Modeling nerve conduction criteria for diagnosis of diabetic polyneuropathy.

INTRODUCTION

In this study we aimed to determine which criteria are valid for nerve conduction (NC) diagnosis of typical diabetic sensorimotor polyneuropathy (DSPN).

METHODS

Eight criteria were assessed from among diabetes databases, the Rochester Diabetic Neuropathy Study (RDNS, N = 456), and in healthy subjects (RDNS-HS, N = 330).

RESULTS

In the RDNS, the most frequent abnormal attributes (≤2.5th/≥97.5th percentile) are: fibular motor nerve conduction velocity (MNCV; 26.3%); sural sensory nerve conduction velocity (SNAP; 25.4%); tibial MNCV (24.8%); ulnar MNCV (21.3%); fibular F latency (16.9%); and ulnar F latency (16.0%). Normal deviate (from percentiles) composite scores of NC included: representative of neurophysiological abnormalities; sensitive and specific for diagnosis and useful for epidemiological surveys; randomized trials; and medical practice. By contrast, abnormality of one or more attributes in any nerve or abnormally of two most sensitive attributes performed poorly.

CONCLUSIONS

Composite sum scores of normal deviates (from percentiles corrected for applicable variables) of sensitive NC attributes and with modifications, RDNS and AAN criteria performed acceptably for diagnosis of DSPN.