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ORIGINAL ARTICLE
Ann Clin Neurophysiol. 2019; 21(1): 36-43.
Published online January 29, 2019.
doi: https://doi.org/10.14253/acn.2019.21.1.36
Associations of nerve conduction study variables with clinical symptom scores in patients with type 2 diabetes
Joong Hyun Park1  , Jae Hyeon Park1  , and Jong Chul Won2 
1Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
Corresponding Author: Jong Chul Won ,Tel: +82-2-950-8860, Fax: +82-2-2091-1464, Email: drwonjc@gmail.com
Received November 12, 2018   Revised: December 26, 2018    Accepted December 28, 2018
ABSTRACT
Background: Diabetic peripheral polyneuropathy (DPN) is associated with a variety of symptoms. Nerve conduction studies (NCSs) are considered to be the gold standard of nerve damage assessments, but these studies are often dissociated from the subjective symptoms observed in DPN patients. Thus, the aim of the present study was to investigate the correlations between NCS parameters and neuropathic symptoms quantified using the Michigan Neuropathy Screening Instrument (MNSI).
Methods: Patients with type 2 diabetes mellitus (T2DM) with or without symptoms of neuropathy were retrospectively enrolled. Demographic data, clinical laboratory data, MNSI score, and NCS results were collected for analysis; DPN was diagnosed based on the MNSI score (≥ 3.0) and abnormal NCS results. Pearson’s correlation coefficients were used to evaluate the relationships between MNSI score and NCS variables.
Results: The final analyses included 198 patients (115 men and 83 women) with a mean age of 62.6 ± 12.7 years and a mean duration of diabetes of 12.7 ± 8.4 years. The mean MNSI score was 2.8 (range, 0.0–9.0), and 69 patients (34.8%) were diagnosed with DPN. The MNSI score was positively correlated with the median motor nerve latency and negatively correlated with the median motor, ulnar sensory, peroneal, tibial, and sural nerve conduction velocities (NCVs). When the patients were categorized into quartiles according to MNSI score, peroneal nerve conduction velocity was significantly lower in the second MNSI quartile than in the first MNSI quartile (p = 0.001). A multivariate analysis revealed that the peroneal NCV was independently associated with MNSI score after adjusting for age, sex, and glycosylated hemoglobin A1c (HbA1c) levels.
Conclusions: The present results indicate that a decrease in peroneal NCV was responsible for early sensory deficits in T2DM patients.
Key words: Diabetic peripheral neuropathy; Nerve conduction study; Michigan Neuropathy Screening Instrument; Peroneal nerve
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