Chae Choong Sik, Park Geun Young, Choi Yong-Min, Jung Sangeun, Kim Sungjun, Sohn Donggyun, Im Sun
Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
Ann Rehabil Med. 2017 Dec;41(6):1028-1038. doi: 10.5535/arm.2017.41.6.1028. Epub 2017 Dec 28.
To determine whether patients with lumbosacral (LS) radiculopathy and peripheral polyneuropathy (PPNP) exhibit sudomotor abnormalities and whether SUDOSCAN (Impeto Medical, Paris, France) can complement nerve conduction study (NCS) and electromyography (EMG).
Outpatients with lower extremity dysesthesia underwent electrophysiologic studies and SUDOSCAN. They were classified as normal (group A), LS radiculopathy (group B), or PPNP (group C). Pain severity was measured by the Michigan Neuropathy Screening Instrument (MNSI) and visual analogue scale (VAS). Demographic features, electrochemical skin conductance (ESC) values on hands and feet, and SUDOSCAN-risk scores were analyzed.
There were no statistical differences in MNSI and VAS among the three groups. Feet-ESC and hands-ESC values in group C were lower than group A and B. SUDOSCAN-risk score in group B and C was higher than group A. With a cut-off at 48 microSiemens of feet-ESC, PPNP was detected with 57.1% sensitivity and 94.2% specificity (area under the curve [AUC]=0.780; 95% confidence interval [CI], 0646-0.915). With a SUDOSCAN-risk score cut-off at 29%, NCS and EMG abnormalities related to LS radiculopathy and PPNP were detected with 64.1% sensitivity and 84.2% specificity (AUC=0.750; 95% CI, 0.674-0.886).
SUDOSCAN can discriminate outpatients with abnormal electrophysiological findings and sudomotor dysfunction. This technology may be a complementary tool to NCS and EMG in outpatients with lower extremity dysesthesia.
确定腰骶部（LS）神经根病和周围性多发性神经病（PPNP）患者是否存在汗腺运动异常，以及SUDOSCAN（法国巴黎Impeto Medical公司）能否补充神经传导研究（NCS）和肌电图（EMG）。
对下肢感觉异常的门诊患者进行电生理检查和SUDOSCAN检查。他们被分为正常组（A组）、LS神经根病组（B组）或PPNP组（C组）。疼痛严重程度通过密歇根神经病筛查工具（MNSI）和视觉模拟量表（VAS）进行测量。分析人口统计学特征、手足电化学皮肤传导（ESC）值和SUDOSCAN风险评分。
三组之间的MNSI和VAS无统计学差异。C组的足部ESC值和手部ESC值低于A组和B组。B组和C组的SUDOSCAN风险评分高于A组。以足部ESC值48微西门子为临界值，检测PPNP的灵敏度为57.1%，特异度为94.2%（曲线下面积[AUC]=0.780；95%置信区间[CI]，0.646 - 0.915）。以SUDOSCAN风险评分29%为临界值，检测与LS神经根病和PPNP相关的NCS和EMG异常的灵敏度为64.1%，特异度为84.2%（AUC=0.750；95% CI，0.674 - 0.886）。
SUDOSCAN可以区分电生理检查结果异常和汗腺运动功能障碍的门诊患者。这项技术可能是下肢感觉异常门诊患者NCS和EMG的补充工具。
