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Medial plantar-to-radial amplitude ratio: does it have electrodiagnostic utility in distal sensory polyneuropathy?
Int J Neurosci. 2017 Apr; 127(4):356-360.IJ

Abstract

PURPOSE OF THE STUDY

We proposed a new electrophysiological parameter medial plantar (MP)-to-radial amplitude ratio (MPRAR), similar to sural-to-radial amplitude ratio (SRAR), in the diagnosis of distal sensory polyneuropathy (DSP), based on the concept that distal nerves are affected more and earlier than proximal nerves in axonal neuropathies. We aimed to investigate the diagnostic sensitivity of this parameter in diabetic DSP, together with sensitivities of SRAR and MP nerve action potential (NAP) amplitude.

MATERIALS AND METHODS

In 124 healthy controls and 87 diabetic patients with clinically defined DSP and normal sural responses, we prospectively performed sensory nerve conduction studies (NCS), and evaluated the MP NAP amplitude, MPRAR and SRAR values. We determined the lower limits of normal (LLN) of these parameters in the healthy controls and calculated their sensitivities and specificities in detecting DSP in diabetic patients.

RESULTS

MP nerve amplitude and MPRAR values were significantly lower in the patient group, compared to controls. However, SRAR values did not differ significantly between the two groups. The LLN of MP NAP amplitude was found to be 4.1 μV. The cutoff values for SRAR and MPRAR were determined as 0.24 and 0.16, respectively. MPRAR was abnormal in 21.8% of patients. However, the most sensitive parameter in detection of DSP was MP NAP amplitude, which showed a sensitivity of 31% and a specificity of 100%.

CONCLUSIONS

Although MPRAR is more sensitive than SRAR in detecting DSP, it does not provide additional diagnostic yield to the assessment of MP NCS alone in diabetic DSP patients with normal sural responses.

Authors+Show Affiliations

a Department of Neurology, Faculty of Medicine , Marmara University , Istanbul , Turkey.a Department of Neurology, Faculty of Medicine , Marmara University , Istanbul , Turkey.a Department of Neurology, Faculty of Medicine , Marmara University , Istanbul , Turkey.a Department of Neurology, Faculty of Medicine , Marmara University , Istanbul , Turkey.a Department of Neurology, Faculty of Medicine , Marmara University , Istanbul , Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27043973

Citation

Kahraman Koytak, Pinar, et al. "Medial Plantar-to-radial Amplitude Ratio: Does It Have Electrodiagnostic Utility in Distal Sensory Polyneuropathy?" The International Journal of Neuroscience, vol. 127, no. 4, 2017, pp. 356-360.
Kahraman Koytak P, Alibas H, Omercikoglu Ozden H, et al. Medial plantar-to-radial amplitude ratio: does it have electrodiagnostic utility in distal sensory polyneuropathy? Int J Neurosci. 2017;127(4):356-360.
Kahraman Koytak, P., Alibas, H., Omercikoglu Ozden, H., Tanridag, T., & Uluc, K. (2017). Medial plantar-to-radial amplitude ratio: does it have electrodiagnostic utility in distal sensory polyneuropathy? The International Journal of Neuroscience, 127(4), 356-360. https://doi.org/10.3109/00207454.2016.1174119
Kahraman Koytak P, et al. Medial Plantar-to-radial Amplitude Ratio: Does It Have Electrodiagnostic Utility in Distal Sensory Polyneuropathy. Int J Neurosci. 2017;127(4):356-360. PubMed PMID: 27043973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medial plantar-to-radial amplitude ratio: does it have electrodiagnostic utility in distal sensory polyneuropathy? AU - Kahraman Koytak,Pinar, AU - Alibas,Hande, AU - Omercikoglu Ozden,Hatice, AU - Tanridag,Tulin, AU - Uluc,Kayihan, Y1 - 2016/04/12/ PY - 2016/4/5/pubmed PY - 2017/3/28/medline PY - 2016/4/5/entrez KW - distal sensory polyneuropathy KW - medial plantar nerve amplitude KW - medial plantar-to-radial amplitude ratio KW - sural-to-radial amplitude ratio SP - 356 EP - 360 JF - The International journal of neuroscience JO - Int. J. Neurosci. VL - 127 IS - 4 N2 - PURPOSE OF THE STUDY: We proposed a new electrophysiological parameter medial plantar (MP)-to-radial amplitude ratio (MPRAR), similar to sural-to-radial amplitude ratio (SRAR), in the diagnosis of distal sensory polyneuropathy (DSP), based on the concept that distal nerves are affected more and earlier than proximal nerves in axonal neuropathies. We aimed to investigate the diagnostic sensitivity of this parameter in diabetic DSP, together with sensitivities of SRAR and MP nerve action potential (NAP) amplitude. MATERIALS AND METHODS: In 124 healthy controls and 87 diabetic patients with clinically defined DSP and normal sural responses, we prospectively performed sensory nerve conduction studies (NCS), and evaluated the MP NAP amplitude, MPRAR and SRAR values. We determined the lower limits of normal (LLN) of these parameters in the healthy controls and calculated their sensitivities and specificities in detecting DSP in diabetic patients. RESULTS: MP nerve amplitude and MPRAR values were significantly lower in the patient group, compared to controls. However, SRAR values did not differ significantly between the two groups. The LLN of MP NAP amplitude was found to be 4.1 μV. The cutoff values for SRAR and MPRAR were determined as 0.24 and 0.16, respectively. MPRAR was abnormal in 21.8% of patients. However, the most sensitive parameter in detection of DSP was MP NAP amplitude, which showed a sensitivity of 31% and a specificity of 100%. CONCLUSIONS: Although MPRAR is more sensitive than SRAR in detecting DSP, it does not provide additional diagnostic yield to the assessment of MP NCS alone in diabetic DSP patients with normal sural responses. SN - 1563-5279 UR - https://www.unboundmedicine.com/medline/citation/27043973/Medial_plantar_to_radial_amplitude_ratio:_does_it_have_electrodiagnostic_utility_in_distal_sensory_polyneuropathy L2 - http://www.tandfonline.com/doi/full/10.3109/00207454.2016.1174119 DB - PRIME DP - Unbound Medicine ER -