Clinical significance of double peak responses in nerve conduction study of diabetic patients

초록

Objectives: To understand the meaning of the double peak responses in NCS of diabetic patients. Methods: 32 diabetic and 53 healthy volunteers were recruited for the study. Conventional Nerve Conduction Studies (NCS) on median, ulnar, peroneal and tibial nerves were done in diabetic groups and the double peak responses (orthodromic submaximimal stimulation) were obtained from median nerve in both groups. Toronto clinical scoring system (TCSS) for diabetic neuropathy was applied to all diabetic patients to determine a clinical neuropathy score. Composite score (CS) of the NCS was obtained from peroneal, sural and tibial nerves. TCSS, CS and double peak responses were analyzed. Results: TCSS showed a significant correlation with double peak responses; 4cm distance 2nd peak latency (r= 0.59, p<0.05) and amplitudes (r=-0.39, p<0.05). CS also showed significant correlation with 4cm distance 2nd peak latency (r=0.62, p<0.05). Conclusion: The double peak response is a valid measurement to reflect the presence and severity of the diabetic neuropathy. The distal finger nerve potential representing as double peak potential can offer clinically relevant meaningful information on the progression of diabetic neuropathy