title: Intraepidermal nerve fiber density and nerve conduction study parameters correlate with clinical staging of diabetic polyneuropathy.
abstract: OBJECTIVE
  To assess the usefulness of the diagnostic and staging criteria for diabetic polyneuropathy (DP) by the Diabetic Neuropathy Study Group in Japan (DNSGJ) we examined clinical features, intraepidermal nerve fiber densities (IENFD) and nerve conduction studies (NCS) and coefficient of variation of the R-R intervals (CVR-R) in 44 patients with diabetes.
  
  
  RESULTS
  The patients were classified into stage I (n=20), II (n=6), III+IV (n=12), and V (n=6) according to the staging criteria by DNSGJ. IENFD decreased as stages progressed (13.8±7.1 fiber/mm in stage I to 0.8±1.3 fiber/mm in stage V). Compound motor and sensory action potential and motor and sensory nerve conduction velocity decreased with progressing stage. F-wave latency prolonged as stages progressed. CVR-R decreased with progressing stage (4.41%±2.65% in stage I to 1.33%±0.57% in stage V). IENFD correlated with the various parameters of NCS (r=0.378-0.636, p<0.05) and CVR-R (r=0.399, p=0.007).
  
  
  CONCLUSIONS
  Clinical staging for DP by DNSGJ reflects the results of small and large fiber neuropathy.
authors.affiliation: Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Arimura
authors.forename: Takahisa
authors.initials: T
authors.lastname: Deguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Tadashi
authors.initials: T
authors.lastname: Uto
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Arimura
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Arimura
authors.forename: Soroku
authors.initials: S
authors.lastname: Yagihashi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Nishio
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takashima
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D015536:Down-Regulation; D004817:Epidermis / Q000294:innervation* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000378:metabolism / Q000473:pathology; D009419:Nerve Tissue Proteins / Q000378:metabolism; D009431:Neural Conduction; D011115:Polyneuropathies / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D043222:Ubiquitin Thiolesterase / Q000378:metabolism
chemical_list: D009419:Nerve Tissue Proteins; C482860:UCHL1 protein, human; D043222:Ubiquitin Thiolesterase