Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy

Jia Ying Sung, Jowy Tani, Tsui San Chang, Cindy Shin Yi Lin

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Article numbere0171223
JournalPLoS One
Volume12
Issue number2
DOIs
Publication statusPublished - Feb 1 2017

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diabetic neuropathy
peripheral nervous system diseases
Diabetic Neuropathies
motor neurons
nerve tissue
action potentials
axons
Action Potentials
Axons
Neural Conduction
testing
noninsulin-dependent diabetes mellitus
Type 2 Diabetes Mellitus
Testing
Medical problems
therapeutics
duration

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy. / Sung, Jia Ying; Tani, Jowy; Chang, Tsui San; Lin, Cindy Shin Yi.

In: PLoS One, Vol. 12, No. 2, e0171223, 01.02.2017.

Research output: Contribution to journalArticle

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