https://scholars.lib.ntu.edu.tw/handle/123456789/467757
標題: | Pathophysiology of neuropathic pain in type 2 diabetes: Skin denervation and contact heat-evoked potentials | 作者: | CHI-CHAO CHAO MING-TSUNG TSENG Lin Y.-J. WEI-SHIUNG YANG SONG-CHOU HSIEH Lin Y.-H. MING-JANG CHIU Chang Y.-C. SUNG-TSANG HSIEH |
公開日期: | 2010 | 卷: | 33 | 期: | 12 | 起(迄)頁: | 2654-2659 | 來源出版物: | Diabetes Care | 摘要: | OBJECTIVE - Neuropathic pain due to small-fiber sensory neuropathy in type 2 diabetes can be diagnosed by skin biopsy with quantification of intra-epidermal nerve fiber (IENF) density. There is, however, a lack of noninvasive physiological assessment. Contact heat- evoked potential (CHEP) is a newly developed approach to record cerebral responses of Aδ fiber-mediated thermonociceptive stimuli. We investigated the diagnostic role of CHEP. RESEARCH DESIGN AND METHODS - From 2006 to 2009, there were 32 type 2 diabetic patients (20 males and 12 females, aged 51.63±10.93 years) with skin denervation and neuropathic pain. CHEPs were recorded with heat stimulations at the distal leg, where skin biopsy was performed. RESULTS - CHEP amplitude was reduced in patients compared with age- and sex-matched control subjects (14.8 ± 15.6 vs. 33.7 ± 10.1 μV, P < 0.001). Abnormal CHEP patterns (reduced amplitude or prolonged latency) were noted in 81.3% of these patients. The CHEP amplitude was the most significant parameter correlated with IENF density (P=0.003) and pain perception to contact heat stimuli (P = 0.019) on multiple linear regression models. An excitability index was derived by calculating the ratio of the CHEP amplitude over the IENF density. This excitability index was higher in diabetic patients than in control subjects (P = 0.023), indicating enhanced brain activities in neuropathic pain. Among different neuropathic pain symptoms, the subgroup with evoked pain had higher CHEP amplitudes than the subgroup without evoked pain (P = 0.011). CONCLUSIONS - CHEP offers a noninvasive approach to evaluate the degeneration of thermonociceptive nerves in diabetic neuropathy by providing physiological correlates of skin denervation and neuropathic pain. ? 2010 by the American Diabetes Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-79951688136&doi=10.2337%2fdc10-1135&partnerID=40&md5=e19eb99e2f0c87f9f15b034574f4e938 https://scholars.lib.ntu.edu.tw/handle/123456789/467757 |
ISSN: | 0149-5992 | DOI: | 10.2337/dc10-1135 | SDG/關鍵字: | adult; age distribution; article; clinical article; contact heat evoked potential; controlled study; denervation; diabetic neuropathy; diabetic patient; electroencephalogram; evoked response; female; heat sensitivity; human; male; multiple linear regression analysis; nerve excitability; nerve stimulation; nervous system parameters; neuropathic pain; nociception; non insulin dependent diabetes mellitus; sex difference; Adult; Aged; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Evoked Potentials; Female; Hot Temperature; Humans; Male; Middle Aged; Neuralgia; Skin; Young Adult |
顯示於: | 解剖學暨細胞生物學科所 |
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