Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic Patients
<i>Background and Objectives</i>: Diagnostic ultrasound of the vagus nerve has been used to examine different polyneuropathies, and it has been suggested to be useful as a marker of autonomic dysfunction in diabetic patients. <i>Materials and Methods</i>: We analyzed the cros...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/3/525 |
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| author | Bianka Heiling Adriana Karl Nadin Fedtke Nicolle Müller Christof Kloos Alexander Grimm Hubertus Axer |
| author_facet | Bianka Heiling Adriana Karl Nadin Fedtke Nicolle Müller Christof Kloos Alexander Grimm Hubertus Axer |
| author_sort | Bianka Heiling |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Diagnostic ultrasound of the vagus nerve has been used to examine different polyneuropathies, and it has been suggested to be useful as a marker of autonomic dysfunction in diabetic patients. <i>Materials and Methods</i>: We analyzed the cross-sectional area (CSA) of the right vagus nerve of 111 patients with type 2 diabetes in comparison to 104 healthy adults and 41 patients with CIDP (chronic inflammatory demyelinating polyneuropathy). In the diabetes group, sympathetic skin response (SSR) was measured as an indicator for autonomic neuropathy. Carotid intima–media thickness (CIMT) was measured as a surrogate for atherosclerosis. Clinical symptoms of polyneuropathy were assessed using the Neuropathy Symptom Score and the Neuropathy Disability Score. <i>Results</i>: In total, 61.3% of the diabetes patients had clinical signs of polyneuropathy; 23.4% had no SSR at the feet as an indicator of autonomic neuropathy. Mean vagus nerve CSA did not differ in patients with and without diabetic polyneuropathy or in diabetic patients with and without SSR at the feet. No significant correlation was found between vagus nerve CSA and CIMT or SSR parameters in diabetic patients. Mean CSA of the right vagus nerve was slightly larger in diabetic patients (<i>p</i> = 0.028) and in patients with CIDP (<i>p</i> = 0.015) than in healthy controls. <i>Conclusions</i>: Effect sizes and mean differences were rather small so that a reliable diagnosis cannot be performed based on the vagus nerve measurement of a single person alone. Vagus nerve CSA seems not suitable as an indicator of autonomic dysfunction or cardiovascular risk in diabetic patients. |
| first_indexed | 2024-03-11T06:11:58Z |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T06:11:58Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-08c18caf9cd945a9a10e018cf591da872023-11-17T12:31:53ZengMDPI AGMedicina1010-660X1648-91442023-03-0159352510.3390/medicina59030525Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic PatientsBianka Heiling0Adriana Karl1Nadin Fedtke2Nicolle Müller3Christof Kloos4Alexander Grimm5Hubertus Axer6Department of Neurology, Jena University Hospital, Friedrich Schiller University, 07747 Jena, GermanyDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, 07747 Jena, GermanyDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, 07747 Jena, GermanyDepartment of Internal Medicine III, Jena University Hospital, Friedrich Schiller University, 07747 Jena, GermanyDepartment of Internal Medicine III, Jena University Hospital, Friedrich Schiller University, 07747 Jena, GermanyDepartment of Neurology, Tübingen University Hospital, 72076 Tübingen, GermanyDepartment of Neurology, Jena University Hospital, Friedrich Schiller University, 07747 Jena, Germany<i>Background and Objectives</i>: Diagnostic ultrasound of the vagus nerve has been used to examine different polyneuropathies, and it has been suggested to be useful as a marker of autonomic dysfunction in diabetic patients. <i>Materials and Methods</i>: We analyzed the cross-sectional area (CSA) of the right vagus nerve of 111 patients with type 2 diabetes in comparison to 104 healthy adults and 41 patients with CIDP (chronic inflammatory demyelinating polyneuropathy). In the diabetes group, sympathetic skin response (SSR) was measured as an indicator for autonomic neuropathy. Carotid intima–media thickness (CIMT) was measured as a surrogate for atherosclerosis. Clinical symptoms of polyneuropathy were assessed using the Neuropathy Symptom Score and the Neuropathy Disability Score. <i>Results</i>: In total, 61.3% of the diabetes patients had clinical signs of polyneuropathy; 23.4% had no SSR at the feet as an indicator of autonomic neuropathy. Mean vagus nerve CSA did not differ in patients with and without diabetic polyneuropathy or in diabetic patients with and without SSR at the feet. No significant correlation was found between vagus nerve CSA and CIMT or SSR parameters in diabetic patients. Mean CSA of the right vagus nerve was slightly larger in diabetic patients (<i>p</i> = 0.028) and in patients with CIDP (<i>p</i> = 0.015) than in healthy controls. <i>Conclusions</i>: Effect sizes and mean differences were rather small so that a reliable diagnosis cannot be performed based on the vagus nerve measurement of a single person alone. Vagus nerve CSA seems not suitable as an indicator of autonomic dysfunction or cardiovascular risk in diabetic patients.https://www.mdpi.com/1648-9144/59/3/525peripheral nerve ultrasoundvagus nervediabetes mellitusautonomic neuropathy |
| spellingShingle | Bianka Heiling Adriana Karl Nadin Fedtke Nicolle Müller Christof Kloos Alexander Grimm Hubertus Axer Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic Patients Medicina peripheral nerve ultrasound vagus nerve diabetes mellitus autonomic neuropathy |
| title | Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic Patients |
| title_full | Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic Patients |
| title_fullStr | Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic Patients |
| title_full_unstemmed | Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic Patients |
| title_short | Evaluating Diagnostic Ultrasound of the Vagus Nerve as a Surrogate Marker for Autonomic Neuropathy in Diabetic Patients |
| title_sort | evaluating diagnostic ultrasound of the vagus nerve as a surrogate marker for autonomic neuropathy in diabetic patients |
| topic | peripheral nerve ultrasound vagus nerve diabetes mellitus autonomic neuropathy |
| url | https://www.mdpi.com/1648-9144/59/3/525 |
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