Motataianu Anca, Barcutean Laura, Bajko Zoltan, Stoian Adina, Maier Smaranda, Voidazan Septimiu, Balasa Rodica
Neurology 1 Clinic, Emergency Clinical County Hospital Mureș, Gh. Marinescu Str., No. 50, 540136 Târgu Mureș, Romania.
Department of Neurology, University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mureș, Gh. Marinescu Str., No. 38, 540139 Târgu Mureș, Romania.
Diagnostics (Basel). 2021 Oct 28;11(11):2005. doi: 10.3390/diagnostics11112005.
To investigate the relationship between neurophysiological sensory and motor nerve function parameters, assessed by nerve conduction studies (NCS) with parasympathetic autonomic function and by heart rate variability (HRV) tests in patients with type 2 diabetes mellitus (T2DM).
A total of 161 T2DM patients underwent NCS. Cardiac autonomic response was assessed by HRV tests to deep breathing (HRV DB), to Valsalva manoeuvre, and during postural change from lying to standing.
The amplitude of motor response in the median nerve, tibial nerve, and peroneal nerve was associated with reduced HRV DB ( = 0.0001). The amplitude of motor response in the median nerve, tibial nerve, and peroneal nerve was associated with reduced HRV Valsalva ( = 0.0001). The correlation between the amplitude of response in all sensory nerves (sural, median, and ulnar) and HRV DB was statistically significant ( = 0.0001).
The results indicate that there is a correlation in T2DM patients between the damage of small myelinated and unmyelinated nerve fibres from cardiac autonomic nerves, assessed by HRV tests and damage of large motor and sensory fibres, assessed by NCS. Based on the above results, a combination of NCS and HRV tests should be considered in the neurophysiological approach to diabetic neuropathy.
通过神经传导研究（NCS）评估神经生理感觉和运动神经功能参数，并结合2型糖尿病（T2DM）患者的副交感自主神经功能和心率变异性（HRV）测试，来研究它们之间的关系。
共161例T2DM患者接受了NCS检查。通过HRV测试评估心脏自主神经反应，包括深呼吸时的HRV（HRV DB）、瓦尔萨尔瓦动作时的HRV以及从卧位到站立位姿势改变时的HRV。
正中神经、胫神经和腓总神经的运动反应幅度与HRV DB降低相关（P = 0.0001）。正中神经、胫神经和腓总神经的运动反应幅度与HRV瓦尔萨尔瓦动作降低相关（P = 0.0001）。所有感觉神经（腓肠神经、正中神经和尺神经）的反应幅度与HRV DB之间的相关性具有统计学意义（P = 0.0001）。
结果表明，在T2DM患者中，通过HRV测试评估的心脏自主神经中小有髓鞘和无髓鞘神经纤维的损伤，与通过NCS评估的大运动和感觉纤维的损伤之间存在相关性。基于上述结果，在糖尿病神经病变的神经生理学研究中应考虑将NCS和HRV测试结合起来。
