was (44.4%), and in terms of foot examination was (51.1%). As people progressed in age, the prevalence increased to 20.0% in patients above 60 years and 8.9% in ≤ 35 years of age. The majority of participants (56.0%) have had DM for less than five years. Females were 57.8% of the study population, while 97.8% of participants had type II DM. Below-knee amputation of the right limb was observed in 22(9.8%) of the participants. The QoL was poor in the majority of the participants (96.9%) patients with DM (P = 0.638 and T = -0.471). This cross-sectional study highlights a high prevalence of peripheral neuropathy and amputation and poor QoL in patients with diabetic mellitus.

Prevalence and disease burden of peripheral neuropathy in the general population in Mexico city: a cross-sectional epidemiological study

Objective Peripheral neuropathy (PN) is one of the most common diseases of the peripheral nervous system. Symptoms range from mild sensory signs to severe neuropathic pain. Untreated PN is progressive and can lead to complications and impair quality of life (QoL). However, PN prevalence is underestimated in the general population and affected individuals often remain undiagnosed. This study aimed to contribute to the global generation of prevalence data and determine sociodemographic and disease-related characteristics of PN sufferers. Methods This cross-sectional study collected information on PN prevalence and associated factors in the adult population (40–65 years) of the Mexico City area. Participants were recruited in public places and screened for PN using the Michigan Neuropathy Screening Instrument (MNSI). Subjects with PN answered the Neuropathy Total Symptom Score-6 (NTSS-6), the Short Form-36 Health Survey (SF-36), and the QoL Pharmacoeconomic Questionnaire. Statistical analysis included descriptive methods and calculation of PN prevalence with 95% confidence intervals. Results Of 3066 participants, 448 had PN based on the MNSI physical examination. The overall PN prevalence was 14.6%, with the highest (18.9%) seen in subjects aged 61–65 years. PN was undiagnosed in 82.6%, and 62.9% had never heard of PN. Although half of all subjects had only mild PN symptoms, QoL was impacted in 91.8%. Conclusions The results confirm that PN prevalence in the general population is high. Despite the disease burden, most affected persons are undiagnosed and unaware of the disease. Almost all felt their QoL was impacted. The data highlight the need to raise awareness and identify undiagnosed individuals to prevent complications.

Combination therapy is it in the future for successfully treating peripheral diabetic neuropathy?

In 2022, the Center for Disease Control and Prevention reported that 11.3% of the United States population, 37.3 million people, had diabetes and 38% of the population had prediabetes. A large American study conducted in 2021 and supported by many other studies, concluded that about 47% of diabetes patients have peripheral neuropathy and that diabetic neuropathy was present in 7.5% of patients at the time of diabetes diagnosis. In subjects deemed to be pre-diabetes and impaired glucose tolerance there was a wide range of prevalence estimates (interquartile range (IQR): 6%-34%), but most studies (72%) reported a prevalence of peripheral neuropathy ≥10%. There is no recognized treatment for diabetic peripheral neuropathy (DPN) other than good blood glucose control. Good glycemic control slows progression of DPN in patients with type 1 diabetes but for patients with type 2 diabetes it is less effective. With obesity and type 2 diabetes at epidemic levels the need of a treatment for DPN could not be more important. In this article I will first present background information on the "primary" mechanisms shown from pre-clinical studies to contribute to DPN and then discuss mono- and combination therapies that have demonstrated efficacy in animal studies and may have success when translated to human subjects. I like to compare the challenge of finding an effective treatment for DPN to the ongoing work being done to treat hypertension. Combination therapy is the recognized approach used to normalize blood pressure often requiring two, three or more drugs in addition to lifestyle modification to achieve the desired outcome. Hypertension, like DPN, is a progressive disease caused by multiple mechanisms. Therefore, it seems likely as well as logical that combination therapy combined with lifestyle adjustments will be required to successfully treat DPN.

