Cloutier Rachel, Horr Samuel, Niemi James B, D'Andrea Susan, Lima Christina, Harry Jason D, Veves Aristidis
Joslin Beth Israel Deaconess Foot Center and Microcirculation Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Int J Low Extrem Wounds. 2009 Mar;8(1):6-10. doi: 10.1177/1534734608330522. Epub 2009 Jan 6.
Acute application of stochastic resonance (SR), defined as a subsensory level of mechanical noise presented directly to sensory neurons, improves the vibration and tactile perception in diabetic patients with mild to moderate neuropathy. This study examined the effect of 1 hour of continuous SR stimulation on sensory nerve function. Twenty diabetic patients were studied. The effect of stimulation was measured at 2 time points, at the beginning and after 60 minutes of continual SR stimulation. This effect was measured using the vibration perception threshold (VPT) at the big toe under 2 conditions: a null (no SR) condition and active SR, defined as mechanical noise below the subject's own threshold of perception. The measurements under null and active conditions were done randomly and the examiner was blinded regarding the type of condition. Immediately after SR application, the VPT with SR in null condition was similar to baseline (32.2 +/- 13.1, P = nonsignificant) but was significantly lower during active SR (27.4 +/- 11.9) compared with both baseline (P = .018) and off position (P = .045). The 60 minutes VPT with active SR (28.7 +/- 11.1) reached significance comparing the baseline when one outlier was removed from the analysis (P = .031). It may be concluded that SR for a continuous 60-minute period can sustain the VPT improvement in diabetic patients with moderate to severe neuropathy. These results permit the conclusion that there is no short-term adaptation to the stimulation signal. Long-term application of this technique, perhaps in the form of a continually vibrating shoe insert, or insole, may result in sustained improvement of nerve function.
随机共振（SR）的急性应用，即直接作用于感觉神经元的亚感觉水平机械噪声，可改善轻至中度神经病变糖尿病患者的振动和触觉感知。本研究考察了1小时持续SR刺激对感觉神经功能的影响。研究了20名糖尿病患者。在持续SR刺激开始时和60分钟后这两个时间点测量刺激效果。在两种条件下，即零（无SR）条件和主动SR（定义为低于受试者自身感知阈值的机械噪声）下，使用大脚趾处的振动感觉阈值（VPT）来测量这种效果。零条件和主动条件下的测量随机进行，检查者对条件类型不知情。SR应用后立即测量，零条件下有SR时的VPT与基线相似（32.2±13.1，P=无显著性差异），但与基线（P=0.018）和关闭状态（P=0.045）相比，主动SR期间的VPT显著更低（27.4±11.9）。在分析中去除一个离群值后，主动SR下60分钟时的VPT（28.7±11.1）与基线相比具有显著性差异（P=0.031）。可以得出结论，持续60分钟的SR可维持中重度神经病变糖尿病患者的VPT改善。这些结果表明不存在对刺激信号的短期适应性。长期应用该技术，或许采用持续振动的鞋垫形式，可能会导致神经功能持续改善。
