Reliability of Quantitative Sudomotor Axon Reflex Testing and Quantitative Sensory Testing in Neuropathy of Impaired Glucose Regulation

Overview

Journal Muscle Nerve

Date 2009 Mar 5

PMID 19260066

Citations 24

Authors

Amanda Peltier

A Gordon Smith

James W Russell

Kiran Sheikh

Billie Bixby

James Howard

Jonathan Goldstein

Yanna Song

Lily Wang

Eva L Feldman

J Robinson Singleton

Affiliations

Soon will be listed here.

Abstract

Reproducible neurophysiologic testing paradigms are critical for multicenter studies of neuropathy associated with impaired glucose regulation (IGR), yet the best methodologies and endpoints remain to be established. This study evaluates the reproducibility of neurophysiologic tests within a multicenter research setting. Twenty-three participants with neuropathy and IGR were recruited from two study sites. The reproducibility of quantitative sudomotor axon reflex test (QSART) and quantitative sensory test (QST) (using the CASE IV system) was determined in a subset of patients at two sessions, and it was calculated from intraclass correlation coefficients (ICCs). QST (cold detection threshold: ICC=0.80; vibration detection threshold: ICC=0.75) was more reproducible than QSART (ICC foot=0.52). The performance of multiple tests in one setting did not improve reproducibility of QST. QST reproducibility in our IGR patients was similar to reports of other studies. QSART reproducibility was significantly lower than QST. In this group of patients, the reproducibility of QSART was unacceptable for use as a secondary endpoint measure in clinical research trials.

Citing Articles

Mismatch between subjective and objective dysautonomia.

Novak P, Systrom D, Marciano S, Knief A, Felsenstein D, Giannetti M Sci Rep. 2024; 14(1):2513.

PMID: 38291116 PMC: 10828385. DOI: 10.1038/s41598-024-52368-x.

Validation of the Body Scan, a new device to detect small fiber neuropathy by assessment of the sudomotor function: agreement with the Sudoscan.

Riveline J, Mallone R, Tiercelin C, Yaker F, Alexandre-Heymann L, Khelifaoui L Front Neurol. 2023; 14:1256984.

PMID: 38020587 PMC: 10644320. DOI: 10.3389/fneur.2023.1256984.

Remote Photoplethysmography for Evaluation of Cutaneous Sensory Nerve Fiber Function.

Marcinkevics Z, Aglinska A, Rubins U, Grabovskis A Sensors (Basel). 2021; 21(4).

PMID: 33670087 PMC: 7916836. DOI: 10.3390/s21041272.

Is there cardiac autonomic neuropathy in prediabetes?.

Zilliox L, Russell J Auton Neurosci. 2020; 229:102722.

PMID: 33011523 PMC: 7704909. DOI: 10.1016/j.autneu.2020.102722.

Potency of descending pain modulatory system is linked with peripheral sensory dysfunction in fibromyalgia: An exploratory study.

Brietzke A, Antunes L, Carvalho F, Elkifury J, Gasparin A, Stefani Sanches P Medicine (Baltimore). 2019; 98(3):e13477.

PMID: 30653087 PMC: 6370006. DOI: 10.1097/MD.0000000000013477.

References

Hallin R, Torebjork H, Wiesenfeld Z . Nociceptors and warm receptors innervated by C fibres in human skin. J Neurol Neurosurg Psychiatry. 1982; 45(4):313-9. PMC: 491366. DOI: 10.1136/jnnp.45.4.313. View

McArthur J, Stocks E, Hauer P, Cornblath D, Griffin J . Epidermal nerve fiber density: normative reference range and diagnostic efficiency. Arch Neurol. 1998; 55(12):1513-20. DOI: 10.1001/archneur.55.12.1513. View

Dyck P, Karnes J, OBrien P, Litchy W, Low P, Melton 3rd L . The Rochester Diabetic Neuropathy Study: reassessment of tests and criteria for diagnosis and staged severity. Neurology. 1992; 42(6):1164-70. DOI: 10.1212/wnl.42.6.1164. View

Smith A, Howard J, Kroll R, Ramachandran P, Hauer P, Singleton J . The reliability of skin biopsy with measurement of intraepidermal nerve fiber density. J Neurol Sci. 2004; 228(1):65-9. DOI: 10.1016/j.jns.2004.09.032. View

