Quantitative sensory testing in type 1 diabetic patients with painful and painless diabetic neuropathy

  • Ahmad T. Alahmar Department of Medical Physiology, College of Medicine, University of Babylon, Iraq & Department of Endocrinology and Diabetes, Institute of Human Development, Centre for Endocrinology and Diabetes, University of Manchester, UK
Keywords: Painful diabetic neuropathy, quantitative sensory testing, McGill visual analog scale

Abstract

The mechanism underlying the development of painful diabetic neuropathy (DN) is unknown. The aim of this study was to compare quantitative sensory testing (QST) characteristics of patients with painful and painless DN and to correlate QST measures with DN pain. 50 type 1 diabetic patients with DN (30 with painful DN and 20 with painless DN) and 32 age-matched non-diabetic controls were included in this study. For all patients and controls, a detailed assessment of DN was performed which comprised McGill visual analog scale (McGill VAS) for pain, neuropathy symptom profile and neuropathy disability score, QST in form of cold thresholds (CT), warm thresholds (WT), and vibration perception thresholds (VPT), nerve conduction studies (NCS), deep-breathing hear rate variability (DB-HRV), and Neuropad staining scores. Measures of QST, NCS, and DB-HRV were correlated with McGill VAS for pain. Apart from NCS, there were no significant differences in CT, WT, and VPT, DB-HRV and Neuropad scores between patients with painful and painless DN. Cold threshold (r = −0.57, P = 0.005), warm threshold (r = 0.47, P = 0.026), and DB-HRV (r = 0.50, P = 0.023), however, correlated significantly with McGill VAS scores of pain. In conclusion, QST is a helpful tool to identify small nerve fibers damage of DN, correlates with pain intensity but cannot differentiate between painful and painless DN. Both central and peripheral neural injury could be implicated in the genesis of DN pain.

Author Biography

Ahmad T. Alahmar, Department of Medical Physiology, College of Medicine, University of Babylon, Iraq & Department of Endocrinology and Diabetes, Institute of Human Development, Centre for Endocrinology and Diabetes, University of Manchester, UK

Department of Medical Physiology, College of Medicine, University of Babylon, Iraq

Department of Endocrinology and Diabetes, Institute of Human Development, Centre for Endocrinology and Diabetes, University of Manchester, UK

McGill visual analog scale, quantitative sensory measures, deep-breathing heart rate variability, diabetic neuropathy
Published
2016-09-30
How to Cite
Alahmar, A. (2016). Quantitative sensory testing in type 1 diabetic patients with painful and painless diabetic neuropathy. Disease and Molecular Medicine, 4(3), 24-30. https://doi.org/10.5455/dmm.20160720024110
Section
Original Article