Contribution of central neuropathy to postural instability in IDDM patients with peripheral neuropathy.
Identifieur interne : 001463 ( Main/Curation ); précédent : 001462; suivant : 001464Contribution of central neuropathy to postural instability in IDDM patients with peripheral neuropathy.
Auteurs : L. Uccioli [Italie] ; P G Giacomini ; P. Pasqualetti ; S. Di Girolamo ; P. Ferrigno ; G. Monticone ; E. Bruno ; P. Boccasena ; A. Magrini ; L. Parisi ; G. Menzinger ; P M RossiniSource :
- Diabetes care [ 0149-5992 ] ; 1997.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Conduction nerveuse (MeSH), Diabète de type 1 (physiopathologie), Encéphale (physiopathologie), Femelle (MeSH), Humains (MeSH), Jambe (MeSH), Maladies du système nerveux central (physiopathologie), Motoneurones (physiologie), Muscles squelettiques (innervation), Mâle (MeSH), Nerf fibulaire commun (physiopathologie), Nerf sural (physiopathologie), Nerf tibial (physiopathologie), Neurones afférents (physiologie), Neuropathies diabétiques (physiopathologie), Neuropathies périphériques (physiopathologie), Posture (MeSH), Potentiels évoqués moteurs (MeSH), Potentiels évoqués somatosensoriels (MeSH), Protéinurie (MeSH), Rétinopathie diabétique (MeSH).
- MESH :
- physiologie : Motoneurones, Neurones afférents.
- physiopathologie : Diabète de type 1, Encéphale, Maladies du système nerveux central, Nerf fibulaire commun, Nerf sural, Nerf tibial, Neuropathies diabétiques, Neuropathies périphériques.
- innervation : Adulte, Conduction nerveuse, Femelle, Humains, Jambe, Muscles squelettiques, Mâle, Posture, Potentiels évoqués moteurs, Potentiels évoqués somatosensoriels, Protéinurie, Rétinopathie diabétique.
English descriptors
- KwdEn :
- Adult (MeSH), Brain (physiopathology), Central Nervous System Diseases (physiopathology), Diabetes Mellitus, Type 1 (physiopathology), Diabetic Neuropathies (physiopathology), Diabetic Retinopathy (MeSH), Evoked Potentials, Motor (MeSH), Evoked Potentials, Somatosensory (MeSH), Female (MeSH), Humans (MeSH), Leg (MeSH), Male (MeSH), Motor Neurons (physiology), Muscle, Skeletal (innervation), Neural Conduction (MeSH), Neurons, Afferent (physiology), Peripheral Nervous System Diseases (physiopathology), Peroneal Nerve (physiopathology), Posture (MeSH), Proteinuria (MeSH), Sural Nerve (physiopathology), Tibial Nerve (physiopathology).
- MESH :
- innervation : Muscle, Skeletal.
- physiology : Motor Neurons, Neurons, Afferent.
- physiopathology : Brain, Central Nervous System Diseases, Diabetes Mellitus, Type 1, Diabetic Neuropathies, Peripheral Nervous System Diseases, Peroneal Nerve, Sural Nerve, Tibial Nerve.
- Adult, Diabetic Retinopathy, Evoked Potentials, Motor, Evoked Potentials, Somatosensory, Female, Humans, Leg, Male, Neural Conduction, Posture, Proteinuria.
Abstract
OBJECTIVE
To evaluate the contribution of central neuropathy on postural impairment observed in diabetic patients with peripheral neuropathy.
RESEARCH DESIGN AND METHODS
Central sensory and motor nervous propagation, nerve conduction velocity, and static posturography were assessed in the following age-matched subjects: 7 IDDM patients with peripheral neuropathy (group DN), 18 IDDM patients without peripheral neuropathy (group D), and 31 control subjects (group C). Somatosensory-evoked potentials (SEPs) during tibial nerve stimulation were recorded, and the spine-to-scalp sensory central conduction time (SCCT) was evaluated. Motor-evoked potentials (MEPs) were recorded from leg muscles during magnetic transcranial brain stimulation, and the scalp-to-spine motor central conduction time (MCCT) was evaluated. The following posturographic parameters were calculated from the statokinesigram: trace length, trace surface, velocity of body sway with its standard deviation, and VFY (a parameter derived from the velocity variance and the anteroposterior mean position of the body).
