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Novel strategy: Identifying new markers for demyelination in diabetic distal symmetrical polyneuropathy.
Souayah, Nizar; Chen, Hongxin; Chong, Zhao Zhong; Patel, Tejas; Pahwa, Ankit; Menkes, Daniel L; Cunningham, Timothy.
Afiliação
  • Souayah N; New Jersey Medical School, 90 Bergen Street DOC 8100, Newark, NJ, 07101, USA.
  • Chen H; New Jersey Medical School, 90 Bergen Street DOC 8100, Newark, NJ, 07101, USA.
  • Chong ZZ; New Jersey Medical School, 90 Bergen Street DOC 8100, Newark, NJ, 07101, USA.
  • Patel T; New Jersey Medical School, 90 Bergen Street DOC 8100, Newark, NJ, 07101, USA.
  • Pahwa A; SMR Consulting, 407 Elmwood Avenue, Sharon Hill, PA, 19079, USA.
  • Menkes DL; Department of Neurology, Oakland University William Beaumont School of Medicine, 3555 West 13 Mile Road, Suite N120, Royal Oak, MI, 48073, USA.
  • Cunningham T; Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, 19129, USA.
Heliyon ; 10(9): e30419, 2024 May 15.
Article em En | MEDLINE | ID: mdl-38765173
ABSTRACT

Objective:

To develop a novel strategy for identifying acquired demyelination in diabetic distal symmetrical polyneuropathy (DSP).

Background:

Motor nerve conduction velocity (CV) slowing in diabetic DSP exceeds expectations for pure axonal loss thus implicating superimposed acquired demyelination.

Methods:

After establishing demyelination confidence intervals by regression analysis of nerve conduction data from chronic inflammatory demyelinating polyneuropathy (CIDP), we prospectively studied CV slowing in 90 diabetic DSP patients with and without at least one motor nerve exhibiting CV slowing (groups A and B) into the demyelination range by American Academy of Neurology (AAN) criteria respectively and 95 amyotrophic lateral sclerosis (ALS) patients. Simultaneously, secretory phospholipase A2 (sPLA2) activity was assessed in both diabetic groups and 46 healthy controls.

Results:

No ALS patient exhibited CV slowing in more than two motor nerves based on AAN criteria or the confidence intervals. Group A demonstrated a significantly higher percentage of patients as compared to group B fulfilling the above criteria, with an additional criterion of at least one motor nerve exhibiting CV slowing in the demyelinating range and a corresponding F response in the demyelinating range by AAN criteria (70.3 % vs. 1.9 %; p < 0.0001). Urine sPLA2 activity was increased significantly in diabetic groups as compared to healthy controls (942.9 ± 978.0 vs. 591.6 ± 390.2 pmol/min/ml, p < 0.05), and in group A compared to Group B (1328.3 ± 1274.2 vs. 673.8 ± 576.9 pmol/min/ml, p < 0.01). More patients with elevated sPLA2 activity and more than 2 motor nerves with CV slowing in the AAN or the confidence intervals were identified in group A as compared to group B (35.1 % vs. 5.7 %, p < 0.001). Furthermore, 13.5 % of patients in diabetic DSP Group A, and no patients in diabetic DSP Group B, fulfilled an additional criterion of more than one motor nerve with CV slowing into the demyelinating range with its corresponding F response into the demyelinating range by AAN criteria.

Conclusion:

A combination of regression analysis of electrodiagnostic data and a urine biological marker of systemic inflammation identifies a subgroup of diabetic DSP with superimposed acquired demyelination that may respond favorably to immunomodulatory therapy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article