Insula Clinical Trials Center, Warsaw, Poland.
Laboratory of Preclinical Research and Environmental Agents, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland.
Adv Clin Exp Med. 2024 Apr;33(4):379-385. doi: 10.17219/acem/168504.
Neuropathy affects 25% of people with diabetes mellitus. The evaluation of disease severity is still a challenge for modern medicine. Many screening instruments are based primarily on clinical criteria. There is a lack of a simple, reliable and precise scoring system that could improve the classification of neuropathy and monitor disease progression using not only clinical criteria but also electroneurography. There is a need to find sensitive neurography parameters that reflect peripheral nerve impairments in this group of patients.
This study aimed to create a scoring system for diabetic neuropathy, based on electroneurography criteria, that reflects the natural course of the disease. A new scoring system will improve the treatment of patients with diabetes mellitus.
A total of 113 patients with distal symmetrical polyneuropathy (DSPN) were involved in the study. Median, ulnar, sural, tibial, and peroneal nerves were examined. Parameters such as amplitude, conduction velocity, distal latency, and F wave latency were analyzed. The results of nerve conduction studies in the investigated group were compared to those of the control group, which consisted of 61 healthy volunteers.
The most sensitive parameter of peripheral nerve impairment severity was a reduction of the sensory action potential amplitude in the peroneal nerve by 72.8% (p < 0.05). The observation of changes in sensory action potential amplitudes in the peroneal nerve is the most important element of our scoring system.
A new electroneurography scoring system of DSPN severity should be based on sensory and motor action potential amplitudes that reflect axonal loss in the examined nerves and the nature of the disease.
周围神经病变影响 25%的糖尿病患者。目前，对于疾病严重程度的评估仍然是现代医学面临的一个挑战。许多筛查工具主要基于临床标准。目前缺乏一种简单、可靠和精确的评分系统，该系统不仅可以使用临床标准，还可以使用神经电生理学来改善周围神经病变的分类并监测疾病进展。需要找到能够反映该组患者周围神经损伤的敏感神经电生理学参数。
本研究旨在创建一种基于神经电生理学标准的糖尿病周围神经病变评分系统，以反映疾病的自然进程。新的评分系统将改善糖尿病患者的治疗效果。
共有 113 例远端对称性多发性神经病（DSPN）患者参与了本研究。研究中检查了正中神经、尺神经、腓肠神经、胫神经和腓总神经。分析了幅度、传导速度、远端潜伏期和 F 波潜伏期等参数。将研究组的神经传导研究结果与由 61 名健康志愿者组成的对照组进行了比较。
周围神经损伤严重程度最敏感的参数是腓总神经感觉动作电位幅度降低了 72.8%（p<0.05）。观察腓总神经感觉动作电位幅度的变化是我们评分系统的最重要要素。
DSPN 严重程度的新神经电生理学评分系统应基于反映检查神经中轴突丢失和疾病性质的感觉和运动动作电位幅度。
