Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy
Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy
复制标题
揭示无症状 2 型糖尿病神经病变的感觉轴突功能障碍
作者：
J. Sung;J. Tani;Tsui;C. Lin
这项研究调查了感觉和运动神经的兴奋性特性，以阐明糖尿病神经病变的发展。总共招募了 109 名 2 型糖尿病患者，并对 106 名患者进行了分析。根据神经病变严重程度，使用总神经病变评分（TNSr）将患者分为 G0、G1 和 G2+3 组。 G0 组患者无症状，TNSr 评分为 0。将糖尿病患者的感觉和运动神经兴奋性数据与 33 名健康对照者的数据进行了比较。分析临床评估、神经传导研究以及感觉和运动神经兴奋性测试数据，以确定糖尿病神经病变的轴突功能障碍。 G0组感觉兴奋性测试显示，50%感觉神经动作电位刺激增加（P<0.05），强度持续时间常数缩短（P<0.01），超兴奋性增加（P<0.01），亚兴奋性降低（P<0.05），对去极化电流的调节减少（P<0.01），阈值电紧张对超极化电流的调节有减少的趋势。所有变化均进展至 G1 (TNSr 1–8) 和 G2+3 (TNSr 9–24) 组。相比之下，G0组运动兴奋性仅对50%复合运动神经动作电位的刺激显着增加（P<0.01）。这项研究表明，感觉轴突中轴突功能障碍的发展发生在运动轴突之前，并且以不同的方式发生。此外，即使在无症状患者中，感觉神经兴奋性测试也可以检测轴突功能障碍。这些见解进一步加深了我们对糖尿病神经病变的理解，并使感觉轴突异常的早期检测成为可能，这可能为神经保护治疗方法提供基础。
This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (P<0.05), shortened strength-duration time constant (P<0.01), increased superexcitability (P<0.01), decreased subexcitability (P<0.05), decreased accommodation to depolarizing current (P<0.01), and a trend of decreased accommodation to hyperpolarizing current in threshold electrotonus. All the changes progressed into G1 (TNSr 1–8) and G2+3 (TNSr 9–24) groups. In contrast, motor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (P<0.01) in the G0 group. This study revealed that the development of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches.
影响因子：
82.9
作者：
Bierhaus, Angelika;Fleming, Thomas;Nawroth, Peter P.
通讯作者：
Nawroth, Peter P.