title: Assessment of the medial dorsal cutaneous, dorsal sural, and medial plantar nerves in impaired glucose tolerance and diabetic patients with normal sural and superficial peroneal nerve responses.
abstract: OBJECTIVE
  This study evaluated the nerve conduction study (NCS) parameters of the most distal sensory nerves of the lower extremities-namely, the medial dorsal cutaneous (MDC), dorsal sural (DS), and medial plantar (MP) nerves-in diabetic (DM) and impaired glucose tolerance (IGT) patients who displayed normal findings on their routine NCSs.
  
  
  METHODS
  Standard NCSs were performed on healthy control (HC), DM, and IGT groups (N = 147). The bilateral NCS parameters of the MDC, DS, and MP nerves were investigated. The Toronto Clinical Scoring System (TCSS) was assessed for the DM and IGT groups.
  
  
  RESULTS
  The mean TCSS scores of the IGT and DM groups were 2.5 ± 2.3 and 2.8 ± 2.2, respectively. No significant differences between the two groups were observed. After adjustment of age and BMI, the DM group showed significant NCS differences in DS and MDC nerves compared with the HC group (P < 0.05). These differences were also exhibited in the left DS of the IGT group (P = 0.0003). More advanced NCS findings were observed in the DM group. Bilateral abnormal NCS responses in these distal sensory nerves were found in 40 and 16% of DM and IGT patients, respectively.
  
  
  CONCLUSIONS
  These results showed that the simultaneous assessment of the most distal sensory nerves allowed the detection of early NCS changes in the IGT and DM groups, even when the routine NCS showed normal findings.
authors.affiliation: Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon-si, Republic of Korea.
authors.forename: Sun
authors.initials: S
authors.lastname: Im
authors.forename: Sung-Rae
authors.initials: SR
authors.lastname: Kim
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Park
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Geun-Young
authors.initials: GY
authors.lastname: Park
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000328:Adult; D000368:Aged; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000503:physiopathology*; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D009460:Neurologic Examination / Q000379:methods; D010543:Peroneal Nerve / Q000503:physiopathology*; D012867:Skin / Q000294:innervation* / Q000503:physiopathology; D013497:Sural Nerve / Q000503:physiopathology*; D013979:Tibial Nerve / Q000503:physiopathology*; D055815:Young Adult
references.citation: Exp Clin Endocrinol Diabetes. 2001;109 Suppl 2:S451-73
references.pmid: 11460591
references.citation: Neurology. 2003 Jan 14;60(1):108-11
references.pmid: 12525727
references.citation: Neurology. 2004 Sep 14;63(5):879-85
references.pmid: 15365140
references.citation: J Neurol Sci. 2006 Mar 15;242(1-2):9-14
references.pmid: 16448668
references.citation: Muscle Nerve. 2010 Aug;42(2):157-64
references.pmid: 20658599
references.citation: Diabetes Care. 2008 Mar;31(3):464-9
references.pmid: 18039804
references.citation: Neurology. 2001 Nov 13;57(9):1701-4
references.pmid: 11706115
references.citation: J Endocrinol Invest. 2010 May;33(5):297-9
references.pmid: 19834315
references.citation: Muscle Nerve. 2005 Mar;31(3):386-9
references.pmid: 15508123
references.citation: Neurology. 2005 Jan 25;64(2):199-207
references.pmid: 15668414
references.citation: Clin Neurophysiol. 2008 Apr;119(4):880-5
references.pmid: 18291716
references.citation: Diabetes Care. 2001 Aug;24(8):1448-53
references.pmid: 11473085
references.citation: Muscle Nerve. 1993 Apr;16(4):424-8
references.pmid: 8455658
references.citation: Diabetes Care. 2005 Sep;28(9):2192-200
references.pmid: 16123489
references.citation: N Engl J Med. 2005 Jan 27;352(4):341-50
references.pmid: 15673800
references.citation: Diabetes Care. 2004 Jun;27(6):1458-86
references.pmid: 15161806
references.citation: J Peripher Nerv Syst. 2005 Sep;10(3):342-3
references.pmid: 16221295
references.citation: Diabetes Care. 2006 Jun;29(6):1294-9
references.pmid: 16732011
references.citation: Diabetes Care. 2002 Nov;25(11):2048-52
references.pmid: 12401755
references.citation: Eur J Neurol. 2008 Aug;15(8):810-6
references.pmid: 18549398
references.citation: Clin Neurophysiol. 2004 Jun;115(6):1452-6
references.pmid: 15134714
references.citation: Clin Neurophysiol. 2007 May;118(5):1155-61
references.pmid: 17321794
references.citation: Eur J Clin Invest. 2009 Mar;39(3):183-9
references.pmid: 19260947
references.citation: Acta Neurol Scand. 2007 Dec;116(6):399-405
references.pmid: 17986099