Correlation of vibratory quantitative sensory testing and nerve conduction studies in patients with diabetes
John C. Kincaid MD
Department of Neurology, Indiana University, Indianapolis, Indiana, USA
Search for more papers by this authorKaren L. Price PhD
Lilly Research Laboratories, Eli Lilly and Co., Lilly Corporate Center, D/C 6112, Indianapolis, Indiana 46285, USA
Search for more papers by this authorMaria C. Jimenez PhD
Lilly Research Laboratories, Eli Lilly and Co., Lilly Corporate Center, D/C 6112, Indianapolis, Indiana 46285, USA
Search for more papers by this authorCorresponding Author
Vladimir Skljarevski MD
Lilly Research Laboratories, Eli Lilly and Co., Lilly Corporate Center, D/C 6112, Indianapolis, Indiana 46285, USA
Lilly Research Laboratories, Eli Lilly and Co., Lilly Corporate Center, D/C 6112, Indianapolis, Indiana 46285, USASearch for more papers by this authorJohn C. Kincaid MD
Department of Neurology, Indiana University, Indianapolis, Indiana, USA
Search for more papers by this authorKaren L. Price PhD
Lilly Research Laboratories, Eli Lilly and Co., Lilly Corporate Center, D/C 6112, Indianapolis, Indiana 46285, USA
Search for more papers by this authorMaria C. Jimenez PhD
Lilly Research Laboratories, Eli Lilly and Co., Lilly Corporate Center, D/C 6112, Indianapolis, Indiana 46285, USA
Search for more papers by this authorCorresponding Author
Vladimir Skljarevski MD
Lilly Research Laboratories, Eli Lilly and Co., Lilly Corporate Center, D/C 6112, Indianapolis, Indiana 46285, USA
Lilly Research Laboratories, Eli Lilly and Co., Lilly Corporate Center, D/C 6112, Indianapolis, Indiana 46285, USASearch for more papers by this authorAbstract
Monitoring the course of diabetic peripheral neuropathy (DPN) remains a challenge. Besides clinical examination, nerve conduction studies (NCS) and quantitative sensory testing (QST) are the most commonly used methods for evaluating peripheral nerve function in clinical trials and population studies. In this study the correlation between vibratory QST and NCS was determined. Patients (N = 227) with diabetes mellitus participated in this multicenter, single-visit, cross-sectional study. QST of vibration measured with the CASE IV system was compared with a composite score of peroneal motor and tibial motor NCS and with individual attributes of peroneal, tibial, and sural nerves. The correlation between QST and composite score of NCS was 0.234 (Pearson correlation coefficient, P = 0.001). The correlations between QST and individual attributes of NCS ranged from 0.189 to 0.480 (Pearson correlation coefficients, P < 0.001). The low to moderate correlation between QST and NCS suggests that these tests cannot replace each other but are complementary. Muscle Nerve, 2007
REFERENCES
- 1 Anonymous. Consensus statement: report and recommendations of the San Antonio conference on diabetic neuropathy. American Diabetes Association and American Academy of Neurology. Diabetes Care 1988; 11: 592–597.
- 2 Bastyr EJ III, Price KL, Bril V. Development and validity testing of the Neuropathy Total Symptom Score-6: questionnaire for the study of sensory symptoms of diabetic peripheral neuropathy. Clin Ther 2005; 27: 1278–1294.
- 3 Bird SJ, Brown MJ, Spino C, Watling S, Foyt HL. Value of repeated measures of nerve conduction and quantitative sensory testing in a diabetic neuropathy trial. Muscle Nerve 2006; 34: 214–224.
- 4 Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care 2005; 28: 956–962.
- 5 Bril V. NIS-LL: the primary measurement scale for clinical trial endpoints in diabetic peripheral neuropathy. Eur Neurol 1999; 41 Suppl 1: 8–13.
- 6 Bril V, Kojic J, Ngo M, Clark K. Comparison of a neurothesiometer and vibration in measuring vibration perception thresholds and relationship to nerve conduction studies. Diabetes Care 1997; 20: 1360–1362.
- 7 Bril V, Perkins BA. Comparison of vibration perception thresholds obtained with the neurothesiometer and the CASE IV and relationship to nerve conduction studies. Diabet Med 2002; 19: 661–666.
