Trigeminal nociceptive function and oral somatosensory functional and structural assessment in patients with diabetic peripheral neuropathy
Trigeminal nociceptive function and oral somatosensory functional and structural assessment in patients with diabetic peripheral neuropathy
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DOI：
10.1038/s41598-018-37041-4
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发表时间：
2019-01-17
影响因子：
4.6
通讯作者：
Baad-Hansen, L.
中科院分区：
文献类型：
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作者：
Costa, Y. M.;Karlsson, P.;Baad-Hansen, L.
本病例对照研究主要比较了糖尿病周围神经病变（DPN，n = 12）和健康受试者（n = 12）的三叉神经伤害性功能，口内体感轮廓和可能的结构神经变化。在右侧眶上神经（V1 R）、眶下神经（V2 R）和颏神经（V3 R）以及左侧眶下神经（V2 L）的入口区施加电刺激，记录伤害性眨眼反射（nBR）。结果是：个体电感觉（I-0）和痛阈（I-P）;均方根（RMS）、曲线下面积（AUC）和nBR R2分量的起始潜伏期。此外，标准化的全套定量感觉测试（QST）和表皮内神经纤维密度（IENFD）或神经纤维长度密度（NFLD）的评估，分别在远端腿和口腔粘膜。正如预期的那样，所有患者的下肢体感敏感度和IENFD均发生改变。与健康受试者相比，DPN患者具有较高的I-0、I-P、RMS和AUC值（p < 0.050）、较低的温热检测阈值（WDT）（p = 0.004）、较高的反常热感觉（PHS）发生率（p = 0.040）和较低的口内NFLD（p = 0.048）。此外，与对照组相比，DPN患者中任何异常口内体感发现的存在更常见（p = 0.013）。三叉神经伤害性易化、口内躯体感觉异常和口内神经元组织丢失的早期体征可在DPN患者中检测到。
This case-control study primarily compared the trigeminal nociceptive function, the intraoral somatosensory profile and possible structural nerve changes between diabetic peripheral neuropathy (DPN, n = 12) patients and healthy participants (n = 12). The nociceptive blink reflex (nBR) was recorded applying an electrical stimulation over the entry zone of the right supraorbital (V1R), infraorbital (V2R) and mental (V3R) and left infraorbital (V2L) nerves. The outcomes were: individual electrical sensory (I-0) and pain thresholds (I-P); root mean square (RMS), area-under-the-curve (AUC) and onset latencies of R2 component of the nBR. Furthermore, a standardized full battery of quantitative sensory testing (QST) and intraepidermal nerve fibre density (IENFD) or nerve fibre length density (NFLD) assessment were performed, respectively, on the distal leg and oral mucosa. As expected, all patients had altered somatosensory sensitivity and lower IENFD in the lower limb. DPN patients presented higher I-0, I-P, RMS and AUC values (p < 0.050), lower warm detection thresholds (WDT) (p = 0.004), higher occurrence of paradoxical heat sensation (PHS) (p = 0.040), and a lower intraoral NFLD (p = 0.048) than the healthy participants. In addition, the presence of any abnormal intraoral somatosensory finding was more frequent in the DPN patients when compared to the reference group (p = 0.013). Early signs of trigeminal nociceptive facilitation, intraoral somatosensory abnormalities and loss of intraoral neuronal tissue can be detected in DPN patients.