Dataset Information

Sensitivity and specificity of high frequency ultrasound score (DCEC) in diabetic peripheral neuropathy.

ABSTRACT:

Objectives

To summarize the ultrasonic characteristics of peripheral nerve damage in type 2 diabetes and to verify the diagnostic value of DCEC score for DPN.

Methods

A total of 289 patients with type 2 diabetes evaluated peripheral neuropathy with neuroultrasound and nerve conduction at the Affiliated Hospital of Guizhou Medical University from June 2016 to June 2020. According to the diagnostic criteria from 2017 guidelines of China, 289 patients with type 2 diabetes were divided into three groups: DPN group: 203 cases; subclinical group: 48 cases; and non-DPN group: 38 cases. Kruskal Wallis test was used to identify the differences and characteristics of ultrasound scores between the all groups. The best cut-off value, sensitivity and specificity of DCEC score were obtained by receiver operator characteristic curve. Taking the diagnostic standard of diabetes peripheral neuropathy as the "gold standard", the best diagnostic threshold, sensitivity and specificity were obtained by drawing the ROC curve of DCEC score, and then the diagnostic value of DCEC score for DPN was verified.

Results

Compared with non-DPN group, DCEC score in DPN group was significantly higher (P < 0.05). Otherwise,according to the ROC curve, the best cut-off value of DCEC score for DPN diagnosis was 12.5 (sensitivity 69.7%, specificity 71.1%).

Conclusions

The DCEC score system can effectively diagnose DPN with length-dependence,mainly including the increase of definition score.

SUBMITTER: Huang H

PROVIDER: S-EPMC9672188 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Sensitivity and specificity of high frequency ultrasound score (DCEC) in diabetic peripheral neuropathy.

Huang Hailun H Tang Chao C Li Mi M Huang Jing J Li Yan Y Wu Shan S

Journal of diabetes and metabolic disorders 20220805 2

<h4>Objectives</h4>To summarize the ultrasonic characteristics of peripheral nerve damage in type 2 diabetes and to verify the diagnostic value of DCEC score for DPN.<h4>Methods</h4>A total of 289 patients with type 2 diabetes evaluated peripheral neuropathy with neuroultrasound and nerve conduction at the Affiliated Hospital of Guizhou Medical University from June 2016 to June 2020. According to the diagnostic criteria from 2017 guidelines of China, 289 patients with type 2 diabetes were divide ...[more]

PMID: 36404810

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Project description:BackgroundDiabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus and can lead to serious complications. Therapeutic strategies for pain control are available but there are few approaches that influence neurological deficits such as numbness.AimTo investigate the effectiveness of acupuncture on improving neurological deficits in patients suffering from type 2 DPN.MethodsThe acupuncture in DPN (ACUDPN) study was a two-armed, randomized, controlled, parallel group, open, multicenter clinical trial. Patients were randomized in a 1:1 ratio into two groups: The acupuncture group received 12 acupuncture treatments over 8 wk, and the control group was on a waiting list during the first 16 wk, before it received the same treatment as the other group. Both groups received routine care. Outcome parameters were evaluated after 8, 16 and 24 wk and included neurological scores, such as an 11-point numeric rating scale (NRS) 11 for hypesthesia, neuropathic pain symptom inventory (NPSI), neuropathy deficit score (NDS), neuropathy symptom score (NSS); nerve conduction studies (NCS) were assessed with a handheld point-of-care device.ResultsSixty-two participants were included. The NRS for numbness showed a difference of 2.3 (P < 0.001) in favor of the acupuncture group, the effect persisted until week 16 with a difference of 2.2 (P < 0.001) between groups and 1.8 points at week 24 compared to baseline. The NPSI was improved in the acupuncture group by 12.6 points (P < 0.001) at week 8, the NSS score at week 8 with a difference of 1.3 (P < 0.001); the NDS and the TNSc score improved for the acupuncture group in week 8, with a difference of 2.0 points (P < 0.001) compared to the control group. Effects were persistent in week 16 with a difference of 1.8 points (P < 0.05). The NCS showed no meaningful changes. In both groups only minor side effects were reported.ConclusionStudy results suggest that acupuncture may be beneficial in type 2 diabetic DPN and seems to lead to a reduction in neurological deficits. No serious adverse events were recorded and the adherence to treatment was high. Confirmatory randomized sham-controlled clinical studies with adequate patient numbers are needed to confirm the results.

