THERMAL THRESHOLD TESTING FOR THE ASSESSMENT OF SMALL FIBER DYSFUNCTION - NORMAL VALUES AND REPRODUCIBILITY

被引:48
作者
BRAVENBOER, B
VANDAM, PS
HOP, J
VANDERSTEENHOVEN, J
ERKELENS, DW
机构
关键词
DIABETIC NEUROPATHY; SMALL FIBER FUNCTION; THERMAL THRESHOLD;
D O I
10.1111/j.1464-5491.1992.tb01836.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Small and large fibre neuropathy are common findings in patients with long-standing diabetes mellitus. The Thermal Threshold Tester was tested to obtain normal values for thermal perception threshold for warmth and cold. This device produces thermal stimuli by means of a Peltier element placed on the skin. Warm and cold thresholds are measured using a forced choice method with an up-and-down-transform rule and expressed in degrees Celsius (degrees-C). Thresholds were measured at the right wrist and right foot in 80 normal subjects, divided into four age groups; 25-34, 35-44, 45-54, and 55-65 years. The repeatability coefficient was assessed by twice measuring 39 diabetic patients without known neuropathy. Warm thermal threshold in the hand showed a significant increase with age from 0.09 +/- 0.5 (mean +/- SD) in the youngest age group to 0.17 +/- 0.08-degrees-C (p < 0.05) in the oldest age group. Cold thermal threshold in the hand (varying between 0.08 +/- 0.04 and 0.14 +/- 0.05-degrees-C) and warm thermal threshold in the foot (varying between 2.45 +/- 1.93 and 4.06 +/- 2.57-degrees-C) did not differ significantly between the four age groups. There was a significant increase in cold thermal threshold in the foot with age, increasing from 0.31 +/- 0.24 to 0.56 +/- 0.44-degrees-C (p < 0.05). Reproducibility in the diabetic subjects was good for measurements of warm and cold threshold in the hand, but poor for warm threshold in the foot in the normal range and for cold thermal threshold in the abnormal range.
引用
收藏
页码:546 / 549
页数:4
相关论文
共 22 条
  • [1] Dyck PJ, James J., O'Brien PC., Diagnosis, staging and classification of diabetic neuropathy and association with other complications, Diabetic Neuropathy, pp. 36-44, (1987)
  • [2] Editorial. Diabetic neuropathy, Lancet, 1, pp. 1113-1114, (1989)
  • [3] Harati Y., Diabetic peripheral neuropathies, Ann Int Med, 107, pp. 546-559, (1987)
  • [4] Sosenko JM, Kato M., Soto RA, Gadia MT, Ayyar DR., Specific assessments of warm and cool sensitivities in adult diabetic patients, Diabetes Care, 11, pp. 481-483, (1988)
  • [5] Jamal GA, Hansen S., Weir AI, Ballantyne JP., The neurophysiologic investigation of small fibre neuropathies, Muscle Nerve, 10, pp. 537-545, (1987)
  • [6] Kenshalo DR., Improved method for the psychological study of the temperature sense, Rev Sci Instruments, 34, pp. 883-886, (1963)
  • [7] Kenshalo DR, Bergen DC., A device to measure cutaneous temperature sensitivity in humans and subhuman species, J Appl Physiol, 39, pp. 1038-1040, (1975)
  • [8] Fruhstorfer HG, Lindblom U., Schmidt WG., Method for quantitative estimation of thermal thresholds in patients, J Neurol Neurosurg Psychiatry, 39, pp. 1071-1075, (1976)
  • [9] Temperature sensitivity and pain thresholds in patients with chronic uremia and peripheral neuropathy, Sensory Functions of skin in Primates, pp. 507-517, (1976)
  • [10] Lindblom U., Verillo RT., Sensory functions in chronic neuralgia, J Neurol Neurosurg Psychiatry, 42, pp. 422-435, (1979)