The Comparison between Double Shock Stimulation Test and Other Electrodiagnostic Tests in Diabetic Neuropathy

J Korean Assoc EMG Electrodiagn Med 2006;8(1):7-13.
Published online May 10, 2006.

Abstract

Objectives: The purpose of this study was to compare the sensitivity of ratios of double-shock stimulation potentials with other electrodiagnostic parameters, such as minimal F-wave latency, sural/radial amplitude ratio (SRAR), whether be able to diagnose diabetic peripheral neuropathy at its early stage. Methods: Electrodiagnostic tests were performed in 60 diabetic patients and 34 normal persons. Diabetic patients were subdivided into a group of normal parameters and a group of abnormal parameters by nerve conduction study. To evaluate ratios of double-shock stimulation potentials, right superficial radial nerve was stimulated twice at intervals of 3, 4, 5, 6, 7 and 8 msec; amplitudes of a sensory nerve action potential (SNAP) and SNAP1/SNAP2 ratios were calculated. Results: Minimal F-wave latency was the most sensitive test in early detection of diabetic peripheral neuropathy (r=0.91), and next was SNAP1/SNAP2 ratios at interval of 3 msec (r=0.41). SRAR was the least sensitive test (r=0.19). Conclusion: The sensitivity of double-shock stimulation indicated its usefulness in diagnosis of diabetic neuropathy. However, it seems to be not superior to the minimal F-wave latency in the early diagnosis of diabetic peripheral neuropathy.

Key Words: Diabetic neuropathy, Nerve conduction study, Diabetes mellitus