RESULTS
SCCT was significantly higher in the DN group than in the C and D groups (P < 0.001). MCCT was similar in all groups. Posturographic parameters were all significantly impaired in the DN group (P < 0.01). While posturographic parameters showed a direct relationship with some parameters of peripheral nerve conduction, no correlations were observed with SEP and MEP central conduction time. These results were also confirmed by logistic regression, which indicates peripheral neuropathy as the only implicating factor in postural instability (odds ratio 0.22, 95% CI 0.07-0.75) after data reduction by means of factor analysis.
CONCLUSIONS
Although diabetic patients with peripheral neuropathy show a delay in central sensory conduction, postural instability may be fully explained by the presence of peripheral neuropathy.
DOI: 10.2337/diacare.20.6.929
PubMed: 9167102
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Di Girolamo</name></author><author><name sortKey="Ferrigno, P" sort="Ferrigno, P" uniqKey="Ferrigno P" first="P" last="Ferrigno">P. Ferrigno</name></author><author><name sortKey="Monticone, G" sort="Monticone, G" uniqKey="Monticone G" first="G" last="Monticone">G. Monticone</name></author><author><name sortKey="Bruno, E" sort="Bruno, E" uniqKey="Bruno E" first="E" last="Bruno">E. Bruno</name></author><author><name sortKey="Boccasena, P" sort="Boccasena, P" uniqKey="Boccasena P" first="P" last="Boccasena">P. Boccasena</name></author><author><name sortKey="Magrini, A" sort="Magrini, A" uniqKey="Magrini A" first="A" last="Magrini">A. Magrini</name></author><author><name sortKey="Parisi, L" sort="Parisi, L" uniqKey="Parisi L" first="L" last="Parisi">L. Parisi</name></author><author><name sortKey="Menzinger, G" sort="Menzinger, G" uniqKey="Menzinger G" first="G" last="Menzinger">G. 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Uccioli</name><affiliation wicri:level="1"><nlm:affiliation>Department of Endocrinology, University of Rome Tor Vergata, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Endocrinology, University of Rome Tor Vergata</wicri:regionArea></affiliation></author><author><name sortKey="Giacomini, P G" sort="Giacomini, P G" uniqKey="Giacomini P" first="P G" last="Giacomini">P G Giacomini</name></author><author><name sortKey="Pasqualetti, P" sort="Pasqualetti, P" uniqKey="Pasqualetti P" first="P" last="Pasqualetti">P. Pasqualetti</name></author><author><name sortKey="Di Girolamo, S" sort="Di Girolamo, S" uniqKey="Di Girolamo S" first="S" last="Di Girolamo">S. Di Girolamo</name></author><author><name sortKey="Ferrigno, P" sort="Ferrigno, P" uniqKey="Ferrigno P" first="P" last="Ferrigno">P. Ferrigno</name></author><author><name sortKey="Monticone, G" sort="Monticone, G" uniqKey="Monticone G" first="G" last="Monticone">G. Monticone</name></author><author><name sortKey="Bruno, E" sort="Bruno, E" uniqKey="Bruno E" first="E" last="Bruno">E. Bruno</name></author><author><name sortKey="Boccasena, P" sort="Boccasena, P" uniqKey="Boccasena P" first="P" last="Boccasena">P. Boccasena</name></author><author><name sortKey="Magrini, A" sort="Magrini, A" uniqKey="Magrini A" first="A" last="Magrini">A. Magrini</name></author><author><name sortKey="Parisi, L" sort="Parisi, L" uniqKey="Parisi L" first="L" last="Parisi">L. Parisi</name></author><author><name sortKey="Menzinger, G" sort="Menzinger, G" uniqKey="Menzinger G" first="G" last="Menzinger">G. Menzinger</name></author><author><name sortKey="Rossini, P M" sort="Rossini, P M" uniqKey="Rossini P" first="P M" last="Rossini">P M Rossini</name></author></analytic><series><title level="j">Diabetes care</title><idno type="ISSN">0149-5992</idno><imprint><date when="1997" type="published">1997</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Brain (physiopathology)</term><term>Central Nervous System Diseases (physiopathology)</term><term>Diabetes Mellitus, Type 1 (physiopathology)</term><term>Diabetic Neuropathies (physiopathology)</term><term>Diabetic Retinopathy (MeSH)</term><term>Evoked Potentials, Motor (MeSH)</term><term>Evoked Potentials, Somatosensory (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Leg (MeSH)</term><term>Male (MeSH)</term><term>Motor Neurons (physiology)</term><term>Muscle, Skeletal (innervation)</term><term>Neural Conduction (MeSH)</term><term>Neurons, Afferent (physiology)</term><term>Peripheral Nervous System Diseases (physiopathology)</term><term>Peroneal Nerve (physiopathology)</term><term>Posture (MeSH)</term><term>Proteinuria (MeSH)</term><term>Sural Nerve (physiopathology)</term><term>Tibial Nerve (physiopathology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Conduction nerveuse (MeSH)</term><term>Diabète de type 1 (physiopathologie)</term><term>Encéphale (physiopathologie)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Jambe (MeSH)</term><term>Maladies du système nerveux central (physiopathologie)</term><term>Motoneurones (physiologie)</term><term>Muscles squelettiques (innervation)</term><term>Mâle (MeSH)</term><term>Nerf fibulaire commun (physiopathologie)</term><term>Nerf sural (physiopathologie)</term><term>Nerf