Project description:BackgroundDecreased lean muscle mass in the lower extremity in diabetic peripheral neuropathy (DPN) is thought to contribute to altered joint loading, immobility, and disability. However, the mechanism behind this loss is unknown and could derive from a reduction in size of myofibers (atrophy), destruction of myofibers (degeneration), or both. Degenerative changes require participation of muscle stem (satellite) cells to regenerate lost myofibers and restore lean mass. Determining the degenerative state and residual regenerative capacity of DPN muscle will inform the utility of regeneration-targeted therapeutic strategies.MethodsBiopsies were acquired from 2 muscles in 12 individuals with and without diabetic neuropathy undergoing below-knee amputation surgery. Biopsies were subdivided for histological analysis, transcriptional profiling, and satellite cell isolation and culture.ResultsHistological analysis revealed evidence of ongoing degeneration and regeneration in DPN muscles. Transcriptional profiling supports these findings, indicating significant upregulation of regeneration-related pathways. However, regeneration appeared to be limited in samples exhibiting the most severe structural pathology as only extremely small, immature regenerated myofibers were found. Immunostaining for satellite cells revealed a significant decrease in their relative frequency only in the subset with severe pathology. Similarly, a reduction in fusion in cultured satellite cells in this group suggests impairment in regenerative capacity in severe DPN pathology.ConclusionDPN muscle exhibited features of degeneration with attempted regeneration. In the most severely pathological muscle samples, regeneration appeared to be stymied and our data suggest that this may be partly due to intrinsic dysfunction of the satellite cell pool in addition to extrinsic structural pathology (eg, nerve damage).Clinical relevanceRestoration of DPN muscle function for improved mobility and physical activity is a goal of surgical and rehabilitation clinicians. Identifying myofiber degeneration and compromised regeneration as contributors to dysfunction suggests that adjuvant cell-based therapies may improve clinical outcomes.

Project description:IntroductionHansen's disease (HD) primarily infects peripheral nerves, with patients without HD being free of peripheral nerve damage. Household contacts (HHCs) of patients with HD are at a 5-10 times higher risk of HD than the general population. Neural thickening is one of the three cardinal signs that define a case of HD according to WHO guidelines, exclusively considering palpation examination that is subjective and may not detect the condition in the earliest cases even when performed by well-trained professionals. High-resolution ultrasound (HRUS) can evaluate most peripheral nerves, a validated technique with good reproducibility allowing detailed and accurate examination.ObjectiveThis study aimed to use the peripheral nerve HRUS test according to the HD protocol as a diagnostic method for neuropathy comparing HHCs with healthy volunteers (HVs) and patients with HD.MethodsIn municipalities from 14 different areas of Brazil we selected at random 83 HHC of MB-patients to be submitted to peripheral nerve ultrasound and compared to 49 HVs and 176 HD-patients.ResultsHousehold contacts assessed by HRUS showed higher median and mean absolute peripheral nerve cross-sectional area (CSA) values and greater asymmetries (ΔCSA) compared to HVs at the same points. Median and mean absolute peripheral nerve CSA values were higher in patients with HD compared to HCCs at almost all points, while ΔCSA values were equal at all points. Mean ± SD focality (ΔTpT) values for HHCs and patients with HD, respectively, were 2.7 ± 2.2/2.6 ± 2.2 for the median nerve, 2.9 ± 2.7/3.3 ± 2.9 for the common fibular nerve (p > 0.05), and 1.3 ± 1.3/2.2 ± 3.9 for the ulnar nerve (p < 0.0001).DiscussionConsidering HRUS findings for HHCs, asymmetric multiple mononeuropathy signs (thickening or asymmetry) in at least 20% of the nerves evaluated could already indicates evidence of HD neuropathy. Thus, if more nerve points are assessed in HHCs (14 instead of 10), the contacts become more like patients with HD according to nerve thickening determined by HRUS, which should be a cutting-edge tool for an early diagnosis of leprosy cases.

Dataset Information

Sensitivity and specificity of high frequency ultrasound score (DCEC) in diabetic peripheral neuropathy.

Objectives

Methods

Results

Conclusions

Publications

Sensitivity and specificity of high frequency ultrasound score (DCEC) in diabetic peripheral neuropathy.

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