ABSTRACT
BACKGROUND: An early diagnosis of peripheral neuropathy in diabetic patients is useful in order to slow down the progress of this complication. Nerve conduction tests are the gold standard for this diagnosis but they are challenging for the patients. This study examines whether it is possible to assess the presence of diabetic neuropathy at an early stage by static posturography tests. METHODS: Static posturography tests were performed on 37 type-2 diabetic subjects (25 neuropathic patients and 12 non-neuropathic control subjects). Each subject was tested twice under two visual conditions: open and closed eyes. Both "global" (classic) and "structural" (model-based) posturographic parameters (PP) were derived from centre-of-pressure trajectories. A total of 65 PP were computed but only five were selected, normalized and fed to a linear classifier based on linear discriminant analysis. RESULTS: This method correctly classified 86.5% of the patients. Five subjects were misclassified and only 2 false negatives out of 25 neuropathic subjects were erroneously diagnosed as control subjects. CONCLUSIONS: This paper shows that "global" and "structural" parameters derived by static posturography tests, and classic linear statistical approaches, can be used for the diagnosis of neuropathy provided PP are properly chosen and normalized.
Subject(s)
Diabetes Mellitus, Type 2/physiopathology , Diabetic Neuropathies/diagnosis , Neural Conduction/physiology , Peripheral Nervous System Diseases/diagnosis , Posture/physiology , Aged , Anthropometry , Body Mass Index , Case-Control Studies , Diabetic Neuropathies/physiopathology , Discriminant Analysis , Early Diagnosis , Female , Humans , Linear Models , Male , Middle Aged , Multivariate Analysis , Neurologic Examination/methods , Peripheral Nervous System Diseases/physiopathology , Peroneal Nerve/physiopathology , Postural Balance/physiology , Reference Values , Severity of Illness IndexABSTRACT
Aim of this work was to evaluate Parkinsonian (PARK) patients at their initial stage of the disease by static posturography in order to study: the stability of posture system; the role of visual input; the influence of an acute administration of levodopa. This would allow the creation of a database that can be useful to follow the progression of the disease. Attention was also focused on the assessment of the reliability of quantitative posturographic parameters (PP); a large number of PP that can be derived using classical, structural, and nonlinear approaches have been considered. Particular attention has been given to this latter approach. The class of PD subjects examined in this work resulted to be very different from classical Parkinsonian subjects studied in literature.
