title: Decreased excitability of the distal motor nerve of young patients with type 1 diabetes mellitus.
abstract: OBJECTIVE
  The compound muscle action potential (CMAP) scan is a novel neurophysiological technique that appears more sensitive in detecting peripheral motor neuropathy than conventional methods. This study explores the value of the CMAP scan for the detection of subclinical diabetic peripheral motor neuropathy.
  
  
  METHODS
  In this cross-sectional pilot study, CMAP scanning of the peroneal nerve was performed in (i) 13 well-controlled patients (8-25 yr old) with type 1 diabetes mellitus (T1DM) duration between 2.5 and 5 yr; (ii) 17 patients (10-25 yr old) with a duration of T1DM of at least 10 yr, poorly controlled and/or with microvascular complications and (iii) 13 adults with T1DM and established clinical diabetic peripheral neuropathy (DPN). Various CMAP scan variables, including measures of axonal excitability and axonal loss and reinnervation, were compared between patients and healthy controls.
  
  
  RESULTS
  Axonal excitability was significantly decreased in the young patient groups as compared to their controls. The CMAP scan measures of axonal loss and reinnervation differed only between patients with clinical DPN and their controls.
  
  
  CONCLUSIONS
  Motor nerve axonal excitability seems to be reduced early in T1DM, even in well-controlled young patients, and probably before (irreversible) axonal damage occurs. These changes can be measured by the CMAP scan, which makes this a promising tool for detecting nerve dysfunction in T1DM.
authors.affiliation: Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands; Department of Pediatric Endocrinology, Sophia Children's Hospital, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Jc
authors.initials: J
authors.lastname: van der Heyden
authors.forename: P
authors.initials: P
authors.lastname: van der Meer
authors.forename: E
authors.initials: E
authors.lastname: Birnie
authors.forename: I F M
authors.initials: IF
authors.lastname: de Coo
authors.forename: M
authors.initials: M
authors.lastname: Castro Cabezas
authors.forename: B
authors.initials: B
authors.lastname: Ozcan
authors.forename: Hj
authors.initials: H
authors.lastname: Veeze
authors.forename: G H
authors.initials: GH
authors.lastname: Visser
authors.forename: H J
authors.initials: HJ
authors.lastname: Aanstoot
authors.forename: J H
authors.initials: JH
authors.lastname: Blok
mesh_terms: D000200:Action Potentials; D000293:Adolescent; D000328:Adult; D001369:Axons / Q000502:physiology; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009431:Neural Conduction / Q000502:physiology*; D010543:Peroneal Nerve / Q000502:physiology*; D010865:Pilot Projects
keywords: CMAP scan; peripheral neuropathy; subclinical; type 1 diabetes mellitus; young