Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes

被引：3

作者：

Lai, Yun-Ru ^{[1
,2
]}

Huang, Chih-Cheng ^{[2
]}

Chiu, Wen-Chan ^{[3
]}

Liu, Rue-Tsuan ^{[3
]}

Tsai, Nai-Wen ^{[2
]}

Wang, Hung-Chen ^{[4
]}

Lin, Wei-Che ^{[5
]}

Cheng, Ben-Chung ^{[1
,3
]}

Su, Yu-Jih ^{[3
]}

Su, Chih-Min ^{[6
]}

Hsiao, Sheng-Yuan ^{[1
,6
]}

Wang, Pei-Wen ^{[3
]}

Chen, Jung-Fu ^{[3
]}

Ko, Jih-Yang ^{[7
]}

Lu, Cheng-Hsien ^{[1
,2
,7
,8
]}

机构：

[1] Natl Sun Yat Sen Univ, Dept Biol Sci, Kaohsiung, Taiwan

[2] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Neurol, 123 Ta Pei Rd, Kaohsiung 833, Taiwan

[3] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Internal Med, Kaohsiung, Taiwan

[4] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Neurosurg, Kaohsiung, Taiwan

[5] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Radiol, Kaohsiung, Taiwan

[6] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Emergency Med, Kaohsiung, Taiwan

[7] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Ctr Shockwave Med & Tissue Engn, Kaohsiung, Taiwan

[8] Xiamen Chang Gung Mem Hosp, Dept Neurol, Xiamen, Fujian, Peoples R China

来源：

CLINICAL NEUROPHYSIOLOGY | 2019年 / 130卷 / 07期

关键词：

Cardiac autonomic neuropathy (CAN); Diabetic distal symmetrical polyneuropathy (DSPN); Heart rate response to deep breathing (HR_DB); Sensory nerve action potentials (SNAPs); Valsalva ratio (VR); DISTAL SYMMETRIC POLYNEUROPATHY; HEART-RATE-VARIABILITY; ELECTRODIAGNOSTIC-MEDICINE; PERIPHERAL NEUROPATHY; AMERICAN-ASSOCIATION; PHYSICAL-MEDICINE; DEFINITION; NEUROLOGY; ACADEMY;

D O I：

10.1016/j.clinph.2019.03.036

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: Both diabetic distal symmetrical polyneuropathy (DSPN) and cardiac autonomic neuropathy (CAN) indicate the length-dependent pattern of disease. Decreased parasympathetic activity has been found in the early phase of CAN and sural sensory nerve action potential (SNAP) imply axonal loss in DSPN. Method: All patients with type 2 diabetes underwent cardiovascular autonomic function and nerve conduction studies (NCS). We constructed modified composite autonomic scoring scale (CASS) and composite score of NCS to measure the severity of CAN and DSPN, respectively. Results: Patients with a longer duration of diabetes had a lower heart rate response to deep breathing (HR_DB), Valsalva ratio (VR), and baroreflex sensitivity (BRS), higher CASS, a higher percentage of CAN, lower sural SNAP, higher composite score of NCS, and a higher percentage of DSPN. Multiple linear regression analysis showed that only sural SNAPs were independently associated with mean HR_DB. Conclusion: Sural SNAP was closely correlated with parameters of cardiovagal functions in patients with different durations of diabetes. The percentage and severity of CAN and DSPN increase with longer duration of diabetes. Significance: The independent association of sural sensory nerve action potential amplitude and heart rate response to deep breathing with type 2 diabetes is important because combined testing increases diagnostic sensitivity and specificity. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

引用

页码：1160 / 1165

页数：6

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