Abstract PO1-11-08: Late effects of breast cancer treatment among long term breast cancer survivors in the Carolina Breast Cancer Study

Abstract Background: Improved precision in breast cancer treatment has contributed to better overall survival. Intensive breast cancer treatments may have long-term impacts on survivor quality of life. Survivors may experience late effects including lymphedema, peripheral neuropathy, and cardiotoxicity from surgery, radiation, or chemotherapy. Estimates of the long-term burden of chronic breast cancer related conditions are important for managing the care of survivors. Methods: The Carolina Breast Cancer Study 3 is a population-based study of female breast cancer survivors diagnosed from 2008 to 2013 in North Carolina. Black and younger (&amp;lt; 50 years at diagnosis) women were oversampled. We calculated the cumulative prevalence of self-reporting of ever being diagnosed with lymphedema, peripheral neuropathy, or cardiac/heart problems as a result of breast cancer treatment over a 10-year follow-up period. Prevalence differences (PD) and 95% confidence intervals (CI), adjusted for age and race, were calculated to describe the differences in late effects in relation to patient characteristics (including latent class SES and access to care barriers). Additionally, we assessed racial disparities in the prevalence of late effects. Results: We included 1133 women who completed follow-up assessments at a mean of 11.2 years (SD=0.5) post diagnosis. The sample was predominately diagnosed with early stage (89.2%) and ER+ disease (75.2%). Treatments included lymph node removal ( &amp;gt;5 lymph nodes 57.9%), anthracycline chemotherapy (34.1%), taxane chemotherapy (60.3%), breast conserving surgery (58.7%), and mastectomy (41.0%). The prevalence of self-reporting lymphedema was 39.9% and was more common among younger (&amp;lt; 50 vs ≥50 PD: 10.2%, CI 4.7-15.7) and Black women (vs. White PD: 19.1%, CI 13.5-24.7), and those with fewer access to care barriers (vs more PD: -19.5%, CI -31.1- -8). The prevalence of peripheral neuropathy was 64.9% and was more common among younger (&amp;lt; 50 vs ≥50 PD: 5.6%, CI 0.2-11.0) and Black women (vs. White PD: 16.5%, CI 11.1-21.9), and those of lower SES (high vs low PD: -11.7%, CI -17.6- -5.7). Rural survivors were less likely to report peripheral neuropathy (PD: -9.7%, CI: -17.5- -2.0). Cardiac problems were reported in 16.7% of the sample and were more common among those of high SES (vs. low PD: -7.7%, CI -12.5, -3.0). All three late effects were associated with higher stage disease, ER+ disease, number of lymph nodes removed, anthracycline chemotherapy, and taxane chemotherapy. Both lymphedema and peripheral neuropathy were associated with mastectomy. Lymphedema was associated with trastuzumab use. Peripheral neuropathy was associated with recurrence. In stratified analyses by ER status, Black women were 13.7-28.8% more likely to have lymphedema in both ER+ and ER- disease (ER+ PD Black vs. White: 13.7%, CI 7.9-20.3; ER- PD Black vs. White: 28.8%, CI 18.3-39.3). Similar patterns were seen in analyses stratified by number of lymph nodes removed and by taxane chemotherapy. Other associations were not suggestive of racial disparities; with one exception. Black women were more likely to have cardiac problems at both high and low levels of SES (High Black vs White PD: 2.8%, CI -3.0, 8.6; low Black vs White PD: -7.0%, CI -15.2, 1.2). Conclusions: This study identified patient characteristics associated with an increased burden of late effects. Black and younger women experience a higher burden of lymphedema and peripheral neuropathy. Disease stage, ER status, lymph nodes removed, and chemotherapy received were associated with a higher prevalence of all three late effects and this is consistent with the observation that the burden of late effects increases with factors associated with more advanced stage of disease. Improved surveillance and prevention measures for breast cancer late effects can help improve survivorship care. Citation Format: Rina Yarosh, Hazel Nichols, Rachel Hirschey, Erin Kent, Lisa Carey, Melissa Troester, Eboneé Butler. Late effects of breast cancer treatment among long term breast cancer survivors in the Carolina Breast Cancer Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-08.

Prevalence of Diabetic Peripheral Neuropathy among Type 2 Diabetes Mellitus patients and its associated risk factors

Background: Diabetic peripheral neuropathy (DPN) is a common and one of the severe complications of diabetes mellitus. It affects almost half the diabetic population and worsens quality of life of the patient. The present study was aimed to determine the prevalence of peripheral neuropathy and associated risk factors. Aims and Objectives: To assess the Prevalence of Diabetic Peripheral Neuropathy (DPN) among Type 2 DM patients and its associated risk factors. Material and Methods: A community based survey was conducted over a period of one and a half year. Cluster sampling technique was used to collect the study sample in urban Etawah. Study participants aged ? 30 years residing in urban Etawah with known history of Type 2 Diabetes Mellitus of ? 5 years were included in the study. Diabetic Peripheral Neuropathy (DPN) was diagnosed using 10 g monofilament test. Results: A total of 400 DM patients were enrolled in the study. Out of which 28% (n = 112) patients were diagnosed with DPN using Semmes-Weinstein (SW) 10-g monofilament test. Statistically significant association was also noted with Family history of DM, BMI, Systolic and Diastolic blood pressure, Family history of HTN and History of Smoking. Conclusion: The current study found a high prevalence of DPN (28%) and it was found to be significantly associated with advancing age, duration of diabetes and history of smoking.

