Sural Velocity Research Articles

The Burden of Peripheral Neuropathy in Nondiabetic Chronic Kidney Disease and the Role of Ghrelin Isoforms in its Development.

Peripheral neuropathy is one of the most common complications in chronic kidney disease (CKD). The neuroprotective role of ghrelin is being explored recently. Here we aim to determine the burden of neuropathy in nondiabetic CKD and to find the association of peripheral nerve function with plasma ghrelin levels in these patients. This was a cross-sectional study conducted in nondiabetic CKD patients on conservative management to determine the magnitude of neuropathy. The association of ghrelin isoforms with nerve functions was assessed between three groups, namely CKD with neuropathy, CKD without neuropathy, and healthy volunteers, with 20 participants in each group. The proportion of neuropathy in nondiabetic CKD was 78% (n = 78), of which 51% (n = 40) were asymptomatic. Des acyl ghrelin (DAG) and total ghrelin (TG) levels were 1545.5 ± 487.4 and 1567.4 ± 485.3 pg/mL, respectively, in CKD patients with neuropathy and were found to be elevated compared to those without neuropathy, who had 1000.4 ± 264.2 and 1019.7 ± 264.3 pg/mL of DAG and TG, respectively (P < 0.001). Assessment of correlation between nerve conduction parameters and DAG levels showed positive correlation between DAG levels and common peroneal latency (r = 0.69; P < 0.01), median sensory latency (r = 0.45; P < 0.05), and sural latency (r = 0.51; P < 0.05). We found negative correlation between median velocity (r =-0.56; P < 0.05), common peroneal velocity (r = -0.64; P < 0.01), median sensory velocity (r =-0.49; P < 0.05), and sural velocity (r = -0.54; P < 0.05). There was no statistically significant difference in acyl ghrelin levels among the groups. The prevalence of peripheral neuropathy in CKD is significantly higher with almost half of them being asymptomatic. Impaired renal clearance in CKD leads to the accumulation of DAG, which subsequently inhibits the neuroprotective functions of AG leading to neuropathy in CKD.

Sural Nerve Conduction Studies in Prediabetics and Diabetics in North Indian Population

Nerve conduction studies (NCS) are the most sensitive and reproducible measure of peripheral nerve functions. These can define and quantitate normal nerve activity. These tests examine the state of rapidly conducting myelinated fibres in a peripheral nerve. Most of the nerve dysfunctions begin in the sensory nerves of the lower extremities. So measurement of sensory function in the lower limb nerves by electrical stimulation is investigational in diabetics. The sensory nerve conduction velocity (SNCV) and sensory latency (SNSL) of sural nerve provides the highest diagnostic sensitivity. Evaluation of sural nerve conduction velocity in prediabetic and diabetic to assess neuropathy. Examination of nerve conduction velocity (NCV) was done in 79 subjects (16 prediabetic and 63 diabetics) by using Synergy machine Viasys. Right and left sural nerve latency were significantly higher and sural nerve velocity were significantly lower in diabetics when compared to prediabetics but in both nerve amplitudes did not differed significantly. Increased Sural nerve latency indicates increased demyelination and decreased sural velocity shows decreased speed of nerve impulse in diabetics when compared to prediabetics indicating progressive neuropathy in diabetics.

Evidence of neurologic dysfunction related to long-term ethylene oxide exposure.

Eight hospital workers with chronic ethylene oxide exposure were age-sex matched with eight nonexposed controls with no significant differences in educational backgrounds and vocabulary scores. The exposed group performed more poorly on all eight measures of cognition, memory, attention, and coordination, with 71.3% less accuracy on the Hand-Eye Coordination Test. There was a dose-response relationship between exposure and the following: Continuous Performance Test and sural velocity. These findings suggest that neurologic dysfunction may result from long-term low-dose exposure to ethylene oxide, and that these effects may occur at exposure levels common in hospital sterilizer operations.