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Abstract Details

Regression Equation Analysis Enhances Detection of Conduction Slowing Beyond Exclusive Axonal Loss in Diabetic Distal Symmetrical Polyneuropathy
Neuromuscular and Clinical Neurophysiology (EMG)
P1 - Poster Session 1 (8:00 AM-9:00 AM)
Conduction slowing caused beyond pure axonal loss has been reported in DSP and was attributed to a demyelinating component. However, standard electrodiagnostic examination does not clearly differentiate between pure large fiber loss and large fiber loss with minor degrees of demyelination.
Objective: To evaluate the ability of regression analysis of conduction slowing to identify superimposed demyelination beyond fiber loss in diabetic distal symmetrical polyneuropathy (DSP).
We previously used regression equation analysis to develop confidence intervals that assess the range of conduction slowing from primary demyelination in chronic inflammatory demyelinating polyneuropathy, and then used the equations to investigate the conduction slowing profile in ALS. This current study uses regression equation analysis to assess conduction slowing in 219 diabetic DSP patients and 219 axonal non-diabetic DSP and 95 ALS patients.
Conduction velocity (CV) is significantly slower in diabetic DSP than in non-diabetic DSP in all tested nerves. More patients fulfill the regression equation criteria in the diabetic group compared to the non-diabetic group (47.0% vs. 23.3%).There is significantly higher number of patients who have more than 2 motor nerves with CV slowing fulfilling the AAN or regression criteria for demyelination in the diabetic DSP group vs. the axonal non-diabetic and ALS groups (25.6% vs. 7.8% vs 0; p < 0.0001). In subgroups with at least one nerve with CV slowing in the American Academy of Neurology (AAN) demyelination range, the estimated likelihood of having more than two motor nerves with CV slowing in the demyelination range by AAN or regression equations criteria is significantly higher in the diabetic DSP group (0.73) compared to non-diabetic DSP group (0.52, p < 0.05), suggesting more diffuse demyelination in the diabetic group.
Regression analysis can identify conduction slowing in patients with diabetic DSP suggestive of demyelination, which is not detected by conventional electrodiagnostic testing.
Kelly Saverino (Rutgers University)
Miss Saverino has nothing to disclose.
No disclosure on file
No disclosure on file
Kazim Jaffry Mr. Jaffry has nothing to disclose.
No disclosure on file
No disclosure on file
Ankit Pahwa Ankit Pahwa has nothing to disclose.
Howard W. Sander, MD, FAAN Dr. Sander has received personal compensation for serving as an employee of Grifols. Dr. Sander has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Law firm.
Nizar Souayah, MD, FAAN (NJMS) Dr. Souayah has received publishing royalties from a publication relating to health care.