IDF23-00047 Prevalence of peripheral neuropathy, amputation, and quality of life in patients with diabetes mellitus

IDF23-00047 Prevalence of peripheral neuropathy, amputation, and quality of life in patients with diabetes mellitus

Neuromuscular manifestations of wild type transthyretin amyloidosis: a review and single center's experience.

Transthyretin amyloidosis (ATTR) is a condition defined by accumulation of insoluble transthyretin amyloid deposits in multiple organs, especially in the peripheral nerve and heart muscle. ATTR may result from transthyretin mutations (variant ATTR or ATTRv) or may occur with normal transthyretin genotype (wild type ATTR or ATTRwt). ATTRwt was previously known as "senile amyloidosis" and causes cardiomyopathy which may lead to heart failure with a preserved ejection fraction, affecting predominantly elderly men. The exact prevalence of ATTRwt in the general population remains unclear, but its occurrence may be underestimated in women. It was observed that a proportion of ATTRwt cardiomyopathy patients may develop slowly progressing neuropathy that is milder and indolent in comparison with typical progressive neuropathy associated with ATTRv. Furthermore, the causality of neuropathy is often uncertain in patients with ATTRwt. Neuropathy symptoms, including distal sensory loss, unsteadiness and (neuropathic) pain are common in elderly patients with multiple potential causes, and as ATTRwt patients are typically older, relatively high prevalence of peripheral neuropathy is expected with frequent comorbidities. Relatively high prevalence of ATTRwt in elderly population contrasts few documented cases of neuropathy caused by ATTRwt, and there is uncertainty whether ATTRwt neuropathy is an infrequent occurrence or a significant manifestation of multisystemic ATTRwt. We review neurologic and musculoskeletal manifestations of ATTRwt and present clinical features of a single center cohort of ATTRwt patients with suspected peripheral neuropathy.

Prevalence and incidence of peripheral neuropathy, peripheral artery disease, foot disease, and lower extremity amputation in people with diabetes in Ireland; a systematic review protocol.

Introduction Internationally, the prevalence of diabetes is increasing, and with this comes an increase in diabetes related complications. Diabetic foot disease is the most common lower extremity complication in people with diabetes, and is associated with major morbidity, mortality, and costs to health services. Despite this burden, the incidence and prevalence of diabetic foot disease is unknown in Ireland. This paper presents a protocol for a systematic review to examine the incidence and prevalence of diabetic foot disease in the Irish population. Methods A systematic review will be performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Pubmed, EMBASE, and Lenus, the Irish Health Research repository, will be searched for publications in any language and without restrictions to date. Title, abstract, and full text screening will be carried out independently by two investigators. Publications reporting on the incidence or prevalence of peripheral neuropathy, peripheral artery disease, ulceration, or amputation in people with diabetes in Ireland, from a defined geographical catchment area of Ireland, will be included. Joanna Briggs Institute (JBI) Critical Appraisal tool will be used to assess included studies methodological quality. Results will be reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Conclusion The results of this systematic review can be used to inform appropriate stakeholders on the incidence and prevalence of diabetic foot disease in Irish populations, enabling decision making around appropriate use of resources to help prevent, and improve management of this disease. Systematic review registration CRD42023472904

Prevalence of Peripheral Neuropathy (PN) Among Patients with Asymptomatic Monoclonal Gammopathies: A Clinical & Electrophysiological Study