tibial (physiopathologie)</term><term>Neurones afférents (physiologie)</term><term>Neuropathies diabétiques (physiopathologie)</term><term>Neuropathies périphériques (physiopathologie)</term><term>Posture (MeSH)</term><term>Potentiels évoqués moteurs (MeSH)</term><term>Potentiels évoqués somatosensoriels (MeSH)</term><term>Protéinurie (MeSH)</term><term>Rétinopathie diabétique (MeSH)</term></keywords><keywords scheme="MESH" qualifier="innervation" xml:lang="en"><term>Muscle, Skeletal</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Motoneurones</term><term>Neurones afférents</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Motor Neurons</term><term>Neurons, Afferent</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Diabète de type 1</term><term>Encéphale</term><term>Maladies du système nerveux central</term><term>Nerf fibulaire commun</term><term>Nerf sural</term><term>Nerf tibial</term><term>Neuropathies diabétiques</term><term>Neuropathies périphériques</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Brain</term><term>Central Nervous System Diseases</term><term>Diabetes Mellitus, Type 1</term><term>Diabetic Neuropathies</term><term>Peripheral Nervous System Diseases</term><term>Peroneal Nerve</term><term>Sural Nerve</term><term>Tibial Nerve</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Diabetic Retinopathy</term><term>Evoked Potentials, Motor</term><term>Evoked Potentials, Somatosensory</term><term>Female</term><term>Humans</term><term>Leg</term><term>Male</term><term>Neural Conduction</term><term>Posture</term><term>Proteinuria</term></keywords><keywords scheme="MESH" qualifier="innervation" xml:lang="fr"><term>Adulte</term><term>Conduction nerveuse</term><term>Femelle</term><term>Humains</term><term>Jambe</term><term>Muscles squelettiques</term><term>Mâle</term><term>Posture</term><term>Potentiels évoqués moteurs</term><term>Potentiels évoqués somatosensoriels</term><term>Protéinurie</term><term>Rétinopathie diabétique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To evaluate the contribution of central neuropathy on postural impairment observed in diabetic patients with peripheral neuropathy.</p></div><div type="abstract" xml:lang="en"><p><b>RESEARCH DESIGN AND METHODS</b></p><p>Central sensory and motor nervous propagation, nerve conduction velocity, and static posturography were assessed in the following age-matched subjects: 7 IDDM patients with peripheral neuropathy (group DN), 18 IDDM patients without peripheral neuropathy (group D), and 31 control subjects (group C). Somatosensory-evoked potentials (SEPs) during tibial nerve stimulation were recorded, and the spine-to-scalp sensory central conduction time (SCCT) was evaluated. Motor-evoked potentials (MEPs) were recorded from leg muscles during magnetic transcranial brain stimulation, and the scalp-to-spine motor central conduction time (MCCT) was evaluated. The following posturographic parameters were calculated from the statokinesigram: trace length, trace surface, velocity of body sway with its standard deviation, and VFY (a parameter derived from the velocity variance and the anteroposterior mean position of the body).</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>SCCT was significantly higher in the DN group than in the C and D groups (P < 0.001). MCCT was similar in all groups. Posturographic parameters were all significantly impaired in the DN group (P < 0.01). While posturographic parameters showed a direct relationship with some parameters of peripheral nerve conduction, no correlations were observed with SEP and MEP central conduction time. These results were also confirmed by logistic regression, which indicates peripheral neuropathy as the only implicating factor in postural instability (odds ratio 0.22, 95% CI 0.07-0.75) after data reduction by means of factor analysis.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Although diabetic patients with peripheral neuropathy show a delay in central sensory conduction, postural instability may be fully explained by the presence of peripheral neuropathy.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">9167102</PMID><DateCompleted><Year>1997</Year><Month>07</Month><Day>24</Day></DateCompleted><DateRevised><Year>2019</Year><Month>05</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0149-5992</ISSN><JournalIssue CitedMedium="Print"><Volume>20</Volume><Issue>6</Issue><PubDate><Year>1997</Year><Month>Jun</Month></PubDate></JournalIssue><Title>Diabetes care</Title><ISOAbbreviation>Diabetes Care</ISOAbbreviation></Journal><ArticleTitle>Contribution of central neuropathy to postural instability in IDDM patients with peripheral neuropathy.</ArticleTitle><Pagination><MedlinePgn>929-34</MedlinePgn></Pagination><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To evaluate the contribution of central neuropathy on postural impairment observed in diabetic patients with peripheral neuropathy.