Clinical trials for polyneuropathy: the role of nerve conduction studies, quantitative sensory testing, and autonomic function testing. 1998

R K Olney
Department of Neurology, University of California, San Francisco 94143-0114, USA.

Clinical trials to assess the treatment of diabetic and other forms of polyneuropathy are becoming increasingly common. Nerve conduction studies, quantitative sensory testing, and autonomic function testing are often used in these trials. This article reviews the sensitivity and reproducibility of these measures to detect change in peripheral nerve function during long-term trials. The attributes of nerve conduction studies that are likely to be most useful are summated or averaged sensory nerve action potential amplitudes and averaged motor nerve conduction velocities. Summated or averaged compound muscle action potential amplitude and mean F-wave latencies are also highly informative. Vibratory detection thresholds are sensitive, specific, and highly reproducible for assessment of large myelinated sensory fibers, with cooling and warming detection thresholds also having good sensitivity for small myelinated sensory fibers. Although less well validated for longitudinal trials, visual analogue scale scoring of heat pain provides assessment of unmyelinated sensory fibers. Heart rate variation to deep breathing, Valsalva, or standing are useful to assess cardiac autonomic function. Based on these data that are reviewed and consistent with the conclusions of previous consensus conferences, a combination of these studies is recommended.

UI MeSH Term Description Entries
D009431 Neural Conduction The propagation of the NERVE IMPULSE along the nerve away from the site of an excitation stimulus. Nerve Conduction,Conduction, Nerve,Conduction, Neural,Conductions, Nerve,Conductions, Neural,Nerve Conductions,Neural Conductions
D010523 Peripheral Nervous System Diseases Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. Peripheral Nerve Diseases,Peripheral Neuropathies,PNS (Peripheral Nervous System) Diseases,PNS Diseases,Peripheral Nervous System Disease,Peripheral Nervous System Disorders,Nerve Disease, Peripheral,Nerve Diseases, Peripheral,Neuropathy, Peripheral,PNS Disease,Peripheral Nerve Disease,Peripheral Neuropathy
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001341 Autonomic Nervous System The ENTERIC NERVOUS SYSTEM; PARASYMPATHETIC NERVOUS SYSTEM; and SYMPATHETIC NERVOUS SYSTEM taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the CENTRAL NERVOUS SYSTEM, especially the HYPOTHALAMUS and the SOLITARY NUCLEUS, which receive information relayed from VISCERAL AFFERENTS. Vegetative Nervous System,Visceral Nervous System,Autonomic Nervous Systems,Nervous System, Autonomic,Nervous System, Vegetative,Nervous System, Visceral,Nervous Systems, Autonomic,Nervous Systems, Vegetative,Nervous Systems, Visceral,System, Autonomic Nervous,System, Vegetative Nervous,System, Visceral Nervous,Systems, Autonomic Nervous,Systems, Vegetative Nervous,Systems, Visceral Nervous,Vegetative Nervous Systems,Visceral Nervous Systems
D012677 Sensation The process in which specialized SENSORY RECEPTOR CELLS transduce peripheral stimuli (physical or chemical) into NERVE IMPULSES which are then transmitted to the various sensory centers in the CENTRAL NERVOUS SYSTEM. Sensory Function,Organoleptic,Function, Sensory,Functions, Sensory,Sensations,Sensory Functions

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