Introduction: Asymptomatic monoclonal gammopathies (MGUS, SMM or aWM) are common among adults &amp;gt;50y. Peripheral neuropathy (PN) refers to any disorder of the peripheral nervous system including mononeuropathies, and symmetrical or asymmetrical polyneuropathy. PN is also common among individuals &amp;gt;50y. Common risk factors include diabetes, vitamin deficiencies, alcohol, renal insufficiency, hypothyroidism, autoimmune diseases and exposure to neurotoxic medication. Epidemiological studies have shown an association between monoclonal gammopathies and PN but a mechanistic link has been established only for some (anti-MAG IgM-related PN, amyloidosis, POEMS syndrome etc). However, the true prevalence of PN among patients (pts) with monoclonal gammopathies is unknown and remains challenging to associate monoclonal gammopathy with PN. The aim of our study is to establish the prevalence of PN in a large cohort of pts with asymptomatic monoclonal gammopathy and identify potential determinants. Methods: This is an ongoing prospective, non-invasive study aiming to screen ~1500 pts with asymptomatic monoclonal gammopathies for PN. Pts under regular follow-up at the Department of Therapeutics, University of Athens, Greece are screened for neuropathic symptoms using the Michigan Neuropathy Screening Instrument (MNSI), a validated screening tool for the presence of PN that consists of 15 yes/no items. A cut off ≥ 4 has been proposed as a screening cut off in diabetic PN. All pts scoring ≥4 on MNSI and pts scoring &amp;lt;4 but without risk factors for PN were assessed clinically and electrophysiologically (EDX) with standard nerve conduction studies (NCS), sympathetic skin response (SSR) test and - if needed - electromyography (EMG) by a specialist. NCS protocol includes assessment of the median nerve (motor and sensory), superficial radial nerve (sensory), tibial nerve (motor) and sural nerve (sensory) conduction studies. Axonal PN was diagnosed when the sural to radial ratio (SRAR) is below 0.25 and/or the sural nerve action potential is below 6μV, demyelinating PN if the EAN/PNS criteria for demyelination are fulfilled and sympathetic dysfunction when the SSR amplitude was &amp;lt;500 uV. Results: As of to date, 320 pts (42.8% males, median 67y) with asymptomatic monoclonal gammopathy have been screened; 64.3% had a diagnosis of MGUS (72.3% IgG, 14.1% IgA, 6.3% IgM, 7.3% light chain only), 23.9% had SMM and 11.8% had aWM. Among enrolled pts, 217 (68%) had no common risk factors for PN and 82 pts (25.6%) had an MNSI score ≥4; the commonest symptoms were cramps (48.4%), weakness (26.9%) and pain when walking (26.3%). Among pts without risk factors for PN, 42 (19.4%) had an MNSI score ≥ 4 and the commonest symptoms were cramps (44.7%), pain when walking (22.1%) and weakness (21.7%) (Table 1). There was no difference in the prevalence of MNSI score ≥4 among pts with different paraprotein types. To date, 105 pts (41.9% males, median 66y) had EDX evaluation, of which 77 (73%) had no common risk factors for PN. Among the EDX evaluated pts, 23 (21.9%) had large fiber PN, 42 (40%) had sudomotor dysfunction and 53 (50.5%) had large fiber PN and/or sudomotor dysfunction. Among the cohort of pts without risk factors for PN, 13 (16.9%) had large fiber PN, 25 (32.5%) had sudomotor dysfunction and 34 (44.2%) had large fiber PN and/or sudomotor dysfunction. Nineteen pts that went through EDX were asymptomatic (MNSI=0), of those 4 (21.1%) had large fiber PN, 4 (21.1%) had sudomotor dysfunction and 7 (33.3%) had large fiber PN and/or sudomotor dysfunction. Only one patient, without other risk factors, had a demyelinating neuropathy while all other pts had a length-dependent axonal sensory or sensorimotor neuropathy. Pts with large fiber PN were older (73.7±11.4 vs 63±9.4, p&amp;lt;0.001) but no significant differences were found regarding sex, or paraprotein or light chain type. Pts with sudomotor dysfunction were more likely to have a non-IgM monoclonal gammopathy (90.2% vs 72.6 %, p=0.029). Conclusion: Peripheral neuropathy is common in pts with monocloncal gammopathies affecting ~20% of those without any other risk factors for PN. Although most pts with PN describe mild symptoms, both large fiber PN and sudomotor dysfunction may remain completely asymptomatic. This data provides a new insight into the prevalence of PN in pts with monoclonal gammopathies with implications for future research. The study is ongoing and updated results will be presented.