Dyck P, Kennedy W, Kesserwani H, Melanson M, Ochoa J, Shy M . Limitations of quantitative sensory testing when patients are biased toward a bad outcome. Neurology. 1998; 50(5):1213. DOI: 10.1212/wnl.50.5.1213. View

Kastenbauer T, Sauseng S, Brath H, Abrahamian H, Irsigler K . The value of the Rydel-Seiffer tuning fork as a predictor of diabetic polyneuropathy compared with a neurothesiometer. Diabet Med. 2004; 21(6):563-7. DOI: 10.1111/j.1464-5491.2004.01205.x. View

Smith A, Ramachandran P, Tripp S, Singleton J . Epidermal nerve innervation in impaired glucose tolerance and diabetes-associated neuropathy. Neurology. 2001; 57(9):1701-4. DOI: 10.1212/wnl.57.9.1701. View

Vlckova-Moravcova E, Bednarik J, Dusek L, Toyka K, Sommer C . Diagnostic validity of epidermal nerve fiber densities in painful sensory neuropathies. Muscle Nerve. 2007; 37(1):50-60. DOI: 10.1002/mus.20889. View

Lehtinen J, Niskanen L, Hyvonen K, Siitonen O, Uusitupa M . Nerve function and its determinants in patients with newly-diagnosed type 2 (non-insulin-dependent) diabetes mellitus and in control subjects--a 5-year follow-up. Diabetologia. 1993; 36(1):68-72. DOI: 10.1007/BF00399096. View

10.

Dyck P, Kratz K, Karnes J, Litchy W, Klein R, Pach J . The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study. Neurology. 1993; 43(4):817-24. DOI: 10.1212/wnl.43.4.817. View

11.

Periquet M, Novak V, Collins M, Nagaraja H, Erdem S, Nash S . Painful sensory neuropathy: prospective evaluation using skin biopsy. Neurology. 1999; 53(8):1641-7. DOI: 10.1212/wnl.53.8.1641. View

12.

Dyck P, Davies J, Litchy W, OBrien P . Longitudinal assessment of diabetic polyneuropathy using a composite score in the Rochester Diabetic Neuropathy Study cohort. Neurology. 1997; 49(1):229-39. DOI: 10.1212/wnl.49.1.229. View

13.

Singer W, Spies J, McArthur J, Low J, Griffin J, Nickander K . Prospective evaluation of somatic and autonomic small fibers in selected autonomic neuropathies. Neurology. 2004; 62(4):612-8. DOI: 10.1212/01.wnl.0000110313.39239.82. View

14.

Grandinetti A, Chow D, Sletten D, Oyama J, Theriault A, Schatz I . Impaired glucose tolerance is associated with postganglionic sudomotor impairment. Clin Auton Res. 2007; 17(4):231-3. DOI: 10.1007/s10286-007-0426-z. View

15.

Bril V, Kojic J, Ngo M, Clark K . Comparison of a neurothesiometer and vibration in measuring vibration perception thresholds and relationship to nerve conduction studies. Diabetes Care. 1997; 20(9):1360-2. DOI: 10.2337/diacare.20.9.1360. View

16.

Russell J, Feldman E . Impaired glucose tolerance--does it cause neuropathy?. Muscle Nerve. 2001; 24(9):1109-12. DOI: 10.1002/mus.1122. View

17.

Sumner C, Sheth S, Griffin J, Cornblath D, Polydefkis M . The spectrum of neuropathy in diabetes and impaired glucose tolerance. Neurology. 2003; 60(1):108-11. DOI: 10.1212/wnl.60.1.108. View

18.

Kihara M, Mitsui M, Nishikawa S, Nishimoto K, Takahashi M . Comparison of electrophysiologic and autonomic tests in sensory diabetic neuropathy. Clin Auton Res. 1998; 8(4):213-20. DOI: 10.1007/BF02267784. View

19.

Kennedy W, Wendelschafer-Crabb G . Utility of the skin biopsy method in studies of diabetic neuropathy. Electroencephalogr Clin Neurophysiol Suppl. 2000; 50:553-9. View

20.

Cohen J, Jeffers B, Faldut D, Marcoux M, Schrier R . Risks for sensorimotor peripheral neuropathy and autonomic neuropathy in non-insulin-dependent diabetes mellitus (NIDDM). Muscle Nerve. 1998; 21(1):72-80. DOI: 10.1002/(sici)1097-4598(199801)21:1<72::aid-mus10>3.0.co;2-2. View