Differential impairment of the sudomotor and nociceptor axon-reflex in diabetic peripheral neuropathy

It is not known whether C‐fiber functional subclasses are differentially affected by diabetes mellitus or whether the patterns of C‐fiber dysfunction are different between type 1 and type 2 diabetes. We therefore examined efferent sympathetic sudomotor and primary afferent nociceptor C‐fiber functio...

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Bibliographic Details
Published in:	Muscle & nerve Vol. 33; no. 4; pp. 494 - 499
Main Authors:	Berghoff, Martin, Kilo, Sonja, Hilz, Max J., Freeman, Roy
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.04.2006 Wiley
Subjects:	Acetylcholine - pharmacology Adult autonomic function axon-reflex Axons - physiology Biological and medical sciences c-fiber Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction Data Interpretation, Statistical diabetes Diabetes Mellitus, Type 1 - physiopathology Diabetes Mellitus, Type 2 - physiopathology Diabetic Nephropathies - physiopathology dysautonomia Female Forearm - innervation Forearm - physiology Humans Iontophoresis laser Doppler flowmetry Male Medical sciences Middle Aged Nerve Fibers, Unmyelinated - physiology Nervous system (semeiology, syndromes) Neurology Nociceptors - physiology Reflex - physiology Regional Blood Flow - physiology silastic imprint method Skin - blood supply Skin - innervation Sweating - physiology Sympathetic Nervous System - physiology Vasodilation - physiology Vasodilator Agents - pharmacology Endocrinopathy Type 2 diabetes Human Immunopathology axon-reflex Nervous system diseases c-fiber dysautonomia Autoimmune disease Metabolic diseases Peripheral neuropathy Axon reflex laser Doppler flowmetry Nociceptor Type 1 diabetes Dysfunction autonomic function Peripheral nerve disease Sweat diabetes silastic imprint method
ISSN:	0148-639X, 1097-4598
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Summary:	It is not known whether C‐fiber functional subclasses are differentially affected by diabetes mellitus or whether the patterns of C‐fiber dysfunction are different between type 1 and type 2 diabetes. We therefore examined efferent sympathetic sudomotor and primary afferent nociceptor C‐fiber function in diabetic patients. Acetylcholine (10%) was used to evoke C‐fiber (axon‐reflex)–mediated responses. The nociceptor (flare) response was measured using a laser Doppler device. The sudomotor response was quantified with silastic imprints. The nociceptor C‐fiber–mediated flare response was reduced in type 2 diabetic patients (P < 0.008) but was similar to controls in type 1 diabetic patients. The sympathetic C‐fiber–mediated responses, including sweat volume (P < 0.05) and the number of activated sweat glands (P = 0.003), were increased in patients with type 1 diabetes. There also was a trend toward a larger axon‐reflex sweat area in patients with type 1 diabetes (P = 0.09). No differences in these sweat responses were found in patients with type 2 diabetes compared to controls. These findings suggest that the functional abnormalities in diabetic peripheral neuropathy are not homogeneous and that C‐fiber subclasses are differentially affected in type 1 and 2 diabetes mellitus. Muscle Nerve, 2006
Bibliography:	ark:/67375/WNG-1NCV834S-L ArticleID:MUS20497 istex:F8FCE5B1DFAF60490C17C5546DC55BAEAB710458 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0148-639X 1097-4598
DOI:	10.1002/mus.20497