</AbstractText><AbstractText Label="RESEARCH DESIGN AND METHODS" NlmCategory="METHODS">Central sensory and motor nervous propagation, nerve conduction velocity, and static posturography were assessed in the following age-matched subjects: 7 IDDM patients with peripheral neuropathy (group DN), 18 IDDM patients without peripheral neuropathy (group D), and 31 control subjects (group C). Somatosensory-evoked potentials (SEPs) during tibial nerve stimulation were recorded, and the spine-to-scalp sensory central conduction time (SCCT) was evaluated. Motor-evoked potentials (MEPs) were recorded from leg muscles during magnetic transcranial brain stimulation, and the scalp-to-spine motor central conduction time (MCCT) was evaluated. The following posturographic parameters were calculated from the statokinesigram: trace length, trace surface, velocity of body sway with its standard deviation, and VFY (a parameter derived from the velocity variance and the anteroposterior mean position of the body).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">SCCT was significantly higher in the DN group than in the C and D groups (P < 0.001). MCCT was similar in all groups. Posturographic parameters were all significantly impaired in the DN group (P < 0.01). While posturographic parameters showed a direct relationship with some parameters of peripheral nerve conduction, no correlations were observed with SEP and MEP central conduction time. These results were also confirmed by logistic regression, which indicates peripheral neuropathy as the only implicating factor in postural instability (odds ratio 0.22, 95% CI 0.07-0.75) after data reduction by means of factor analysis.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Although diabetic patients with peripheral neuropathy show a delay in central sensory conduction, postural instability may be fully explained by the presence of peripheral neuropathy.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Uccioli</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Endocrinology, University of Rome Tor Vergata, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Giacomini</LastName><ForeName>P G</ForeName><Initials>PG</Initials></Author><Author ValidYN="Y"><LastName>Pasqualetti</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Di Girolamo</LastName><ForeName>S</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Ferrigno</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Monticone</LastName><ForeName>G</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Bruno</LastName><ForeName>E</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Boccasena</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Magrini</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Parisi</LastName><ForeName>L</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Menzinger</LastName><ForeName>G</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Rossini</LastName><ForeName>P M</ForeName><Initials>PM</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Diabetes Care</MedlineTA><NlmUniqueID>7805975</NlmUniqueID><ISSNLinking>0149-5992</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001921" MajorTopicYN="N">Brain</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002493" MajorTopicYN="N">Central Nervous System Diseases</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003922" MajorTopicYN="N">Diabetes Mellitus, Type 1</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003929" MajorTopicYN="N">Diabetic Neuropathies</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003930" MajorTopicYN="N">Diabetic Retinopathy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019054" MajorTopicYN="N">Evoked Potentials, Motor</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005073" MajorTopicYN="N">Evoked Potentials, Somatosensory</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007866" MajorTopicYN="N">Leg</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009046" MajorTopicYN="N">Motor Neurons</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018482" MajorTopicYN="N">Muscle, Skeletal</DescriptorName><QualifierName UI="Q000294" MajorTopicYN="N">innervation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009431" MajorTopicYN="N">Neural Conduction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009475" MajorTopicYN="N">Neurons, Afferent</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010523" MajorTopicYN="N">Peripheral Nervous System Diseases</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010543" MajorTopicYN="N">Peroneal Nerve</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011187" MajorTopicYN="Y">Posture</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011507" MajorTopicYN="N">Proteinuria</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013497" MajorTopicYN="N">Sural Nerve</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013979" MajorTopicYN="N">Tibial Nerve</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1997</Year><Month>6</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1997</Year><Month>6</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1997</Year><Month>6</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId 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