Clinical and demographic profile of peripheral neuropathy in chronic kidney disease in tertiary hospital in Bundelkhand region, Central India

Background: Peripheral neuropathy is the most common chronic kidney disease (CKD)-related complication, with a prevalence of more than 60%. It is directly proportional to the duration and severity of CKD. Aims and Objectives: The study focuses on the prevalence, clinical, and demographic profile of peripheral neuropathy in CKD patients. Materials and Methods: The present study was cross-sectional and conducted in a tertiary hospital in Central India from October 2021 to September 2022. Among 100 CKD patients, peripheral neuropathy was assessed clinically and by electrophysiological nerve conduction studies. Results: Out of 100 subjects, 66% were male and 34% were female. Males were affected more (66.66%) than females (58.82%). Out of 46 pre-hemodialysis (HD) patients, 25 (54.34%) showed peripheral neuropathy. Out of 54 HD patients, 41 (75.92%) showed peripheral neuropathy, maximum age group with neuropathy &gt;60 years, duration of uremia of 31–36 months, and average creatinine &gt;9 mg/dL. The most common pattern observed was mixed sensory-motor neuropathy (axonal+demyelination) at 86.36%. Conclusion: The prevalence of peripheral neuropathy increases with the duration and severity of CKD. The most common pattern is distal symmetrical mixed sensory-motor neuropathy.

NEUROLOGICAL ABNORMALITIES IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

Objective: The objective of the study is to find out the prevalence of neurological abnormalities in children between 5 and 15 years with type-1 diabetes mellitus (T1DM) of at least 2 years duration and the risk factors associated with the development of neurological abnormalities. Methods: Hospital-based cross-sectional study on 150 Children of 5–15 years of age having type I diabetes of at least 2 years’ duration by simple random sampling fulfilling the inclusion criteria, at Department of Pediatric Medicine, Sardar Patel Medical College and P.B.M. Hospital Bikaner. Results: Mean age was 10.9±3.6 years, male to female ratio was 1.63:1. The prevalence of peripheral neuropathy was 42.3% when 1 abnormal attribute in at least 1 nerve was considered, it was 7.3% when 2 abnormal attributes in 2 nerves were considered, 4.6% had autonomic neuropathy and 4% had cognitive abnormalities. The peripheral neuropathy was subclinical in a substantial number of cases as up to 39.4% and 39.3% of T1DM cases having peripheral neuropathy had normal neuropathic symptom score and neuropathic disability score, respectively. Female with longer duration of diabetes, higher mean age of diagnosis, and higher mean HbA1c level were significantly more likely to develop peripheral neuropathy. Conclusion: Neurological complications begin quite early and insidiously in T1DM patients highlighting the importance of early and regular screening by nerve conduction study.

Evaluation of foot self-care status and foot screening problems in patients with diabetes in Iran: a national multicenter study

Background and purposeThe lack of timely foot care among individuals with diabetics often lead to ulceration followed by infection and amputation. This study aimed to evaluate the foot self-care status and foot screening practices among patients with type 2 diabetes in various cities across Iran.MethodsThe cross-sectional descriptive study was performed on patients with type 2 diabetes in 10 main cities of Iran. The information about demographic and lifestyle factors, diabetes history, and diabetic foot self-care (DFSQ) was assessed. Additionally, the neurological and vascular condition of the foot were screened by Inlow’s 60-Second Screen.ResultsThe study included 1094 diabetic patients with, with a majority being female (64.8%) and married (92.5%). The average age of the participants was 57.6 ± 10.21 (mean ± SD), and the mean duration of diabetes was 11.56 ± 7.41 years. Based on Inlow’s 60-Second Screen criteria, 58% of the patients should undergo yearly foot ulcer screening, 47% exhibited peripheral neuropathy, and 37% were found to have inappropriate footwear.ConclusionThe high prevalence of peripheral neuropathy observed in approximately half of the participants across different regions of Iran underscores the importance of continuous patient education regarding foot care and appropriate footwear. Furthermore, regular foot ulcer screenings, following the recommended intervals outlined in Inlow’s screening protocol, should be implemented to effectively manage diabetic foot complications.

