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Indian Journal of Pathology: Research and Practice

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Pathophysiological Changes in Nerve Conduction Studies in Diabetic Peripheral Neuropathy: An Integrative Overview

Kumar Senthil P. , Kumar Senthil P. , Adhikari Prabha , Jeganathan P.S. , D’Souza Sydney C. , Misri Z.K.

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Indian Journal of Pathology: Research and Practice 2(3):p 85-98, Sept - Dec 2013. | DOI:

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Abstract

Background: Nerve conduction studies (NCSs) involve the delivery of electric stimuli to peripheral nerves at accessible locations on the human body and the recording of electrophysiological responses. NCSs are considered as important evaluation tools for peripheral neuropathy (PN) and common disabling cause for PN is diabetic peripheral neuropathy (DPN). Objective: To perform an integrative overview on evidence for nerve conduction and its pathophysiological changes due to DPN in terms of assessment and treatment studies. Methods: A systematic review was performed using search terms ‘diabetic neuropathy’ and ‘nerve conduction’ in PubMed, CINAHL and Google scholar to identify relevant studies based upon their title, abstract and fulltext and they were descriptively synthesized for their data and reported for measurement properties, comparison with other assessments and studying efficacy of interventions. Results: Of the total 45 included studies, 17 studies were on measurement properties (sensitivity/specificity=2, reliability=3, population comparison=3, prevalence=7, anthropometric factors=2); 12 studies compared NCSs with other assessment methods (clinical examination=2, clinical scales=4, current perception thresholds=1, electromyography=1, exercise-induced stress=1, ultrasonography=1, vibration perception thresholds=1, nerve morphology=1); and, 16 studies used NCSs as a therapeutic outcome measure for effects of interventions (4-methylcatechol=1, acetyl-l carnitine=1, adenosine=1, carbamazepine=1, pancreatic transplantation=1, alpha lipoic acid=2, fidarestat=2, gangliosides=1, insulin therapy=1, vitamins=1, ponalrestat=1, silymarin=1, sorbinil=1, zenarestat=1).Conclusion: NCSs remain to be established as a ‘stand-alone’ gold-standard objective and accurate assessment tool for diagnosis, therapeutic and prognostic decision-making for patients with DPN. 
 
Keywords: Neurophysiology; Diabetic polyneuropathy; Electrodiagnosis; Electrophysiology; Physical examination.   

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