- 8 Dyck PJ, Bushek W, Spring EM, Karnes JL, Litchy WJ, O'Brien PC, et al. Vibratory and cooling detection thresholds compared with other tests in diagnosing and staging diabetic neuropathy. Diabetes Care 1987; 10: 432–440.
- 9 Dyck PJ, Davies JL, Litchy WJ, O'Brien PC. Longitudinal assessment of diabetic polyneuropathy using a composite score in the Rochester diabetic neuropathy study cohort. Neurology 1997; 49: 229–239.
- 10 Dyck PJ, Dyck PJ, Larson TS, O'Brien PC, Velosa JA. Patterns of quantitative sensation testing of hypoesthesia and hyperalgesia are predictive of diabetic polyneuropathy: a study of three cohorts. Nerve growth factor study group. Diabetes Care 2000; 23: 510–517.
- 11 Dyck PJ, Kratz KM, Karnes JL, Litchy WJ, Klein R, Pach JM, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester diabetic neuropathy study. Neurology 1993; 43: 817–824.
- 12 Dyck PJ, Litchy WJ, Lehman KA, Hokanson JL, Low PA, O'Brien PC. Variables influencing neuropathic endpoints: the Rochester diabetic neuropathy study of healthy subjects. Neurology 1995; 45: 1115–1121.
- 13 Dyck PJ, O'Brien PC, Kosanke JL, Gillen DA, Karnes JL. A 4, 2, and 1 stepping algorithm for quick and accurate estimation of cutaneous sensation threshold. Neurology 1993; 43: 1508–1512.
- 14 Dyck PJ, Sherman WR, Hallcher LM, Service FJ, O'Brien PC, Grina LA, et al. Human diabetic endoneurial sorbitol, fructose, and myo-inositol related to sural nerve morphometry. Ann Neurol 1980; 8: 590–596.
- 15 Fedele D, Comi G, Coscelli C, Cucinotta D, Feldman EL, Ghirlanda G, et al. A multicenter study on the prevalence of diabetic neuropathy in Italy. Italian Diabetic Neuropathy Committee. Diabetes Care 1997; 20: 836–843.
- 16 Gregersen G. Vibratory perception threshold and motor conduction velocity in diabetics and non-diabetics. Acta Med Scand 1968; 183: 61–65.
- 17 Kastenbauer T, Sauseng S, Brath H, Abrahamian H, Irsigler K. The value of the Rydel-Seiffer tuning fork as a predictor of diabetic polyneuropathy compared with a neurothesiometer. Diabet Med 2004; 21: 563–567.
- 18 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–174.
- 19 Maser RE, Steenkiste AR, Dorman JS, Nielsen VK, Bass EB, Manjoo Q, et al. Epidemiological correlates of diabetic neuropathy. Report from the Pittsburgh epidemiology of diabetes complications study. Diabetes 1989; 38: 1456–1461.
- 20
Miller LE.
Correlations: description or inference?
J Agricult Ed
1994;
35:
5–7.
10.5032/jae.1994.01005 Google Scholar
- 21 Pestronk A, Florence J, Levine T, Al-Lozi MT, Lopate G, Miller T, et al. Sensory exam with a quantitative tuning fork: rapid, sensitive and predictive of SNAP amplitude. Neurology 2004; 62: 461–464.
- 22 Siao P, Cros DP. Quantitative sensory testing. Phys Med Rehabil Clin N Am 2003; 14: 261–286.
- 23 U.S. Department of Health and Human Services. Guidance for industry. E6 Good clinical practice: consolidated guidance. 1996.
- 24 Vinik AI, Park TS, Stansberry KB, Pittenger GL. Diabetic neuropathies. Diabetologia 2000; 43: 957–973.
- 25 World Medical Association General Assembly. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Nurs Ethics 2002; 9: 105–109.
- 26 Young MJ, Boulton AJ, MacLeod AF, Williams DR, Sonksen PH. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom Hospital clinic population. Diabetologia 1993; 36: 150–154.
- 27 Young MJ, Every N, Boulton AJ. A Comparison of the neurothesiometer and biothesiometer for measuring vibration perception in diabetic patients. Diabetes Res Clin Pract 1993; 20: 129–131.