基于神经病变量表测量，在有临床糖尿病神经病变和无临床糖尿病神经病变的糖尿病患者以及对照参与者中，感觉神经动作电位的价值和诊断准确性。

Values and diagnostic accuracy of sensory nerve action potentials in control participants and participants with diabetes with and without clinical diabetic neuropathy, based on neuropathy scale measurements.

机构信息

Department of Neurology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Neuromuscular Medicine Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

Brain Behav. 2024 Feb;14(2):e3423. doi: 10.1002/brb3.3423.

DOI:10.1002/brb3.3423

PMID:38351301

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10864687/

Abstract

BACKGROUND

The assessment of the normative values of sensory nerve action potentials (SNAP) and their diagnostic accuracies using validated neuropathy-assessment tools to classify participants into groups with and without neuropathy was not previously described in the literature.

METHODS

The Utah Early Neuropathy Scale (UENS), Michigan neuropathy-screening instrument, and nerve conduction data were collected prospectively. We described and compared the values of the sural, superficial peroneal sensory (SPS), and superficial radial SNAP amplitude in different age groups for three groups. Group 1 (G1)-control participants (UENS <5), group 2 (G2)-participants with diabetes without clinical diabetic neuropathy (UENS <5), and group 3 (G3)-participants with clinical diabetic neuropathy (UENS ≥5). We also described the diagnostic accuracy of single-nerve amplitude and a combined sensory polyneuropathy index (CSPNI) that consists of four total points (one point for each of the following nerves if their amplitude was <25% lower limit of normal: right sural, left sural, right SPS, and left SPS potentials).

RESULTS

We assessed 135 participants, including 41, 37, and 57 participants in G1, G2, and G3, respectively, with age median (interquartile ranges) of 51 (45-56), 47 (38-56), and 54 (51-61) years, respectively, whereas 19 (46.3%), 18 (48.7%), and 32 (56.14%) of them were males, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) scores were 68.4%, 92.3%, 86.7%, and 80% for the sural amplitude; 86%, 58.3%, 62%, and 84% for the SPS amplitude; 66.7%, 94.4%, 90.5%, and 78.2% for the CSPNI of 3; and 54.4%, 98.6%, 96.9%, and 73.2% for the CSPNI of 4, respectively.

CONCLUSION

Sural nerve had a high specificity for neuropathy; however, the CSPNI had the highest specificity and PPV, whereas the SPS had the highest sensitivity and NPV.

摘要

背景

使用经过验证的神经病变评估工具评估感觉神经动作电位（SNAP）的正常值及其诊断准确性，并将参与者分为有神经病变和无神经病变的组，这在文献中尚未描述。

方法

前瞻性收集犹他州早期神经病变量表（UENS）、密歇根州神经病变筛查工具和神经传导数据。我们描述并比较了三组不同年龄组的腓肠神经、腓浅感觉（SPS）和桡浅感觉 SNAP 振幅值。组 1（G1）-对照组（UENS<5）、组 2（G2）-无临床糖尿病神经病变的糖尿病患者（UENS<5）和组 3（G3）-有临床糖尿病神经病变的患者（UENS≥5）。我们还描述了单个神经幅度和包含四个总分的综合感觉多神经病指数（CSPNI）的诊断准确性（如果右侧腓肠、左侧腓肠、右侧 SPS 和左侧 SPS 电位的幅度低于正常下限的 25%，则每个神经各得一分）。

结果

我们评估了 135 名参与者，分别为 G1、G2 和 G3 组的 41、37 和 57 名参与者，年龄中位数（四分位间距）分别为 51（45-56）、47（38-56）和 54（51-61）岁，其中分别有 19（46.3%）、18（48.7%）和 32（56.14%）名男性。腓肠神经幅度的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为 68.4%、92.3%、86.7%和 80%；SPS 幅度的敏感性、特异性、阳性预测值和阴性预测值分别为 86%、58.3%、62%和 84%；CSPNI 为 3 时的敏感性、特异性、阳性预测值和阴性预测值分别为 66.7%、94.4%、90.5%和 78.2%；CSPNI 为 4 时的敏感性、特异性、阳性预测值和阴性预测值分别为 54.4%、98.6%、96.9%和 73.2%。