Pernille Tind, Anna Larsen, Mette Krabsmark Borbjerg, Silvia Lo Vecchio, Ken Steffen Frahm, Niels Ejskjær, Carsten Dahl Mørch, Johan Røikjer
{"title":"在非选定的 1 型糖尿病患者群体中验证组胺和热诱导的轴突反射发散反应。","authors":"Pernille Tind, Anna Larsen, Mette Krabsmark Borbjerg, Silvia Lo Vecchio, Ken Steffen Frahm, Niels Ejskjær, Carsten Dahl Mørch, Johan Røikjer","doi":"10.1002/mus.28325","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction/aims: </strong>Diabetic peripheral neuropathy affects small nerve fibers early, but adequate evaluation has proven difficult. One method for functional assessment of small nerve fiber function is the axon-reflex flare (ARF) response. This study aimed to 1) validate the histamine-induced ARF response in a nonselected population with diabetes, 2) compare the response to that induced by local heating, and 3) compare both methods to an established method (quantitative sensory testing) in a nonselected population with diabetes.</p><p><strong>Methods: </strong>Thirty-four participants with type 1 diabetes were included. The participants underwent a neurological examination, quantitative sensory testing, sural nerve conduction, and histamine- and heat-induced ARF response measurements by full-field laser speckle perfusion imaging after epidermal application of histamine and after local heating by 44<sup>°</sup> Celsius thermode, respectively. Spearman's correlations were assessed. Logistic regression was used to generate receiver operating characteristic curves using the cold detection threshold of quantitative sensory testing as reference.</p><p><strong>Results: </strong>The histamine-induced ARF had an area under the curve (AUC) of 0.82, a sensitivity of 67%, and a specificity of 70%. The heat-induced ARF had an AUC of 0.40, a sensitivity of 36%, and a specificity of 57%. No significant correlation between the histamine- and the heat-induced ARF responses was found.</p><p><strong>Discussion: </strong>The histamine-induced ARF response is a valid marker for small fiber neuropathy even in nonselected populations with diabetes with good agreement with established markers and can thus be used for evaluation of C-fiber function. The lack of correlation with the heat-induced ARF may be due to insufficient heating.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"237-243"},"PeriodicalIF":2.8000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Validation of the Histamine- and Heat-Induced Axon-Reflex Flare Response in a Nonselected Population of People With Type 1 Diabetes.\",\"authors\":\"Pernille Tind, Anna Larsen, Mette Krabsmark Borbjerg, Silvia Lo Vecchio, Ken Steffen Frahm, Niels Ejskjær, Carsten Dahl Mørch, Johan Røikjer\",\"doi\":\"10.1002/mus.28325\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction/aims: </strong>Diabetic peripheral neuropathy affects small nerve fibers early, but adequate evaluation has proven difficult. One method for functional assessment of small nerve fiber function is the axon-reflex flare (ARF) response. This study aimed to 1) validate the histamine-induced ARF response in a nonselected population with diabetes, 2) compare the response to that induced by local heating, and 3) compare both methods to an established method (quantitative sensory testing) in a nonselected population with diabetes.</p><p><strong>Methods: </strong>Thirty-four participants with type 1 diabetes were included. The participants underwent a neurological examination, quantitative sensory testing, sural nerve conduction, and histamine- and heat-induced ARF response measurements by full-field laser speckle perfusion imaging after epidermal application of histamine and after local heating by 44<sup>°</sup> Celsius thermode, respectively. Spearman's correlations were assessed. Logistic regression was used to generate receiver operating characteristic curves using the cold detection threshold of quantitative sensory testing as reference.</p><p><strong>Results: </strong>The histamine-induced ARF had an area under the curve (AUC) of 0.82, a sensitivity of 67%, and a specificity of 70%. The heat-induced ARF had an AUC of 0.40, a sensitivity of 36%, and a specificity of 57%. No significant correlation between the histamine- and the heat-induced ARF responses was found.</p><p><strong>Discussion: </strong>The histamine-induced ARF response is a valid marker for small fiber neuropathy even in nonselected populations with diabetes with good agreement with established markers and can thus be used for evaluation of C-fiber function. The lack of correlation with the heat-induced ARF may be due to insufficient heating.</p>\",\"PeriodicalId\":18968,\"journal\":{\"name\":\"Muscle & Nerve\",\"volume\":\" \",\"pages\":\"237-243\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Muscle & Nerve\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/mus.28325\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Muscle & Nerve","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/mus.28325","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Validation of the Histamine- and Heat-Induced Axon-Reflex Flare Response in a Nonselected Population of People With Type 1 Diabetes.
Introduction/aims: Diabetic peripheral neuropathy affects small nerve fibers early, but adequate evaluation has proven difficult. One method for functional assessment of small nerve fiber function is the axon-reflex flare (ARF) response. This study aimed to 1) validate the histamine-induced ARF response in a nonselected population with diabetes, 2) compare the response to that induced by local heating, and 3) compare both methods to an established method (quantitative sensory testing) in a nonselected population with diabetes.
Methods: Thirty-four participants with type 1 diabetes were included. The participants underwent a neurological examination, quantitative sensory testing, sural nerve conduction, and histamine- and heat-induced ARF response measurements by full-field laser speckle perfusion imaging after epidermal application of histamine and after local heating by 44° Celsius thermode, respectively. Spearman's correlations were assessed. Logistic regression was used to generate receiver operating characteristic curves using the cold detection threshold of quantitative sensory testing as reference.
Results: The histamine-induced ARF had an area under the curve (AUC) of 0.82, a sensitivity of 67%, and a specificity of 70%. The heat-induced ARF had an AUC of 0.40, a sensitivity of 36%, and a specificity of 57%. No significant correlation between the histamine- and the heat-induced ARF responses was found.
Discussion: The histamine-induced ARF response is a valid marker for small fiber neuropathy even in nonselected populations with diabetes with good agreement with established markers and can thus be used for evaluation of C-fiber function. The lack of correlation with the heat-induced ARF may be due to insufficient heating.
期刊介绍:
Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.