OVERVIEW OF PERIPHERAL NEUROPATHY IN CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HEMODIALYSIS AT DR. MOHAMMAD HOESIN HOSPITAL PALEMBANG

Neurological complications occur in almost 60% of patients with advanced CKD and affect the nervous system at all levels, both central and peripheral. Peripheral neuropathy in CKD is usually asymptomatic until renal function is below 15%, and glomerular filtration is less than 10-12 ml/min. This study seeks to identify and characterize peripheral neuropathy in patients with chronic kidney disease undergoing hemodialysis at Dr. Mohammad Hoesin Hospital Palembang. This is a descriptive cross-sectional study with the research sample comprising chronic kidney disease patients undergoing hemodialysis at Dr. Mohommad Hoesin Palembang Hospital. The distribution of research subjects based on the Neuropathy Symptom Score (NSS) revealed that 65.7% fell into the mild neuropathy category, based on an NSS of 3-4. According to the electrophysiology results, 82.9% of patients exhibited peripheral neuropathy, while 17.1% showed normal NCS results. Sensory motor neuropathy accounted for 51.4%, including 71.5% with axonal neuropathy, 11.4% with axonal-demyelinating lesions, and no demyelinating lesions. The high prevalence of peripheral neuropathy in CKD patients identified through electrophysiological examination (ENMG) emphasizes the importance of nerve conduction examination as a diagnostic tool for peripheral neuropathy in CKD patients. This can aid in determining the progression of peripheral neuropathy in CKD patients, allowing for appropriate management and prevention of disability complications to enhance the quality of life for these individuals.

The prevalence of peripheral neuropathy among the patients with diabetes in Pakistan: a systematic review and meta-analysis

The most frequent complication of diabetes is peripheral neuropathy. The estimated prevalence of peripheral neuropathy in people with diabetes varies substantially between published studies in Pakistan. We conducted this meta-analysis to summarize the prevalence of peripheral neuropathy in people with diabetes. Different electronic databases were systematically searched using keywords and MeSH terms. Random-effects meta-analysis was conducted to pool the prevalence of peripheral neuropathy in people with diabetes in Pakistan. Heterogeneity was investigated by random-effects meta-regression and stratification. Two independent authors reviewed studies, extracted data, and conducted the risk of bias analysis. Nineteen studies with a total of 8487 diabetic patients were included. The overall pooled prevalence of diabetic peripheral neuropathy was 43.16% (95% CI 32.93–53.69%), with significant heterogeneity between estimates. The prevalence of peripheral neuropathy among those newly diagnosed with diabetes was 26.52% (95% CI 14.97–39.96%, n = 5). According to the subgroup meta-analysis, the pooled prevalence of diabetic peripheral neuropathy was highest in Khyber Pakhtunkhwa (55.29%; 95% CI 23.91–84.50%), followed by Sindh (40.04%; 95% CI 24.00–57.25%), and the lowest was found in Punjab (34.90%; 95% CI 15.05–57.95%). A significant association was found between the pooled prevalence estimate and the duration of diabetes. The results of this meta-analysis indicate a relatively high prevalence of peripheral neuropathy in people with diabetes in Pakistan. The study protocol has been registered in the PROSPERO, with the registration number CRD42022371617.

Associations of Cardiac Biomarkers With Peripheral Artery Disease and Peripheral Neuropathy in US Adults Without Prevalent Cardiovascular Disease.

NT-proBNP (N-terminal pro-B-type natriuretic peptide), high-sensitivity cardiac troponin T (hs-troponin T), and high-sensitivity cardiac troponin I (hs-troponin I) are increasingly being recommended for risk stratification for a variety of cardiovascular outcomes. The aims of our study were to establish the prevalence and associations of elevated NT-proBNP, hs-troponin T, and hs-troponin I with lower extremity disease, including peripheral artery disease (PAD) and peripheral neuropathy (PN), in the US general adult population without known cardiovascular disease. We also assessed whether the combination of PAD or PN and elevated cardiac biomarkers was associated with an increased risk of all-cause and cardiovascular mortality. We conducted a cross-sectional analysis of the associations of NT-proBNP, hs-troponin T, and hs-troponin I with PAD (based on ankle-brachial index <0.90) and PN (diagnosed by monofilament testing) in adult participants aged ≥40 years of age without prevalent cardiovascular disease in NHANES (National Health and Nutrition Examination Survey) 1999 to 2004. We calculated the prevalence of elevated cardiac biomarkers among adults with PAD and PN and used multivariable logistic regression to assess the associations of each cardiac biomarker, modeled using clinical cut points, with PAD and PN separately. We used multivariable Cox proportional hazards models to assess the adjusted associations of cross categories of clinical categories of each cardiac biomarker and PAD or PN with all-cause and cardiovascular mortality. In US adults aged ≥40 years, the prevalence (±SE) of PAD was 4.1±0.2% and the prevalence of PN was 12.0±0.5%. The prevalence of elevated NT-proBNP (≥125 ng/L), hs-troponin T (≥6 ng/L), and hs-troponin I (≥6 ng/L for men and ≥4 ng/L for women) was 54.0±3.4%, 73.9±3.5%, and 32.3±3.7%, respectively, among adults with PAD and 32.9±1.9%, 72.8±2.0%, and 22.7±1.9%, respectively, among adults with PN. There was a strong, graded association of higher clinical categories of NT-proBNP with PAD after adjusting for cardiovascular risk factors. Clinical categories of elevated hs-troponin T and hs-troponin I were strongly associated with PN in adjusted models. After a maximum follow-up of 21 years, elevated NT-proBNP, hs-troponin T, and hs-troponin I were each associated with all-cause and cardiovascular mortality, with higher risks of death observed among adults with elevated cardiac biomarkers plus PAD or PN compared with elevated biomarkers alone. Our study establishes a high burden of subclinical cardiovascular disease defined by cardiac biomarkers in people with PAD or PN. Cardiac biomarkers provided prognostic information for mortality within and across PAD and PN status, supporting the use of these biomarkers for risk stratification among adults without prevalent cardiovascular disease.

