The early diagnosis value of brainstem auditory evoked potential for diabetic neuropathy

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The early diagnosis value of brainstem auditory evoked potential for diabetic neuropathy

 

Author: Hui, Hiu-man Human
Title: The early diagnosis value of brainstem auditory evoked potential for diabetic neuropathy
Degree: M.Sc.
Year: 2006
Subject: Hong Kong Polytechnic University -- Dissertations
Diabetic neuropathies
Evoked potentials (Electrophysiology)
Nervous system -- Diseases -- Diagnosis
Audiometry, Evoked response
Brain stem -- Diseases -- Diagnosis
Department: Dept. of Health Technology and Informatics
Pages: x, 79 leaves : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b1968126
URI: http://theses.lib.polyu.edu.hk/handle/200/5556
Abstract: Diabetes mellitus (DM) can affect the peripheral, autonomic and central nervous systems and cause neuropathy. However, central defects were documented not so well as other defects. Besides, all clinical diagnosis of diabetic neuropathy is conducted according to the results of peripheral and autonomic examinations nowadays. These examinations can diagnose diabetic neuropathy only when the condition has become moderate to severe. Unfortunately, neuropathy cannot fully reverse with drug treatment or glucose control at these moderate to severe stages. The purpose of this study was to evaluate the values of Brainstem Auditory Evoked Potential (BAEP) examination for early diagnosis of diabetic neuropathy with normal routine nerve conduction study (NCS) on peripheral nerves. BAEP was performed in three groups of Type 2 DM patients. DM-S group (16 subjects), no symptoms of neuropathy with normal routine NCS; DM+S group (16 subjects), with symptoms of neuropathy but normal or borderline routine NCS; DM+N group (14 subjects), with symptoms and abnormal routine NCS and clinically diagnosed diabetic neuropathy. Besides, 20 subjects without DM or history of neuropathy were recruited as control group with age and sex matched with the other three groups.
One-way ANOVA and post he Bonferroni were used to analyze the absolute latencies (waves I, III and V), interpeak latencies (I-III, III-V and I-V) and amplitudes (waves I and V) of BAEP waves. The results showed significant difference (P<0.00l) in absolute latencies (waves I, III and V), interpeak latencies (I-III, III-V and I-V) and amplitude V between DM+N group and the other groups. The results also demonstrated a significant difference (P<0.05) in absolute latency of wave V, interpeak latency of I-V and amplitude V between DM+AS and DM-S groups. There was no significant difference in all components between DM-S group and the control group. In this study, we found a more central but less peripheral effect of diabetes on the conduction velocity of the auditory pathway. The delay in absolute latency of wave V and interpeak latency of I-V showed that the diabetic neuropathy is particularly evident at the level of the upper brainstem. Consequently, BAEP can identify central neuropathy in suspected diabetic neuropathy cases together with normal routine NCS. Thus, BAEP may be a valuable indicator to predict other diabetic complications. BAEP offers a useful means to detect central neuropathy in the early stage of diabetic neuropathy. The role of BAEP in early detection of diabetic complications needs further study.

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