Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark; Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Denmark.
Institute of Neurology, University College London, Queen Square, London, UK.
Clin Neurophysiol. 2019 Oct;130(10):1981-1987. doi: 10.1016/j.clinph.2019.08.003. Epub 2019 Aug 16.
Detection of motor involvement in diabetic polyneuropathy (DPN) by nerve conduction studies (NCS) does not occur until there is substantial loss of motor units, because collateral reinnervation maintains compound muscle action potential (CMAP) amplitude. Motor unit number estimation (MUNE) methods may therefore be more sensitive. This study was undertaken to test whether the novel method, MScanFit MUNE (MScan) can detect motor involvement in DPN despite normal NCS.
Fifty-two type-2 diabetic patients and 38 healthy controls were included. The median nerve was examined in all participants using standard NCS and a detailed CMAP scan, used for MScan. Additional lower extremity NCS in patients were used for DPN diagnosis.
Of 52 diabetic patients, 21 had NCS-defined DPN while lower extremity NCS were normal in 31 patients. MScan motor unit number and size showed higher sensitivity and incidence of abnormality than motor NCS parameters, and a similar sensitivity to sensory NCS.
MScan is able to detect motor axonal damage at times when collateral reinnervation limits NCS changes.
MScan is a sensitive method to detect motor involvement in DPN, which our data suggests is present as early as sensory.
在运动单位大量丧失之前，通过神经传导研究（NCS）检测糖尿病性多发性神经病（DPN）中的运动神经受累不会发生，因为侧支神经再支配可维持复合肌肉动作电位（CMAP）幅度。因此，运动单位数量估计（MUNE）方法可能更敏感。本研究旨在测试新型 MScanFit MUNE（MScan）方法是否即使在 NCS 正常的情况下也能检测 DPN 中的运动神经受累。
纳入 52 例 2 型糖尿病患者和 38 名健康对照者。所有参与者的正中神经均接受标准 NCS 和详细 CMAP 扫描（用于 MScan）检查。对患者进行额外的下肢 NCS 检查以诊断 DPN。
52 例糖尿病患者中，21 例有 NCS 定义的 DPN，而 31 例患者的下肢 NCS 正常。MScan 运动单位数量和大小的敏感性和异常发生率均高于运动 NCS 参数，且与感觉 NCS 的敏感性相似。
MScan 能够在侧支神经再支配限制 NCS 改变时检测到运动轴突损伤。
MScan 是一种检测 DPN 运动神经受累的敏感方法，我们的数据表明，运动神经受累可能与感觉神经受累一样早出现。