Prevalence of Peripheral Nervous System Involvement in Adult Leukodystrophies (P2-5.031)

<h3>Objective:</h3> na <h3>Background:</h3> Leukodystrophies are genetic, neurodegenerative white matter diseases of the central nervous system (CNS) caused by mutations in various genes, presenting with heterogeneous clinical features and age of onset. It is well established that some leukodystrophies have peripheral nervous system (PNS) involvement, whether demyelinating, axonal or mixed in pathology. However, the prevalence of peripheral neuropathy in adult leukodystrophies is unknown. Early recognition of PNS involvement in these disorders is imperative to enable appropriate management and care of the symptoms. <h3>Design/Methods:</h3> We performed a retrospective review of all adult subjects followed at our two institutions for white matter disease of genetic origin to select patients with evidence of PNS involvement as documented by nerve conduction studies (NCS) and/or electromyography (EMG)For these subjects we collected and analyzed data on sociodemographic status, family history, clinical characteristics, and disease course, nerve conduction studies (NCS), electromyography (EMG), MRI features and genetic testing results. <h3>Results:</h3> From our combined cohorts of 161 adult subjects followed for genetic white matter diseases, we identified 14 patients (8.7%) with documented PNS involvement. A definite genetic diagnosis was established in 5 subjects (3 with adult polyglucosan body disease, 1 with metachromatic leukodystrophy, 1 with POLR3-related disorder) while 9 subjects remained undiagnosed despite extensive genetic investigations. The demographic, clinical, radiological, and electrophysiological data will be presented. <h3>Conclusions:</h3> This is the first study conducted to assess the prevalence of peripheral neuropathy in adult patients with leukodystrophy. In our two independent cohorts, PNS involvement is rare, however, early recognition of the concurrence of CNS and PNS involvement is essential to plan appropriate management of the patients’ symptomatic care and is key as more treatment options are becoming available. <b>Disclosure:</b> Dr. Alsabah has nothing to disclose. Dr. Hasiloglu has nothing to disclose. Dr. Massie has received personal compensation in the range of $500-$4,999 for serving as a Expert consultant with INESS (Quebec Public Health agency). Dr. Massie has received personal compensation in the range of $500-$4,999 for serving as a Lecturer with Amylyx Pharmaceuticals. Dr. Brais has nothing to disclose. Dr. Orthmann Murphy has received research support from Conrad N. Hilton Foundation. Dr. Orthmann Murphy has received research support from Institute for Translational Medicine and Therapeutics’ (ITMAT) Transdisciplinary Program in Translational Medicine and Therapeutics, University of Pennsylvania. The institution of Dr. Orthmann Murphy has received research support from Vigil Neurosciences. The institution of Dr. Orthmann Murphy has received research support from National MS Society. Dr. Orthmann Murphy has received personal compensation in the range of $500-$4,999 for serving as a Invited Speaker with Temple University . Dr. Orthmann Murphy has received personal compensation in the range of $0-$499 for serving as a Consultant with American Neurological Association. Roberta La Piana has nothing to disclose.