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The role of blink reflex R1 latency as an electrophysiological marker in diabetic distal symmetrical polyneuropathy
Clinical Neurophysiology ( IF 3.7 ) Pub Date : 2020-01-01 , DOI: 10.1016/j.clinph.2019.09.022
Yun-Ru Lai, Chih-Cheng Huang, Wen-Chan Chiu, Rue-Tsuan Liu, Nai-Wen Tsai, Hung-Chen Wang, Wei-Che Lin, Ben-Chung Cheng, Yu-Jih Su, Chih-Min Su, Sheng-Yuan Hsiao, Pei-Wen Wang, Jung-Fu Chen, Jih-Yang Ko, Cheng-Hsien Lu

OBJECTIVE Studies showed a relatively prolonged blink R1 latency in patients with diabetic distal symmetrical polyneuropathy (DSPN) compared to that without DSPN. We tested the hypothesis that blink R1 latency would provide a diagnostic alternative to nerve conduction studies (NCS) in DSPN and act as a marker of the severity of NCS abnormalities in DSPN. METHOD A total of 109 patients with type 2 diabetes underwent blink reflex studies and NCS. We used the composite amplitude scores of nerve conductions (CAS), which consisted of motor (tibial, peroneal and ulnar) and sensory (sural and ulnar) amplitudes for estimating the severity of NCS. RESULTS Patients with DSPN had longer blink R1, R2, and contralateral R2 latencies (P < 0.0001, P = 0.001, and P = 0.031, respectively) and higher CAS (P < 0.0001). Area under curve on receiver operating characteristic curve analysis in diagnosing occurrence of DSPN in blink R1 latency was 0.772 (P < 0.0001). Multiple linear regression analysis showed that blink R1 latency was independently associated with CAS. CONCLUSION Blink R1 latency may be valuable in auxiliary diagnosis and in determining the severity of NCS abnormalities in DSPN. SIGNIFICANCE Blink R1 latency can be added as a supplemental marker of severity of NCS in DSPN, especially if the patient's sural amplitudes has a floor effect.

中文翻译:

眨眼反射 R1 潜伏期作为电生理标志物在糖尿病远端对称性多发性神经病中的作用

目的 研究表明,与没有 DPN 的患者相比,患有糖尿病远端对称性多发性神经病 (DSPN) 的患者的眨眼 R1 潜伏期相对延长。我们测试了以下假设,即眨眼 R1 潜伏期将为 DSPN 中的神经传导研究 (NCS) 提供一种诊断替代方案,并作为 DSPN 中 NCS 异常严重程度的标志物。方法 共有 109 名 2 型糖尿病患者接受了眨眼反射研究和 NCS。我们使用神经传导 (CAS) 的复合振幅评分,其中包括运动(胫骨、腓骨和尺骨)和感觉(腓骨和尺骨)振幅来估计 NCS 的严重程度。结果 DSPN 患者的眨眼 R1、R2 和对侧 R2 潜伏期更长(分别为 P < 0.0001、P = 0.001 和 P = 0.031)和更高的 CAS(P < 0.0001)。在诊断眨眼 R1 潜伏期中发生 DSPN 时,接受者操作特征曲线分析的曲线下面积为 0.772 (P < 0.0001)。多元线性回归分析表明,眨眼 R1 潜伏期与 CAS 独立相关。结论 Blink R1 潜伏期在辅助诊断和确定 DSPN 中 NCS 异常的严重程度方面可能是有价值的。重要性 Blink R1 潜伏期可以作为 DSPN 中 NCS 严重程度的补充标志物,特别是如果患者的腓肠振幅具有底线效应。结论 Blink R1 潜伏期在辅助诊断和确定 DSPN 中 NCS 异常的严重程度方面可能是有价值的。意义 Blink R1 潜伏期可以作为 DSPN 中 NCS 严重程度的补充标志物,特别是如果患者的腓肠振幅具有底效应。结论 Blink R1 潜伏期在辅助诊断和确定 DSPN 中 NCS 异常的严重程度方面可能是有价值的。意义 Blink R1 潜伏期可以作为 DSPN 中 NCS 严重程度的补充标志物,特别是如果患者的腓肠振幅具有底效应。
更新日期:2020-01-01
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