Relationship between nerve ultrasonography image and electrophysiology in diabetic polyneuropathy

J Diabetes Investig. 2024 Nov 21. doi: 10.1111/jdi.14353. Online ahead of print.

Abstract

Aims/introduction: This study aims to investigate the association between cross-sectional area (CSA) imaging findings of nerve ultrasound and conventional nerve conduction studies (NCS) for patients with distal symmetric sensorimotor polyneuropathy (DSPN) due to type 2 diabetes mellitus.

Materials and methods: We enrolled 103 patients with type 2 diabetes mellitus and collected their demographic data, modified Michigan Neuropathy Screening Instrument (mMNSI) score, NCS, and ultrasonography images of peripheral nerves. The relationship of ultrasound variables for individual nerves and the ultrasound pattern sum score (UPSS) to conventional NCS findings was investigated.

Results: A higher grade of DSPN was associated with a notably higher CSA. Multivariate step-wise regression analysis revealed that the number of abnormal nerves was a positive independent variable for UPSS (β coefficient = 0.4205; P < 0.0001). Of the five nerves studied, abnormalities of the tibial nerve (P ≤ 0.0100) and ulnar nerve (P = 0.052) were the most significant variables.

Conclusions: The tibial nerve exhibited the most substantial association with elevated UPSS. In addition, a strong correlation was observed between abnormal NCS findings and UPSS in patients with DSPN.

Keywords: Diabetic polyneuropathy; Nerve conduction studies; Nerve ultrasound.