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Thermal threshold tester, a useful tool for detection of very early nerve damage--determination of normal values in a healthy population unexposed to Mycobacterium leprae and its application in the A9 study.
Ethiop Med J. 2007 Oct; 45 Suppl 1:25-33.EM

Abstract

INTRODUCTION

In Ethiopia, a large percentage of leprosy patients present with established nerve damage. Present techniques for measuring nerve function impairment show no abnormality until 30% of nerve axons are destroyed. Nerve damage in leprosy occurs first in small diameter unmyelinated fibres, then in small myelinated fibres, and much later in large myelinated fibres. The Thermal Threshold Tester (TTT) was used to measure function in nerves carrying heat sensation (unmyelinated C fibres) and cold sensation (thinly myelinated Adelta fibres).

PATIENTS

A school and community health survey, assessed 234 students and adults aged 10-75 years from Chencha Woreda, an area with low endemicity of leprosy. A group of students in Addis Ababa, exposed to leprosy, were also studied.

RESULTS

The upper limits of normal were: wrist hot threshold (HT): 0.17 degrees C, wrist cold threshold (CT): 0.19 degrees C, foot HT: 0.17 degrees C and foot CT: 0.20 degrees C. Both the leprosy group and also controls in Addis Ababa showed significantly increased TTT values.

CONCLUSION

The TTT detects nerve damage before clinical neuritis occurs and is a valuable tool for early diagnosis of leprosy or detecting clinical relapse of treated patients and for sequential and quantitative monitoring of small diameter nerve function in other neuropathies.

Authors+Show Affiliations

Armauer Hansen Research Institute, Addis Ababa, Ethiopia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18710071

Citation

Duncan, M Elizabeth, et al. "Thermal Threshold Tester, a Useful Tool for Detection of Very Early Nerve Damage--determination of Normal Values in a Healthy Population Unexposed to Mycobacterium Leprae and Its Application in the A9 Study." Ethiopian Medical Journal, vol. 45 Suppl 1, 2007, pp. 25-33.
Duncan ME, Hansen S, Tadesse T, et al. Thermal threshold tester, a useful tool for detection of very early nerve damage--determination of normal values in a healthy population unexposed to Mycobacterium leprae and its application in the A9 study. Ethiop Med J. 2007;45 Suppl 1:25-33.
Duncan, M. E., Hansen, S., Tadesse, T., Bezuneh, E., Yassin, M. A., Zeleke, A., Solomon, A., Jamal, G. A., Hunegnaw, M., Kazen, R., Aseffa, A., Challis, A., & Wagaye, W. (2007). Thermal threshold tester, a useful tool for detection of very early nerve damage--determination of normal values in a healthy population unexposed to Mycobacterium leprae and its application in the A9 study. Ethiopian Medical Journal, 45 Suppl 1, 25-33.
Duncan ME, et al. Thermal Threshold Tester, a Useful Tool for Detection of Very Early Nerve Damage--determination of Normal Values in a Healthy Population Unexposed to Mycobacterium Leprae and Its Application in the A9 Study. Ethiop Med J. 2007;45 Suppl 1:25-33. PubMed PMID: 18710071.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thermal threshold tester, a useful tool for detection of very early nerve damage--determination of normal values in a healthy population unexposed to Mycobacterium leprae and its application in the A9 study. AU - Duncan,M Elizabeth, AU - Hansen,Stig, AU - Tadesse,Terefe, AU - Bezuneh,Elisabeth, AU - Yassin,Mohammed A, AU - Zeleke,Assefa, AU - Solomon,Abebe, AU - Jamal,Goran A, AU - Hunegnaw,Mesfin, AU - Kazen,Roland, AU - Aseffa,Abraham, AU - Challis,Andrew, AU - Wagaye,Wondu, PY - 2008/8/20/pubmed PY - 2008/9/5/medline PY - 2008/8/20/entrez SP - 25 EP - 33 JF - Ethiopian medical journal JO - Ethiop Med J VL - 45 Suppl 1 N2 - INTRODUCTION: In Ethiopia, a large percentage of leprosy patients present with established nerve damage. Present techniques for measuring nerve function impairment show no abnormality until 30% of nerve axons are destroyed. Nerve damage in leprosy occurs first in small diameter unmyelinated fibres, then in small myelinated fibres, and much later in large myelinated fibres. The Thermal Threshold Tester (TTT) was used to measure function in nerves carrying heat sensation (unmyelinated C fibres) and cold sensation (thinly myelinated Adelta fibres). PATIENTS: A school and community health survey, assessed 234 students and adults aged 10-75 years from Chencha Woreda, an area with low endemicity of leprosy. A group of students in Addis Ababa, exposed to leprosy, were also studied. RESULTS: The upper limits of normal were: wrist hot threshold (HT): 0.17 degrees C, wrist cold threshold (CT): 0.19 degrees C, foot HT: 0.17 degrees C and foot CT: 0.20 degrees C. Both the leprosy group and also controls in Addis Ababa showed significantly increased TTT values. CONCLUSION: The TTT detects nerve damage before clinical neuritis occurs and is a valuable tool for early diagnosis of leprosy or detecting clinical relapse of treated patients and for sequential and quantitative monitoring of small diameter nerve function in other neuropathies. SN - 0014-1755 UR - https://www.unboundmedicine.com/medline/citation/18710071/Thermal_threshold_tester_a_useful_tool_for_detection_of_very_early_nerve_damage__determination_of_normal_values_in_a_healthy_population_unexposed_to_Mycobacterium_leprae_and_its_application_in_the_A9_study_ L2 - https://medlineplus.gov/mycobacterialinfections.html DB - PRIME DP - Unbound Medicine ER -