Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes

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*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

2 Scopus citations

Abstract

Objective: Both diabetic distal symmetrical polyneuropathy (DSPN) and cardiac autonomic neuropathy (CAN) indicate the length-dependent pattern of disease. Decreased parasympathetic activity has been found in the early phase of CAN and sural sensory nerve action potential (SNAP) imply axonal loss in DSPN. Method: All patients with type 2 diabetes underwent cardiovascular autonomic function and nerve conduction studies (NCS). We constructed modified composite autonomic scoring scale (CASS) and composite score of NCS to measure the severity of CAN and DSPN, respectively. Results: Patients with a longer duration of diabetes had a lower heart rate response to deep breathing (HR_DB), Valsalva ratio (VR), and baroreflex sensitivity (BRS), higher CASS, a higher percentage of CAN, lower sural SNAP, higher composite score of NCS, and a higher percentage of DSPN. Multiple linear regression analysis showed that only sural SNAPs were independently associated with mean HR_DB. Conclusion: Sural SNAP was closely correlated with parameters of cardiovagal functions in patients with different durations of diabetes. The percentage and severity of CAN and DSPN increase with longer duration of diabetes. Significance: The independent association of sural sensory nerve action potential amplitude and heart rate response to deep breathing with type 2 diabetes is important because combined testing increases diagnostic sensitivity and specificity.

Original languageEnglish
Pages (from-to)1160-1165
Number of pages6
JournalClinical Neurophysiology
Volume130
Issue number7
DOIs
StatePublished - 07 2019

Bibliographical note

Publisher Copyright:
© 2019 International Federation of Clinical Neurophysiology

Keywords

  • Cardiac autonomic neuropathy (CAN)
  • Diabetic distal symmetrical polyneuropathy (DSPN)
  • Heart rate response to deep breathing (HR_DB)
  • Sensory nerve action potentials (SNAPs)
  • Valsalva ratio (VR)

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