title: Clinical significance of the double-peak sensory response in nerve conduction study of normal and diabetic patients.
abstract: OBJECTIVE
  The aim of this study was to understand the meaning of the double-peak responses in digital nerve conduction study in normal and diabetic patients.
  
  
  METHODS
  This was a cross-sectional and correlative study. Sixty healthy subjects (10 people per decade from 20 to 79 yrs of age; 26 men; mean age, 48 yrs) and 60 diabetic patients (10 people per decade from 22 to 79 yrs of age; 36 men, mean age, 53 yrs) were included. The composite score of the nerve conduction study was obtained. Orthodromic sensory nerve conduction studies were performed on the median nerves using submaximal stimulation. The latencies and amplitudes of first and second peaks were measured. The Toronto clinical scoring system for diabetic neuropathy was applied to all diabetic patients.
  
  
  RESULTS
  The first and second peak latencies of both 3- and 4-cm interpeak distance in diabetic patients were significantly increased compared with those of age-matched control subjects (P < 0.05). The correlation between the Toronto clinical scoring system and first and second peak latency and amplitude were significantly high, and the correlation between the composite score and first and second peak latency and amplitude was also related.
  
  
  CONCLUSIONS
  The double-peak response represents the far distal nerve pathophysiology. The authors suspect that they will find an increasing role in diagnosing the peripheral neuropathy, which starts at the distal nerve in centripetal pattern.
authors: Department of Rehabilitation Medicine, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan City, Korea.
authors: Kyung-Lim
authors: KL
authors: Joa
authors: Chang- Hwan
authors: C
authors: Kim
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D004558:Electric Stimulation; D004576:Electromyography; D005260:Female; D005385:Fingers / Q000294:innervation; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D055815:Young Adult